Here’s a cold truth: Despite much media hand-wringing on the subject, most of us give about as much thought to those who lack health coverage as we do to soybean subsidies.The major obstacle to change? Those of us with insurance simply don’t care very much about those without it. It’s only when health care costs spike sharply, the economy totters or private employers begin to cut back on benefits that the lack of universal health care comes into focus. Noticing the steadily growing ranks of the uninsured, the broad American public — “us” — begins to worry that we’ll soon be joining the ranks of “them.”

The reality, however, is that only a minority of the uninsured are either the typical Redbook reader or that nice shopkeeper down the street. Two-thirds of those without health insurance are poor or near poor, according to the Kaiser Family Foundation. And there are clear disparities in how different racial and ethnic groups are affected. Only 13 percent of non-Hispanic white Americans is uninsured, compared with 36 percent of Hispanics, 33 percent of Native Americans, 22 percent of blacks and 17 percent of Asians/Pacific Islanders.

Politicians understand what this means in practical terms. If a lack of health insurance were truly a white middle-class crisis, then conservatives and liberals would long ago have joined together, carved out a compromise and done something. Instead, we’re served a constantly recycled set of excuses for legislative stalemate.

It has been nearly a century since Theodore Roosevelt, a Republican running unsuccessfully on the Bull Moose Party ticket, boldly became the first presidential candidate to promise universal health coverage. That was in 1912. Nearly a century later, we’re still waiting for a leader with the courage and skill to break through our fears and successfully lead the charge up that particular hill.