Every day, approximately 100,000 people lose health insurance coverage in the United States. Over forty-four million Americans do not have health insurance at all. The people who have HMO's as their only choice of insurance routinely face rejection of payment when serious health problems arise. The doctors employed by HMO's make decisions about a person's health without laying hands on the patient. They do not examine, listen to or have any contact with the patient about whom life and death decisions are made regarding their health.

There are over 1500 insurance companies in America with different rules of what services will or will not be funded. Our facility has hired two people just to handle the health insurance questions that arise every day. They often have a frustrated and perplexed look in their eyes as they undertake to find solutions to problems, and then have to contact a faceless bureaucratic entity about whether or not a service will be paid for.

Health care workers have accepted the unacceptable and do not seem to know the way out of the quagmire.

00 for a seven year old patient who was in an automobile accident, and suffered a lower spinal cord injury. He is paralyzed from the waist down. The proposed goal for the fund raiser was to buy a handicapped accessible van. Since these vans cost anywhere from $15-30,000.

At the fund raising dinner, I sat with the patient's grandmother. She told me she wanted the money to be put in a trust fund to pay for the child's catheter supplies, diapers and medicine that the Managed Care Insurance company would not pay for.

Back in the office the following week, one of the women whose job it is to deal with insurance questions, solved the dilemma and the supplies are now paid for. The child's mother had receipts, and the HMO reimbursed her from the time of the car accident.

Physicians for a National Health Program in America have devised the following plan for implementation. For more information, please access www.pnhp.org.

Single Payer Insurance is defined as a single government fund with each state which pays hospitals, physicians and other health care providers, thus replacing the current multi-payer system of private insurance companies and other plans.

It would eliminate the financial threat and impaired access to care for tens of millions who do not have coverage and are unable to afford the out-of-pocket expenses because of deficiencies in their insurance plans.

It would relieve businesses of the administrative hassle and expense of maintaining a health benefits program.

It would control health care inflation through constructive mechanisms of cost containment that improve allocation of our health care resources, rather than controlling costs through an impersonal business ethic that robs patients of care so as to increase profits for the privileged few.

So why don't we have a National Single Payer Plan?