One of the overlooked problems with single payer (which I believe is our only hope) is the amount of money we spend for health care in the U.S.

Right now we spend about $8000 per person in the U.S. annually ($2.4 trillion in spending for 300 million population).

That's $32K per year for a family of four, which is $2667 per month. It’s $667 per month for an individual. I don't know many folks who could afford that under a single payer plan that distributes the costs evenly among a universal pool of enrollees.

But wait.

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France spends about $3600 per capita according to the latest OCED figures for 2007. Let's say that has gone up to $4000 by now. That's about half of what we spend and they have better outcomes. So let's say we could figure out how to deliver health care as efficiently and cost-effectively as the French, thus reducing our $8000 per capita to $4000. Other countries do it for even less.

Now we are talking about a single payer system which has to cover 300,000,000 people at a cost of $4000 per person, which works out to about $1.2 trillion.

Now consider that the federal government already covers about $665 billion through Medicare and the federal portion of Medicaid (paid for by existing payroll taxes, Medicare premiums, and general tax revenues). So we are already paying $2217 per individual towards the $4000. (So much for "keep the government out of my health care!")

That leaves $1783 per individual to cover a single payer system for every U.S. citizen. That's $149 per month per individual, or $594 per month for a family of four.

And even if we continued with the current employer-based system, employers would pay a portion of $594 per month for family coverage instead of paying a portion of $1928 per month.

And we would eliminate $140 billion in state Medicaid spending, which represents anywhere from 4% to 25% of state budgets (about 17% nationwide). We might have to raise the 2.9% Medicare payroll tax a little and have sliding-scale premiums and vouchers to cover the needy and the uninsured. Maybe we have higher deductibles and co-pays for high-net-worth individuals. But it would be a lot cheaper to insure everyone at $4000 per than at $8000 per.

Now the only problem is reducing the per capita cost to $4000. A single payer national universal health insurance system would eliminate insurance company profits, executive bonuses, redundant billing and payment systems, etc., saving anywhere from 15% to 30%. Let's be conservative and say 20%. This reduces our $8000 per capita to $6400 right out of the gate.

Now we need to find $2400 more (37.5%) in savings. Maybe we pay $750 for an MRI instead of $1200. And maybe we pay $6 instead of $10 for a hospital aspirin. Etc. My doctor gives a 40% discount for paying cash and he seems to be doing OK. We can reduce health care spending by 37.5% if we want to get serious about the problem.

Congress ought to be able to figure it out. In fact, they have already figured out the single payer part. It's called HR676. All this other stuff we're arguing about is a waste of time, and will end badly for everyone except insurance and pharmaceutical companies.