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The continuing health are reform debate appears to focus on questions of whether fundamental reform of the system is needed, what form the reforms should take, and how they should be funded. Should we publicly fund health care or should we privatize it? From where I sit, there are many crosscutting issues that must be considered. A report by Ben Furnas indicates that "since the failure of health care reform in 1994, costs have increased, quality has been inconsistent, and more Americans have joined the ranks of the uninsured (18 09)." Fifteen years ago, America had a similar opportunity to reform health care. But, says, north face clearance online Furnas, "Conservatives and insurance industry lobbyists defeated efforts by claiming the plan would "socialize medicine," and arguing that there was no health care crisis." Today, as politicians and their constituencies meet to discuss health care reform, similar arguments are emerging. Bush, there was President Reagan. Then there was President Clinton's turn. He was followed by 8 years of George W. Bush. Nothing happened! QUESTION: Is the need for health care reform real or imagined? In 2001, a comprehensive assessment of health care quality was conducted by The Commonwealth Fund. The findings revealed that on a wide range womens north face jacket clearance of health care quality measures, many Americans do not fare well. This is particularly true for AfricanAmericans, Asian Americans, and Hispanics. These groups are more likely than whites to experience difficulty communicating with the physician, to feel that they are treated with disrespect when receiving health care services, and to experience barriers to care, including lack of insurance or a regular doctor. In my view, these findings may be due to income levels more than race, although race enters the picture when shortages exist among health care service providers. The study also found that Hispanics and Asian Americans have problems communicating with their doctors. Asian Americans are least likely to feel that their doctor understand their background, to have confidence in their doctor, and to be involved in decision making as they would like, according to The Commonwealth Study. The survey did indicate that progress has been made in health care for AfricanAmericans. Receipt of preventive care reported by AfricanAmericans was similar to or higher than that reported by whites. Reported levels of patient satisfaction were comparable as well. A 2005 National Health Care Disparities Report from the Agency for Healthcare Research and Quality found that disparities related to race, ethnicity, and socioeconomic status still pervade the American health care system, but efforts are being made to help reduce disparities in health care. One major problem with the current health care system stems from rising costs. Since 1994, the cost per person of American health care has more than doubled, with an annual growth rate (regularly) more than twice that of inflation. Fueled by rising costs of prescription drugs, inefficient outpatient care, expensive and unnecessary medical procedures, and ballooning insurance premiums, these costs, says a report on "American Health Care Since 1994," are a burden on states and the federal government, businesses, and families. Health care costs burden American employers, who are forced to cut back on providing coverage and benefits. Without workplace health insurance, Americans must struggle to find coverage in what some called "the unregulated private market, go on public assistance, or become uninsured." There is a health care dilemma and/or crisis. What happens if no legislation is passed? The Center for American Progress suggests that an America without health care reform is an America where families face even higher health insurance premiums, businesses drop coverage and trim employee benefits, doctors like access to objective information about treatments they provide, and millions of Americans live just one medical emergency away from bankruptcy. Others indicate that without reform, our broken health care system will continue to squeeze families, businesses, doctors, the federal budget and the economy. What is clear, health care costs stretch family budgets. A study from Families USA finds that "one in four Americans under the age of 65 some 64.4 million people will spend more than 10 percent of their family income on health care in 2009The vast majority of these people (82.6 percent) have health insurance. Without health care reform, it has been predicted that more Americans will lose their health insurance or find it difficult to maintain continuous coverage, and fewer Americans will have insurance that is sufficient and affordable. The State of Massachusetts passed Health Care Reform legislation based on private options under the leadership of former Gov. Mitt Romney. What is not known about the Romneyinduced legislation is whether, in the long run, the plan will be more expensive than a public assistance option. His legislation named Planned Parenthood as a member of the Advisory Board of Commonwealth Care, a health insurance program for low and moderate income residents who did not have health insurance. Many referred to it as "Taxpayer Funded Abortion." Will there be a public option in our health care future or not? The Houston Chronicle (81909) posed this question and Secretary of Health and Human Services Kathleen Sebelius insists that the public option is still on the table. Meanwhile, while the debates continue, $263.4 million was spent on lobbying during the first half of 2009, with 50 percent of that amount contributed by drug makers. If there is a silent majority in America committed to finding common ground on health care reform legislation, please step forward. If opponents of reform succeed, we may be faced with higher and higher costs for a health care system that leaves an estimated 47 million people behind; 16 million of which will be adults. Naomi W. Led is a retired Senior Research Scientist, Distinguished Professor and University Administrator. She serves as President/Chair of the Board of the Samuel Walker Houston Museum and Cultural Center in Huntsville, Texas.