With all the sturm and drang of health systems reform, real opportunities for the wider public, experts and policymakers to engage in collaboration are missing. This wiki is a design-wiki, offering people the opportunity to establish the framework, issues, priorities and developments that would help define a health system that people will be happy to pay for and value.

Now that public finances are really going to take a hit over the next few years, and perhaps for many more to come, current levels of public financing of health care are likely to come under considerable stress. The issue is whether this will trigger a review of how health systems work. This thinking, though, will challenge much of the health policy research and thinking that has been done to date, as many basic assumptions about the priority within public financing of healthcare may be replaced as other sectors appear more needful -- between bailing out banks, paying to keep auto companies afloat and generally dealing with dropping tax revenues and rising unemployment.