In February Rep. John Conyers (D-Mich.) introduced HR-676, the United States National Health Insurance Act (NHIA), which would establish a national single-payer health care system. Conyers said his bill will free our nation “from having to put up with the outrageous costs that keep millions of Americans from receiving medical care and needed medications.” Reps. Barbara Lee (D-Calif.), Jim McDermott (D-Wash.), Luis Gutierrez (D-Ill.), Dennis Kucinich (D-Ohio) and Julia Carson (D-Ind.) are among its 26 co-sponsors.

HR-676 would be funded by an estimated 4.75 percent payroll tax that would replace employer contributions to present health insurance plans. It provides all medically necessary health care services to all residents and has no co-payments and no deductibles. The NHIA would operate on the principles of Medicare: government financing, with the care delivered by physicians and other providers of the patient’s choosing. Insurance companies would be barred from selling health insurance.

Most independent studies have shown that the elimination of existing administrative waste in the system would free up more than enough money to pay for coverage of the uninsured and truly comprehensive benefits for all. According to Dr. Don McCanne, president of Physicians for a National Health Program (PNHP), “A single-payer system, funded at our current level of spending, would provide high quality, comprehensive, affordable health care for everyone. But we can achieve this only if we throw out the wasteful, ineffective middlemen – the health plans – and spend the money on patients instead.”

PNHP says the federal government spends $2,600 per person/year on health care through Medicare, Medicaid, public health and tax exclusions for employers who provide workers’ coverage.

In drafting the legislation, Conyers consulted with several eminent healthcare professionals, including Dr. Marcia Angell, former editor of the New England Journal of Medicine, and two former presidents of the American College of Physicians, including two former U.S. Surgeons General. Some 4,000 physicians have endorsed the legislation.

According to Rep. Kucinich, a candidate for the presidential nomination of the Democratic Party, government expenditures account for 60 percent of total U.S. health care costs. “Our citizens re so close to paying for a universal health care system, but so far from getting it,” he said.

Introduction of HR-676 coincides with a growing recognition that the nation’s health care system – if you can call it a “system” – faces a meltdown. According to the United Auto Workers (UAW), as many as six million people are likely to be added to the ranks of the uninsured this year as states cut Medicaid reimbursement and federal budget increases for Medicare continue to lag behind inflation. Thousands of retired steelworkers and many other workers who once knew excellent health benefits are losing employer-paid coverage. More thousands lose their coverage when their plant closes. Coverage is shrinking, as more employers decide to cap their contributions to health insurance and workers find they cannot pay additional co-pays. Private health insurance premiums are rising at the rate of 13 percent per year – and as much as 25 percent in some areas, making it impossible for many families to pay for any health insurance, let alone adequate insurance. Increased unemployment brings with it an increase in the number of uninsured.

As Angell said, the system cannot be tinkered with; it needs to be changed. She added that disparities in income, material possession or social privilege “should not extend to denying some essential services” to people because of their income.

Ron Gettlefinger, president of the United Auto Workers, was even more direct when he recently put automakers on notice that they cannot stop rising health care costs by shifting the burden to workers and retirees. “You can’t fix the health care crisis in America at any one bargaining table with any one employer or with any one industry,” Gettlefinger told the Detroit Economic Club. “We need a universal, comprehensive single-payer health care program to cover every man, woman and child in the United States.”

For more information, contact Joel Segal, legislative assistant to Rep. Conyers, at (202) 225-5126, or e-mail at

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