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HELENA - As part of a grass-roots effort to reform health care, Montanans are sending ideas to President-elect Barack Obama - and so far, many are saying that a national "Medicare for all" system is the way to go.

"The consensus of (our group) was that we did not see a lot of change coming unless we went to a single-payer, universal health system," said Deborah Hanson of Miles City, who organized a meeting of local citizens at the behest of Obama's transition team. "That was sort of a general consensus - knowing, of course, that may not happen."

The Miles City meeting, held Dec. 21 at Hanson's home, was one of several in Montana and thousands held across the nation during the last two weeks of December.

Obama's designated secretary of Health and Human Services, former U.S. Sen. Tom Daschle of South Dakota, asked that Obama supporters hold local health care community discussions nationwide to gauge the problems that people see with America's health care system and how they'd like to reform it.

The feedback will be compiled in a report delivered to Obama and "will help shape the health care reform process," an official with his transition team said last week.

A Medicare-for-all system, also referred to as a single-payer system, would offer health coverage for all Americans, funded largely by some sort of broad-based tax.

Citizens would choose their own doctor and caregivers, and bills would be paid by the national plan.

Obama has not proposed such a reform and said he probably wouldn't support it. U.S. Sen. Max Baucus, D-Mont., who has proposed wide-ranging health reforms, has said a single-payer system is "off the table" for consideration.

Both Obama and Baucus have said they support reforms that maintain America's system of private health insurance provided by employers, along with publicly funded programs like Medicare for the elderly and Medicaid for the poor.

But at several of the Montana health care meetings held in conjunction with the Obama transition team, attendees said a Medicare-style program should extend to everyone.

The Gazette State Bureau spoke with organizers of meetings in Missoula, Bozeman, Helena and Miles City. At three of the meetings, attendees agreed that a national single-payer system is most likely to solve problems with the current system, such as lack of coverage for many, lack of access to care, lack of preventive care and high costs.

In Helena, attendees said the biggest problem with the current system is its reliance on private health insurance through employers.

Marshall Mayer, an Internet marketer who organized the Dec. 28 meeting attended by 25 people, said small-business owners said they shouldn't have to shop for health coverage for their employees, especially as it's becoming more unaffordable.

"They really felt strongly about that," he said. "They said, 'I don't want to be put in this position. I want to do my own business.' "

"Paying into a public pool, such as Medicare (for all), is the much-preferred route," the group's report to Obama said. "No one in our group opposed paying more taxes in exchange for access to a quality health care system."

In Missoula, only four people attended a meeting organized by retired urologist Roger Munro, although three of them, including Munro, were physicians or retired physicians.

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Munro said he was surprised that his group agreed that a single-payer system is the only reform that tackles "all sides of the problem: access, cost and administrative efficiency."

He also said group members wondered how to convince Baucus that single-payer should not be "off the table."

The group in Bozeman, organized by retired physician Richard Damon, did not come to a consensus on reforms, but employer-based insurance was not very well-received among those at the meeting, Damon said.

Hanson said 15 people attended the meeting at her and her husband Terry's home in Miles City, some of them health care professionals and most of them Democrats.

Putting bandages on the system isn't really fixing it, her group members felt, and health insurance should not be tied to where you work or whether you work, she said.

Hanson works at her husband's law office and they own and manage some rental property in Miles City. She said they pay $12,000 a year for health insurance, with a $2,500 deductible.

Yet while the group felt some form of national health insurance is the way to go, it must be paired with strong initiatives for prevention, to push people to lead healthier lifestyles and impose lower costs on the system, she added.

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