In the past month, as a family physician I have admitted two patients to the hospital just because they didn’t have health insurance. One ran out of his heart medicines, and couldn’t afford more. He came into the hospital with a dangerous heart rhythm and was in the Intensive Care Unit for three days.

Another patient was admitted with chest pain and had a complete heart workup including heart catheterization, and was in the hospital for three days. The cause of her chest pain was found to be her stomach; she had run out of her stomach medicine and couldn’t afford more. Both of these hospital stays were a waste of time and money for the patient, and sources of anxiety for the patients and doctors.

This would not have happened in any other developed country in the world, because their medicines would have been provided via their health insurance.

Why didn’t these people have health insurance? Because they could not afford it. The rich and upper- middle class in the United States have health insurance through their employers. The very poor have Medicaid. Many people in the middle (who work for small businesses, or who are low-wage, self-employed or part-time workers) have no insurance.

“The U.S. spends more than twice as much on health care as the average of other developed nations, all of which boast universal coverage. Yet more than 41 million Americans have no health insurance, and many more are underinsured.” (Journal of the American Medical Association, 2003.) The number of uninsured has now increased to 44 million in the past year.

The U.S. health care system has a voter approval rating of 11 percent, lowest of the top 10 industrialized nations. Only 2 percent of Canadians think the United States has a better health care system than their own (Gallup Poll). Nearly half of all bankruptcies involve unpaid medical bills. One-third of the uninsured earn at least $50,000 a year but still cannot afford health insurance premiums. Family premiums have risen $2,600 over the last three years. The World Health Organization rates the health of U.S. citizens 35th in the world.

We now have a health care system crisis in this country.

John Kerry has the following plan to improve health care financing:

1. Lower family premiums by up to $1000 a year. John Kerry would create a “catastrophic costs” fund to help health insurance plans lower their premiums. This would help decrease costs to corporations and small businesses as well as individuals.

2. Make prescriptions drugs more affordable. Sen. Kerry would negotiate discounts with drug companies for the uninsured and senior citizens on Medicare.

3. Insure every child. John Kerry would expand Medicaid, the government medical program for the poor.

4. Allow all Americans access to the same health plan as members of Congress. Kerry would offer the affordable plan available to 9 million federal employees.

Kerry’s health plan would cost $653 billion over 10 years, and cover 27 million of the uninsured. (Bush’s tax cut is $750 billion over 10 years.)

Although not perfect, Kerry’s health plan would be a major step forward toward universal coverage and lowering health costs. George Bush’s plan would cut $16 billion from Medicaid, cover only 2.4 million more people (no net progress in light of the 3 million people who lost their insurance this year), and allow no negotiating of discount prices with drug companies.

The Bill of Rights says we have the “Right to Life, Liberty and the pursuit of happiness.” How can you have life, liberty or happiness without your health? Health care should be a right, not a privilege. Thirty-four countries offer better-quality health care to all their citizens, for less money than our country spends.

Our country needs new leadership to move us forward toward universal coverage and lower health care costs. Please consider the above facts when voting in November.

Kathryn Bourgoin, M.D., of Orono, is a family physician.