America is a country founded in the pursuit of a vision, the realization of an ideal. In words that are built into our national DNA, all of us are created equal, endowed with the inherent and inalienable right to life, liberty and the pursuit of happiness.

None of that is possible without good health. Unfortunately, in today’s America, when it comes to health and health care, we are not all equal, are we?

What would the signers of the Declaration of Independence think of today’s America where your zip code determine your life expectancy, you are twice as likely to be obese if you haven’t gone to college, or your baby is more likely to die if you only have a high school education? Life isn’t just better at the top, it’s longer.

But the health of all America depends on the health of all Americans. When huge numbers of us are left behind, more of the nation’s future is left behind as well.

The problem is real. In the U.S., disparities in health are enormous. Decades of research prove that education, economic development, housing, job security, geography, and income all affect health just as strongly as personal behavior. We even know now that poverty impacts the overall death rate of American adults at about the same rate as cigarette smoking.

While much of the current public debate on health care centers on access and affordability, the evidence tells us that whether or not a person gets sick in the first place in most cases has little to do with access to care. A far greater determinant is the sometimes toxic relationship between how we live our lives and the surrounding economic, social and physical environment in which we live. Some of the factors affecting our health we certainly can influence on our own; many of the factors, however, are outside our sphere of individual control.

To this physician and philanthropist, it starts with basic questions: What kind of values do we have? Is it okay for 8 million kids to be uninsured? For thousands to die each year because the economics of health care are against them? For disparities in the health and health care of our people to weaken America’s global competitiveness? For health care costs to consume one-sixth of the nation’s economy with such great disparities in quality and equality of care?

It’s time to start seeking answers: to identify solutions that will work, partners to mobilize and actions to take that will alter the trajectory of the health and well being of the nation. All Americans would agree with Mr. Jefferson, that life is a fundamental human right. We also agree that the security of the nation’s future depends on the good health of all our people. Making sure that every person in America has a fair chance for a healthy life and an equal opportunity for adequate health care is not a matter of ideology – it’s a matter of national survival.