As during other eras of American history, both the current debate and attempts to reform the health care system are fraught with vested interests and conflict among policy makers, consumers, the health and medical complex, insurers, and the business community. The process reflects both the strengths and the limitations of our democratic system, and demonstrates the factional battles that must be waged to attain fundamental social change in American society.

Although racial justice is not the dominant issue, the parallels between the present congressional deliberations and polemics and the passage of civil rights legislation in the 1960s are inescapable. For one, a major goal is to codify the basic human right of health care for all, regardless of medical or socioeconomic condition—that is, universal health insurance. Second, although a general feeling exists among the public that considerable change is needed in our health care system, elected representatives cannot agree on an appropriate course of action.