*Health Insurance in the United States: Failure of Private and Multi-Payer Financing DOI: http://dx.doi.org/10.5772/intechopen.103937*

Although much of organized medicine in the U.S. has opposed national health insurance over the years, that stance is beginning to change as so many physicians find our present multi-payer financing system such an impediment to daily medical practice. Medicare for All already has strong support among the general public, physicians and nurses. Experience and evidence over the years confirms its advantages as shown by **Table 2** [31]. Had Medicare for All been in place during 2019, it is estimated that we would have saved more than \$1 trillion. **Figure 5** shows how those savings would have been taken place [32].

If and when Medicare for All can be enacted, it will bring a new system of national health insurance for all Americans with comprehensive benefits based on medical need, not ability to pay, together with full choice of hospitals, physicians and other health professionals anywhere in the country. Administrative simplification will drop its single-payer overhead to about 3%, one-sixth of today's multi-payer overhead.


#### **Table 2.**

*Comparison of four reform alternatives based on evidence (Table 13.1, 60 years, 160).*

#### **Figure 5.**

*Medicare for all savings compared to current system, 2019 (Figure 14.2, MIC 269).*

Cost savings will be achieved through large-scale cost controls, including (a) negotiated fee schedules for physicians and other health professionals, who will remain in private practice; (b) global annual budgeting of hospitals and other facilities; and (c) bulk purchasing of drugs and medical devices. Cost sharing through deductibles and copayments will be eliminated at the point of service, and pre-authorization of services will no longer be needed. Higher priority will be given to primary care and public health, while the risk for costs of illness and accidents will be shared across our entire population of 330 million Americans.
