At a recent town hall meeting, widely shown on cable TV, a nearly hysterical, sobbing woman was saying that her insurance company had denied home health care for her bedridden husband.

The congressman listened to her, promised that his staff would look into the matter and went on to say that the trouble with America today is government.

Americans in such situations have to turn to each other for help, he said, warning there is too much dependence on government.

Leaving aside the obvious fact that the congressman-who-hates-government is part of government — and gets his paycheck from taxpayers, how many neighbors have the proper nursing skills and the time to help with rigorous daily care for someone who is not a relative?

A few days later a report by the National Conference on Citizenship reported that Americans have cut back on the amount of volunteering and civic works they do, largely attributable to the recession.

Their annual "civic health index," based on polling data from May, reports that 72 percent of Americans said they have "cut back on time engaged in civic participation, which includes time spent volunteering, participating in groups or performing other civic activities in their communities."

It also said 66 percent of Americans say they feel others are responding to the recession by "looking out for themselves."

The report quotes the conference’s chairman, Michael Weiser, as saying, "The economic crisis has triggered civic foreclosure," although he added, "The good heart of Americans is still very evident, though, as they refocus on basic needs."

One way President Obama is proposing to pay for health-care insurance reform is to cut back on charitable deductions taxpayers now take. Taxpayers earning more than $250,000 a year now give about $81 billion annually to charity. By one estimate, that could drop by nearly $4 billion if the tax deduction decreases. Needless to say, the philanthropic community is concerned.

At the same time, many charities, hit hard by the economic downturn, had intended to rely more on volunteers.

But all this overlooks the fact that most health care for the elderly — the biggest users of health care in America — is provided by relatives, usually spouses and daughters. Very little is being done to help them, as witnessed by the panicked woman at the town meeting.

Despite the heated rhetoric, we are far, really far, from solving the health care mess in this country. The unwieldy, convoluted 1,017-page health insurance reform bill passed by the House (America’s Affordable Health Choices Act of 2009 to "provide affordable, quality health care for all Americans and reduce the growth in health care spending") is full of inconsistencies, vague promises and loopholes.

As summer draws to a close, the Senate still has no version. (If Democrats push through a version with no Republican support or input, it will be disastrous. The country will rebel.)

And we still have no clear idea what President Obama wants or where his line in the sand is although health care is allegedly his top priority.

Health-care costs account for 15 percent of our entire Gross Domestic Product, a figure that the Congressional Budget Office predicts will be 49 percent by 2082 if nothing is done. And 47 million Americans remain uninsured, with thousands more losing insurance every day. Yet, despite Obama’s latest deadline of September, a compromise plan has yet to emerge.

We begin September with no comprehensible package in hand, with anger and fear on all sides from the residue of riotous town meetings, with little leadership from the White House even as we hope for serious negotiations.

It would be nice if the sentiment over the death of Sen. Edward M, Kennedy would spur compromise and action, although that is unlikely.

This whole endeavor has been so badly handled by nearly everyone involved, it’s heartbreaking. If nothing is done, millions more will lose their faith in government. If nothing is done, government then truly will be the problem, not the solution.

(Ann McFeatters has covered the White House and national politics since 1986. E-mail amcfeatters(at)

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