(This report is from March 2009)
Roles in a Reformed U.S. Health Care System: Participants in Health Care Community Discussions frequently
stressed the importance of collaboration in both fi xing and operating the health system. The theme of “shared
responsibility” was common. However, Health Care Community Discussion groups had differing views on
whether the roles of the main actors in the health system – the government, private sector, businesses, and
individuals – should expand or contract in a reformed health system.
● Role of Government v. Market: The debate among participants was less about whether government
should have a role in a reformed health system and more about the size of that role. A number of “singlepayer”
advocates participated in Health Care Community Discussions. From Livermore, California:
“This group was almost strident in its belief that we should simply adopt a single-payer system similar
to what is enjoyed in Canada and much of Europe and take the burden off of individual employers and
corporations altogether.” Others expressed concerns about the approach. From St. Louis, Missouri:
“
major concern with public v. private plan was the quality of care received with a public
plan.” This debate took place within as well as across groups. From Bristol, Virginia: “Many argued
that the insurance industry should be completely removed from the health care delivery system,
but others saw how they acted as ‘gatekeepers’ to control costs, and to offer affordable coverage to
some employers.” Other groups supported a “hybrid” model that would include both types of plans.
...
Conclusion: President Obama has encouraged all Americans to have a direct say in the effort to reform
the health system. Individuals who participated in the Health Care Community Discussions rose to this
challenge. These Health Care Community Discussions brought together people in all 50 states and the
District of Columbia from all walks of life – patients, doctors, business owners, and advocacy groups – who
united around a common concern: the need to reform health care in America. The stories of hardships that
emerged from the Health Care Community Discussions, and thousands of similar stories, affi rm the need to
reform America’s broken health care system. The Health Care Community Discussions represent two related
Administration commitments: to an open, inclusive style of governance that engages Americans in the policy
process and to health reform that is directly responsive to the problems Americans face, the stories they
share, and the solutions they offer.
http://healthreform.gov/reports/report_on_communitydiscussions.pdfI don't think anyone in government read the report...