Despite 15 years of incremental, market-based approaches to reform health care payment and delivery systems in the United States, systemic transformation remains elusive. The health care system continues to be inequitable, fragmented, ineffective, costly and often fraught with errors. ANA embraces an ongoing commitment to the principle that all persons are entitled to affordable, readily accessible, high quality health care services. ANA has pursued this mission through an integrated series of public and private sector advocacy and education efforts using, as its foundation, the tenets of ANA’s Health Care Agenda 2005, ANA’s current policy statement on the subject.