No one should choose between putting a meal on the table or buying a prescription drug or visiting a doctor. But on this Labor Day, millions of Americans face that choice. One in seven families has problems paying medical bills, forcing trade-offs between food, medicine and keeping a roof over their heads. Health care costs have increased at five times the rate of inflation in recent years. This Labor Day - on a day we celebrate our country's working men and women - our nation needs to wake up to the harsh realities of unaffordable health care that America's working families face each day.

Health care is a basic right. Yet nearly 82 million Americans - one of every three younger than age 65 - lacked health coverage for all or part of 2002 and 2003. And things are getting worse. The ranks of the uninsured in Ohio grew by 89,000 from 2000 to 2002. Chances are that readers of this article have someone in their lives who has gone without health insurance in the last few years.

Americans know that a full-time job no longer guarantees employer-provided health care coverage or a family's ability to pay for health care. More and more employers are cutting back, or even eliminating, health coverage for workers, reversing a trend in which employee coverage increased in the mid-1990s. New jobs in Ohio are less likely to offer health insurance than the old jobs.

America's largest private employer, Wal-Mart, exemplifies the trend of employer health care cuts. Health care coverage at Wal-Mart is too expensive and out of reach for its own employees. Fewer than half of Wal-Mart workers are insured under the company plan. In fact, Wal-Mart actually directs many of its workers to state funding for family health care, thus profiting at the entire community's expense. Companies like Wal-Mart must be held accountable, and not allowed to shift costs to taxpayers.

The last four years have seen little progress to stop the spread of rising costs and little to help families who are going without coverage. President Bush has put forward no plan and taken no effective steps to remedy this crisis. When employers drop health care coverage, workers are forced to rely on the public system. Instead of shoring up that system, Bush's budget would reduce net funding for Medicaid by nearly $1 billion in fiscal year 2005 and by almost $16 billion between 2005 and 2014.

It doesn't have to be this way. The richest of nations can make sure that no one has to go without health care. We need to curb runaway drug prices and make sure every patient dealing with an insurer has basic rights. Ultimately, we must reform our health system to ensure universal health coverage for all Americans.

Although the crisis is complex and the quagmire feels deep, America's working families deserve more. Health care is our right, not a luxury for the rich and privileged. Safety nets for America's families should be strengthened during this emergency, not undermined.

This Labor Day, we pledge to take back America, because we can't let one more person in our country go without health care.

Dan Radford is executive secretary of the Cincinnati AFL-CIO.