Consensus on Health Care System Fixes Remains Elusive

Congress orders a taskforce to re-launch the national health care debate. The effort is intended to go around the usual special interests, directly to the American public. While attendees across the country agree that the system is in trouble, consensus on how to fix it remains elusive.

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RENEE MONTAGNE, host:

The government wants to know what you think about the nation's healthcare system. Really. A task force chartered by Congress is now midway through a series of nationwide town hall meetings intended to find out just how sick the public thinks the healthcare system is and how it could be cured. NPR's Julie Rovner joined some 250 people who attended a session last week in Philadelphia and filed this report.

JULIE ROVNER, host:

The crowd, patients, health provides and community activists, gathered in the cavernous ballroom of the College of Physicians of Philadelphia. There, beneath portraits of eminent physicians from the past three centuries, they pursued something those doctors never achieved, a healthcare system that serves everyone.

Mr. WENDELL YOUNG (Citizens Healthcare Working Group): Everybody should have the same quality of healthcare, it should be high quality of healthcare, and there should be access...

Mr. ROB FREDERICK (Citizens Healthcare Working Group): Even noncitizens should have healthcare in this country.

Ms. TIFFAN BROWN (Citizens Healthcare Working Group): There is a racial disparity when it comes to healthcare.

Mr. GREG BENJAMIN (Citizens Healthcare Working Group): If there was some form of national healthcare, it would kind of even...

ROVNER: That was, in order: Philadelphians Wendell Young, Rob Frederick, Tiffany Brown and Greg Benjamin. They were discussing one of four questions Congress ordered the Citizens Healthcare Working Group to answer. How should healthcare be delivered? How should it be paid for? What benefits should be available? And what tradeoffs is the public willing to make to ensure healthcare is available to everyone? First, however, using keypads that can calculate totals instantly, moderator Jonathan Ortmans asked the crowd how serious they think the problems are with the nation's current healthcare.

Mr. JONATHAN ORTMANS (President, Public Forum Institute): All right 77 percent said a crisis, 23 percent said it has major problems. Looks like no one in the room thinks we only have minor problems. You just sent message number one from Philadelphia to Washington. Thank you.

ROVNER: The debates at the individual table showed a wider variety of opinions. Over at table seven, community organizer Greg Benjamin discussed what should be in a health benefits package.

Mr. GREG BENJAMIN (Community Organizer): Should there be a number of doctor visits, or just some way of keeping some kind of control? Because, you know, sometimes a person will go to the doctor because they had a finger that was just hurting and they didn't know why, so they decided, I have health benefits. Let me go to the doctor.

ROVNER: He was challenged by Wendell Young, of the United Food and Commercial Workers Union. Young says limits intended to prevent inappropriate use of healthcare can end up hurting those with legitimate needs.

Mr. WENDELL YOUNG (United Food and Commercial Workers Union): Today I met a member whose wife was injured in an accident and is now a quadriplegic. The plan calls for 30 treatments a year. She needs two a week. The exposure, out-of-pocket costs to somebody like that is astronomical.

ROVNER: Those are exactly the kinds of conversations Senator Ron Wyden of Oregon was hoping the meetings would prompt. Wyden, a Democrat, sponsored the legislation creating the working group with Utah Republican Senator Orrin Hatch. Wyden says their goal was to break what's become a familiar pattern when it comes to health reform.

Senator RON WYDEN (Democrat, Oregon): From the days of Harry Truman, in 1945, you've had exactly the same thing take place. You've had somebody in Washington, D.C., a president, a member of Congress, propose a major national piece of legislation, the citizens find it hard to comprehend such a difficult proposal, the special interest groups attack the proposal and each other, and everything dies.

ROVNER: Wyden says he hopes that working from the public up, instead of the lawmakers down, will help break that logjam. The legislation creating the working group requires the president to sign off on the report and Congress to hold hearings.

But it's clear that the biggest hurdle in healthcare, how to pay for it, has yet to be overcome.

Mr. ORTMANS: What about relying on market competition? Some people maintain that the market (unintelligible)? And then I think a gentleman over here talked about the fact that we used to have a lot more emphasis as a nation on our neighborhood delivering healthcare. What about neighborhood health clinics?

ROVNER: In addition to urging an end to the war in Iraq or repealing President Bush's tax cuts to pay for care, participants at one table suggested legalizing marijuana and then taxing it.

In more Republican areas, there's been more support for market-based competition, but working group member Dottie Bezos(ph), who attended the Philadelphia meeting, says she's been surprised by the amount of support even in Republican parts of the country for a health system that guarantees coverage for everyone.

Ms. DOTTIE BEZOS (Philadelphia Working Group Member): I think the most important thing that I've learned is that Americans seem to be wanting an equitable and just healthcare system for all Americans, and they want change now.

ROVNER: This week the working group is holding seven more meetings in six states. Its report to Congress and the president is due in September.

Julie Rovner, NPR News.

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