Medicare for All

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Medicare for All
Medicare for All.
Everybody In. Nobody Out.

Current Condition

Health and the Cost of Health Care
and the Resulting Mystery, Conclusion and Challenge

Summary of the sections of this web page

  1. United States poor health performance is well documented as being poor relative to other countries. Examples include an astonishingly high cost, a shockingly low life expectancy, a position of dead last among 19 countries in minimizing the number of deaths due to preventable diseases, and a very poor maternal mortality.
  2. Why is U.S. health getting worse? Poor access, people not getting health care.
  3. Why is U.S. access to health care poor? Inability to pay.
  4. Why do Americans and American businesses have to pay so much for health care? A complex, inefficient method of paying for it
  5. Why do the other free-market industrialized countries have such a low cost per person? They have implemented simple, efficient methods of paying for health care. The implementation in other countries has been a trend for over 125 years. Other countries have non-profit national health insurance, such as the simplest, most efficient version, which is “non-profit single-payer national health insurance” … or “single-payer”. Meanwhile the U.S. experiment with its for-profit “managed care” solution is an economic and health care failure.
  6. What is the impact on Americans? For the answer to this question go to real life stories. Please DO go there sometime! The list of topics alone is worth your consideration.
  7. What will be the government’s role? The politicians simply need to create the law that establishes the one public agency that is needed to administer non-profit single-payer national health insurance.
  8. The Mystery, Conclusion and Challenge I often find that people in other countries are amazed regarding the U.S. and its failure to have health care for everyone without any major medical bills for any patients. Despite the information in this web page, the U.S. has failed to take the same action that other free-market industrialized countries … and other countries … have taken. Based on the combination of all the facts and information that is presented on this web page, one would logically conclude that individual Americans need to take action. We, as individuals, can act “together”, which is that one million of us all do the same activity in unison to get the peace of mind we have denied ourselves and our country for so very long.

1. United States Poor Health Performance

Health Performance:
Cost and Life Expectancy

World Health Organization data: 2005 and 2006

We're not getting our money's worth!

Life Expectancy and Country
as read from the rounded values above:

82 Japan *
81 Sweden *
80 Canada *
80 France *
80 Singapore *
80 Spain *
79 Finland *
79 Greece *
79 Netherlands *
79 New Zealand *
79 United Kingdom *
78 Ireland *
77 United States *
77 Costa Rica
77 Cuba
77 Denmark
77 Portugal
77 Chile

27th - 29th — That the U.S. has a low life expectancy is thoroughly studied and documented. Prior to the World Health Organization’s update of June 2008 that established the U.S. in a 30th ranking position for life expectancy, various studies place the U.S. at either 27th or 28th or 29th … or, according to the CIA Factbook, the U.S. ranks 50th. See [Health Outcomes] for sources.

About Canada. As indicated above, the average lifespan of our neighbors, the Canadians, is 2-3 years longer, and they enjoy benefits similar to that of all other free-market, high-income industrialized countries (except the U.S.).


See Health Outcomes

June 2008 Update: U.S. still pays an amazing 250% times the average of 29 other free-market, industrialized countries. The U.S. World Health Organization documented that the U.S. life expectancy rank dropped to (a shockingly low) 30th in life expectancy ranking in the world.

1. United States Poor Health Performance

Health Performance:
Deaths from Preventable Diseases

January 2008: The ability of the United States to minimize deaths due to PREVENTABLE diseases is at rock bottom / dead last. The associated unnecessary deaths are tens of thousands of real people, people we knew and loved. Perhaps more importantly are the days, weeks and months of unnecessary pain and suffering prior to our unnecessary deaths.

Death Due to Preventable Diseases: Dead Last

Preventable Diseases: Unnecessary Deaths

Rankings from 1st to 19th

the Netherlands
New Zealand
United States

Further Information with Sources

This information is available at the Further Information section of the Real People web page.

1. United States Poor Health Performance

Deaths Due to Preventable Diseases:
Bad to Worst for the U.S.

Preventable Diseases: Drop in Performance

As seen above, over a 5 year period the U.S. dropped in performance rank among 19 countries from 15th position to 19th position.

Further Information with Sources

Go to the Further Information section of the Real People web page.

1. United States Poor Health Performance

Maternal Mortality Very Poor

Maternal mortality, the deaths of women who die during or shortly after a pregnancy, is dramatically higher than other countries.

Maternal mortality may be a better indicator of health care performance than infant mortality, especially considering the debate about how infant mortality rates are determined across different countries.

U.S. Maternal Mortality

2. Why is U.S. health getting worse?

Due to having more elderly people
than other countries? No!

Is our poor performance because we have more people who are age 65 and older? Clearly the answer is no …

The percentage of people age 65 years and older is lower in the United States than in other “free-market” industrialized countries.

Percent Elderly

2. Why is U.S. health getting worse?

Due to People Not Getting Health Care? Yes!

We Americans, on average, are NOT getting to the doctor, thus blocking the ability of doctors contribute to PREVENTING diseases. Take a look at our performance on having a society where people get to the doctor.

Physician Visits

3. Why is U.S. access to health care poor?

The Inability to Pay the High Cost

Many Americans cannot afford to go to the doctor and/or they are afraid that the visit may end up with a huge medical bill. Although other factors also contribute to the problem of access, the inability to pay is increasingly seen within more income levels.

Note: People in all other free-market, high-income, industrialized countries (26 of 26) do not have any major medical bills.

Too many Americans have little or no access to health care.

42% of Americans between the ages of 19 and 64 are either uninsured or underinsured

78.5 million Americans!

The numbers were determined prior to millions of job losses.

78,500,000 total divided by 435 U.S. Congressional Districts equals an average of 180,000 uninsured or underinsured in every U.S. Congressional District out of about 700,000 persons in each U.S. Congressional District.

4. Why do Americans and American businesses
have to pay so much for health care?

Answer: a complex, inefficient method of paying for health care

America’s individuals and families are burdened with living in a country that puts a heavy financial burden on people who need health care.

An annual survey is done in the United States regarding the cost of health care per family for all sizes of businesses for their employees. The most recent report (pdf) documents that the average cost for a family across all sizes of businesses is $13,914 per year. Special note: many Americans probably do not, or at least did not, know how extremely expensive health insurance costs in the United States, because their employer does … or did … pay a large percentage of the cost of the health insurance. Nor do many Americans know of the huge savings per person in the U.S. when taxes go up a relatively small amount and the health insurance premiums go to zero.

The U.S. has an especially complex, high-cost, inefficient way to pay for health care. The cost per person is an astonishing 250% times the cost of the other 29 other free-market countries within the OECD (The OECD is explained below at “Free-Market Industrialized Countries?”).

The United States’ bureaucracy (listed below) with the use of 1300 to 1600 health insurance companies and 51 sets of federal and state programs results in only 70 to 75% of every health care dollar actually being spent on health care. In comparison, U.S. Medicare, before the U.S. Congress started privatizing it, had 95 to 97 of its funds spent on health care. In other words, the U.S. has a huge amount of unnecessary cost due to excessive administrative costs. The average U.S. cost in 2006 was $6,714 per person compared to the $2,690 per person average of the other countries. Those countries cover everyone at 40% of the cost of the U.S.!

4. Why do Americans and American businesses
have to pay so much for health care?

Other countries cover 100% of their people; their per person cost is 40% of the U.S. per person cost.
The U.S. way of paying for health care includes 42% of persons 19-64 years old being either uninsured or underinsured. The U.S. per person cost is 250% the cost of the average of 29 other free-market industrialized countries.

There is something fundamentally wrong here, but it is very easy to identify the problem! Bureaucracy everywhere!

  • Insurance companies and people who must deal with them
  • Government departments and programs and people who must deal with them
  • Supporting bureaucracy: “third-party” individuals and organizations who either have their income based on the bureaucracy or who must deal with the bureaucracy

In summary: what a bureaucratic mess that we don’t need to have continue!

We need only one organization, a public agency, to manage the simple, cost-efficient collection of our contributions and the simple, cost-efficient payment for health care.

We don’t need the current condition, which includes day-to-day decisions by politicians in Washington, D.C. and 50 states!

As indicated previously, the cost-efficient payment of our contributions will be accompanied by a large savings per person by no longer having to pay health insurance premiums.

The ten regions of the public agency will address regional differences.

4. Why do Americans and American businesses
have to pay so much for health care?

Health Insurance Company Bureaucracy

Examples of items that are part of the complexities of U.S. health care financing.

  • Premiums
  • Co-pays
  • Deductibles
  • Percentage not covered by insurance
  • Health care bills after the lifetime limit is exceeded
  • Added costs for those burdened by medical expenses:
    • Credit card interest
    • Interest on loans to pay medical debts
  • Results from dealing with health insurance companies
    • Large billing departments of hospitals and other medical facilities
    • Large billing staffs at physicians’ offices
    • Businesses of all sizes needing to decide what health insurance company and plan to use for the next year
  • Over 1300 health insurance companies, each of which is working to not only maintain and/or expand their operations, but also maintain and increase their profits; these companies are the reasons for most or all of the previous examples listed above

Examples of additional complexities associated with health insurance companies

  • In-network and out-of-network medical professionals (such as physicians) and facilities
  • Denial of health insurance coverage for a very long list of reasons and situations

4. Why do Americans and American businesses
have to pay so much for health care?

Government Bureaucracy

Examples of items that are part of the complexities of U.S. health care financing.

  • Medicaid programs in all 50 states
  • COBRA The U.S. Department of Labor’s management of the program resulting from the Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • The medical component of:
    • Workers compensation programs in all 50 states
    • Auto insurance health insurance component: seen as “coordinated medical benefits”; this does not apply to all states
  • Government cash incentives to health insurance companies
    • Just a few examples so far for this list:
      • Medicare Advantage Plans — this is a huge issue of the spending of our tax dollars that has been in the news a lot. It’s payments of our tax dollars to for-profit health insurance companies. It’s costing us a fortune, as part of the Medicare Modernization Act of 2003.
      • The Medicare Modernization Act of 2003 included a guarantee for the initial period of the Drug Prescription Benefit program that health insurance companies would not lose money. (I’d have to research to confirm if this was a year or longer.)
      • The further privatization of Medicare, scheduled to start in 2010 as per the same Medicare Modernization Act, is also scheduled to pay billions of dollars to for-profit health insurance companies to “encourage” (!) them to participate. Another case of guaranteeing companies that they will not lose.
  • Reductions in taxes for employers who provide health insurance to their employees; this is an indirect payment of private health insurance by the government

  • A variety of additional existing programs are unfortunately associated with (and/or directly include) an amazing bureaucracy of programs and grants and grant-writing and more activities that have nothing to do with the actual activity of delivering health care; the following list is all that I have gathered so far. If I learn of more, I will add them. It is not my intent to research all of these, nor defend them being on the list or not. It is my intent to give some tiny indication of the massive opportunity for simplicity and efficiency.

    • Rural Assistance Center
    • Rural Health Clinics
    • Federally Qualified Health Centers
    • Community Health Centers (CHCs)
    • Migrant Health Centers
    • Health Care for the Homeless programs
    • Public Housing Primary Care programs
    • Urban Indian and Tribal Health Centers

4. Why do Americans and American businesses
have to pay so much for health care?

Third-Party Supporting Bureaucracy

Examples of items that are part of the complexities of U.S. health care financing.

  • Legal activities related to Medicaid and long-term care
    • Relevant titles: Medicaid planning by a “Medicaid planning attorney” or “Medicaid planning lawyer”
    • Clarification: this topic is primarily related to Medicaid and not Medicare
  • Bankruptcy lawyers
  • Financial management support, such as credit counseling
  • Fund-raising organizations related to raising money to cover health care costs

4. Why do Americans and American businesses
have to pay so much for health care?

The U.S. Politicians Have Been and Still Are
Destroying the Original Medicare;
their interference is not appreciated.

Especially since the privatization of Medicare that started in 2003 and continues in phases, the U.S. has been going in the wrong direction. The U.S. no longer has coverage for people 65 and older that includes a simple, efficient non-profit financing of health care like all other free-market, high-income industrialized countries have (26 of 26). Other countries provide true, automatic, low-cost Health Care for All with coverage of ALL medically necessary care from pre-natal until the end-of-life! We need Medicare for All via one public agency that operates without day-to-day interferences by politicians!

We Want Simplicity and Efficiency!
Eliminate Bureaucracy with Single-Payer!

5. Why do the other free-market industrialized countries have such a low cost per person?

Answer: a simple, efficient method of paying for health care

The other countries have non-profit national health insurance, especially the best version, which is single-payer.

Other countries rely on non-profit financing of health care and the U.S. does not. Don’t let anyone tell you that some countries, such as France and Germany, use health insurance companies. Those groups are strictly-regulated non-profit “sickness funds”.

Remember this: all of the other free-market, high-income industrialized countries in the world (26 of 26) have non-profit national health insurance that provides the payment of health care to its citizens from pre-natal to the end of life and includes the feature of having no patient or family being responsible for any major medical bill.

Free-Market Industrialized Countries

The following list of countries is often what is meant when “industrialized countries” is mentioned. The reason is that the OECD (explained below) is an excellent source of statistical information about the 30 countries. The organization is based on countries with a market-oriented ideology. All of the free-market, high-income, (26 of 26) have health care for everyone. Everybody In. Nobody Out. [It is time to stop bureaucracy, start efficiency, and catch up to the rest of the world when it comes to being efficient in paying for health care.]

Czech Republic
New Zealand
Slovak Republic
United Kingdom
United States


The list of countries is the set of (27 of 30) member countries of the OECD – Organization for Economic Cooperation and Development, which provides statistical information for this set of countries. The 27 are the high-income countries, which do not include Mexico, Poland and Turkey.

5. Why do the other free-market industrialized countries have such a low cost per person?

Other countries decided to do what makes sense for the physical and financial well-being of their citizens plus the economic well-being of their businesses and their jobs
… while the United States does the opposite!
See below!

Global Trend / World View

Twenty-seven (27 of 29) other free-market countries provide health care from pre-natal to the end-of-life at 40% the cost of what the U.S. pays. How could this situation have developed? According to a world’s view, the entire world has been moving to simple, cost-efficient, non-profit financing of health care except for the Unites States.

Worldwide Expansion of
Non-Profit Financing of Health Care

1883 Germany
1911 Switzerland
1935 United States - CONGRESS FAILED TO ACT
    Proposed by the President.
    Strong public support, but failed in the U.S. Congress.
1938 New Zealand
1945 Belgium
1945 France
1946 United Kingdom
1947 Sweden
1948 United States - CONGRESS FAILED TO ACT
    Proposed by the President.
    Strong public support, but failed in the U.S. Congress.
1961 Greece
1961 Japan
1966 Canada
1973 Denmark
1974 Australia
1978 Italy
1979 Portugal
1986 Spain
1991 United States - CONGRESS FAILED TO ACT
The U.S. Government’s own report was provided to the U.S. Congress. That report is one of many economic studies, governmental and private, which document clearly that the U.S. and its citizens would benefit from non-profit financing of health care.
1994 United States - CONGRESS FAILED TO ACT
    Proposed by the President.
    Strong public support, but failed in the U.S. Congress.
1995 Taiwan
1996 South Africa
    U.S. Congress added privatization to Medicare
    via Medicare Advantage plans
    and Medicare Part D
2006 United States - CONGRESS FAILED TO ACT
Overwhelming support expressed by citizens for non-profit financing of health care. The final report went to the U.S. Congress on September 29, 2006. This report was the culmination of effort by the U.S. Congress own citizens working group. The group conducted meetings for over 15 months across the country.

United States’ Free-Market Failure

Following is the comparison of the economic success of the Canadian national health plan during the same 40 years as the so-called “managed care” experiment in the United States. That difference is seen clear in the Canada vs. United States spending, below.

FYI, regarding Canada’s physical and financial health: “Life expectancy in Canada is 81 years, versus 78 in the United States; “healthy life expectancy” is 72 years, versus 69. American car companies have moved so many jobs to Canada to take advantage of lower health-care costs that since 2004, Ontario and not Michigan has been North America’s largest car-producing region.” - Newsweek, February 7, 2009

Canada vs U.S. Spending
on Health Care

U.S. Congress Support for Single-Payer

7. What will be the government’s role?

Will we have government-controlled health care? No. The relationships between physicians and their patients will improve. The decisions will be made more on common sense and what the physician and patient decide, not on what the health insurance company decides.

Will we have government-administered health care? In terms of the day-to-day decisions of U.S. politicians and 50 states of politicians, the government will not be involved. The administration will be conducted by one non-profit, public agency, which is accountable to the people and insulated from the federal and state legislatures.

What will be the government’s role? The politicians simply need to create the law that establishes the one public agency that is needed to provide non-profit single-payer national health insurance.

8. The Mystery, Conclusion and Challenge

The Mystery - Part One - Past and Current

I’ve had conversations with people from all over the world regarding health care. Most recently I’ve been reading stories written by Americans who live all over the world. Those people who live in other countries are mystified. Whether based on the clear expressions on their faces or based on what they write in their stories, they tend to express themselves with much amazement about United States regarding health care, referring to the facts and information in the previous sections of this web page.

People in other countries have experienced the peace of mind of having no major medical bills and knowing that their health care is covered for their entire lives. They wonder in amazement why we continue to deny ourselves the benefits of having a non-profit national health insurance system.

Americans in other countries have been and are experiencing what people in other countries have. They like it.

People express astonishment that the United States does not do the same as their countries did years ago to provide a major contribution to:

  • physical and financial well-being
  • businesses and jobs
  • peace of mind regarding medical bills
  • freedoms that we’ve denied ourselves for decades:
  • Here are some details:
    • Savings: less than half the cost; no health insurance companies; fewer government programs.
    • All necessary care - (see Benefits)
    • No more rationing based on ability to pay.
    • Everyone included, pre-natal to the end-of-life.
    • Freedom to choose doctors, medical facilities, professions, jobs, and employers.
    • Lower costs for physicians to run their private practices; more of physicians’ time for patients.
    • Lower business costs = recovery & creation of jobs.
    • A healthier workforce. As documented in section 1 of this web page, Our life expectancy is 30th in the world; we are 19th of 19 countries in minimizing deaths due to preventable diseases! When people can get to a doctor, we will do better!

It’s especially puzzling to people that we continue the use of 1300-1600 health insurance companies when one considers the dramatic economic failure of the use of that free-market approach. It’s puzzling to consider that other free-market industrialized countries have been steadily doing what makes sense to do, while the U.S. only goes in the wrong direction. The global trend has been successful and the United States has failed badly.

The Mystery - Part Two - The Future

U.S. politicians are preparing proposals that will make the current condition even worse for some Americans. Do we care about the millions of people who will be caught in the lower middle class? The mystery question: will we Americans take action NOW to find those who care about this topic and ask them to participate in the Million Letters for Health Care Campaign? And will many of us do that as soon as possible?

President Obama has not yet seen his requirement fulfilled by having a mandate established by Americans by following his specific suggestion. We must act on his suggestion to establish the health care policy that Americans want and America needs. When U.S. President-Elect Obama conducted his New Hampshire meeting on 4/3/2007 he gave us a specific suggestion of how to participate in the democratic process to get the health care that we want. That suggestion was to send letters in the U.S. mail in every U.S. Congressional District. He said ” … two thousand people writing letters in every Congressional District …”. Immediately after that meeting he stated to the local reporter that he requires a mandate from the American people.

There is MUCH evidence in 2009 that some members of the U.S. Congress are working toward a FAST creation of a law for one of the alternatives that will MAINTAIN and most likely expand the health insurance companies’ bureaucracy and will definitely EXPAND the government bureaucracy.

Any proposal other than non-profit provides a Lose-Lose situation for the American people. Our taxes will go up, and our payments to health insurance companies will go up! Instead, we could be saving money and all of us getting health care!

Even if the efforts of the politicians and the health insurance companies are not successful, then Medicare is scheduled become more privatized anyway in 2010. The plans for 2010 are the latest for what is the wrong direction, as established by U.S. Congress in 2003.

We can and will ulfill the President’s mandate and suggestion via the Million Letters for Health Care campaign

WE MUST DO THIS for our physical and financial well-being!

The Conclusion

We American citizens have suffered enough unnecessary pain, suffering and death.

We need to do what the other countries have done, and we need to do it as soon and as fast as possible. Too much time has passed with too many hardships occurring.

Now we are taking the best action possible by printing and sending our letters to our U.S. Representatives.

You can:
— sign up by getting reminders, so we can know how many citizens are participants and so that you can receive the set of suggestions each month for adding a note by hand to the letter … minimizing your effort and maximizing the impact of your effort
— print, sign and send your letter each month and
— get others to do the same.

Can we get this done? YES, WE CAN!.

The Challenge

Americans have been active …

We Americans clearly expressed our overwhelming support to the U.S. Congress’ working group on health care in 2005 and 2006 in meetings held all over the country. During the campaign we gave very clear face-to-face input in New Hampshire to Barack Obama during his own health care meeting. We answered the polls throughout all of 2007. During 2007 and 2008 we increased the public activities of demonstrations, “truth hearings”, and vigils in 2007 and 2008 and plan to have more in 2009. Now we are documenting the stories of Americans who live in other countries.

But the opposition is active …

Media propaganda has been controlling the minds of many Americans for many years. Regarding health care that mind-control has been demonstrated in dramatic ways, such as massive defeats on citizen-initiated ballot questions over the years. That mind-control is seen via the facial expressions and words of concern from the citizens who have been most impacted by the propaganda.

Now (2007-2009) additional well-financed campaigns of tens of millions of dollars are contributing to the mind-control activity by doing additional activities, such as doing small group meetings and well-financed training. One of the campaigns announced in July 2008 that it would raise “an activist army at least 100,000 strong”. Those campaigns are spending even more millions of dollars per year than ever before into the attempts to control our minds. [By the way, consider where part of that money originated, either directly or indirectly: our bloated health care premiums!]

So we need to take action …

  • Please participate in the campaign, preferably including that extra 1 minute of hand-writing or hand-printing one of the notes that has already been created for you as soon as you receive your reminder each month.
  • Please consider telling others about this web page and letting them come to their own conclusion about whether or not joining Million Letters for Health Care (by getting the reminders) is a critical activity.

The Need to Focus on the Positive

Please do not get distracted by what we do not want, such as Medicare being further privatized starting in 6 cities in 2010. We can focus on the positive via the Million Letters for Health Care Campaign. The campaign tries to focus as much as possible on what we want to have happen, not on what we don’t want to have happen. We need to focus on we want our U.S. Representatives to help make happen.

We need to implement simple, non-profit single-payer national health insurance. We need the U.S. Congress and the U.S. President to set up our public agency that will run the very simplified, highly cost-efficient operation that pays for all of our major medical bills and almost everything else that we need for health care, as well as negotiating the drug prices way down like other countries do.

It is an urgent matter to focus on the best solution. U.S. politicians in Washington D.C. in 2009 need to focus on getting non-profit single-payer national health insurance in order to eliminate the bureaucracy documented on this web page. Unless a proposal is anything other than the implementation of a simple, efficient method of paying for health care called “single-payer”, then there is most likely going to MORE complexity and MORE pain and suffering and deaths for the average American. Simplest is best! Non-profit is best! Single-payer!

This is an exciting and truly grassroots activity. The Million Letters for Health Care Campaign has been initiated by and is being accomplished by individual Americans, most of whom are covering their own costs to make the campaign successful. So, if you can help some individual with time or money or effort, please do it!

Additional Information

  • Overview of what single-payer is
  • Handout (pdf) for Million Letters for Health Care Campaign
  • Sources about health. Refer to Health Outcomes for sources about life expectancy and the ability to minimize deaths due to preventable diseases.
  • Explanation of 1300-1600. About 1300 health insurance company members are members of the national association of those companies (deliberately not named here).
  • Credits. Our small Medicare for All team is very grateful to so many people across the U.S. and the world. The source for the images that have “Source” in the lower left is PNHP, Physicians for a National Health Program. My fellow PNHP activists and my fellow Healthcare-Now activists, as well as additional Americans, have been very helpful of the years and currently. As a result, I consider my work to be the result of all those who helped. It’s been a collective effort with the number of persons involved as truly too long to mention. Many thanks to all!

Special Note about Additional Sources for those persons who very much like to have proof of information. This website has extensive information with many detailed sources, such as in the Single-Payer Education section. You are welcome to go to the rest of this website for more information and refer to the many sources of that information.

We Americans can sign up to take action together. Our one million letters each month to Washington, D.C. represent our voices raised in unison to get what we have denied ourselves and our country for so very long.

We Need a Non-Profit Way to Pay for Health Care
Such as the Best Version:
Non-Profit Single-Payer National Health Insurance

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