When 1,700 Western New Yorkers were questioned by local health care reformers, their top concerns centered around how they are treated by medical professionals and how to get broader access to care.

In Washington, the top concern is how to pay for changes in a system that consumes an astounding 17 percent of gross domestic product—far more than any competitor nation—without covering everyone and with no commensurate benefit for the extra money.

That disconnect underlines the health care crisis of 2009, where patients worry about quality, politicians worry about costs, and conservatives try to use both concerns to kill reform—again.

That’s why it’s noteworthy that controlling costs was not among the top five concerns that came out of 114 community meetings to hear what Western New Yorkers want.

That may be because many on public programs or who have good employer coverage don’t feel costs very directly, said Ann F. Monroe, president of the Community Health Foundation of Western and Central New York, one of the organizers of this unprecedented project.

But Monroe said it also may be that Western New Yorkers recognize there is —or at least should be—a relationship between cost and value, and they’re focusing on the latter.

“We’re not getting the value out of the system,” she said.

For instance, fewer than two-thirds said they could get urgent care as soon as they thought they needed it, and barely half said it’s easy to see specialists. Monroe said that if consumers thought they were getting more value, “cost would be less of an issue.”

Still, much of what the survey uncovered is related to cost, even if indirectly. For instance, Monroe noted that if health professionals take time to “make the human connection” that is patients’ top priority, patients are a lot more likely to follow the treatment regimen. Cultivating that type of patient buy-in can save in the long run.

So can other priorities identified in “What People Want for the Future of Health Care in WNY,” such as more focus on preventive care and cutting bureaucratic hassles.

Still, we know much of the care being dispensed has little medical benefit but is demanded by patients and dispensed by doctors afraid of being sued. Each of us with a sprained ankle wants the same high-tech treatment given an injured Buffalo Bill, whether it’s merited or not.

Yet it appears the public is no more ready than President Obama to face a key question on controlling costs: What are we willing to give up?

Obama dodged that question in his news conference, and with good tactical reason. Protectors of the status quo already are warning that meaningful reform— with a public option—means people will die as Obama performs surgery and House Speaker Nancy Pelosi sets your broken bone.

Of course, those on Medicare, those in the military and members of Congress already have “government run” health care, and I have yet to see any Republicans or Blue Dog Democrats relinquish their own “socialized medicine.”

Nevertheless, if they insist that health care be a public works program for insurance companies—which Americans apparently love and want to keep—the least we can do is make sure we get the value that Western New Yorkers say is missing despite the money being spent.

In spotlighting that issue, the local project may help steer the reform debate in a direction that puts the focus back on people.

Maybe then we’ll all get care as good as the care we fund for members of Congress— including those members fighting to kill reform.