Americans Speak on Health Reform: Report on Health Care Community Discussions

IV. Solutions to the Problems in the U.S. Health Care System

D. Relationships between Concerns and Solutions

One of the most striking results from the analysis described in this report was the lack of differences in the concerns and solutions across the country: Americans who participated in Health Care Community Discussions were generally united in what they felt was wrong with the system and the general direction on how to fix it. No significant differences were found in the results when looking at the groups’ locations by rurality, region, average income, and unemployment. As such, the information from the Health Care Community Discussions is relevant to policy makers at the local, state, and national level.

That said, some patterns emerged in the detailed analysis of the Health Care Community Discussion reports. The analysis team separately analyzed reports that were from Health Care Community Discussions where a majority of attendees were from provider groups or advocacy groups, and compared them to groups where a majority of attendees were interested citizens. Provider groups were more likely to express concerns on a number of topics. Specifically, they were more concerned about provider shortages, the lack of a "system," inadequate research, payment rates, medical malpractice, the inefficiency of the system, and the inadequate treatment of mental health (see Figure 9).

A different pattern emerged in the comparison of topics of interest to advocacy groups and typical Americans. Health Care Community Discussions where the majority of attendees were from advocacy groups were more interested in access than average Americans and much more interested in women’s health and comprehensive coverage. (Planned Parenthood, among other advocacy groups, recommended that its members participate in Health Care Community Discussions.) (see Figure 10).

Relationships also emerged between perceived problems of Health Care Community Discussion participants and their solutions. For example, groups that expressed concern about accessing health insurance due to pre-existing conditions, the cost of prescription drugs, and the uninsured were also concerned that a health system includes for-profit providers and insurers. Health Care Community Discussion groups that raised problems with the employer-based health care system were more likely to support a single-payer system than others. And, those groups where the cost of the entire health system was at issue were significantly more likely to support education and prevention as solutions.