Amit Ai Etzioni

PREAMBLE We seek to understand and control the forces that govern our lives, to participate in shaping our futures. We are no longer confident that specialists and administrators-the staff of our social institutions-will govern them wisely and justly without our participation. Health services cannot be excluded from the demand for greater public accountability and participation. Health is too important to be left solely to doctors and to hospital administrators. We must find new ways to inform ourselves and to take part in the government of our hospitals, clinics, and public health departments, as well as in the regulation of medical researchers and practitioners and all others entrusted with the government of our body. While greater public accountability and participation are not a cure-all for the present complex health crisis, they are vital elements in its treatment and in the prevention of new problems. 4. Research assistants, information analysts, and computers should be made available to the CHP boards for independent review of data submitted by health providers. 5. Consumer representatives should be paid at the same rate as doctors serving on the boards. 6. Consumer representatives like those on the boards of CHPs should be placed on all boards or councils that regulate or finance health services, from Medicaid to Medicare to those of private or not-for-profit health insurance corporations. 7. Consumer representatives should be elected by the citizens of the areas they serve in biannual elections that coincide with congressional elections. 8. The Department of Public Health should negotiate with schools ot public health, medical schools, community colleges, and others to secure adult education opportunities for citizens who wish to acquire the necessary background to become consumer representatives. HEALTH GOVERNMENT The federal, state, and local governments, health administrators, and health "providers" and insurers have been unable to curb skyrocketing medical costs, secure quality service, or provide care that is comprehensive, preventive, and In addition to involving citizens in all agencies that oversee the expenditures of health units and systems, citizens should be represented in the new organizational bodies that are being set up to supervise the medical practices of hospitals.