BURLINGTON, Vt. - A retiree from Concord, N.H., spoke of the agony of having to beg a foundation for money to help her afford the drug she needs to stay alive.
The head of a Cape Cod medical supply company wanted to know how much emphasis the Obama administration would place on home healthcare.
A nurse recounted the successes of a program in Vermont that helps patients with chronic diseases take better care of themselves by exercising, getting the right medications, and eating properly.
"I think there should be more of me," Mitya Schoppe, a chronic care coordinator in Lyndon, Vt., said with a laugh.
The White House, seeking to engender political support for a healthcare overhaul later this year, brought its traveling health policy forum to New England yesterday. Governor Jim Douglas of Vermont, a Republican, and Governor Deval Patrick of Massachusetts, a Democrat, co-hosted a forum with about 400 people on the frontlines of healthcare about how to make sweeping changes to the existing system.
The free-flowing and often passionate conversation, which lasted two hours, was far more detailed and lively than the relatively formal one held at the White House earlier this month. The doctors, patients, business people, and government officials repeatedly emphasized similar themes: the need to prevent and manage chronic disease better, attract more primary care doctors, simplify bureaucracy, and find a way to get everyone access to treatment at an affordable price.
But the point of the forum was not so much to give the White House a pipeline for new ideas - though President Obama's staff has been studying the Vermont and Massachusetts health systems closely. Rather, the goal was to help set the stage politically for what Obama has promised: to make significant changes to the existing healthcare system.
Yesterday's forum allowed two governors from opposing parties - both Obama allies in charge of states that have undertaken bold experiments in healthcare - to act as cheerleaders for the White House effort.
"The time is now," Patrick said at the end of the forum. "The movement is happening."
"I believe by working together we can accomplish a goal that's . . . an economic and fiscal imperative for the future of our country," Douglas said.
After the forum, Nancy-Ann DeParle, the point person for healthcare reform at the White House, said the two governors' participation served a significant political goal.
"There has to be support for the direction our leaders are trying to take us," she said. "You have two governors here who have figured that out."
The Obama administration is also trying to project a sense that it is aggressively soliciting public opinion as part of an "open, inclusive, and transparent process," as White House aides put it - even though, for the moment at least, the bills being written in Washington are being assembled privately by congressional leaders.
The Obama White House is trying to collect public feedback in a more organized and consolidated way than the Clinton administration did 15 years ago, when Hillary Rodham Clinton drew criticism for the amount of time she spent in sessions across the country. Late last year, as he was preparing to take office, Obama invited volunteers to hold community discussions about healthcare and created a website to invite further comment. The White House is asking for additional feedback through www.healthreform.gov.
Yesterday, presaging what is likely to be a sharp debate within the Democratic Party in the coming months, a good share of the crowd in this liberal state - as well as about 200 protesters outside - enthusiastically cheered for Canadian-style government-run healthcare, or at least an option to buy into a public insurance plan like Medicare.
Obama has said it is not politically feasible to get rid of private insurers, but in his campaign he proposed letting people choose to buy into a public insurance option - something insurers view as potentially fatal to their business.
Deborah Richter, a Vermont physician and advocate of a Medicare-for-all style system, said the country can no longer afford to squander precious healthcare dollars on administrative hassles associated with private insurance. If everyone is "deemed worthy" of insurance, then the government should come up with a single benefits package for everyone. "Why would we even need private insurance?" she said.
Patrick, serving as referee, gently suggested that the landmark 2006 Massachusetts healthcare law might offer a different route to the same goal.
"In Massachusetts, the only debate we used to have, for decades, . . . was: 'What's a perfect solution?' And if we can't get to that, nothing is worth trying," Patrick said.
Massachusetts eventually settled on a kind of hybrid solution that has expanded existing public programs and uses a combination of market reforms, regulations, and subsidies to help lower-income people afford private insurance.
DeParle asked how many people at the forum were uninsured. Only a couple of people raised their hands. The problem with a Medicare-for-all style system, she said, is that most people already have insurance and they just want it to cost less - but they're basically satisfied.
"They're worried about a disruption, they're worried about a big change," she said.