This guide provides a framework for study circles to use in discussing the health care crisis in the United States. The guide begins with a background section that gives an overview of the health care crisis; then it presents a two-part framework for discussion. Part 1 focuses on the ethical issues that underlie any policy decisions. It points out the hard efficiency, equity, justice, freedom from government interference, and individual autonomy. Part 2 focuses on proposed reforms, first by looking at ways in which some states have restructured their health care systems and then by examining three basic approaches for health care reform on the national level. Discussion centers on presenting the strengths and weaknesses of each approach and examining how any of the approaches can satisfy the goals discussed in Part 1. The material is designed for use in 1-2 discussion sessions of 2 hours each. The guide also includes sources of additional information, suggestions for leading this discussion on health care, guidelines for leading a study circle, suggestions for participants, and a follow-up form. (KC)