The panel included Geisel School of Medicine professor Elliott Fisher, National Center for Policy Analysis Chief Executive Officer John Goodman and Patrice Harris, a trustee of the American Medical Association and director of Health Services for Fulton County, Ga. Ellen Meara, a professor at The Dartmouth Institute, moderated the debate.
The forum aimed to evaluate "whether and how existing and proposed reforms improve quality and access to care for the nation's most vulnerable populations," Meara said.
The panelists began by introducing their positions on health care reform. Fisher spoke about his work on accountable care organizations, which reward providers for delivering effective care while decreasing costs. These organizations, he said, will effectively address the challenges of health care by promoting flexibility, creativity and partnership throughout the health care system.
Goodman advocated a "free market" approach to health care policy. Government regulations lead to the suppression of the health care market, causing inflated costs and failing to reward doctors for providing efficient care, he said.
"If you're really serious about changing the health care system, you need to liberate the doctor, the patient, the entrepreneur," he said.
Harris discussed how her background as the director of Fulton County Health Services gave her insight into how the health care bureaucracy inhibits communication and prevents uninsured and underinsured patients from accessing effective care. One solution, she said, is to focus on developing a "uniquely American" approach that addresses the social causes of health care disparity.
"We need to move from more treatment focus to a prevention focus," she said.
The debate's most contentious issue was the 2010 Affordable Health Care Act, with disagreement stemming from an ideological divide over whether the government or individual doctors should be responsible for improving care.
Goodman criticized the law's top-down approach, saying that the government's role in health care should be to reward physicians for creative solutions and to let market economics take care of the rest.
"Price competition sparks quality competition," he said.
Harris and Fisher, however, praised the act for protecting underserved patients, especially those on Medicare, Medicaid and without insurance.
Although the plan "isn't perfect," it represents progress for the most vulnerable populations, Harris said.
Goodman and Fisher also challenged Harris' support for AMA policies, saying that protecting physician salaries should not be a priority at this stage of health care reform.
Salman Rajput '14, who attended the forum, commented on how the complicated ideological approaches to health care reform ultimately reflect a simple goal.
"Something that isn't complex is the suffering that people go through at the hands of a fragmented system," he said. "The people who are most impacted have the least access to learn about the problem."
The forum, which took place Thursday evening in Spaulding Auditorium, was organized by Jaya Batra '13 and Vaidehi Mujumdar '13, who chose the topic of health care due to its national prominence in the media and the problems aggravated by the current system, according to Batra.
One goal of the forum was to expose students to the wide-ranging approaches to the health care issue, Batra said.
"We want to bring experts from different backgrounds and from different ideas but experts in their area to Dartmouth so we can get all the information and so that we as students can make thoughtful, informed decisions," she said.
Rajput said that the debate gave him insight into the difficulty of balancing the role of government and the private sector.
"The breadth of perspectives reflects how dynamic and messy this problem we're facing is and how different approaches and ideologies color how we talk about the problem," he said.
Batra and Mujumdar wanted the forum to take place outside the umbrella of the College administration so that they could invite more controversial speakers, according to Batra. Batra said the College would not have invited Goodman to speak because of his past criticism of the Dartmouth Atlas project.
"The fact that it's a student organization gives the event some sense of autonomy and the freedom to invite speakers the administration wouldn't," she said.
Batra said that she created the Ad Fontes Forum last year to spark a dialogue among students about prominent national issues and promote informed debate on subjects often simplified in media portrayals.
"We're not saying we're going to solve health care reform in one sitting, but we can spark a conversation and get people talking about this and engaged in a thoughtful and informed way," she said.
The event was co-sponsored by the Office of the Provost, the Office of the Dean of Faculty, the Dartmouth Center for Health Care Delivery Science and the Rockefeller Center.
The forum cost about $11,500 to organize, with most of the funding allocated to bring speakers from across the country to participate in the forum, according to Batra.
