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Overcoming the Prejudice Against Establishing a National Health Care System

Richard J. Botelho, MD
Arch Intern Med. 1991;151(5):863-869. doi:10.1001/archinte.1991.00400050017005.
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Our health care system has been very successful in providing the most technologically advanced medical care in the world to affluent and well-insured segments of society. Pride in this accomplishment has contributed to a success-induced blind spot. Our society overlooks and fails to adequately respond to the most significant shortcomings of our health care system, namely, social inequality in access to health care and escalating health care costs.1-6

Our country spends the highest percentage of gross national product on health care and, yet, 37 million uninsured Americans have limited access to medical care7,8; 11 million of these Americans are children, 7 million of whom go without regular medical care. In contrast, all other western democracies implicitly or explicitly used the moral ideal, "health care as a human right," to establish different types of national health care systems (NHCS). These systems provide health care to all citizens regardless of


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