In an article in the January-February 2008 issue of Health Progress, Jack Glaser, senior vice president for theology and ethics at St. Joseph Health System, Orange, California, writes:

Ethical wisdom is the gift not of ethical experts, but rather, as I have argued in a previous Health Progress article, the gift of the right community — the "community of concern." Different ethical issues require different communities of concern, I noted. "Gathering the community of concern requires people who command essential perspectives on the issue at stake and also share an overarching concern for the common good." ("The Community of Concern," Health Progress, March-April 2002, pp. 17-20).

However, in generating ethical wisdom, "communities of concern" consistently need further tools. This article suggests some tools for the moral/ethical challenge of health care reform ("Tools for Ethical Discernment," Health Progress January-February 2008, p. 51).

Ethics committees, boards, executive teams, departments and staff can all constitute "communities of concern" in addressing the reform of our health care system.

In addition, in a CHA resource, Building Consensus for Change: A Guide to Organizing Roundtable Discussions on Health Reform, Sr. Carol Keehan, D.C., president and CEO of the Catholic Health Association, writes: "[T]he Catholic Health Association is urging individuals and organizations to take a moment to consider the values and priorities that should drive health reform in America — and how we can build and sustain consensus for productive change" (p.2).

We provide here two resources that can be used to foster discussion about health reform in your organization, parish or community. One is a survey tool from Jack Glaser's Health Progress article which focuses on identifying priorities that should shape a reformed health system. www.chausa.org/hpsurveytool.

The second resource is a study tool to help you assess various reform proposals. It is on the CHA website at www.OurHealthCareValues.Org.

Additional resources for dialogue and discussion about health care reform are listed in the Resources section of this newsletter.

SURVEY

Values for Shaping the U.S. Health Care System:
What Priorities Should Shape the Future?

Health care is an important concern for most people and is an important topic in our government at the national, state and local levels. We want to know your opinion of what should shape the future of the U.S. health care system. From the 15 items below, please select the five priorities that you believe should be shaping the future U.S. health care system. FIRST, PLEASE READ THROUGH ALL 15 OF THE ITEMS. THEN PICK YOUR TOP FIVE PRIORITIES IN ORDER OF IMPORTANCE.

1. My top priority is: _________

3. My next priority is: _________

2. My next priority is: _________

4. My next priority is: _________

5. My next priority is: _________

01 - Advances in research: The U.S. health care system should spend more money on research to prevent and treat health problems than it does now.

02 - Universal access: The U.S. health care system should make needed services available to all regardless of ability to pay.

03 - Build on the current system: The U.S. health care system should expand and improve on the current system — job-based insurance and public programs like Medicare and Medicaid.

04 - Comprehensive services: The U.S. health care system should provide access to a broad range of health care — prevention, emergency services, trauma, and care for on-going illnesses, as well as care for dental, vision and mental health problems, with the care provided and supported at the most appropriate facilities and locations, including the home.

05 - Consumer good: The U.S. health care system should treat health care like other goods and services; it should be available to the extent that you have money to buy it.

06 - Health care as a business: The U.S. health care system should allow health care businesses — such as hospitals, insurance, drug and supply companies — to make as much profit as they can within tax and other relevant regulations.

07 - Health care as a national concern: The U.S. health care system, like homeland security and interstate freeways, needs national planning and financing.

08 - Minimize the role of government: The U.S. health care system should reduce the role of government in financing health care (e.g., through Medicare, Medicaid and tax benefits) and providing health care (e.g., through public clinics and the Veterans' Administration).

09 - Patient choice: The U.S. health care system should give patients as full a choice of doctors and other providers, settings and treatments as possible.

10 - Prevention: The U.S. health care system should give priority to services and programs that promote health and keep people from getting sick, such as smoking prevention and nutrition/diet education, childhood immunizations and cancer screenings.

11 - Public participation: The U.S. health care system should have effective ways for the public to help set priorities for health care, influence decisions about important health care issues, and improve the health care system.

12 - Quality of health care: The U.S. health care system should have a more effective way of improving the quality of care and reducing medical mistakes.

13 - Spend health dollars for direct patient care: The U.S. health care system should spend as much as possible on direct patient care and as little as possible on administrative costs.

14 - Stable costs: The U.S. health care system should keep health care costs from rising faster than the costs of other goods and services.

15 - Uninterrupted care: The U.S. health care system should reduce to a minimum the need to change doctors, hospitals, insurance companies and levels of coverage.

1. Working individually, consider your reaction to the survey results. Compare your priorities with those of the group. What do you notice? What surprises you?

2. In small group discussions, create a dialogue in which each person shares an idea or two from his or her reflection on the survey results. As you listen to the conversation at your table, what do you notice?

3. To what extent does the current health care system reflect the priorities of the group?

4. What would need to happen for our current health care system to better reflect the priorities of the group?

Copyright © 2008 CHA. Permission granted to CHA-member organizations and Saint Louis University to copy and distribute for educational purposes. For reprint permission, contact Betty Crosby or call (314) 253-3490.