Democratic members of Congress are taking the case for health reform to a series of "town-hall meetings". In many cases these have turned into brawls--and so far as most reporting is concerned, rage rather than the substance of the issues is now the story. Many protesters are hoping not to debate but to shut the meetings down. They carry posters of politicians with devils' horns, or of Obama with a Hitler mustache. They claim the administration wants to bring in euthanasia, among other things. It is all very ugly.

There are valid and invalid criticisms of the protesters. A bogus criticism is the Democrats' complaint that the protests are "orchestrated". No doubt they often are. But what is wrong with that? Democrats have been known to orchestrate a thing or two. Progressive groups turn up for regular strategy consultations in the White House. What is that about, if not "orchestration"? Also, directed or not, the passion of the protesters is not synthetic. They are against these bills, and they are entitled to say so.

I'd go a little further in defending them. These town halls are not really an exercise in consultation. The politicians are not asking their constituents, "What should we do about healthcare reform?" They are saying. "This is what we plan to do and why. Any questions?" The Democrats, after all, had hoped to get the whole thing done by now, no consultation required. This recess is an inconvenience not an opportunity. In that sense, the town halls are mainly for show. The politicians are not there to learn anything. I can understand the view that shouting at them is the only way to get their attention. I think a degree of frustration among the audience is justified.

Of course, the notion that the administration plans euthanasia for sick retirees is literally insane--can anybody seriously believe this? And there are many other instances of outlandish misinformation. But this does not mean that the proposed reforms give no grounds whatever for concern, as many liberals seem to believe.

In particular, the fear that standards of care for the elderly might fall has some justification. If stricter tests of cost effectiveness in health care are to be brought to bear--as they should be, in my view--spending unlimited sums on one or two low-quality end-of-life years will likely fail them. And the stricter rationing of treatments for the elderly is not a malicious fantasy of the conservative right. In systems like Britain's NHS, it is standard operating procedure.

These are difficult issues. They have to be faced. What a pity this cannot be done in a civil way, with tolerance and mutualĀ  respect. In the US today, this is asking the impossible. The two sides don't just disagree. They loathe each other. They would literally wish to see each other destroyed. It is hard to see how you get from here to any kind of consensus.

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