Grass roots participation in health care reform

Concerned citizens have responded to the health care crisis by developing the health decisions movement. American Health Decisions, a national consortium of 21 state organizations, leads a grass roots discussion network of community meetings committed to education and consensus on the ethical, technologic, legal, and economic issues (the tough issues) of health policy. The movement (with its stages of development, structure, process, and accomplishments) is described, and potential roles for physician cooperation and participation in forging functional, community-based health policy are delineated.