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May 13, 2009

Commitment to Care for the Community

Author Affiliations

Author Affiliations: Dr DeAngelis (cathy.deangelis@jama-archives.org) is Editor in Chief, JAMA.

JAMA. 2009;301(18):1929-1930. doi:10.1001/jama.2009.642

Once again health care reform is a national priority, and President Obama has made a commitment that his administration will work to ensure health care for all US citizens. It is assumed that this includes the 47 million individuals who are currently uninsured and the other millions who have inadequate insurance because they lack the financial means to purchase adequate health care.

The United States has assiduously opted not to join other developed nations by enacting a national health service, a national health insurance, or any single-payer health system, and there is little likelihood that this will occur now. Why is this the case? The United States is a nation built on commitment, certainly to freedom and to capitalism. But what has happened to the entreaty “Give me your tired, your poor, your huddled masses yearning to breathe free . . . ,” inscribed on a bronze plaque currently located inside the Statue of Liberty exhibit?1 Perhaps US citizens have become too tired and there are too many poor, huddled masses yearning, so the sense of community has dramatically changed.