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January 18, 1995

Welcome to Year 83

JAMA. 1995;273(3):256-257. doi:10.1001/jama.1995.03520270092048

In this competitive society, Roger Evans, PhD, has written, the plight of the uninsured poor "reflects the unwillingness of our sociopolitical system to reward failure."1 What, then, should be the response of health care folk to the failure of the sociopolitical system to protect the uninsured?

One response—which is eagerly anticipated by some—is to fold the tents and go home. After all, more than 80% of the population (including most people who work in health care) have coverage,2 although some of it (notably Medicaid) is threadbare on its good days, and little of it is reliable in the face of catastrophic disease or injury.

Furthermore, is the battle not lost? Congress was unwilling even to pass reforms that would guarantee coverage (albeit at high cost) to those Americans whose health status makes it impossible for them to obtain private insurance, to protect 13 million uninsured children, or to

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