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MIAMI-June Kirchik, fifty-eight years old, discovered a large lump in her breast. When she went to a private hospital, she was denied treatment because she was indigent and her case was not considered an emergency. A public hospital performed a biopsy, which was positive, and gave her an appointment for treatment three weeks later. When Mrs. Kirchik arrived for treatment, however, the public hospital turned her away because she had not yet applied for Medicaid. Mrs. Kirchik tried another public hospital, but was turned away because she was not a resident of the hospital's service area. When Mrs. Kirchik's story appeared in the newspaper, the first public hospital admitted her-to a private room-four months after she had first discovered the lump. Two weeks later, Mrs. Kirchik died.

I The June Kirchiks of this country seem forgotten in the current debate about health care reform. Americans keep asking: How do we contain the ever-increasing costs of health care? How do we pay for health care? We are so focused on these questions that we have narrowed our vision too much and lost sight of the real questions and the real issues.

The real question for American health care reform ought to be: How do we improve Americans' health? Especially, how do we improve the health of those, like June Kirchik, who live in the inner city, are poor and overwhelmingly minority, and who are systematically under-served by our health care establishment? This is the question we should be asking. Sadly, we are not.