The lengthy list of suggestions that Nancy-Ann DeParle, director of the White House Office of Health Reform, will take back to President Barack Obama from the Regional White House Forum on Health Reform on March 17 at the Davis Center shows the complexity of trying to fix a health care system that everyone agreed is in need of an overhaul.

The size and scope of the overhaul was a different matter, as proposals (presented by some of the 400 people from around the Northeast invited to attend the second of five town hall-style events across the country) ranged from a slight tweaking to a government-financed, single-payer system. Despite differing opinions among the crowd of doctors, nurses, legislators, insurance providers, policy experts, business owners, educators and patients, there was consensus that everyone should be covered. Most of the discussion that followed fell into one of six categories: accessibility; prevention and wellness; universal coverage; quality; simplification of the system; and cost.

Sandra Burt from Concord, N.H. came to the forum to share her story, which served as an example of how the current system fails many Americans. Burt, who has an autoimmune disorder and needs medication that costs $2,730 a month to stay alive, lost her health insurance last year at age 65 when she was laid off from the company she was employed by for 40 years. Her husband, who has cancer, sold his truck to help pay for her medications while she's spent her time pleading with foundations for money to pay for them. "I don't think it's right," she said. "I worked for 47 years. I have five grandchildren. I'm active. I want to live."

Massachusetts Gov. Deval Patrick, who co-hosted the forum with Gov. Jim Douglas, said reforms in his state that have resulted in a 97 percent coverage rate never would have happened without key stakeholders from the private and public sectors coming to the table to form a broad coalition committed to covering everyone. He said there's been a mindset that there are only two choices: "the perfection solution and no solution at all. Is there one way?" he asked.

The crowd of about 150 single-payer advocates rallying outside the Davis Center made it clear that a government-funded health care system like Canada's and some European countries who spend less money and have better health outcomes is the perfect system. Inside, Gov. Patrick not only brought up the issue, he pressed for more discussion on it. Dr. Deb Richter, a Montpelier family physician and single-payer advocate, said the multitude of programs created to deal with escalating health care costs don't save the system any money. "Why don't we just say, 'everybody in one system,' and pay for it through taxes?"

Although Richter said she didn't see the need for private insurance, others said they liked the idea of a hybrid system where a government-financed option was available to everyone as well as a private one for those willing and able to pay for it. Gov. Douglas said a handful of major fiscal issues related to health care costs must first be addressed. He pointed to the fact that 75 percent of the total cost of health care is spent on chronic care and that senior citizens in Vermont — the second oldest state in the nation — spend the majority of their health care dollars in the last few years of their life.

Vermont, Massachusetts plans held up as leading models

A large portion of the forum focused on the successes of the health care plans in Vermont and Massachusetts. DeParle said both Patrick and Douglas should be commended for "moving off the dime" and helping implement plans that show outside-the-box thinking while meeting the ultimate goal of affordable and accessible health care. Vermont has been identified as a key state by the Obama administration for some of its innovative health care initiatives such as Blueprint for Health and Catamount Health.

No one sounded under the illusion that either state has the problem solved. Martha Ahmed, a nurse at Fletcher Allen Health Care, said rising health care costs have forced patients to neglect medical problems — often times until it's too late. Ian Byock, director of palliative care at Dartmouth-Hitchcock, said that when a new system is being considered the focus needs to be on "people not patients." UVM senior Bronwyn Fleming-Jones wanted to know how a new plan would address her needs as a young person in need of health care following graduation.

Rev. Rev. Hurman E. Hamilton, Jr., a founding leader of the Greater Boston Interfaith organization and senior pastor of Roxbury Presbyterian Church, closed the forum with a story about an elderly woman his organization helped get health care coverage after 17 years without it. A visit to the doctor's office for a sinus attack revealed a tumor that was soon removed. When Hamilton visited her in the hospital she whispered in his ear, "Thanks." "This is what health care reform is all about," he said. "We're talking about saving people's lives."

Watch the video from the forum: