TY - JOUR T1 - Atoms JF - Archives of Disease in Childhood JO - Arch Dis Child SP - i LP - i DO - 10.1136/adc.2009.174698 VL - 94 IS - 11 A2 - Bauchner, Howard Y1 - 2009/11/01 UR - http://adc.bmj.com/content/94/11/i.abstract N2 - As most of you are aware, the USA spends more money on healthcare than any other country in the world, and sadly, one in every six Americans is uninsured. Remedying this problem has led to intensive debate in the States. Unfortunately, any notion of a “single-payer” was discarded early in the discussion, and currently the only possible option for increased government involvement appears to be a “public insurer”. Conservatives have protested for two reasons, first, it would have an unfair advantage over its private counterparts, because it could negotiate deep financial discounts with doctors, hospitals, device manufacturers and the pharmaceutical industry. Second, it would be inefficient. President Obama has succinctly pointed out that it is impossible to reconcile these two concerns. Interestingly we already have a successful public health care plan—Medicare—which provides health insurance for all elderly Americans. Administrative overhead is approximately 3-5%. This compares quite favourably to the 15–17% administrative costs of private insurers. Some have suggested that the best approach to insuring more citizens is to reduce the age of eligibility for Medicare … ER -