This is a subject close to my heart, since I've spent at least half of the past decade as a member of the uninsured class. Right now, I'm unemployed again and paying COBRA out of reader donations - donations which run out next month, with no job in sight. Oh well!

When Obama announced Tom Daschle as his health czar, my heart sank. After all, Daschle worked for a law firm whose lobbying arm represented the insurance industry, and that didn't bode well for actual reform. Instead, it seems to point toward corporate-friendly incrementalism.

I hope I'm wrong. I hope the Obama administration and the Democratic Congress are focused enough to produce legislation which actually solves this massive problem. But voters will certainly have to stay vocal if they want to make their own interests the priority in this national healthcare debate:

Karen Goroncy, a home health aide in Washington, Pa., has taken care of people for 25 years but can't afford health insurance to take care of herself.

A reader has promised to buy Goroncy insurance after she was profiled this fall in The Inquirer, and she hopes to have hernia surgery in the New Year.

But short of the generosity of readers - not a good national solution - Goroncy and millions like her are awaiting the sweeping health reform now being considered by President-elect Barack Obama.

Obama's plan, which has not been formally announced, could mark the biggest change in health care in 40 years. A central goal will be to cover 50 million Americans who don't have insurance. It is conceivable that all Americans will be required by law to have health insurance.

A principal architect of Obama's reform - Tom Daschle, nominated to become secretary of the Health and Human Services Department - has written at length about creating a powerful new board that would control health-care spending much like the Federal Reserve Board influences the nation's monetary policy.