In a January, 1996 Harris Poll only 16% of Americans agreed with the statement, "on the whole, the health care system works pretty well and only minor changes are needed;" 59% said that "fundamental changes" were needed; over 70% felt that the situation will worsen over the next three years. The American people are savvier than their elected representatives. They are right; there is plenty wrong with the American system:

• The Uninsured: In this, the richest country in the world, there are 42 million uninsured people. That is almost 17% of our population and the number is growing at an annual rate of 1.1 million.
• The Under-insured: Having health insurance, or being covered by Medicare or Medicaid, is not a guarantee of financial security when it comes to health costs. Between 50 and 70 million Americans have inadequate insurance. Any major health problem would send most of them into financial ruin.
• The Quality: The quality of the American system is such that we pale in comparison to other industrialized nations when we look at the standard measures of health care. The Organization for Economic Cooperation and Development (OECD) is a group of twenty four industrialized nations. Among them, the U.S. ranked 17th in male life expectancy, 16th in female life expectancy, and 21st in infant mortality.
• Health Care Costs: We spend far more per capita on our health care than any other country, over $4000 per person. Health care costs now comprise almost 14% of the Gross National Product (GNP). The growth has been phenomenal. At the present rate of increase, by the year 2000 we will be spending $1.74 trillion on health care, 18.1% of the GNP. By comparison, most other developed countries (with universal coverage) have stabilized their health care costs at 8 or 9% of GNP. So, despite all our sophistication, our expertise and advanced research, our high-tech medical devices, we are clearly not the best (as some of our politicians have assured us). We spend more for less and are being short-changed!

For those who quake at the thought of yet another governmental bureaucracy, consider these facts:

• We already have a government-run health care model, Medicare. Medicare is more efficient than any private insurance program, spending only 3% for overhead and administrative costs.
• Those in the Medicare program (over 65 or disabled) are the only universally insured portion of our population. In 1987 24% of America's health care dollars went to pay administrative costs, it is still more today. In the same year, only 11% of Canada^Òs total health care bill went to administration. Remember, we are not talking about the actual cost of health care itself, only that of its management.

Apparently the American health care industry is not very efficient. In 1990 it took Blue Cross / Blue Shield of Massachusetts 6,600 people to administer insurance to its 2.5 million clients in New England. In the same year, 435 people in British Columbia managed the provincial health program for that province^Òs 3.1 million people. In fact, Blue Cross / Blue Shield of Massachusetts employs more administrators than does Canada's entire health care system, which serves over 26 million people.

The Congressional Budget Office (CBO) estimated that by adopting a Single-Payer national health care system, we would reduce medical spending by more than $114 billion a year by 2003.