On 27 December 2008, Dr. Elaine Fox hosted a community discussion on health care at the Rogers Memorial Library in Southampton. The discussion format was based on the guidelines provided by the Obama-Biden Transition Project. Mark Seidler assisted Dr. Fox by facilitating the discussion.

The instructions provided by the Transition Team framed this discussion as “part of the President-elect’s continuing efforts to reach out and directly involve the American people in their own government. Health care is a top priority for President-elect Obama, and he wants your help in designing a system that provides quality, affordable health care for all Americans.”

Participants responded to 7 questions concerning health care. The results of the discussion were recorded, and Dr. Fox will forward a summary of the group’s responses to the Transition team, as part of a nationwide dialogue process. Participants also completed a 3 question written survey and results are available by request.

There was an overflow crowd in the Maria Cooper room at the library. Among others, the questions asked participants to describe what they saw as the biggest problems in the American health care system, and what they thought were the best ways for policy makers to plan to address these problems.

Central issues discussed were, not surprisingly, the skyrocketing cost of both medical care and medical insurance premiums, the resulting bankruptcies and foreclosures, the impact on American businesses, and the rising numbers of uninsured and underinsured. Also raised were perceptions of waste, lack of transparency, and a general sense of disempowerment of individuals in relation to their health care system.

There was some concern that the major proposed alternative to the present system - the single payer system - was not sufficiently explored. This alternative was favored by many at the meeting.

The format provided by the instructions really only invited discussion around the plan currently being considered by Obama-Biden, which essentially focuses on working with and improving the current system. Even for those who questioned whether a single payer system is desirable or feasible, the time frame allowed only minimal exploration and debate on the complexities of that question.

Intimately tied to this choice (incremental improvement vs. radical change) is the question about the actual and desirable role of the insurance companies. Many in the group saw them as the core of the problem, while others pointed out that they are a political reality, and that any efforts at reform need to include them in the process. Many participants wanted further dialogue, and expressed the desire to have input into the political process as the reform initiatives develop at the national level.

For further information and potential follow-up events, please contact: Dr. Elaine Fox at 631.287.1093, or