Four fundamental goals have shaped our system. First, we want high quality health care that can provide the greatest benefits. Second, we want freedom of choice so that we can decide the “who, when, and where” for our health care. Third, we expect our health care to be affordable so that we have resources for all of the other things we need or want. Fourth, we want our fellow citizens to share in the costs and also benefits of health care (American College of Emergency Physicians, 2011 (Links to an external site.)).

With these common goals for our society, why is reform of the American health care system such a controversial issue?