“We are rightly proud of the high standards of medical care we know how to provide in the United States. The fact is, however, that most of our people cannot afford to pay for the care they need.” These words were spoken in January of an election year by a man who was to become the Democratic nominee for president and eventually defeat his Republican opponent that November. However, the speaker was not Bill Clinton on the campaign trail in 1992, but Harry Truman addressing Congress on the State of the Union in 1948. Truman continued, “This great nation cannot afford to allow its citizens to suffer needlessly from the lack of proper medical care.”

Truman provided the diagnosis, but more than 50 years later the cure still eludes us. Today, there are more than 41 million Americans without adequate health coverage — the problem is overwhelming, and action is imperative. However, as President Clinton’s reform attempt in 1993 proved, the politics are treacherous. Any solution we come up with must be ambitious, but it must also be realistic, targeted, affordable and, above all, passable. It’s a tricky balance, but it can be done — I know, because I’ve already done it.

As governor of Vermont, I was able to ensure that 92 percent of adults and virtually every child in the state had health coverage, and I did it while balancing the state budget. My plan worked in Vermont because it focused only on those who lacked insurance, rather than trying to fit every single resident into a state-run program. As a candidate for president, I recently unveiled a plan to expand national health coverage that is based on the same strategy and would ensure access to affordable health care for virtually every American.

The plan is the centerpiece of my “Healthy America” reform initiative and is built upon four components. First, we will make sure children are covered, expanding current federal programs to everyone under 25 up to three times the poverty level and requiring employer health plans to cover dependents up to age 25. Second, we will focus on families, covering those with incomes up to 185 percent of the poverty level and allowing those above that level to buy into a plan similar to the insurance plan for federal employees. Third, we will support small businesses, letting them buy into the same insurance plan that families will have access to at very reasonable rates. Finally, we send a strong message to large companies that don’t provide coverage by limiting their tax deductions and government contracts.

As a governor, I learned that in a world of good intentions, it is results that matter. As a doctor, I learned that in a world of diagnoses, it is cures that matter. But as a Democrat, I believe that in a world of pessimism, it is hope that matters. My campaign is about showing Americans that there is a reason to hope for something better than what we have.

Our health care system in this country has long been broken, but that does not mean it will always be so. When I am president, I will go beyond telling Americans that we must fix health care — I will show them that we can.

Former Vermont Gov. Howard Dean is a candidate for the Democratic presidential nomination.