The Universal Declaration of Human Rights, adopted by the United Nations in 1948, declares, in part, "Everyone has the right to a standard of living adequate for the health and well-being of himself and his (sic) family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."

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Halfway solutions won't work, particularly those that put more taxpayer money into helping people buy more private health insurance. Private health insurance is not only extremely costly, it will also result in more and more under-insurance and will actually move us away from achieving quality universal coverage. In order to maintain profits and control their costs, private insurers will jack up deductibles and co-pays and cut benefits. Private insurers will do all they can to recruit the healthy and avoid the sick, who are burdened with pre-existing conditions.

That's the fallacy of the "level the playing field" argument put forward by politicians and pundits who propose that we offer Medicare to everyone and let it compete with private health insurance. The competition will not be fair, because private insurers will figure out how to attract the well by offering perks like free health-club memberships and by advertising aggressively among healthier groups, and how to skip over the less healthy by undermarketing to high-risk populations, even if they are legally required to insure all applicants. This will inevitably leave a disproportionate number of the sick to Medicare, which will in turn raise Medicare premiums, which will make it less attractive to healthy people than private insurance.

Many reformers advocate regulating private insurance to prevent these abuses, but the record of government regulation in this country is poor. The private industry being regulated uses its clout to constrain and distort government intervention. Moreover, no one has proposed comprehensive regulations to curb the worst features of the insurance industry, its built-in desire to avoid paying claims. Most regulation being proposed primarily involves selling insurance, not actually paying for health care.

We already have a clear example of how private health insurance avoids regulation when it coexists with public health insurance when we compare traditional Medicare to Medicare Advantage in which private insurance companies provide coverage. These private plans receive 12 to 18 percent more funding than traditional Medicare and yet have been fraught with major problems. "Tens of thousands of Medicare recipients have been victims of deceptive sales tactics and had claims improperly denied by private insurers according to a review of 91 audit reports conducted by the New York Times." [12] The companies reviewed included three of the largest participants in the Medicare market, United Health, Humana, and Wellpoint. The problems, described in the audit reports, include "the improper termination of coverage for people with H.I.V. and AIDS, huge backlogs of claims and complaints, and a failure to answer telephone calls from consumers, doctors and drugstores.... The audits document widespread violations of patients' rights and consumer protection standards. Some violations could directly affect the health of patients -- for example, by delaying access to urgently needed medications."

The danger of halfway solutions is not only that they won't work but also that their failure can discredit the whole effort on behalf of universal coverage. The public will blame the advocates for universal coverage for the lack of improvement in affordability and coverage. Moreover, the halfway measures that have been proposed add legitimacy and resources to the private insurance companies, who will use those assets to fight single payer every step of the way.

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Dr. Martin Luther King Jr. warned, "A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual doom."