For the first time since the collapse of efforts to overhaul the nation’s health care system in 1993-’94, health care reform is inching its way onto the congressional radar screen.

Several factors account for this new level of concern: 1) An alarming increase in the number of uninsured, fueled by layoffs of large numbers of workers once covered by employment-based plans; 2) the continuing decline in the number of small and low-wage firms that subsidize coverage; 3) increases in the cost of insurance; and 4) the skyrocketing price of prescription drugs.

According to a poll by the Kaiser Family Foundation only one-fifth of respondents think the present system works even “pretty well” and seventy-plus percent of those responding said they favored “expanding state government programs for low-income people, to provide health coverage.” Other KFF polls show that 40 percent of respondents support the “single payer” option patterned after the Canadian health care system.

But recognizing a problem and finding its solution are two different things, especially when the problem is as complex as overhauling a system where millions of workers are covered by union-negotiated insurance plans, more millions by company programs and still more millions by government plans, to say nothing of the millions more who are uninsured and underinsured.

I think we can agree: The present system costs too much – $1.3 trillion in 2000 – and excludes too many – 44 million and growing monthly. Thus the question: How to fit into a movement whose slogan has become, “Everybody in, nobody out”?

We do not have to reinvent the wheel in search for our answer. There are dozens of national organizations that have a health care component in their social justice agenda: the Service Employees International Union, NAACP, Alliance of Retired Americans, Children’s Defense Fund and the Committee to Defend Social Security and Medicare. There are health care justice organizations in 20 states, with reform campaigns – generally a variant of “single payer” – underway in eleven.

There are four fundamentals of meaningful health care reform: First, it must be universal – it must be accessible and provide coverage for everyone. Second, it must be comprehensive and provide a full range of services to combat illness and maintain health. Third, it must be affordable, so that out-of-pocket expenditures do not create financial barriers to needed care. Fourth, it must be publicly accountable to make sure that public health care dollars are used properly.

If it is to succeed, the campaign for health care reform must be guided by one fundamental principle – that we need not agree on this or that reform before joining the fray. To insist that the campaign be forced into a common mold – to spend precious time debating the “best” solution – will contribute nothing to furthering the effort. Rather, the challenge is to join the fight – to win public support for meaningful health care reform by publicizing the principles elaborated above, thus making them a yardstick against which to measure any and all legislative proposals.

The Health Care Access Resolution (, with its mandate that Congress “enact legislation by October 2004 to guarantee that every person in the United States, regardless of income, age, employment or health status, has access to health care,” offers one avenue for those looking for a place to start.

Titled House Concurrent Resolution 99, the legislation, introduced by Rep. John Conyers (D- Mich.) is now endorsed by 86 members of the House and more than 300 organizations. It is a product of the Congressional Universal Health Care Task Force, whose self-imposed mandate is promotion of “discussion and strategic planning in Congress and the nation on how to achieve affordable, high quality health care for all.” While listing 14 key attributes of a just and efficient health care system, the resolution does not specifically endorse any one model of reform.

There are several arguments in support of this approach – of working to build public support for the issues that real health care reform must address. Debate over the final form of the reform can wait until after the movement has demonstrated its desire – and more importantly, its strength.

The Health Care Access Resolution is not the only legislation dealing with health care reform now pending in Congress. In October 2001, Rep. Barbara Lee (D-Calif.) introduced HR-3080, which would “establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery.” The legislation now has eight cosponsors, including Conyers.

Fred Gaboury is a member of the People’s Weekly World Editorial Board. He can be reached at



Fred Gaboury
Fred Gaboury

Fred Gaboury was a member of the Editorial Board of the print edition of  People’s Weekly World/Nuestro Mundo and wrote frequently on economic, labor and political issues. Gaboury died in 2004. Here is a small selection of Fred’s significant writings: Eight days in May Birmingham and the struggle for civil rights; Remembering the Rev. James Orange; Memphis 1968: We remember; June 19, 1953: The murder of the Rosenbergs; World Bank and International Monetary Fund strangle economies of Third World countries