Leaders in health care and health care policy believe that Americans should have a choice of public and private health insurance plans, and two-thirds believe the public plan should incorporate innovative methods for paying providers, including global fees, according to the latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey. A large majority of opinion leaders supports the establishment of a national health insurance exchange with strong authority to enforce standards of participation, set rating rules, standardize benefits, and review or negotiate premiums. A majority thinks the standard required benefit package should be similar to the Federal Employees Health Benefit Program’s standard Blue Cross Blue Shield option, although one-third support a less generous benefit package. Whatever their views concerning the details of health reform, two-thirds of respondents (68%) agree upon the urgency of enacting comprehensive changes, including an expansion of insurance coverage, this year.