Barack Obama has taken on the task of major health reform and, unlike his predecessors, he might succeed—in the sense that Congress could pass broad legislation. However, given the views of Congressional leadership, it is less clear that legislative success would yield a sustainable health care system based on values shared by most Americans. The current health reform debate is the latest battle ground for the hearts and minds of the people. As we learned when that phrase was last popular, tactical victories in health reform will lead to strategic failures if the policy we pursue is fundamentally at odds with the core interests, behaviors, and beliefs of most of our fellow citizens.