The American health care system is in crisis, and now is the time to build a movement for universal health care. Although the United States is the world’s wealthiest nation and spends more than twice as much per capita on health care as its economic competitors, the World Health Organization ranks the United States 37th in overall quality of health care. We have more than 40 million people who are without insurance and at least half that number who are underinsured or insecurely insured, with fatal consequences: more than 18 000 Americans die each year because they have no health insurance.
Unlike every other industrialized nation, we do not have universal health care. Other countries pay less for their health care systems, while covering everyone. How can we create a health care system that provides accessible, affordable, and high-quality health care for all Americans? As a start, 2 years ago I founded the Congressional Universal Health Care Task Force. At that time we introduced House Concurrent Resolution 99, so far signed by 95 representatives, which commits Congress to passing universal health care legislation by 2004.
I receive many requests from my colleagues to sign on to incremental health care proposals, most of which provide quick fixes to a fundamentally flawed health care system: bills to increase the number of nurses, bills to expand Medicare here, Medicaid there—without offering the comprehensive systemic reform we need.
We need a fresh approach: we must take the for-profit insurance companies out of the health care system. I will soon introduce a national health insurance bill that would create a greatly improved and expanded Medicare for All program. Under this plan, every US resident would have a national health insurance card; would receive all medically necessary services, including prescription drugs and long-term care; have no co-payments or deductibles; and see the doctor of his or her choice. I have worked closely on this bill with Dr Marcia Angell, former editor of the New England Journal of Medicine, and with Physicians for a National Health Program.
The author speaks at a health care reform rally. Photo courtesy of Corey Weinstein, MD, CCHP.
Medicare has a 2% to 3% administrative overhead rate, whereas for-profit health maintenance organizations (HMOs) and insurance companies have an overhead of between 20% and 30%—to cover the costs of stockholder dividends, lobbyists, huge executive salaries, marketing, and wasteful paperwork. In 1991 the Congressional Budget Office concluded that a single-payer system—that is, an improved Medicare for All program—would save approximately $100 billion dollars per year. Economists estimate that this $100 billion could provide coverage for all of the uninsured and substantially help the underinsured.
Every other country in the industrialized world has adopted a not-for-profit health care system because they realized that for-profit systems were too costly, complex, unfair, bureaucratic, and inefficient—bad for the people and bad for the economy. To achieve a publicly financed and publicly administered universal health care program in the United States, we will need to build a broad-based movement that cuts across party lines so that the voices of the underinsured and insecurely insured middle class, as well as the uninsured and the poor, will be heard on Capitol Hill.