Physician Support for Covering the Uninsured: Is the Cup Half Empty or Half Full?

More than 43 million Americans—17.2 % of the pop-ulation younger than age 65 years—lack health in-surance (1). Over the past 25 years, in good times as well as bad, the general trend has been one of growth in the num-bers of uninsured (2, 3). This trend has continued despite substantial expansions in Medicaid eligibility in the late 1980s, enactment of the State Children’s Health Insurance Program in 1997, and incremental reforms in the regula-tion of private health insurance (2–4). Why is expansion of coverage so difficult to achieve? Stuart Altman, a former Nixon Administration and Con-gressional appointee and an expert on health policy, once observed that although people disagree over the best path to reform, the status quo is everyone’s second choice (5). Despite our proclivity for inertia, health insurance reform is likely to be a potent issue in the upcoming presidentia