THE theme issue of The Journal on caring for the uninsured and underinsured1 was thought-provoking and addressed the pressing need for improved access to health care for Americans. Although The Journal is to be commended for its bold initiative in presenting an array of views related to health care access, the failure to substantively address health promotion and the prevention of disease and disability in this context was conspicuous. Although the issue was devoted to access to health care for those with inadequate insurance coverage and necessarily focused on costs, the preoccupation with diagnostic and therapeutic interventions and the virtual neglect of prevention cut to the essence of the long-standing and growing health care problems facing our nation.
Access to affordable and quality health care is a fundamental right that should be extended to and enjoyed by all Americans. As amply demonstrated by the recent flurry of proposals, there