A national nurses' union is lobbying for a single-payer health care system, saying it's the only plan most Americans can afford. Proponents also argue that Medicare-for-all is more fiscally hawkish than Romney's new running mate.

Mitt Romney's vice-presidential choice of Wisconsin Congressman Paul Ryan, an arch enemy of the Affordable Care Act, may push President Barack Obama's health care reform into the center of the 2012 political ring.

For advocates of a full-scale public health insurance program--and for women's health as well--that could mean another chance to carve out their position as deficit-hawks with much sharper budget-cutting teeth than Ryan himself.

"Research shows that private insurance bureaucracy and paperwork consume 31 percent of every health care dollar," said Dr. Diljeet K. Singh, who is a board member of Physicians for a National Health Program, a Chicago-based nonprofit of 18,000 physicians across the country who support a Medicare-for-all system. "Streamlining payments through a single nonprofit payer system would save the United States more than $400 billion a year, enough to provide comprehensive, high-quality coverage for all Americans."

Singh, a Gilbert, Ariz., gynecologist, predicts that more women will support a single-payer system because under the Affordable Care Act insurance companies and drug companies will still be able to charge what they want due to weak restrictions on premium rate increases and out-of-pocket costs. Older people may pay up to three times more for insurance than younger patients.

"These restrictions will hit women hard because they use more health services, have lower incomes and live longer than do men," Singh said. "This will lead to more patients skipping care and suffering serious health and financial consequences. Illness and medical bills are linked to 52 percent of personal bankruptcies in the United States."

Jean Ross is co-president of the California Nurses Association/National Nurses United, the Oakland-based union that has more than 85,000 registered nurse members in 50 states and is lobbying for California to adopt a single-payer health care system.

"Despite its modest benefits, the ACA is no remedy for our health care crisis because it perpetuates the principle of all the health care you can afford," Ross said in a recent telephone interview, referring to the Affordable Care Act. "In California and a growing number of states, insurance premiums already equal or exceed 20 percent of median incomes. If premiums continue to rise at the current rate, the average family premium would total $24,000 by 2020."

Drumming Up Support

To drum up grassroots support for passage of a single-payer health system in California, the California Nurses Association sponsored a bus tour that visited 19 communities during June and July. The tour drew about 1,000 people for free blood pressure readings and blood sugar screenings and another 2,000 to the town hall meetings.

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Single-payer healthcare is more budget hawkish than Ryan's plan