OAKLAND — Democrats are being "out-shouted" in the health care reform debate, U.S. Sen. Barbara Boxer acknowledged Tuesday while trying to roll out some facts in support of reform efforts.

"I think we can do better on the messaging and I think we will do better once we have a final (Senate) bill," Boxer, D-Calif., told reporters at a news conference in Kaiser Permanente's new medical office building, soon after watching an electronic medical record demonstration and holding a round-table meeting with Kaiser doctors, nurses and administrators.

"There's no question we're being out-shouted" by Republicans, she said, adding "all this hullabaloo" about public funding for abortions or government "death panels" deciding who'll live or die "is made up." She said she's especially offended by the "chutzpah" of Republicans who claim Democratic health care proposals would gut Medicare coverage for seniors; she's appalled by "the nerve of folks who were against Medicare, who said it should die on the vine, who now say Democrats are against Medicare."

"Am I frustrated that we're being out-shouted? Sure. But I'm patient "... because I know the truth is going to come out," she said.

That truth, she said, is that 46 million Americans remain uninsured. Because the uninsured are getting their health care in the most inefficient and costly way, through emergency rooms, for example, it costs every insured American about $1,100 per year in extra premiums. Another 14,000 people lose insurance every day either through job losses, skyrocketing costs, capped benefits or rescission, the retroactive cancellation of insurance after a patient has become ill.

"It's a very dicey situation today," she said, emphasizing health care reform is just as much about those who have insurance but could lose it at a moment's notice as it is about those already uninsured.

It's also about controlling costs, Boxer said, citing a study that found that by 2016, California families on average could be paying 41 percent of their household income to health insurance premiums. Already, she said, two-thirds of personal bankruptcies are linked to high medical costs.