For years, Joe Cesa has made do without health insurance. Until his café went under, he didn’t really need it: he'd always earned enough to pay his medical bills.

 
Since times got tough, this former employer has found himself vulnerable to the slightest medical problem. “I don’t know what I would do if something happened”, he says. “I’ve got nothing left”.

 
Joe isn't alone: 47 million Americans are in his shoes, without insurance in a country where medical care is among the worlds most expensive.

 
But not everyone is for reforming the current system.

 
Conservative activists have been monopolizing media coverage of the healthcare debate, demonstrating in front of every single town hall organized this summer to explain the current plans for reform.

 
Their argument: publicly funded healthcare is quite simply anti-American. “I don’t like big government, I am an American. I am independent, I want my freedom. I don’t want the governement taing care of me”, says Patty Anderson. She is a stay at home mom whose insurance is provided by her husband’s job.

 
Under pressure from these opponents, Obama is scaling down planned reforms.

 
Joe feels that the debate has got off track. He says it’s not about trying to get the government to help him. “The majority of people without healthcare are working people, just like me,” he says.

 
Newly out of work, Joe already has a future business underway: roasting his own coffee in his basement.

 
Until his venture takes off, however, daily life is far from worry free.

A few months ago, Joe had chest pains. He worries about his heart but a visit to the doctor is out of the question: “I thought: the last thing I need is to go to the ER. I know if it tell them I have chest pains, there’s going be cardiac specialists and other people and I’m going to end up walking out of here with a bill 10 or 20.000 dollars. I can’t picture having a 10, 20.000 dollars medical that I pay off a little bit every month for the rest of my life”. 

It is precisely this type of emergency room visit that Doctor George Taler hopes to prevent. As a general practitioner, he is a rare find in the US. Even more unusual: he makes house calls.

 
By visiting his patients regularly, he helps them avoid the costly visits to the ER that have contributed to soaring health insurance prices.

 
Doctor Taler says that the priority should be to rebuild the base of physicians like him. “In the rest of the developed world, the primary care physician is the base of the healthcare system. In the US that seems to be eroding. The better that we take care of people in the community, the more we can avoid going to the Emergency department, the more money we can save”.

 
Avoiding unnecessary hospitalization: for many in the medical profession that’s the key to making the US healthcare system less expensive and therefore accessible to everyone.