Aspirations and Reality in the Law and Politics of Health Care Reform: Examining a Symposium on (E)qual(ity) Care for the Poor

Although the poor had suffered from insufficient health care for years, it was only when the middle class felt the economic pinch that health care reform moved to the top of the national agenda. In this way, the poor, a group with little political power, could benefit from the enormous political power of the middle class. In the Fall of 1992, it appeared that it was time for the poor to consider building a coalition with the middle class to work for universal coverage and improved quality of care. Yet, many questions remained about whether a coalition would benefit the poor and, if so, how it should advocate health care reform. Exactly what type of reform would benefit the poor and underserved? Was this reform the same as or substantially different from that needed by the middle class? To what extent was there a national consensus that health care had to be reformed? Should advocates for the poor strive for universal health insurance, or should they work for broader based changes that would alter the delivery and quality of care? What type of reform, if any, would be politically feasible? Is politically feasible reform worth fighting for or would it actually harm the poor and disadvantaged? Should those representing the poor compromise in order to build a coalition with the middle class? If so, to what extent? If not, what course of action should advocates for the poor take? Although there are no definitive answers to these questions, these and other issues surfaced repeatedly at the Symposium. This Article will summarize the articles contained in this Symposium edition, it will describe in even greater detail the dialogue that took place at the Symposium that is not memorialized in any of the articles. It will attempt to draw together the main themes, suggestions and concerns voiced by the speakers and members of the audience