Over the past two decades, PNHP research has influenced health policy and focused debate on the need for fundamental health care reform.

1. Administrative costs consume 31 percent of US health spending, most of it unnecessary.

2. Medical bills contribute to half of all personal bankruptcies. Three-fourths of those bankrupted had health insurance at the time they got sick or injured.

3. Taxes already pay for more than 60 percent of US health spending. Americans pay the highest health care taxes in the world. We pay for national health insurance, but don’t get it.

4. Despite spending far less per capita for health care, Canadians are healthier and have better measures of access to health care than Americans.

5. Business pays less than 20 percent of our nation’s health bill. It is a misnomer that our health system is “privately financed” (60 percent is paid by taxes and the remaining 20 percent is out-of-pocket payments).

6. For-profit, investor-owned hospitals1-4, HMOs,5 nursing homes6,7 and home health care agencies8 have higher costs and score lower on most measures of quality than their non-profit counterparts.

7. Immigrants1 and emergency department visits2 by the uninsured are not the cause of high and rising health care costs. Immigrants also subsidize Medicare’s trust fund.3

8. 45,000 annual deaths are associated with lack of health insurance1. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002. The uninsured do not receive all the medical care they need — one-third of uninsured adults have chronic illness and don’t receive needed care2. Those most in need of preventive services are least likely to receive them.

9. The US could save enough on administrative costs1 (more than $350 billion annually) with a single-payer system2 to cover all of the uninsured.

10. Competition among investor-owned, for-profit entities has raised costs, reduced quality in the US



Himmelstein DU, Woolhandler S. “Competition in a publicly funded healthcare system.” BMJ 2007;335:1126-1129 (1 December), doi:10.1136/bmj.39400.549502.94 Hellander I, Himmelstein DU, Woolhandler S. “Medicare overpayments to private plans, 1985-2012: Shifting seniors to private plans has already cost Medicare US$282.6 billion.” International Journal of Health Services 2013;43(2):305–319. doi: http://dx.doi.org/10.2190/HS.43.2.g

11. The Canadian single payer healthcare system produces better health outcomes1,2 with substantially lower administrative costs3,4 than the United States.

12. Computerized medical records1-3 and chronic disease management4 do not save money. The only way to slash administrative overhead5 and improve quality6,7 is with a single payer system.

13. Alternative proposals for “universal coverage” do not work. State health reforms over the past two decades have failed to reduce the number of uninsured1.