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Jeanne Andrews helps her mother, Dolores Hanson, 77, from her wheelchair to a chair in their living room after taking her outside for some fresh air. A self-employed medical transcriptionist, Andrews takes care of her mother, who has Alzheimer's and Lewy body dementia. Read Jeanne's story below. After you get past the competing signs, slogans and rhetorical flourishes ? "Universal Nightmare," "Keep Your Hands Out of My Wallet," "Medicare for All" ? the national debate over health care reform should be about people and their health care needs. When the sound and fury of the public meetings held in August die down and the work of crafting solutions revs up again, members of Congress should remember the individual faces at the town hall gatherings and focus on the problems that need to be solved in our health coverage system. Doing nothing is not an option. Our representatives in Washington also will have to find new ways to address the concerns and contradictions revealed during the August recess. Many people believe that offering a public health insurance option to small businesses and to individuals who don't get insurance through their employer will crowd out private insurance. Yet this country has all sorts of public-private hybrids that coexist ? public and private universities, public postal service and private delivery firms, and states have private workers' compensation insurance companies and public pools for those unable to get insurance in the private market. Older Americans, who were the predominant participants at town hall meetings in our region and across the country, receive Medicare, the public insurance plan that has covered the over-65 population since 1965. Ironically, they have been the most vocal in criticizing a public option. Young people, who make up the largest segment of the uninsured, have been largely absent from the public debates. Equally ironic is that many people attending the town hall meetings believe that when a public health plan such as Medicare refuses to pay for a procedure or medical service, it is "rationing," but when a private insurance company denies coverage it is something else altogether. But when you get down to how individuals actually experience the health care system in the United States, you can really see the core issues that need to be addressed. As Congress returns to Washington on Tuesday, the needs of the people should be its focus. At a town hall meeting in Jackson in late August, Dr. Bob Hartmann, Amador County's health officer and a physician in private practice, provided a good framework for a focused health care debate: ? The status quo is unacceptable. ? Reform must be as revenue-neutral as possible. ? We need more emphasis on primary care; our system is much more oriented to procedures and specialty care than in other countries. ? We need to train more physicians for rural areas. ? We need more support for public health, the safety net for the disadvantaged. ? We need to move toward electronic health records to provide better care. ? Members of Congress, the White House, the president's Cabinet members and their staff need to experience the same problems as other Americans with coverage, co-pays, denials and reimbursement. ? High-cost drugs are part of the problem. ? Insurance companies also are part of the problem, cherry-picking healthier patients, increasing co-pays, denying service and shifting costs. ? A public option is necessary for true health care reform. But vigorous debate is not an end in itself. Health care reform has been debated for more than 60 years in the United States. As President Harry Truman said in 1945, "Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health. Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection." Can Congress and the president deliver on the promise to pass health care legislation this year? They might follow the advice of President Lyndon B. Johnson, who successfully pressed for Medicare legislation over vocal opposition in 1965. He cautioned Congress not to "let it sit there like a lot of dead cats on the porch. Move it out." Jeanne Andrews, Roseville Jeanne is independently employed as a medical transcriptionist and takes care of her mother, Dolores Hanson, who has Alzheimer's, at home. Her wages have gone down as the market for medical transcription has changed. She buys health insurance through an independent Kaiser plan. But she says it is increasingly unaffordable at $520 a month. Eight years ago, she says, the cost was $320 a month. She's thankful, however, that she has insurance: "I'm in it, and I don't have to re-enroll." But, she adds, "I'm paying too much for my income. If I don't pay this month, I'm not covered." She'd like to see "alternate insurance for people like me who have to be independently insured." Jennifer Cerri, Elk Grove Jennifer had gotten a new job that included health insurance, and her family took the only health plan they could afford, at just under $500 a month. When their young daughter needed eye surgery, they learned that their share of the cost would be $8,000 of about $14,000 ? nearly 60 percent of the bill. "I burst into tears," she said. "I don't have that kind of money." They borrowed money from family, got a waiver from the surgeon and paid off the bill over a period of months. She says she still lives with the constant concern that if some unexpected health event comes up, it won't be covered. "We had health coverage, yet our health costs were prohibitive due to something beyond our control." Adrian Vidal, Granite Bay Adrian gets private insurance through his union. "It's never let me down," he said. He laments that out-of-pocket costs have gone up for co-pays and emergency room visits. But he gets "great care." He wants to see choices maintained. "I don't want just one plan. I don't want anyone rationing my care." Sondra Rogers, Fair Oaks Sondra receives health coverage through Medicare and is among the one-fifth of beneficiaries who have chosen a private plan through Medicare Advantage. "I'm very happy with what I have," she says. "I'd rather have an insurance company and doctor to deal with, not the government." She's concerned that if the health care system is reformed, costs could go up. Various proposals, for example, would end current subsidies to private insurers in Medicare Advantage and equalize payments between the private plans and traditional Medicare, providing some funds to cover uninsured Americans. "I don't want to pay for a national health care plan," she says. Paul and Kate Carroll, Rancho Cordova An executive with a global firm, Paul was laid off in January. Under federal law, workers can keep their health insurance when their job ends through COBRA, the Consolidated Omnibus Budget Reconciliation Act of 1986. Normally, they would have to pay the full premium, but Paul's company agreed to pay for eight of the 18 months of coverage the law requires. He'll have to pay the cost on his own for the remaining 10 months, which concerns him. "The full cost is quite high," he said. After that, "I have to find some other insurance." Kate left her job with a store in January to start her own interior decorating firm. Paul has started a small consulting firm. He has friends in other countries with universal health coverage and says, "The transition in other countries to small business or a nonprofit is not a concern for them." Paul and Kate are exploring independent personal coverage, various associations that provide a larger pool and bare-bones plans that cover "major medical" or catastrophic care. He'd like to be able to keep the physicians with whom he's built relationships, and he doesn't want to see his access or quality go down. He asks, "Why don't we have good, affordable coverage for everybody?" Del Surette, Citrus Heights Del has health insurance through his work, but costs have gone up. "We have a good health plan, but it's expensive. It costs me $11 an hour off my paycheck" ? $20,000 a year. He'd like to see better coverage for preventive care, complaining that his insurance "wouldn't pay for well-baby care." He also doesn't like that when he has billing issues, "You have to call and argue with a clerk" who has no medical background. He does not want to see a government-run system, but he doesn't object to a government-financed system: "I want what older people have ? Medicare." Alexandra Wallace, Fair Oaks Alexandra, sitting with her mother, Joan, is a student at UCLA working on a major in business and economics and a minor in film and TV. She's going into her sophomore year and plans to graduate in 2012. She's on her parents' health insurance, which they get through their work. Alexandra says that she's had multiple surgeries and has been very happy with her health plan. She says she's not worried about getting health coverage after college when she'll no longer be eligible for coverage through her parents' insurance. "I'll get insurance through an employer," she says. Dennis Wade, Fair Oaks Dennis has what he calls "relatively affordable" health coverage through his wife's employer. He'd like to see health insurance be more portable when people change jobs or start a business. But he fears that private options will disappear with the current proposals for health care reform. Erica Rhyne-Christensen, Sacramento Erica graduated from college last year and had been under her parents' insurance. When she turned 23, she had to start paying for her own insurance. She got a part-time job in food service, which doesn't provide health insurance. She was able to get a continuation plan through her parents' insurance, which costs her $403 a month, "pretty much all of my pay" she says. She tried to get cheaper insurance but couldn't. She has had chronic ear problems and needs to see a doctor every six months. She and her friends have payroll taxes taken out of their paychecks for the Social Security pensions and Medicare health benefits of older Americans, and she wonders why more retirees don't support a Medicare-type system for younger people. Brian McMillan, Sacramento Brian was homeless for 17 of the last 20 years, has serious medical problems and struggled with drug addiction. He could not get private insurance or qualify for Medi-Cal, the public health program for the poor, so he fell through the cracks. For years, he said, he'd end up in emergency rooms. Now he's part of a new program pioneered by Sutter, Sacramento and "The Effort" nonprofit to get him out of the emergency room and into housing and treatment. Jeannene Moore of Carmichael asks a question of U.S. Rep. Dan Lungren, R-Gold River, during a health care forum at Rancho Cordova City Hall on Aug. 26.