Not many in attendance for the Citizens' Health Care Working Group community meeting on Tuesday would say America's health care system isn't in need of repair. And for that reason, more than 400 businessmen, health professionals and average citizens shared their thoughts at the Express Event Center and lent a hand to the Citizens' Health Care Working Group in its recommendations to President Bush and Congress. The group is a nonpartisan entity authorized by the Medicare Prescription Drug, Improvement and Modernization Act of 2003. Officials said it was a record turnout for a Citizens' group forum. Participants identified problems in health care and insurance and offered suggestions during a multimedia presentation and moderated discussion that delved into how health care services are rendered and financed. Catherine McLaughlin of Citizens' Health Care Working Group told the audience there were financial ramifications of a new health system, not just for the consumer. "The $1.9 trillion spent (annually on health care) means $1.9 trillion in revenue," McLaughlin said. "We don't want to do away with it, but we want to reshuffle it."

The audience shared personal experiences and many offered ways to make it financially easier on health providers and consumers. Medication, Medicare, end-of-life and palliative care, high employee and employer costs, and coverage restrictions gained the most attention. "My son has autism and my health care provider won't cover him," said Paul Crone of Oklahoma City. "I cover the costs out of pocket. I'm not lower-income. I'm middle-income and I didn't go to the government. Now I'm forced to. We need to look at autism. One in 164 and counting has it." The objective was to improve on a plan that has been compiled through 80 community meetings and from 23,000 participants. The crowd was asked if the package improves the health care system, and 12 percent said yes, 42 percent said yes, but it could do better, 28 percent were unsure and 20 percent said no. Individual responsibility plays a significant factor, and health institutions, as well as individuals, pay the price when lifestyles are unhealthy. "OU Medical Center and Hillcrest Hospital (in Tulsa) ran high costs for indigent patients, and one thing that helped was a tax on cigarettes," said Ron Dellinger of Tulsa. "Most of those who couldn't afford health care smoked. That needs to be fixed. Health insurance has quadrupled from five or 10 years ago. We need a healthier lifestyle. Too many people don't pay attention to what they eat and drink." Glenn Hightower of Oklahoma City said the government could do a better job with its money. "The $120 billion spent in Iraq would pay a lot of health insurance premiums," he said. State Insurance Commissioner Kim Holland said community participation can only help. "The challenge is how to build a consensus," she said. "It's fascinating and it's evidence that our citizens care." Forty-five percent indicated that everyone should be required to participate in the suggested system, 41 percent said no and 14 percent were unsure. Ten percent said it should be publicly financed, 10 percent said it should be privately financed, and 80 percent called for a public-private mix. The participants were put in groups of eight, and each had a comment on various issues. Suggestions on ways to pay for the system included: sharing the costs between employees and employers; look at resources and redundancies; being consistent across state borders; creating a national consumer-directed plan with a scale; repealing income tax cuts and changing the way medical services are delivered; looking at universal health care; and giving major players such as health care providers, insurance companies and lawmakers a set of guidelines to keep the system from spiraling out of control. One of the groups of eight came up with its own suggestion – have a sin tax on junk food. "That has come up in several parts of the country," said Citizens' Health Care Working Group moderator Jonathan Ortmans.