I see the importance of health care reform every day in my health care practice. The current system bogs me down and gets in the way of delivering services, and that's to the folks who can afford coverage.

I'm exhausted by patients not being able to afford prescription meds, and I don't care what anyone says or tries to explain, the Medicare Part D plan is awful and broken and makes no sense whatsoever.

And I regret that small business owners, like my 56-year old younger brother, cannot afford health insurance as a one-man operation, or that my 64-year old older brother, now receiving SSA and able to work only limited hours as an RN to supplement that income, cannot afford insurance either. There are thousands like them. This is nuts, and we're better than this.

Limited access, unaffordable premiums, medication costs that are outrageous (the belief that generics are available/affordable to all and always the same quality is simply not true), citizens of this country not eating to buy meds or keep on the lights ... who do we think we are?

I have done way beyond my share of pro bono work, and if I could do it all the time, I would. That's how desperate the need for reform has become. I deliver care and negotiate these systems without outrage so as not to damage a patient's chances for mental health treatment, but what I take home with me is not the problems of my patients, but the feeling of powerlessness to help more. And powerlessness leads to alienation, and I don't ever want to go there. I don't want to drop out. People need me and others like me too much to fill in these shameful gaps.

Most of all, I believe health care reform is possible -- because I still believe in our abiity to do anything once we get the big picture and commit to taking action.