MUCH to the credit of The Journal and its editors, this in-depth discussion is significant in its timeliness. It should be a precursor to action. Having just passed the largest federal deficit reduction package in the history of this nation, the federal government is in a position to tackle the societal problems that have seemed so intractable for so long. One of the most intractable problems has been caring for the health of the uninsured and underinsured, the theme of this issue ofThe Journal. As this issue makes its way to hundreds of thousands of key decision makers in and outside of the medical community, it is crucial that ever larger portions of that community become actively committed to comprehensive reform and to helping ensure that the terms "uninsured and underinsured Americans" will be removed from the American health care vocabulary. THE ENVIRONMENT FOR CHANGE Why this great need