The evolving role of partnerships in addressing community public health issues: policy and ethical implications.

The current state of health insurance coverage in the United States is deteriorating. Historically, efforts to address access at the federal level have met with insurmountable opposition. This article describes a model utilizing the Partnership Approach to Community Health Improvement to engage communities in developing creative ways of addressing local health issues, discusses the policy implications of such a model, and explores ethical issues inherent in the discussion of universal access. An argument is presented for a national dialogue seeking societal agreement to approach access and health from a perspective of solidarity.