Medical Mosh Pits

Understanding the clashes at the health care "town halls"

Clashes keep breaking out at the "town hall" meetings devoted to discussing health care reform. Usually the excitement amounts to some angry questions and heckling, but sometimes there's more. Six people were arrested at a demonstration outside a meeting in St. Louis. Violence erupted at a town hall in Tampa after opponents of ObamaCare were locked out of the building. A North Carolina congressman cancelled a meeting after receiving a death threat; the pro-market group FreedomWorks, which was involved in some of the protests, fielded a death threat of its own. Supporters of the president's health care reforms, who used to tout the support he'd received from the pharmaceutical and insurance industries, are now accusing the very same companies of riling up "mob violence" to stop the plan.

As the charges and countercharges fly, here are three maxims to keep in mind:

1. It isn't Astroturf after the grassroots show up. When the San Francisco Chronicle asked House Speaker Nancy Pelosi what she thought of the protests, she replied: "I think they're Astroturf." In other words, there isn't real grassroots dissatisfaction with the direction health care reform is taking. There's just a facsimile of discontent, a show ginned up by cynical political operatives.

The Chartered Institute of Public Relations, a London-based body of PR professionals, defines Astroturfing as "the practice of falsely creating the impression of independent, popular support by means of orchestrated and disguised public relations activity"; the examples it offers include "posting comments on others' blogs or on message boards" and "submitting supposedly amateur videos to YouTube." The equivalent action at the "town hall" meetings would be if someone claimed to be something she's not. That has happened: Early in August, a woman asking a pointed question at Wisconsin meeting identified herself as "just a mom from a few blocks away" who was "not affiliated with any political party." She turned out to have a long history of Republican activism.

But there's no evidence that any significant fraction of the protesters are poseurs. Some of them have thrown themselves into health care activism full time—when a friend attended this week's meeting in Philadelphia, he reported that some of the plan's opponents "had been at so many of these meetings, the congressman knew them by their first names"—and some of them haven't. When reporters interview the demonstrators, they don't generally have trouble finding local people with genuine concerns about the proposals presently floating around Washington. ("I went to school in this school," a man at a Maryland meeting told ABC News. "I don't see anyone in this room that isn't from Mardela Springs right now.") You should expect to find opposition to Obama's proposals out there, given how poorly they've been polling lately. His opponents may have a sense of showmanship, but there's far more fakery in the "town hall" meetings themselves, gatherings that draw on the iconography of town-meeting democracy but are designed to sell a program devised in Washington, not to gather input from the sticks.

"Any 'astroturf' campaign on the modern media landscape is going to require actually ginning up some broad-based activism if it's going to be effective," my former colleague Julian Sanchez recently wrote. "And any genuinely spontaneous, bottom-up action that seems even moderately interesting and resonant with national issues is going to find a whole lot of political professionals eager to promote, guide, replicate, or co-opt it. Sure, you can still talk about more or less manufactured movements, but the lines seem a lot blurrier to me. If a few locals decide maybe there should be a rally in the town square, and a high-profile blogger or Twitter user picks it up and promotes it, is that astroturf? What if it's the big-name activist who has the idea, and the locals decide to pick it up and run with it?"

There are links, sometimes loose and sometimes strong, between the protesters and larger political players. It's not entirely clear which of those is leading and which is following, and it's certainly not clear why such ties are any more objectionable than the connections between, say, the netroots and traditional Democratic interest groups. (They orchestrate, we organize.) Now the Dems are calling up the grassroots troops that helped elect Obama, telling them that "special interest attack groups are stirring up partisan mobs with lies about health reform" and asking them to come to the town halls to support the proposed measures. Is that Astroturf? Only if no one but professional Democrats show up.

2. It isn't unprecedented if there are obvious precedents. When someone like New York Times columnist Paul Krugman claims that the "mob aspects" at the meetings are "something new and ugly," all he's demonstrating is that he's an economist, not a historian. When it comes to bands of angry citizens being disruptive, it isn't hard to find earlier examples in American history. It isn't even hard to find earlier examples in 21st century American history. Just go to Google and punch in phrases like "guerrilla theater," "antiwar protest," and "Code Pink."

It's entertaining to watch the same people who spent the Bush years smearing the antiwar movement as "on the other side" suddenly rediscovering the virtues of noisy protest. But at least they're moving in the right direction, no matter how haphazardly or hypocritically. What's depressing is to see the people who piously defended the right to dissent suddenly writing off public protest as a subversive conspiracy.

3. It isn't fascism if…actually, you can stop there. IT ISN'T FASCISM, you numbskulls. Nancy Pelosi complained this month that protesters were "carrying swastikas and symbols like that to a town meeting on health care." The swastikas in question had slashes through them or were inscribed next to slogans like "No to Fascism," but Pelosi's remark made it sound as though the demonstrators were displaying the Nazi iconography approvingly. In the aftermath, as foes of Pelosi's plans reacted angrily, liberal groups like Media Matters argued that Pelosi had merely been innocently describing some of the signs she'd seen. But it's hard to believe she wasn't trying to insinuate that her foes were fascists.

Some people won't stop at insinuation. The liberal writer Sara Robinson has composed a remarkable essay for OurFuture.org called "Fascist America: Are We There Yet?" It begins by recalling "the dark years of the Bush Administration," when "Constitutional protections vanished, nativist rhetoric ratcheted up, hate speech turned into intimidation and violence, and the president of the United States seized for himself powers only demanded by history's worst dictators." Many on the left were worried that we were becoming a fascist state, Robinson continues, but she and her colleagues didn't think we were there yet: "though we kept looking, we never saw clear signs of a deliberate, committed institutional partnership forming between America's conservative elites and its emerging homegrown brownshirt horde….The two sides kept a discreet distance from each other, at least in public. What went on behind closed doors, we could only guess."

Then, scaremongering with a shamelessness that would embarrass even the direct-mail industry, she lets the other shoe drop:

Now, the guessing game is over. We know beyond doubt that the Teabag movement was created out of whole cloth by astroturf groups like Dick Armey's FreedomWorks and Tim Phillips' Americans for Prosperity, with massive media help from FOX News. We see the Birther fracas—the kind of urban myth-making that should have never made it out of the pages of the National Enquirer—being openly ratified by Congressional Republicans. We've seen Armey's own professionally-produced field manual that carefully instructs conservative goon squads in the fine art of disrupting the democratic governing process—and the film of public officials being terrorized and threatened to the point where some of them required armed escorts to leave the building. We've seen Republican House Minority Leader John Boehner applauding and promoting a video of the disruptions and looking forward to "a long, hot August for Democrats in Congress."

This is the sign we were waiting for—the one that tells us that yes, kids: we are there now. America's conservative elites have openly thrown in with the country's legions of discontented far right thugs. They have explicitly deputized them and empowered them to act as their enforcement arm on America's streets, sanctioning the physical harassment and intimidation of workers, liberals, and public officials who won't do their political or economic bidding.

It's easy to throw this sort of argument back in Robinson's face. While a few of those "discontented far right thugs" have engaged in low-level violence or intimidation, the same is true of a few of the activists on the other side of the issue, a fact that prompted the conservative blogger Michelle Malkin to give the Service Employees International Union's lavender-clad activists an equally hyperbolic (though admittedly funny) tag, the "Purple Shirts."

But that isn't the deeper problem here. Nor is it the fact that we do not, in fact, "know beyond doubt" that the Tea Parties were "created out of whole cloth" by Astroturfers. It's the fact that Robinson begins her essay with a reference to the real expansions of executive power during the Bush years, but by the end doesn't seem to have any interest in discussing the topic, even though most of those constitutional protections are still missing and the president is still taking on new powers. Instead we're supposed to be afraid of a group whose only sin is sometimes to be unruly or paranoid—as though both unruliness and paranoia haven't been a constant presence in American history from the beginning. At the end, she complains: "Every day that the conservatives in Congress, the right-wing talking heads, and their noisy minions are allowed to hold up our ability to govern the country is another day we're slowly creeping across the final line beyond which, history tells us, no country has ever been able to return." Set aside the fact that many countries have, in fact, returned from fascism. How did we reach the point where people exercising their First Amendment rights are an existential threat to liberty, while freedom's defenders are those who won't "allow" the noisemakers "to hold up our ability to govern"?

The swastika signs are silly, and I won't defend them. But there's a difference between a little Nazi-baiting invective against the powers that be, and Nazi-baiting invective against a group of citizens whose sin is simply to get in their governors' way. Yes, the protesters sometimes sound like a teenager who can't tell the difference between the petty tyrant in the principal's office and Benito Mussolini. But writers like Robinson resemble Basil Fawlty self-righteously declaring "this is exactly how Nazi Germany started" when his guests complain about the service at his hotel.

Jesse Walker is managing editor of Reason magazine.