On June 29th and 30th, 2009, the Center for Rural Affairs health care forums in Hillsboro, Harvey and Mandan and policy trainings in Mandan and Hillsboro. The discussions were engaging and informative for the CFRA organizers who were there. Below is a prioritized list of the answers people gave when we asked the question, "If your legislators were here, what would be your top two priorities for health care reform that you would want to tell them?"

Mandan, ND - June 29th, 2009

• 22 people attended community forum
• 7 stayed for policy training

Issues that participants prioritized (in order of priority, bold had 4 or more people making similar points):

• Affordability - A strong emphasis at this meeting on whether people can afford health care and health insurance
• Accessibility - Rural people need primary care doctors in their communities and access to other needed services like mental health without having to travel long distances
• Public Health Insurance Option - North Dakota needs the choice of a public health insurance option to compete against Blue Cross Blue Shield of North Dakota, which controls 88% of the state's health insurance market currently.
• Home Health Care Providers - More home health care providers are needed, allowing elderly to stay in their homes saves on health care costs and improves quality of life. 
• Reimbursement Reform - We need to reform reimbursement rates for both public (Medicare and Medicaid) and private health insurance plans to reestablish geographic fairness and to attract new practitioners to rural areas. 
• Dental Health Care - We need more dentists in rural areas, especially on Indian Reservations. 
• Preventative Care - Access to preventative care needs to be improved.  Additional patient education to improve attitudes about disease prevention and healthy lifestyles is needed. 

Harvey, ND - June 30th, 2009

• 25 people attended

Issues that participants prioritized (in order of priority, bold had 5 or more people making similar points):

• Mental Health Care - Access to quality, affordable mental health care is needed in rural areas. 
• Prevention - There needs to be a focus on disease prevention, not just treatment.
• Accessibility - Participants emphasized that everyone should have access to doctors in or close to their communities.
• Third-Party Involvement in Health Care Decisions - Neither insurance companies nor the government should be involved in patient treatment or profit from the denial of care.
• Affordability - Again, a strong emphasis at this meeting on whether people can afford health care, prescription drugs and health insurance.
• Universal coverage - Single-payer health insurance that covers everyone.
• Recruitment - With an aging rural population and the rising age health care practitioners, more should be done to train people as doctors, nurses, etc.
• Public Health Insurance Option - North Dakota needs a public health insurance option to provide an affordable option for rural communities.
• Home health care - More home health care providers are needed, allowing elderly to stay in their homes saves on health care costs and improves quality of life.
• North Dakotans need increased access to health savings accounts.
• Food Systems - Relationship between food systems and human health. 

Hillsboro, ND - June 30th, 2009

• 25 people attended
• 11 stayed for policy training

Issues that participants prioritized (in order of priority, bold had 6 or more people making similar points):

• Accessibility - Rural people need primary care doctors in their communities and access to other needed services like urgent care without having to travel long distances
• Affordability - A common refrain, this meeting again had a strong emphasis on people's ability to afford health care, prescription drugs and health insurance.
• Workforce - More should be done to "grow our own" rural health care providers 
• Public Health Insurance Option - North Dakota needs a public health insurance option to provide an affordable option for rural communities.
• Preventative Care - Access to preventative care needs to be improved. Participants also brought up both personal and corporate accountability, with an emphasis on outcomes.
• Reimbursement Reform - We need to reform reimbursement rates for both public (Medicare and Medicaid) and private health insurance plans to attract new practitioners to rural areas. 
• Universal coverage - Single-payer health insurance that covers everyone.
• Third-Party Involvement in Health Care Decisions - Neither insurance companies nor the government should be involved in patient treatment or profit from the denial of care.
• Home health care - More home health care providers are needed, allowing elderly to stay in their homes saves on health care costs and improves quality of life.
• Health Care Information Technology - Rural communities need increased access to tele-health care while maintaining strict privacy standards.