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Commentary
January 26, 2004

A Tide in the Affairs of Medicine

Arch Intern Med. 2004;164(2):134-136. doi:10.1001/archinte.164.2.134

There is a tide in the affairs of men, Which, taken at the flood, leads on to fortune; Omitted, all the voyage of their life Is bound in shallows and in miseries.—William Shakespeare

If Benjamin Franklin were alive today, he would probably update his most famous quip to read, "There is nothing certain in life but death, taxes, and national health insurance." The reason is twofold. First, some 45% of the $1.4 trillion health care bill is paid directly from tax revenues, primarily Medicare, Medicaid, and military and veterans' health care systems. Second, the number of uninsured and underinsured Americans is well past the 85 million mark, and the exponentially increasing cost of health care and insurance guarantees that that number will exceed 120 million. Excluding people older than 65, this means that more than half of the US population will be clamoring Congress for relief: ergo, national health insurance.

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