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Why now is the time to enact health care reform.

The following is an excerpt from the forthcoming book, Health Care Reform Now!, by George Halvorson, to be published by Jossey-Bass Publishing in August 2007. Published with permission of Jossey-Bass. 
 
We spend more money on health care by far than any other country and yet nearly 50,000,000 Americans are uninsured at least part of the time each year.1 To make matters worse, well-documented studies show us that nearly 50% of the time American patients are receiving less than adequate, inconsistent, and, too often, unsafe care.2 
 
We have reached the point where both health care delivery and health care financing in America need new directions. The old approach isn't technically broken—because it continues to function—but it performs at unacceptable and unaffordable levels in far too many ways for far too many people. Our current approaches to care delivery and health care financing are sadly inadequate for what we need health care to do in this country today. 
 
We don't really have a health care delivery system in this country. We have an expensive plethora of uncoordinated, unlinked, economically segregated, operationally limited micro systems, each interacting in ways that too often create suboptimal performance both for the overall health care infrastructure and for individual patients. Our current approach to financing both care and health care coverage too often leaves us with major operational problems as well as serious ethical issues relative to resource allocation. Our current approach to health care resource consumption can lead to unconscionably inadequate access to quality care for far too many Americans. Those problems are exacerbated for minority Americans. When it comes to racial and ethnic disparities in care and coverage, we very sadly have grown to accept as the status quo in America what should be seen as completely unacceptable differences in care delivery and care outcomes for our various minority populations. Our current nonsystem is expensive, frequently ineffective, and the distribution of care resources are often dangerously and shamefully inequitable. 
 
We have an expensive plethora of uncoordinated, unlinked, economically segregated, operationally limited micro systems, each interacting in ways that too often create suboptimal performance both for the overall health care infrastructure and for individual patients. 
 
This is clearly the wrong place to be. 
 
What we need to do at this point is bring everyone—labor, management, consumers, carriers, the uninsured, the underinsured, caregivers, government agencies, patients, and the community—together to form a consensus on an approach that can truly get the job done. Then we need to turn that consensus into practical, functional operational reality as soon as we can get that whole agenda in place.