Danna Walker and her husband Russ have a problem, the New York Times reports. In the sinking economy. Danna Walker has lost her job. Russ Walker is struggling to keep his feed supply store open in Texas. That's not the worst of it. The big problem is that their son, Jake, lost his health care coverage when his mother lost her job. And Jake, 21, a survivor of metastatic testicular cancer, needs high-quality, ongoing care.

The good news is that Jake is in remission, and attending classes at Oklahoma State University. The bad news is that he needs constant monitoring to make sure he stays healthy. If the cancer strikes again, the health plan his parents managed to get for him through his college won't cover the care he needs.

Jake's recovery came in large part from the excellent care he received at the renowned M.D. Anderson Cancer Center, where he underwent an advanced regimen of surgeries, experimental chemotherapy, and stem cell transplants. Jake's cancer went into remission in March 2008, but during a checkup in December, Ms. Walker told hospital officials that her son's insurance would expire by the end of January. They told her she had two options: pay up front or seek treatment elsewhere.

The Walkers cannot afford to enter Jake into the Texas Health Insurance Risk Pool, nor do they have enough money to pay the reduced premiums under COBRA. They have just enough equity in their modest house to make them ineligible for other government assistance. The Walkers are applying to the M.D. Anderson charity care program, but the hospital Vice President Dr. Ron Walters told the Times that the economic downturn is making it more difficult to finance such safety nets. Jake is too old to qualify for Medicaid in Texas as a child, and the fact that he has a pre-existing condition makes it nearly impossible for him to get coverage in the individual market.

Pre-existing conditions are just one of the problems faced by cancer patients. According to a study by the American Cancer Society, cancer patients must cope with high cost-sharing that can push their families into bankruptcy, annual benefit caps, the loss of jobs and benefits, extreme difficulty obtaining coverage on the individual market, and exclusion from high risk pools. The Walkers experienced many of these problems firsthand. And denial of coverage for pre-existing conditions isn't just limited to cancer patients, millions of people with chronic conditions or a history of illness also struggle to obtain health coverage.

The Walkers' story illustrates many of the most pressing problems in our health care system today. Cutting edge facilities, technological advances, and skilled clinicians show the good side of American health care, making it easy to believe that we have the best health care system in the world. But, as the Walkers found out, we also have one of the worst. Jake's recovery from cancer came from the excellent care he received, but after losing health coverage, Jake is struggling to receive any care at all. Even basic monitoring procedures that could, again, save his life. Successful health reform needs to provide all Americans, including those with pre-existing conditions or chronic health problems, with sustainable, affordable, quality health insurance.