The pressing interest and current activity surrounding health care access and health system reform by physicians, other health care professionals, policy makers, and the public is well justified and increasingly urgent. Health care expenditures in the United States are at an all-time high and are projected to exceed $2 trillion in 2006,1 with Medicare and Medicaid accounting for more than $400 billion and more than $300 billion,1 respectively. At the same time, the number of individuals with inadequate health insurance coverage also has reached an all-time high: nearly 47 million are uninsured and at least 16 million more are underinsured.2
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