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

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

E. Suggestions for Future Engagement

The Health Care Community Discussion Participant Survey solicited more than just concerns and policy solutions: it asked how policy makers should reach out to them, and what they need to do to remain involved in health reform. To help summarize the participants' thoughts on the "next steps" of the health care reform process, the Participant Survey asked, "What do you think is the best way for policy makers to develop a plan to address the health system problems?" The possible responses were:

• Community meetings like these;
• Traditional town hall meetings;
• Surveys that solicit ideas on reform;
• A White House Summit on Health Reform; and
• Congressional hearings on C-SPAN.

Among participants, the most popular way to develop a plan for health care reform is more community meetings similar to the Health Care Community Discussions. Thirty-seven percent of respondents named this as the best way for policy makers to develop a reform plan, and at over 90 percent of meetings at least one person supported this idea (see Figure 11). Participants in rural communities were slightly less likely to prefer this approach (34% support), probably due to the physical challenge of convening Health Care Community Discussion groups (Map 4). These survey results are a promising indication that participants had positive experiences at the Health Care Community Discussions.

Over one in five (21%) of the 30,603 survey respondents supported the idea of a White House Summit on Health Reform. This idea was more popular in the Midwest and the West (22%) compared to those in the Northeast (17%). Surveys to solicit ideas on health reform were supported by 18 percent of respondents. Participants in rural communities (22%) and the Northeast (20%) were more likely than other participants to prefer surveys. One in ten participants chose C-SPAN hearings as the best way to develop a plan for health care reform.

Comments on how policy makers should develop health reform plans included:

• In Gardiner, New York, a dinner gathering among friends and family concluded, "Most felt that the best way for policy makers to develop a plan to address the health system problems is through traditional town hall meetings and communications campaigns targeted to people who are uneducated about health, wellness and prevention."

• In Tallahassee, Florida, a Prison Reform/Human Rights/Family Support advocacy group encouraged "traditional town hall meetings" and "community meetings like these whereby our government involves its people in discussions about what is best for our country."

• At a local restaurant in Aurora, Illinois, one group felt that "community meetings, town hall meetings [and] keeping in touch with the people, the average citizens, will give the people cause for hope. Each person will begin to believe that they can help make a difference."

• In Syracuse, New York, at a town hall meeting in a local church, participants agreed: "Local citizen participation in health planning is very important."

• Groups in San Bernardino, California and Watkinsville, Georgia advocated for "seeking grassroots input" and "keep[ing] the general public involved."

Many groups provided additional comments on having the opportunity to share their thoughts and concerns with the Obama health policy team.

• In Green Acres, Washington, participants reported, "We are extremely encouraged that President-elect Obama is reaching out to all Americans rather than special interest groups to come up with a solution. More than ever, we are optimistic that this solution will be reached."

• In Aurora, Colorado, participants at a Health Care Community Discussion organized by a community based organization "had a wonderful and meaningful discussion on health care. Everyone was engaged and appreciative to be part of the global discussions being held across the nation."

• One group, led by a pediatrician in Tampa, Florida, said, "Thank you very much for giving us the opportunity to let our voices be heard. We are hopeful things really are going to be done differently in Washington D.C. and America from now on."

• In Riverhead, New York, a Health Care Community Discussion host shared that participants "were all engaged and encouraged by the fact that this team actually solicited input from the populace."

In addition to asking about what policy makers should do, the Participant Survey asked, "After this discussion, what additional input and information would best help you to continue to participate in this great debate?" The possible answers were:

• More background information on problems in the health system;
• More information on solutions for health reform;
• More stories on how the system affects real people; and
• More opportunities to discuss the issues.

Most participants (38%) wanted more information on health reform solutions as a means for continuing participation and 31 percent of respondents wanted more opportunities to discuss the issues (see Figure 12). Those in Health Care Community Discussion groups in the West (40%), rural areas (41%), and areas with per-capita income above $45,000 (41%) were particularly interested in information about solutions (Map 5). The level of interest in opportunities to discuss the issues was constant across different types of communities. More background information on problems and more stories about how the system affects real people were selected by 18 percent and 13 percent of respondents, respectively.

Lastly, Health Care Community Discussion participants' recommendations on how to proceed with health reform related to their own concerns and interests. Among the 30,603 survey respondents, participants more interested in quality than cost were more interested in Congressional hearings and stories and less interested in community discussions like the ones that they had participated in. People who were most interested in receiving more information on solutions were less interested in opportunities to discuss the issues. Those who most wanted a White House Summit on Health Reform were the least interested in C-SPAN hearings.