This book is about ethics and health care reform. More precisely, the author provides several arguments derived from a variety of ethical theories to support a unifying vision for reform of the American health care system. His vision is a health care system that achieves eight goals: Ensure equitable access and effective care; provide cost-efficient care and finance health care fairly; generate and sustain the resources required; protect participants' rights and ensure representation of everyone in the system; and finally, provide health care services responsive to the population's expectations and health care needs. These elements and norms constitute the author's definition of universal health care. A basic premise of the author's argument is that our health care debate is not solely about economic, political, medical, or legal issues; it is fundamentally a moral issue and reflects a persistent conflict of values. In other words, to achieve and sustain universal health care in America requires wider agreement about the kind of society we should be and ought to become. Health care reform is ultimately a matter of social ethics. A second premise of this book is that an ethical analysis should be an essential element in all phases of a policy cycle - problem identification policy formulation, implementation, and evaluation. Policy proposals should cite their guiding values and moral justifications.