More than 45 million Americans go without health care. At 14% of the gross domestic product, national health care spending is at an all time high. Health care issues and prescription drug costs continue to gain increasing attention during election campaigns, and many Americans are calling for the need to provide national health coverage as a universal service to all residents.

The government already provides healthcare to 28% of Americans. Medicaid programs cover medical treatments for people who are of low income and limited resources. Medicare provides health care coverage to U.S. citizens over the age of 65, and to certain people under the age of 65 with specific disabilities. While neither of these systems are perfect, advocates call for the expansion of similar national health care products to service all U.S. citizens. Although 61% of Americans have private health insurance, usually through a group employer, proponents of national health care coverage believe that only government reforms and mandates can control rising health care costs and make coverage available to all citizens.

Among physicians who support a national health care system, a single-payer system is seen as the only solution capable of providing coverage to the uninsured or underinsured, while also controlling the skyrocketing health costs due to drug pricing, malpractice suits, and long-term care. Under a single-payer system, the government would finance health care, but delivery of services to the consumer would be managed by private parties. How to integrate this in a cost-efficient manner, without breaking our current system, continues to be a source of much debate.

The call for a universal health care system began under the Theodore Roosevelt administration, and was a major issue and topic of debate during the Clinton administration. During this time, First Lady Hillary Clinton was appointed by President Bill Clinton to head the Task Force on National Health Care Reform, making national health care her primary concern. The system reforms she proposed were too complex for many Americans to understand and they were defeated in Congress. In 2003, President George W. Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act. This was done to overhaul and expand a system which had become antiquated.

Despite this, many experts believe Medicare will run out of money as the baby-boomer generation requires greater, more intensive health care, and suggest national health insurance as the only solution. Many proponents of national health care point to the face that the United States, which is vastly rich in its resources, should be capable of providing the same type of national health care coverage that is universally offered in other modern, industrialized nations. National health care systems have been in practice for some time in many European nations. Those systems don't provide the same independence of choice that individuals in the U.S. demand.