- October 13 - Ralph Nader said today that health care in the U.S.
should be provided by a national health insurance program providing
comprehensive benefits to all Americans and funded directly by the
federal government under a “single-payer” system. Already, one half of
health expenditures are taxpayer dollars including by Medicare, and
federal, state and local employee health plans.
“Our country needs full Medicare for everyone with free choice of
doctors and hospital by patients,” Nader said. “Any health care payment
system should also stress prevention of disease and injuries.”
Nader, the Green Party candidate for President, said massive savings
from a single-payer system would be more than enough to provide
universal coverage for the same amount as the nation pays now for an
inadequate health care system that leaves more than 45 million Americans
-- with 10 million added under the Clinton-Gore Administration -- with
no health care coverage.
Under the current system, Nader said unnecessary and fraudulent billing,
administrative costs for health-care vendors and huge profits and
bloated salaries at large HMOs and other health care companies. He
described the current system a “disgrace to our democracy.” “The U.S. is
the only western nation that does not provide health insurance coverage
for all its people.
“The U.S. pays more per person for health care than any other country
in the world,” Nader said. “Yet, according to the World Health
Organization, the U.S. is ranked 37th in the overall quality of health
Nader said access to health care is distributed unequally among the rich
and poor and among racial groups. Among whites, 11 percent lack health
insurance while 21 percent of African-Americans and 21 percent of
Asian-Americans are without insurance, along with 33 percent of
Hispanics. Young people (18 to 24 year olds) have an uninsured rate of
29 percent—a higher uninsured rate than any other age group.
13 October 2000
Universal Health Care
The state of health care in the United States is a disgrace to our
democracy. The United States spends more per person on health care than
any other country in the world, but the World Health Organization ranked
the U.S. 37th in the overall quality of health care that it provides.
We are the only industrialized country that lacks universal health
care. More than 42 million Americans have no health insurance.
Access to health care is distributed unequally among rich and poor, and
also among the races. Among whites, 11% lack health insurance, already
a shocking number. But 21% of African-Americans, 21% of Asians and 33%
of Hispanics lack health insurance. This translates directly into
higher infant mortality and lower life expectancy. Young people aged
18-24 have a higher uninsured rate than any other age group, with 29%
In addition to leaving broad segments of the population uninsured or
under-insured, the U.S. health care system has many other important
faults that could be remedied by a system of universal coverage. These
include serious gaps in coverage for: prescription drugs and medical
supplies; dental, vision and hearing care; long-term care; mental health
care; preventive care for children; and treatment for substance abuse.
Health care should be provided by a national health insurance program
providing comprehensive benefits to all Americans throughout their
lives, and funded directly by the federal government (known as a
"single-payer" system). Under the current system, hundreds of billions
of dollars a year go into insurance company overhead, unnecessary and
fraudulent billing and administrative costs for health-care providers,
and huge profits and high salaries at large HMOs and other health-care
companies. Studies show that savings from a single-payer system would
be more than enough to allow us to provide universal coverage for the
same amount that we are now paying for inadequate health care.
We find persuasive a plan based on the "Physicians' Proposal" for a
national health program published by Physicians for a National Health
Program in the New England Journal of Medicine in 1989, and their
proposal for a national long-term care program published in the Journal
of the American Medical Association in 1991. Under this plan:
- Everyone would be included in a single, comprehensive public plan
covering all medically necessary services, including acute,
rehabilitative and long-term care, mental-health services, dental care,
prescription drugs and medical supplies.
- Everyone would have access to personalized care with a local primary
care physician, and free choice of doctors at all times.
Health care providers would still be in the private sector, and the
health plan would provide for different payment schemes for health-care
providers, to minimize the disruption of the existing system. The
payment schemes would be designed to prevent profit motives from
influencing physicians, so there would be no incentives to recommend too
much or too little care.
A transition fund would be established for those health-care
administrators and insurance-company employees whose jobs would be
eliminated due to the simplicity of the single-payer system.
Although we could provide universal, single-payer health insurance for
the same amount that we spend on health care now, we would need funding
to replace the portion now paid for by employers and individuals. We
would do this through several mechanisms:
- A small payroll tax (<4%) on employers. The tax would represent a
large savings for employers who now pay health-insurance premiums for
their employees, but an additional cost for those who do not.
A small tax on stock and bond transactions (1/4 of 1% of transaction
value for both the buyer and the seller). For long-term investors, this
tax would be negligible. It would have the additional effect of
reducing short-term speculation and thus the volatility of the markets.
An additional income tax on the wealthiest 5% of Americans. Other
Americans would pay no additional taxes, and would be free from
health-insurance premiums and from out-of-pocket spending for medically
Closing corporate tax loopholes to ensure that corporations pay their
fair share of taxes.
Providing universal health care can only be accomplished through a
single-payer system: no country has ever achieved universal coverage
with private health insurance. The time to act is now.