It’s not an avalanche yet, but the momentum is definitely building for reforming the nation’s broken health care system. A recent New York Times/CBS News poll found that access to affordable health care is the public’s top domestic concern, and that, regardless of political affiliation, people are willing to make sacrifices to ensure that everyone has access to health insurance. Our own research shows the same direction and intensity.

Political leaders across the country are responding. President Bush has proposed tax breaks for those who buy their own insurance. California Gov. Arnold Schwarzenegger, R, has an initiative to insure all Californians [see March Bulletin]. Massachusetts—under former governor and now Republican presidential hopeful Mitt Romney—and Vermont acted last year, and are moving forward. And 25 other states are wrestling with reform initiatives. Democratic presidential candidate John Edwards unveiled his plan to cover America’s 47 million uninsured, and other candidates are also talking about what should be done.

The California initiative is especially significant because it could serve as a model for national health care reform. It broadly tackles the problem (in a state where approximately 20 percent of the population is uninsured) by requiring all individuals to secure coverage for themselves and their families. It creates market improvements, sets wellness and quality goals and cost limits, expands coverage for low-income adults and kids, and shows how to finance it all.

Health care reform tops AARP’s agenda in Washington and in the states. The California proposal has our attention because the potential is so great. Nationally, we’re focused on lowering prescription drug prices: by giving Medicare the authority to negotiate cost reductions; by getting Congress to allow for the safe, legal importation of drugs from abroad; by obtaining greater market access for generic drugs, including biological drugs; by helping states bargain for better prices; and by expanding comparative effectiveness research to evaluate which drugs work best.

A big opportunity we’re pursuing now is the reauthorization of the State Children’s Health Insurance Program to provide care for kids from low-income families who lack insurance. Another 2007 goal is to modernize information technology to improve efficiency and cut down on medical errors. There are other steps we can take this year and next, but fixing the health system is so huge that it will spill over onto the next president’s agenda. Our job is to make sure that whoever wins the election is focused like a laser on the need for a system that works for all of us.

Together, we can help our presidential candidates and other political leaders understand that health care is not just a personal, local, state or national issue; nor is it a Republican or Democratic issue. This is an American issue—and Americans have the right to know where our candidates stand. We need action, we need answers, and we need accountability.