06/13/2009 05:12 am ET | Updated Nov 17, 2011

Voters Need More Substance on Health Care Reform

Access to quality, affordable health care is fundamental if Americans are to live healthier, longer, more independent lives. Many health policy experts are hard at work on various proposals to address problems in our current system, and that is good news.

But outside the beltway, a critical need is emerging that goes hand in glove with reform efforts: our health care reform debate has become an exercise of illustrating extremes, rather than a thoughtful conversation about the spectrum of solutions or the trade-offs required.

If the outcome is to be more successful than the last time the nation took on large-scale health care reform, it is time to extend the discussion out of Washington and engage the public about the options for change and what they mean.

A nationwide survey released today by the Stanford Center on Longevity shows that when reform proposals and trade-offs are clearly articulated, the voting public understands the issues and raises legitimate concerns.

The Stanford survey, developed by a bipartisan group of health economists and political and policy experts, asked voters to consider six policy proposals that could increase access and reduce the cost of health care, two objectives voters rank at the top of health care priorities. The proposals were described in general terms, along with the advantages and disadvantages of each.

Voter viewpoints were thus measured not in the abstract as simply "pro" or "con", but instead, in terms of the trade-offs and compromises entailed in pursuing various reforms. The average respondent spent almost an hour absorbing the information and offering informed feedback.

Voters voice great concern about both access and cost. Democratic respondents are relatively more concerned than Republicans about universal access to health care; Republicans are relatively more concerned than Democrats about cost. But, there is bipartisan concern about both.

While voters rated health reform as a very high priority, they did not form a consensus around any one of the six proposals, expressing instead ambivalence as they weighed the tradeoffs involved in the implementation of each. Notably, none of the six proposals are clearly rejected outright either. Instead the findings reflect voters' willingness to engage in a serious and substantive way on the topic of health care reform and their desire for more detailed information.

Champions of reform must bring the public along with them in their quest to improve the system.

Leaders in all sectors of the discussion - members of Congress, policymakers, consumers, providers, businesses, insurers, patient advocates - must help raise the level of conversation to an honest, straightforward exchange about the system and what change will mean to individuals.

The Stanford survey discussion tool is available online, so any interested voter can participate and policymakers or advocates can access it as an aid for discussion.

Health policy is inextricably linked to how well we age as a nation. To the extent that long-lived people are physically fit, mentally sharp, and financially secure, societies will thrive. This debate is too important to resort to sound bites.

Dr. Carstensen is the Fairleigh S. Dickinson Jr. Professor in Public Policy, a Professor of Psychology, and Director of Stanford University's Center on Longevity