Health care is etched on my mind these days not only because of the Capitol Cacophony but also because a husband and wife I know, my former neighbors, are undergoing the kind of heartbreak no family should endure.

Zack Liu and Jan Li, along with their two young daughters, lived a few doors away from me. Then a couple of years ago they moved to Hong Kong, and paid $4,500 per year for a health insurance policy for Jan and the girls (Zack was covered through his job).

Last April 24, their world collapsed: Jan was diagnosed with late-stage stomach cancer.

Opponents of the reform proposals argue: If you like the Department of Motor Vehicles, you’ll love Obamacare. But as the drama of Zack and Jan shows, the only bureaucrats more obdurate than those at the D.M.V. are the ones working for insurance companies. The existing system is preposterous: we rely on insurance companies whose business model is based on accepting premiums from healthy people and devising ways to exclude from coverage those who most desperately need medical care.

Jan’s stomach was removed, and she underwent extensive chemotherapy. Then in October, her doctors discovered that the cancer had spread to her intestines. She has been hospitalized ever since.