Intended for healthcare professionals

Rapid response to:


Uninsured Americans and the new Democratic Congress

BMJ 2006; 333 doi: (Published 30 November 2006) Cite this as: BMJ 2006;333:1134

Rapid Response:

Universal Insurance in the U.S. is Impossible

Professor Reinhardt is right when he claims that comprehensive insurance for all in the United States is impossible at present, even though Democrats will dominate the next Congress. He errs, however, when he attributes this failure to an American belief that those who are uninsured should blame themselves for their misfortune. (See Reinhardt, Uninsured Americans and the New Democratic Congress, BMJ.) After all, substantial proportion of uninsured, or underinsured Americans, are the middleclass and are not viewed by themselves or others as poor. The true reason for lack of National Health Insurance in the U.S. is the paculiar American system of financing national elections. The system allows the major actors in the health care industry - the American Medical Association, the American Hospital Association, the Health Insurance Association of America, and most recently - the coalition of pharmaceutical companies to control government policy towards financing and delivery of health care through substantial monetary contributions to election campaigns of favored political candidates. Thus, these actors reward those politicians who are against universal health insurance with substantial contributions, and punish politicians who favor universal insurance by denying them these contributions. In additon, they dominate the airwaves in any debate about financing and consumtion of health care. No one else in the United States has such an abundance of resources which can be thrown immidiately into media advertising to defeat any national health insurance plan that violates the interests of these actors. Propaganda about "socialized medicine" and long waiting time in the U.K and Canada fall on receptive minds of mostly poorly educated Americans.These associations not only control Congress but also dominate public debates about national health policies. Recent mergers of media conglomarates and decline in outlets for public debates makes the job of these pressure groups easier.

Competing interests: None declared

Competing interests: No competing interests

02 December 2006
Boris Odynocki
Associate Professor
Southern University, New Orleans, 70122