US health care costs are the highest in the world and are again rising. A reopening of debate on health care reform is imminent. More than 44 million Americans have no health insurance, an increase of 11 million people since 1989. Although women have been slightly more likely to have health insurance than men, recent declines in Medicaid enrollment resulting from welfare reform are eroding this slim advantage. Being uninsured is associated with compromised access to primary care and an increased risk of dying. At least 29 million Americans are underinsured; although they have some insurance, they would nonetheless be bankrupted by a major illness. A single-payer national health insurance system would cover all Americans in a non-profit, tax-funded system similar to Social Security. It would simplify health administration, saving at least $100 billion annually on paperwork and redirecting that money to patient care.

作者：C B, Kirschenbaum；S, Woolhandler

来源：Journal of the American Medical Women's Association (1972) 2000 年 55卷 1期