SAM DEAN The Roanoke Times

Ken King, leader of the Citizens Coalition for Responsible Healthcare, listens to the concerns of an attendee at a meeting Tuesday. The coalition discussed how to improve the way health care is paid for.

Continued frustration over the complexities of the financial side of the health care system was the main focus of a meeting held by a local coalition formed over concerns about Carilion Clinic's business practices.

But the Citizens Coalition for Responsible Healthcare didn't draw anywhere near the 400 people who attended its first gathering in early September.

During the coalition's second public meeting Tuesday night, about 60 people gathered to discuss ways to improve how health care is paid for and delivered.

"We are on our own and we're going to have to grow this from the bottom up," said coalition president Ken King. "I think the people who came here are the ones who are really serious and concerned about this."

King said the coalition's membership, those who pay dues, has grown to 77 people.

The coalition leadership used the meeting to further outline its broad goals for addressing concerns with the local and national health care systems, while continuing to highlight its criticisms of Carilion's business practices.

Several people shared stories about difficulties they have faced with health care payments. Two people spoke about not being able to pay large medical bills owed to Carilion and not qualifying for reductions in payment.

Much of the discussion focused on the price for care and the discrepancy between a hospital charge and what an insurance company actually pays for a particular service.

"If you don't have insurance, you pay top dollar because you don't have someone negotiating for you," King said. "When we know what the price is we can compare, and once we can compare we can choose. And when we can choose we are no longer in the dark. As long as we are in the dark, we are paying far more than we should be."

Lewis Hopkins said that because he has insurance with a $5,000 deductible he wanted to be able to price medical care like he could when shopping around for other purchases. But, he said, he couldn't get straight answers from providers.

"I think these stories are enlightening and I think they are the good if it brings us together to do something to change the system," said Sandra Meador, one of the coalition's active members.

The coalition unveiled six goals, including asking that all medical service providers supply itemized bills for services and making lists of charges available to the public.

While soliciting ideas on how to improve responsible health care, King listed seven proposals that the coalition would like to see implemented.

These included establishing a written agreement for referrals that is not limited just to one provider. Carilion has said it is establishing referral agreements with its employed staff, but the coalition would like to see this go beyond just one entity and encompass all those involved with the Medical Society of Virginia.

"We know we have a broken system," King said. "Our aim and goals are to try and do something to fix it."