Rebuilding a broken health care system was a sentiment echoed by many during a forum last Monday at the Northwestern Memorial Hospital. A group of panelists and concerned Chicagoans filled the Pritzker Auditorium to discuss an issue that touches every American.

The town hall meeting, moderated by U.S. Rep. Danny Davis, addressed the inherent problem of lack of access to health care – a key problem for various health organizations in Chicago.

“The system is so broken that you cannot expect to fix it, you have to rebuild it,” said Eleana Butkus, vice president of the Illinois Hospital Association, of the present state of American health care. “What we have is a sick-care system. The system looks at treatment and diagnosis as opposed to a health care system.”

Although there are several “musts” for improving the status of healthcare in America, the participants noted that the goals are common. The priority is to provide health care to those without it, and for those with it, to make it more affordable. The issues of access and affordability plague many minorities as disparities continue to exist between African-Americans, Latinos and other races.

According to statistics from the National Center on Minority Health and Health Disparities and the Kaiser Family Foundation, between 45 million and 47 million Americans have no health insurance.

At the heart of doctors’ and hospitals’ inability to provide quality health care are pharmacy benefit managers, according to J. Michael Patton, executive director of the Illinois Pharmacists Association,.

Pharmacy benefit managers are third-parties involved in prescription drug programs and these entities are primarily responsible for paying prescription drug claims.

“Let’s look at health care top to bottom,” said Patton. “But especially these out-of-control pharmacy benefit managers. They have no essence of health care whatsoever. They negotiate, negotiate, negotiate.”

Although Patton doesn’t predict the large chains will close. But because of this problem, he believes these benefit managers could cause independent pharmacies to close and large chains to ignore underserved neighborhoods.

Susan Hayes of Pharmacy Outcomes Specialists, an Illinois-based pharmacy consulting firm, shared this grim forecast.

“It (the health care system) needs some level of reform,” she said. “At some point, a decision about whether they are going to raise everyone’s co-pay or not cover a patient’s really expensive-but needed-drugs will have to be made.”

Another important concern the participants noted is violence.

“Teen violence is an epidemic,” said Sidney Weissman, professor of psychiatry at the Feinberg School of Medicine at Northwestern University, adding that violence impacts health in ways that reach far beyond dealing with an immediate injury.

Weissman and others, such as Chicago resident William Davis, expressed concern that as violence rises in many Chicago neighborhoods, opportunities for families to practice healthy habits – like walking or jogging – will be lost.

The panelists addressed solutions to the overall health care problem, such as a single-payer reform, where the government becomes the primary subsidizer of insurance for all citizens. This, some argued, would eliminate the need for individuals and employers to negotiate with private insurance companies.

“Single-payer is the most prudent thing on the table if we have a criterion of universal coverage,” said Quentin Young, co-founder of the Health and Medicine Policy Research Group.

The Chicago-based advisory group advocates a single-payer system.

“The private system is based on investment and it doesn’t have the health status of people in mind,” said Young.

But some, like Butkus, opposes single-payer plans.

Butkus maintained that getting rid of all insurance companies and for-profit health care would mean building an entirely new system. This transition period is where potential problems could arise.

“The question then becomes, as insurance companies go away, who is going to provide the access and the assurance to the population that you are truly going to be getting health care in that interim time period?”

As this discussion about health care reform rages on, according to Weissman, one variable remains constant: need. “Whatever model we follow, the quality and availability must be equal and that is not the case today.”