COOS BAY — The question wasn’t if or why, but how to reform Oregon’s health care system at the Oregon Health Forum’s community meeting Tuesday night at Southwestern Oregon Community College.

About 40 Bay Area residents gathered to participate in the discussion, which was just one stop in “Your Oregon, Your Health” series of 14 community forums throughout the state.

“Through these 14 meetings we hope we get to hear what is important to you,” said William Thorndike Jr., chairman of the Oregon Health Fund Board.

The board was created by the Healthy Oregon Act passed by the state Legislature in 2007 to offer recommendations for reforming the state’s health care system in the 2009 Oregon legislative session.

Tuesday’s discussion wasn’t just about the concept of universal health care, as much as how to make such a system work.

For many in attendance, private insurance companies were not part of the equation. Several people in blamed insurance companies high insurance rates that cost more than individuals and employers could afford. Renee Menkens, a nursing instructor at Southwestern Oregon Community College, suggested the state should give private insurance companies a little competition.

“Why can’t private insurance vie for business with the state?” she asked.

Many at the meeting were in favor of a hybrid system. They wanted the state to offer a basic plan to all Oregonians, regardless of ability to pay. Those who could afford to would have the option of purchasing more coverage.

That brought up the concern over who would pay for the system.

 Menkens was in favor of a system where all people pay to the extent they can afford, but was afraid low-income individuals and small businesses would have to pay too much.

“I like the concept of a sliding scale,” Menkens said.

That was a popular option, but as the conversation turned to how a reformed health care system should be paid for, people didn’t quite see eye-to-eye.

“People on (the bottom) tier go to the doctor and they are treated differently,” Myrtle Point resident Patt Ciccarelli said.

Some suggested raising taxes or implementing more or higher sin taxes — and a few brave individuals suggested the “s” — sales — tax word.

Others believed there was room for streamlining health care administration to save money and make a universal system less expensive to manage.

“Hospitals, primary care providers should be looking at ways of shrinking the cost of health care,” Menkens said.

Money could very well be the biggest hurdle to implementing any reforms.

State Sen. Joanne Verger said health care reform is at the top everybody’s to-do list.

“The problem is how do you pay for it,” Verger said. “It will be another discussion ... and one of the number one concerns of everyone.”

The Oregon Health Fund board will consolidate the suggestions offered at the statewide forums into a set of goals in August. The board then will hold a series of public hearings in September to review and refine the findings before presenting them to the state legislature in the 2009 session.