Bruce Vladeck, the head of Medicare and Medicaid in the Clinton administration, says that covering the nation''s 41 million uninsured would cost "only a single-digit percentage" of the $1.6 trillion that will be spent on health care this year, Reuters Health reports.

"This problem is not nearly as big as we have made it out to be if we take it on frontally," Vladeck told a forum sponsored by the American Public Health Association.

Vladeck, now teaching at the Mount Sinai School of Medicine in New York City, said that having so many uninsured in America hurts not only those without coverage, but the nation''s economy as a whole.

For example, he pointed out that one-third to one-half of all personal bankruptcies are "associated with high out-of-pocket health costs," meaning that providing universal coverage could substantially lower the number of people who default on their debts.

Vladeck said the government has been unwilling to cover everyone out of fears that costs will not be contained. But every other industrialized country with a national health insurance system, he said, has extended the benefit first "and worried about all that other stuff later."

"We''re holding the uninsured hostage to our inability to address costs or address inefficiencies," Vladeck said.

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