Former Minnesota Republican Sen. David Durenberger widely emails periodic musings and commentaries which give rather frank and illuminating glimpses inside the heart and mind of a somewhat disillusioned moderate. (He's currently excited about the prospect of Jeb Bush becoming a senator from Florida and Caroline Kennedy taking the seat from New York.) Durenberger remains active in health policy circles and is reasonably optimistic about coming changes in the way we finance and deliver health care, a little more worried about how far we'll get with coverage expansion. Still he's impressed by a lot of what he is seeing from the incoming administration and likes that incoming HHS Secretary Tom Daschle has issued an open invite to the American people to send in their views about health care reform. But Durenberger, who also knows the power of lobbies and special interests, is also worried that this great democratic debate can be subverted. Here's his take:

HEALTH CARE HOUSE PARTIES
Sounds like a great idea from the Obama transition team. Let's ask America what we can do to improve healthcare—in house parties all over the country. The vaunted Obama internet team must have ways of gathering all the megabytes of recommendations and sorting them into specific "grassroots ideas" for the president-elect and the czar and czarina of health policy.

To prove that every really good idea can be diluted by the power of monied interests in Washington, DC, every national healthcare stakeholder organization has turned on its "grassroots" PR machines. The health insurance industry, ("we are mobilizing our grassroots coalitions and encouraging industry employees"), medical associations, hospital and medical technology associations all are sponsoring living room lobbying sessions across the country. It remains to be seen how some really unique thoughts from the hinterland will ever get to Tom Daschle or Jeanne Lambrew or anyone else in a city inhabited by 16,000 lobbyists.

He also reports that it's tough to find a copy of Daschle's book in Duluth. Which we hope tells us something about how health reform might play in Peoria.