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Health reform gains momentum, policy-makers seek public's input.

As lawmakers grapple with how to reform the nation's health care system, Americans continue to speak out for the need for cost control, improved access and more emphasis on prevention and wellness.

The national health reform effort gained momentum in March when the U.S. Department of Health and Human Services debuted a new Web site,, that seeks to further open the issue to the public. That site gives access to discussions from recent national and regional White House health reform forums and allows people to sign a statement supporting President Barack Obama's commitment to enacting comprehensive health reform this year.

The site also features "Americans Speak on Health Reform: Report on Health Care Community Discussions," a report that summarizes comments from thousands of Americans who hosted and participated in health reform community discussions across the country in late 2008 and early 2009. According to the report, "one of the most striking results" from an analysis of about 3,300 group reports "was the lack of differences in the concerns and solutions identified by participants." Top concerns included cost, lack of emphasis on prevention, limited insurance access for those with pre-existing conditions and concerns about quality of care.


At the White House Forum on Health Reform in early March, Obama spoke of the need for reform and pledged that "every voice must be heard. Every idea must be considered. Every option must be on the table."

"I know people are skeptical about whether Washington can bring about this change," Obama said at the March 5 forum.

"But I am here today because I believe that this time is different ... This time, there is no debate about whether all Americans should have quality, affordable health care--the only question is, how?"

At a series of five White House Regional Health Forums in March and April, a myriad of people gathered in Michigan, Vermont, Iowa, North Carolina and California to speak out about health needs. APHA Immediate Past President Linda Degutis, DrPH, MSN, represented APHA at the Vermont forum in March and said almost everyone brought up the issue of cost.

"There were a number of people who raised the issue of prevention, which was like, 'whoa, people are actually talking about it," Degutis said. "I thought that was good."

Degutis, who worked with the late Sen. Paul Well-stone on landmark mental health parity legislation, also said it was gratifying to hear people mention access to mental health care.

"I think people were hopeful," Degutis said about the Vermont forum, which was hosted by the governors of Vermont and Massachusetts and also featured Nancy-Ann DeParle, director of the White House Office for Health Reform. "The overall sense was there's a real opportunity for making something different and changing things."

At the Iowa forum, Sen. Tom Harkin, D-Iowa, laid out a tentative timeline for health reform. He said the president is pushing Congress to complete work on the effort by the August congressional recess so he can enact health reform by September or October.

As part of its health reform advocacy work, APHA has played an active role in the Health Reform Dialogue, a group of diverse stakeholders ranging from the American Medical Association to the American Cancer Society to the U.S. Chamber of Commerce. Coming together six months ago to work on the "urgent, national necessity" of health reform, the group in March released a report, "A Dialogue on U.S. Health Reform," outlining recommendations for health system change. Among the recommendations are to improve public health care program enrollment, increase support for prevention and help small businesses provide employee health coverage.

"Until now, comprehensive health care reform has been deadlocked." said Georges Benjamin, MD, FACP, FACEP (E), APHA's executive director. "The time has come to set aside some of our differences, talk openly with each other and begin to find common ground. This process has significantly helped steer us toward that outcome."

APHA has also been working to create an "Agenda for Health Reform" spelling out the most critical changes needed to improve the public's health through reform. The agenda was released in early April.

For a copy of the Health Dialogue Report or APHA health reform agenda, visit For more on health reform, visit
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Title Annotation:THE NATION: Health news at the national and federal levels
Author:Currie, Donya
Publication:The Nation's Health
Date:May 1, 2009
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