America is known for its generosity in sending emergency responders to help with medical issues around the world. Major philanthropic organizations such as the Red Cross and Médecins Sans Frontières (Doctors without Borders) provide helpful gear such as mosquito nets and send in food and medical care to disaster sites. Despite this active approach to taking care of the world's inhabitants, the health care picture at home is far from solved. In the United States in the first decade of the 21st century, 47 million Americans lack health insurance, meaning that easy and affordable access to health care is out of reach for an astonishing number of Americans. This may mean very little to the healthy 24-year-old who cannot envision a day when he might need health care, but it may make a big difference to a person with debilitating arthritis who needs to be on maintenance medications.

Since 2000, the number of uninsured has increased by more than 20 percent, reaching 47 million in 2006. The numbers of the uninsured have grown in the 21st century as the rates of employer-based coverage have stalled or declined. While there has been an increase in the number of children who are covered by the Medicaid State Children's Health Insurance Program (SCHIP), over the last 10 years, it does not fully compensate for the loss of job-based coverage for other Americans. Young adults, ages 19 to 29, have the highest uninsured rate (30 percent) of any age group. More than half of these people are full-time workers, but their low incomes make it difficult to afford coverage. Members of minority groups are more likely to be uninsured.

In addition, rising health care costs are squeezing many middle-income Americans, even those with insurance, who report difficulties paying medical bills due to a lack of adequate coverage. The Kaiser Foundation states that 25 million people are underinsured. These people are more likely not to seek care because they know there will be very high out-of-pocket costs.

To add to this negative news, Americans have the most expensive health care system in the world, but we have no bragging rights over outcomes. The United States ranks 29th in infant mortality, 48th in life expectancy, and 19th in preventable deaths. These are shocking statistics for a country that is supposed to be one of the most socially advanced in the world. . .

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