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Panel asks Americans for health-care ideas

A working group formed by Congress to examine health care in America has published the results of its efforts thus far as a "Health Report to the American People."

Now panel members hope that individuals all over the country will contribute their thoughts, to build the foundation for recommendations that may be used to forge the framework of health-care reform. The goal? "Health care that works for all Americans," according to the working group.

Members want citizens to enter the discussion by e-mail, online, through letters or at community meetings — whatever it takes to convey their own stories and suggestions for improving a system that is in some ways among the best in the world, but in others sorely lets people down, according to the findings of the Citizens' Health Care Working Group.

Those contributions will be culled for suggestions and concerns.

"Based on what we hear over the next six months, the Working Group will write a citizens' road map of recommendations," to be released next May, said Jessica Federer of the working group's staff. That will be followed by a 90-day comment period, then the working group will present final recommendations to President Bush and the five congressional committees that must hold hearings on them in early fall.

"This initiative gives people a way to actually do something about the situation at hand. Instead of always talking about the problems, here is an initiative where the American people are being asked to get involved in finding solutions for Congress to hold hearings on," she said.

Since the full report was recently published online at, "the responses so far have been pretty good," she said.

The group held several regional hearings while gathering information for the report, including one in Salt Lake City. As for what the members found, "It's a complicated story," the report says, "but here's the bottom line: We have serious problems to address," including sharply rising health care costs, shortcomings in the quality of care we receive and people who don't have access to care.

Americans spend more on health care than most industrialized countries and the costs are rising. Many Americans get care that is "neither the right care nor the best care." And millions of Americans can't afford medical care even when it's available, a problem that's getting worse, according to the report.

The panel hopes that people will take the time to think about, discuss and answer a series of questions to help the panel as they grapple with issues and possible solutions. For instance, they want to know what concerns Americans most about the health care system. And what benefits and services should be provided. They also want to know how it should be delivered and paid for. A big question is what trade-offs the public might be willing to make in either benefits or financing to ensure the access of all Americans to affordable, high-quality care.

To help people find answers, they provide a framework of often-sobering facts about health care as it exists today. A small sampling:

Costs for health care per person averaged about $6,400 in 2004 and are projected to reach $11,000 each by 2014. Americans spent $1.7 trillion nationally in 2003 on health care, 96 percent of it for either professional health care services, hospital services or prescription drugs.

In 1960, a nickel of every dollar went to health care. Today, it's 15 cents, expected to "rise sharply" over the next 10 years.

Health care costs are responsible for tough, fundamental choices. The need for employer-sponsored health insurance, for example, forces some workers to postpone retirement, causes some mothers to return to work, it says, and leads some people to decide against starting their own small businesses.

Quality of care isn't all rosy, either. Adults, on average, get only 55 percent of the recommended care for many common conditions.

Unnecessary medical errors occur, with from 44,000 to 98,000 deaths each year as a result.

Only 10 percent of elderly Americans have private long-term care insurance, although it is estimated that about half of Americans over 65 will at some point need long-term care.

As a consequence of these and other problems, individuals are having trouble affording health care, governments are feeling pressured by cost increases to either raise taxes, cut health care benefits they pay for or cut other programs. Businesses are finding it harder to provide insurance as a benefit. Jobs are also going to other countries to save companies money, which puts more pressure on the system.

The report is exhaustive and well footnoted, going into each issue in much more detail, with graphics to help tell the story.