DEARBORN, Mich. — “We have an economic crisis and one of the primary reasons is health care. We cannot afford not to reform,” Melody Barnes, director of President Obama’s Domestic Policy Council, told a White House regional health reform forum here March 12.

Moderated by Barnes and the governors of Michigan and Wisconsin, it was the first of five such forums around the country.

A dramatic came moment came early in the meeting when Adrian Campbell Montgomery, 26, spoke of her bout with cervical cancer four years ago and the denial of payment by BlueCross BlueShield (her insurer through her husband’s General Motors plan). “Have to stop denying people” she declared.

Her testimony came soon after Michigan BlueCross BlueShield CEO Dan Loepp described the insurance giant as a nonprofit provider.

She said the ensuing debt forced her to work full time while going to school in addition to being a mother of a small child. In the meantime her husband has lost his job, she has no insurance and she is battling a new diagnosis: ovarian cancer.

Sister Mary Ellen Howard, from Detroit’s St. Francis Cabrini Church, which runs the nation’s oldest free clinic, stood up and demanded, “Who is going to help this woman?”

At that point, Mike Duggan, CEO of the Detroit Medical Center, stood and said he would see that care was given. But it was clear to all that, if not for the presence of the press, TV cameras and hundreds of witnesses, this young woman would be on her own.

Suggestions came fast and furious throughout the forum.

“Why does health care have to be linked to a job?” asked emergency room doctor Jim Michener. “If you lose your job, you don’t lose your auto insurance or your life insurance.” And a later speaker pointed out, “A good job doesn’t mean anything any more. Serious illness can wipe people out.”

Wouldn’t it be great if the first question asked is “how can we help, not what is your insurance?” said American Postal Workers Union leader Paul Felton. “I understand the political realities but why not start out with the best, Medicare for all via HR 676?” he asked, referring to the “Medicare for All” bill introduced by Rep. John Conyers (D-Mich.).

“Doctors are the ones who should have control over medical care, not insurance companies,” said Claudia Fagan, a doctor from Illinois. “I went to school for a long time” to acquire medical training, she added.

Sitting in the audience was Jay Kommareddi, a volunteer board member of the Genesee County free health care clinic in Flint, Mich. She said she believed “health care should be a right, not a privilege,” and was “thrilled” that this conversation on fixing health care is finally taking place.

Kommareddi said her clinic was “never intended to take care of the really sick,” but with Flint devastated by the collapse of the auto industry, the clinic is now seeing patients with major illness like cancer.

“We can’t advertise because we’d be overrun,” she said.

People lacking insurance are going to great lengths to avoid going to a doctor. One man came to the clinic with a tooth hurting after he had used a wrench to try and remove it.

Kommareddi’s husband is a primary care physician, one of a dwindling number of such providers, she noted. Primary care doctors, who coordinate and oversee a patient’s care, are essential, but their workload is high, medical school debt is monumental and reimbursements are so low that students opt to become specialists to make money. “Doctors get money for doing procedures, not for sitting with a patient,” she commented.

Speaking of her clinic and the scale of the problems a city like Flint faces, she said, “You do need government help. There is only so much we can do ourselves.”

At the opening of the forum, Rep. Conyers told the participants, “One of the most important things the president has done is the way he’s gone about this — he wants your thinking.”

“We’ve never had a president say: keep advising him,” Conyers said.

The consensus here — insurance CEOs being the exception — that what is needed is a system that is not employer-based, covers all from cradle to grave, puts prevention and wellness first, and does not deny coverage for prior conditions. Many speakers mentioned Conyers’ HR 676 bill as the best.

Michigan Gov. Jennifer Granholm noted that the cost of employer-based health care is part of the auto industry’s woes, pointing out that embedded in every car’s price tag is a $1,200 to $1,600 health care premium.

The forum made it clear that change is coming to our health care system. The depth of that change will be determined by people getting involved in the process as they did here March 12.