High costs alone are enough to make anyone dizzy. How can health care and health insurance be understood now when tight budgets are presenting tougher and tougher choices to individuals and policy makers? One answer is to step back and take another look at what quality research says about the costs and benefits of health and health insurance and match those facts and figures with experiences among Arizonans. This report does just that. It also presents recommendations that could help Arizona fare better in the coming years. Money may make the world go round, but choices determine the future. In addition to reviews of state and national economic studies, focus groups and interviews were held with metro Phoenix and metro Tucson residents who did not have, or recently lost, health insurance. Participants’ own words are used throughout the report to illustrate a variety of research findings.

St. Luke's Health Initiatives and the Flinn Foundation strive to make Arizona a better place to live for all of its residents. Despite our state's assets, Arizona has many issues to address, with health and poverty among the most important. Our organizations have been pleased to sponsor the state capacity research that provided the background and impetus for "More Promises to Keep: Sustaining Arizona's Capacity for Welfare and Health Reform." St. Luke's Health Initiatives and the Flinn Foundation view the information and analysis provided in this report as a good way to stimulate discussion of health and welfare policy options and community actions. Research and dialogue are essential steps in the process of constructive change, as is communication with the public. We urge readers to consider the ideas presented in this paper and to continue to work together to improve the health and welfare of all Arizonans.