"The doctor will see you now," is a phrase heard less and less often. Last year, 28% of Americans with specific illnesses or injuries had to wait over a week to see the doctor. Rising health care and drug costs, a severe nursing shortage, too few physicians in some regions, and insurance providers dropping out of plan networks all add up to an impending crisis in Americans' ability to obtain adequate and timely health care.

Cost is the top barrier to care. Over 40 million (16%) have no health insurance - more than the population of 23 states plus D.C. 93% of uninsured and over 50% of insured people say cost is the reason for not receiving care.

We have the best health care on earth - for those who can afford it. Poorer people live sicker and die younger. And those in the middle are squeezed by prohibitive costs and inadequate insurance coverage. Families making under $35,000 a year are twice as likely not to receive care as those with higher incomes.

We face a critical shortage of nurses that will only worsen in years to come. Low wages combined with high stress mean high turnover and low recruitment rates, jeopardizing quality of care:

• Since 1993, nurses' wages have declined every year (save 1998), taking inflation into account.
  
  
• More than 126,000 nurses are needed to fill vacancies nationwide.
  
  
• A third of nurses under 30 will quit in the next year. Numbers of nurses under 30 are down 41% since 1983.
  
  
• 44,000 to 98,000 patients die in hospitals each year as a result of preventable errors in their care.

President Bush's 2003 budget proposes $89 billion in health tax credits over 10 years - far too small, say industry analysts, to make coverage affordable for low-income families and unemployed workers. Critics fear rising costs and bigger budget deficits atop the recent tax cut will starve critical safety nets like Medicare and Medicaid.

Do we have a responsibility to provide adequate health care to all our citizens, regardless of income, or is it each patient for themselves? Should health care be a business or a service, a right or a privilege? Would our health system perform better if it were centered on patient care rather than profit margins?