The problems in our health care system were not addressed legislatively, and they still exist despite many state and private sector attempts to control costs while increasing access. The public was seldom exposed to widespread discussion of the complex and interrelated problems in the current health care system, and consequently did not understand the need for reform, the various strategies being proposed, or the language of reform. It was easy for special interest groups to scare an untrusting public into believing that the status quo was safer than change.Despite the massive U.S. spending on health care, the population's health status does not appear to justify the investment. Prevention may be the single most effective long-term cost containment strategy available.Nurses can play a vital role in shaping health policy by engaging and educating the public, and helping to educate state and federal legislators.