There is an old and wise saying, generally attributed to Republicans, that “;the best social program is a good job.”; Democrats would like to add to that saying, “;and good health for everyone.”; They go hand in hand.

That's why it was historic when President Barack Obama and key stakeholders jointly announced their commitment to achieve sharp reductions in the nation's health care costs.

Medical insurers, the American Hospital Association, the American Medical Association and others outlined goals to prioritize preventative care, manage chronic illnesses, curtail unnecessary tests and procedures, standardize insurance claim forms and use electronic medical records. This could save the nation 1.5 percent per year or $2 trillion over the next 10 years.

The historic moment created momentum for one of the most difficult challenges facing our country — national health reform. The president tied the need for reform to the country's economic woes, saying it's not just a “;moral imperative; it's a fiscal imperative.”;

Throughout his presidential campaign, at every stop, Barack Obama met Americans struggling to keep their families healthy. The roots of his promise to reform health care run deep into the rebirth of this country.

The president has enunciated three principles that reform must achieve: 1) Reducing costs; 2) Guaranteeing choice in plans and doctors; and 3) Ensuring all Americans have quality affordable health care.

Though we tend to think of Hawaii, with our state prepaid health care act, as a leader in health care for our residents, we have lost vital ground over the years. A national study by Families USA found that 27 percent of Hawaii residents under age 65 were uninsured during a portion or all of 2007-2008. Although better than the 33 percent national average of uninsured, we are a far cry from being the wellness pinnacle we once were.

Hawaii's efforts, from pre-paid health care to programs like Keiki Care, deserve praise. But in growing numbers, people who have lost jobs to the poor economy are struggling for health care insurance. Neighbor islanders will tell you that they frequently can get no specialized health care. And budget cuts have stretched the safety net to unfortunate extremes. The governor's recent announcement to cut $42 million of state support for those on Medicaid hits doubly hard. That's because these state dollars match federal money that we now stand to lose. If these factors haven't affected you, they have affected your friends and family.

We need a national, comprehensive approach that will support local initiatives like we have in the Aloha State and that will strengthen them. America has great health care providers, but a broken health care system.

Tomorrow, there will be community-based health care kickoffs across Hawaii and the nation where people will join to support national reform from the ground up. You can find more information at http://www.barackobama.com.

President Obama's recent White House gathering of strange bedfellows offers us new promise in what is possible if we shake off the old constraints. But make no mistake. This is a huge undertaking that requires a sustained grass-roots movement to drive it forward.

So get involved. As the president has said, “;Reform is not a luxury that can be postponed, but a necessity that cannot wait.”;

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Brian Schatz is chairman of the Democratic Party of Hawaii and spokesperson for Hawaii for Obama.