To get health care for everyone at the lowest price, a single-payer system is the way to go. Single-payer health care insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Some people confuse single-payer and socialized medicine. In socialized medicine, both the financing and the care delivery are controlled by a public agency. Medicare is an example of a single-payer system where employers and taxpayers pay into the system that provides financing for health care for adults over the age of 65 and disabled individuals of all ages.

Americans ask, “How can we pay for a single-payer system?” The answer is that the money is already in the system. We pay almost twice as much as any other industrialized country for health care, but life expectancy is lower and infant mortality is higher.

Besides providing health care, where else does the money go? A very substantial part of the money goes to marketing, billing and other administrative costs. Can you imagine how much money we’d save if we eliminated the hospital billing department? If everyone was covered and the money was paid by a single payer, we wouldn’t need to send all those bills. In the United States we pay $420 per person for hospital billing and administration; in contrast, in Canada the cost is $64 per person. We could provide health care coverage for a lot of people with that savings.

Administrative costs for insurance companies run about 19 to 26 percent. Administrative costs for Medicare run about 3 percent because Medicare is a single, publicly financed plan that provides universal health care coverage for older adults in the United States. The insurance overhead in the United States was $314 a person in 2001, while in Canada the cost was $54 per person. Think what it would mean if we could spend the difference on health care for the uninsured.

Besides providing health care, where else does the money go? A very substantial part of it goes for profit. Some of the biggest recipients are pharmaceutical companies and insurance companies. For example, according to the Centers for Medicare and Medicaid Services, pharmaceutical companies only spend 30 percent on producing drugs. They spend 31 percent on marketing and administration and keep 20 percent as profit. Could you live without commercials about how to prevent incontinence or how to build up your blood if you ever get cancer? What if we spent all the money that is currently spent on advertising on providing health care?

Our for-profit health care system creates a conflict of interest between patients and profits. The often-quoted economist, Milton Friedman said, “Few trends could so thoroughly undermine the very foundations of our free society as the acceptance by corporate officials of a social responsibility other than to make as much money for their shareholders as possible.”

A single publicly financed plan works because it lowers profit, marketing, billing and administrative costs and uses that money to provide universal health care. There’s enough money in the system if we’re willing to consider the option of a single-payer system. For me, it’s a decision based on values. Just as I believe that a democracy like the United States should provide public education to every child, I believe that we should provide health care to every citizen.

In the United States, 46 million people have no health care insurance. That’s about one in six people. Who are the uninsured? Fifty percent of the uninsured are employed, but either they don’t have benefits provided by their employer, or they can’t afford to buy the health insurance that’s offered. Twenty-five percent of the uninsured are children. Failing to invest in the health of our children doesn’t bode well for the health of our country.

The health care debate is about values.

What’s fair? What’s just? What is our social responsibility as U.S. citizens? Cardinal Joseph Bernardin provided leadership in the debate when he said, “Health care is an essential safeguard of human life and dignity, and there is an obligation of society to ensure that every person be able to realize this right.”

There is money in the health care system to provide universal health care to all U.S. citizens, but it’s unlikely to happen until we have campaign finance reform. The insurance and pharmaceutical lobbies are too influential.

When I grew up in the 1960s, it took the will of the people to make civil rights a reality. Today it will take a similar personal and societal transformation to make universal health care a reality. We need a change in values as well as a change in policy to create the kind of society we want.