From Vicki Totten

Moderating National Issues Forums Institute (NIFI) forums is a great way to delve more deeply into what is concerning people.  Some forums, however, seem to tap into concerns that are much more universal than others.  A November, 2016, forum focused on "Health Care: How Can We Reduce Costs and Still Get the Care We Need?" is an example of one such issue.

Hosted by the George W. Bush Presidential Library in Dallas, Texas, the 18 participants represented a broad spectrum of cultural backgrounds, economic situations, gender, and age.   What they all had in common, however, was a story illustrating why this issue mattered to them personally.

For example, we heard from a school nurse who came to the forum because she was seeing first hand the challenges parents were having trying to navigate a complex health care system to obtain care for a sick or injured child.  Another participant shared that she was finding it much more difficult to control costs with our health care system than in her native Germany.   There was also a retired CEO who expressed concerns about the inequities of a system that enabled him to afford the best health care available, while preventing many low and middle income families that same access.  Another retiree reflected the other end of that spectrum when talking about the choices that she sometimes had to make between a particular medication or eating well that month.  All of these stories represented just how challenging this issue is for people and the impact it is having on their lives.

In order to focus on the option presented in the issue guide to "learn to live within our means" the group felt work needed to be done around the second option, which was "to make health care more transparent, accountable, and efficient."  The participants gave examples of how difficult it is to live within your means in regard to health care costs when you don't know in advance how expensive a trip to the emergency room or a test is going to be. 

The final option discussed was the need to lower health care costs by focusing on wellness.  The participants explored how hard it can be to prepare healthy meals when both parents are working full time or when there is a limited budget or limited access to healthy foods in particular neighborhoods.  Some people expressed a desire to have schools offer more frequent recesses and physical education classes, while others felt it was the parent's job to model healthy habits. 

To learn more about this topic, the issue guide is available on the NIFI website.  Since the forum was one of several being held at different Presidential Libraries this fall, a more complete report and findings from all of them will be available sometime this spring.