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Should the U.S. have a national health-care system?

Health care is likely to be one of the key issues in next year's election

We have two health-care systems in America. People with good insurance get excellent care. But most families are just one bad break, like a lost job or a serious illness, away from crisis.

I believe we should build one America, with one health system in which everyone can get decent, affordable health care. This means asking everyone to share the responsibility of helping to finance health care for all and paying what you can for your own care.

A universal health-care system would translate into reality what Americans believe—that health care is a right, not a privilege. America is one of the wealthiest nations in the world, but 18,000 people die each year because they don't have insurance. That's just wrong.

Insisting that every American participate in a universal system will save money by spreading out the risk. Today, families with insurance pay more for their coverage—an additional $922 a year on average—because they wind up footing part of the bill for treating the uninsured.

But this debate is about more than 45 million uninsured Americans. Millions more have inadequate insurance that doesn't cover all their needs. And because our current system relies mostly on employers to provide insurance, other people stay in jobs they'd otherwise leave just to hold on to their health insurance.

It's time to act. A million Americans lose their health insurance every year. Universal health care is the most important thing we can do to provide security for American workers and families.

Former Senator John Edwards
Democratic candidate for President

Politicians of all stripes are talking about health care these days, with many implying that "universal health insurance" will put everything right with America's health-care system.

But there's a big difference between coverage and care. Many countries provide universal health insurance but deny critical procedures to people who need them.

At any given time, 850,000 Britons are waiting for admission to National Health Service hospitals. In Canada, where more than 800,000 people are on waiting lists for procedures, the Chief Justice of the Supreme Court wrote in a 2005 decision that "patients die while on the waiting list."

About 45 million Americans lack health insurance, but most go without for only short periods (for example, between jobs). Those who truly cannot afford insurance are already covered by Medicaid (government health insurance for the poor), and all Americans have access to at least emergency care, which hospitals are legally obligated to provide, regardless of ability to pay. And though we all end up paying indirectly—through higher medical and insurance charges—for the care uninsured people receive, that's tiny compared with what a national health-care system would cost.

There are steps we can and should take to make insurance more affordable—like exempting insurance costs from taxes and removing regulations that prevent insurers from competing for our business. But we shouldn't let an obsession with universal coverage lead us to neglect more-modest reforms that would actually do more good.

Michael Tanner
The Cato Institute