The Care of the Uninsured in America

As Dr. Cullen's chapter on information technology points out, what is required is not just a new electronic system that follows the patients, but a new language that creates and defines a system that can appropriately care for the patient. What we design for the complexities of caring for the medically underserved can serve as model for caring for everyone in this country. Many innovative, bold, and wonderful solutions have been developed as local/ regional models. As communities and states we can learn from, and support, each other. But the local models are not, by and large, self-sustaining. Ultimately, so- tions to the lack of medical insurance in this country will require a national persp- tive, and federal funding. That is part of the work we all must do, and Dr. Dalen's chapter points out some of the possibilities and pitfalls other countries have experienced. When I wonder how the system we have hasn't already collapsed from its own weight, I just need to look at the people working within it. Healthcare is a service industry, and we have been blessed with professionals who understand and live the concept of service in their daily lives, who go the extra mile for the patient despite the vagaries, the barriers, and the sometimes mean spiritedness of the organi- tional infrastructure.

Nancy J. Johnson is Chief Operating Officer at El Rio Community Health Center in Tuscon, Arizona. She is also President of Quality Health Consultants, a healthcare consultancy.

Lane P. Johnson is Director of the MD/MPH program at the University of Arizona College of Medicine. He is the author of the Clinical Pocket Guide to Herbal Remedies (Blackwell, 2002).