There is great admiration throughout the world for the advanced science, technology, and practice of American medicine. The work of expert researchers, renowned clinical and academic institutions, and accomplished practitioners continues to advance the practice of medicine in the United States.

As a result, Americans with access to health care benefit from widely available medications and treatments for diseases such as cardiovascular disease, cancer, and various infections, in addition to state-of-the-art equipment and professionals when hospitalization is required.

However, the benefits of American medicine are available only to those with access to the health care system. Although there is worldwide respect for the American medical system, there is also concern that the U.S. has yet to provide basic health care coverage to all Americans.

• Uninsured Americans, compared with the insured, are up to 66% less likely to have had a recent physician visit
• Uninsured children, compared with the insured, are up to 2.8 times less likely to have had a recent physician visit
• Uninsured adolescents, compared with the insured, are 2.5 times less likely to have had a recent physician visit

The Census Bureau estimates that 44.3 million people in the United States, or 16.3% of the population, had no health insurance in 1998 -- an increase of about 1 million people since 1997. Those most likely to lack health insurance continue to include young adults in the 18-to-24-year-old age group, people with lower levels of education, people of Hispanic origin, those who work part-time, and the foreign born.

Now, we have between 46 to 48 million without medical care at all. On top of those uninsured millions, we have many millions more who are "under insured" - that is, they have some insurance, perhaps through their employers, but their deductibles, copays and disallowables are so high that they effectively "go without" medical services because they cannot afford the out-of-pocket expenses. Effectively the underinsured are in the same boat as the uninsured.

An organization called Physicians for a National Health Program offer this information about single-payer healthcare for the U.S.:

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 46 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans' health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Canada, with a system of universal health insurance, spends about half as much on health care per capita as does the United States, yet Canadians live 2 to 3 years longer. United States residents are less able to access care than are Canadians. Universal coverage appears to reduce most disparities in access to care. (Am J Public Health. 2006;96:XXX-XXX. doi:10.2105/AJPH.2004.059402)

Population-based data available on health habits and processes of care in the 2 countries that might explain this paradox. Karen E. Lasser, MD, MPH, David U. Himmelstein, MD, and Steffie Woolhandler, MD, MPH, published a paper in 2006, Access to Care, Health Status, and Health Disparities in the United States and Canada, in which they are able to arrive at these conclusion:

Compared with Canadians, US residents are one third less likely to have a regular medical doctor, one fourth more likely to have unmet health care needs, and are more than twice as likely to forgo needed medicines.

Problems accessing medical care are particularly dire for the US uninsured. When they do receive medical care, US residents are more likely than Canadians to rate their satisfaction at the extremes (high and low) of the satisfaction scale.

Health disparities on the basis of race, income, and immigrant status are present in both countries, but appear to be more pronounced in the United States.

Bankruptcies are increasingly the result of "under insurance." Many Americans who are insured do not realize that they are "under insured" until it's too late. Many with normal plans obtained through their employers discover that their coverage will not pay fully or at all for many life saving procedures or treatments.

The choice they are left with is to die without treatment or to seek treatment (if they can find someone to give it to them) and risk personal bankruptcy. many health insurance policies prove to be too skimpy in the face of serious illness.

"Many insured families are bankrupted by medical expenses well below the 'catastrophic' thresholds of high-deductible plans that are increasingly popular with employers. Indeed, even the most comprehensive plan available to us through Harvard University leaves faculty at risk for out-of-pocket expenses as large as those reported by our medical debtors," say David U. Himmelstein, Elizabeth Warren, Deborah Thorne, and Steffie Woolhandler in their article Illness And Injury As Contributors To Bankruptcy. They conclude:

Only broad reforms can address these problems. Even universal coverage could leave many Americans vulnerable to bankruptcy unless such coverage was much more comprehensive than many current policies.

As in Canada and most of western Europe, health insurance should be divorced from employment to avoid coverage disruptions at the time of illness... The low rate of medical bankruptcy in Canada suggests that better medical and social insurance could greatly ameliorate this problem in the United States.

In 1591, Pope Gregory XIV fell gravely ill. His doctors prescribed pulverized gold and gems. According to legend, the resulting depletion of the papal treasury is reflected in his unadorned plaster sarcophagus in St. Peter's Basilica.

Four centuries later, solidly middleclass Americans still face impoverishment following a serious illness.

A lack of insurance or "under insurance" is not simply an inconvenience. It is a real barrier to access and definitely contributes to poorer health.

I also borrowed the following synopsis of some benefits of single-payer healthcare:

In a single-payer health system, everyone has health insurance. According to the Institute of Medicine, 18,000 people in the United States die every year from a lack of health insurance--that's two people every hour. The US also has higher infant mortality levels(more children under 1 year of age die) compared to most other democratic companies. Babies would be healthier if all pregnant women could get access to a doctor while they're pregnant. Or think of how much less-crowded emergency rooms would be if people could see a primary care doctor when they were sick, instead of only going to an ER when they become sicker.

Imagine if all doctors and all hospitals in the US had just one type of form to fill out. And all patients had one insurance card. And all patients had health insurance by virtue of being US citizens. And now think of the savings in time, money, paper-pushing. Doctors would have more time to care for patients; everyone would have fewer headaches waiting to talk to their HMO to prove their coverage; nurses would be less frustrated with their work.

By having one organization handle all of the bureaucracy and all of the administration of the health care system (mostly consisting of paperwork and payments) paper-pushing greatly decreases in frequency and cost. More of each of our dollars that go toward health care would actually be used to care for people's health, instead of going toward managers and forms. Single-payer eliminates the bulk of paperwork duplication, and in the process, could potentially save hundreds of BILLIONS (that's 100,000 million) of dollars. As it is right now, American businesses are at an economic disadvantage, because their health costs are so much higher than in other countries. The Canadian branches of Ford, GM, and Daimler-Chrysler all publicly support Canada's health care system, because it saves them an enormous amount of money, compared to their counterparts in the US.

What's more, a single-payer system would mean fewer personal bankruptcies due to medical bills--and an end to patients actually receiving bills. In most countries with a single-payer system, patients never see a bill. The billing process doesn't even involve patients. (This saves money, too--think of how much work goes into itemizing each bill, sending it to each patient, following up on the bill if there's been an error... and on, and on.)

Most single-payer systems save a ton of money by buying prescription drugs for its patients in huge bulk quantities. You know the money you save for buying in bulk at Costco or Sam's Club? Think of applying that concept to buying prescription drugs for America's 290 million people. (Hint: this is what Canada does--it's what makes their drugs much cheaper.)

Americans love choices. We love having options. With a single-payer system, patients could go to any doctor they wanted (try doing that with your HMO!). You could see the doctor that's closest to you, the one that your friends all recommend, or pick one that's your same religion, ethnicity, or race. It'd be a much different experience than getting a specific list from your HMO, telling you who you're allowed to see, if you don't want to pay an arm and a leg for it.

Even better, people wouldn't be tied to their current job for the health insurance it provides. People could find jobs they're happier with or even consider starting their own businesses. It would make employers work harder to make employees happy, and employers could be more confident their workers were a good fit for their jobs.

With 46 to 48 million Americans uninsured, and 100,000 more added to their ranks each month, their vulnerability to poorer health has reached epidemic proportions.

This matters a lot. Life, liberty and happiness depend upon access to health care.

This is perhaps the most important matter before our nation today.

We have to fix this.

How can we save money, time and lives?

Single payer universal health care is the way, most likely the only way.

To do anything else is just putting off the inevitable. In the interim, before we implement single payer health care, we are allowing our fellow citizens to suffer and to die from lack of access to medical services.

Suffering and death.

Those aren't solutions.

Single payer healthcare is a solution.

Healthcare is not just another commodity. It is not a gift to be rationed based on the ability to pay. It is time to make universal health insurance a national priority, so that the basic right to health care can finally become a reality for every American. - Senator Ted Kennedy