The rhetoric of health care reform now bombards us daily, with the often unspoken message that once there is universal health insurance, the health problems of America's vulnerable populations will cease to exist or to be matters of concern. Two recent papers in the Journal speak forcefully to this point. In the first, Pappas et al. point out that although death rates in the United States have declined in the past three decades, poverty and educational attainment remain powerfully associated with mortality. Poor and poorly educated Americans continue to die at higher rates than their better-off counterparts (New England Journal
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