I took the liberty of looking up some numbers, because clearly you haven't. The answer to your question is over 46.6 million Americans(1) (you have 300 million total), the ones without health insurance.

Add another 25 million Americans(2) who are underinsured and the number is scarier. Underinsured is defined as people who have insurance but end up spending >10% of their income on health care expenses.

The same source (2) indicates that 42% of working adults (19 to 64 years-old) are uninsured or underinsured.

So in short, who in the US doesn't have access to health care? Apparently 42% of them.

"Quite honestly, I don't see why this is such a massive issue with everyone right now..."

You don't see an issue with someone breaking a leg and going bankrupt because of it? You don't see an issue with a population going broke just to keep themselves hobbling along?

Here's some more fun. 50% of bankruptcies in the US today are due to health care costs (5). In fact, 68% of those who declare bankruptcy due to unaffordable health care costs have health insurance (4).

You don't see a problem here?

"Medical innovation (in it's current state, meaning building things on a molecular level) is prohibitively expensive."

Yet Europe and Canada (and other first-world nations with public health care) are doing fine at their own medical research. It's s till expensive, but it's being funded by the government, and the people still get great health care (some of it is better than the US...).

Your thesis is one that is trotted out a lot by proponents of the private system, but it simply holds no water. We have many cases of massive medical R&D being done in countries where every single person receives free health care.

"Also, how does the US Gov't plan on getting the cost of healthcare down?"

Easy. By going public. You asked if there is a magic wand, and I'm here to tell you it doesn't get more magic-wand-y than this. Right now 25% of every health care dollar spent is going towards administrative expenses (2), compared to 1% to 5% for public health systems around the world (2).

By cutting out the private insurance companies you instantly gain a 26-32% efficiency on your health care dollars. Imagine the number of people you can cover with that massive amount of money (some $400 billion per year as of 2003).

(1) http://www.cbpp.org/cms/?fa=view&id=628

(2) http://health.usnews.com/articles/health/healthday/2008/06/1...

(3) http://www.medicalnewstoday.com/articles/8800.php

(4) http://www.nchc.org/facts/cost.shtml

(5) http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf

Lacking health insurance (i.e., a financial services product) is not the same thing as lacking medical services.

But lets ignore that and look more closely at your numbers. Of the 46.6 million uninsured, 14 million are eligible for medicaid/SCHIP, but haven't bothered to sign up. 27 million make at least $50,000/year and simply choose to spend money on other things. Another fun fact: excluding people eligible for medicaid, 70% are uninsured 4 months or less.

http://www.washingtontimes.com/news/2009/jun/25/who-are-the-...

That leaves about 5.6 million people. I expect we could solve the problem of those 5.6 simply by enforcing our immigration laws.

These are two different things.

As the sibling replies noted, everyone in America does have access to at least basic healthcare. If a homeless person is brought into the emergency room after being hit by a car, he won't be denied treatment. The Medicaid program in America reimburses hospitals (and other providers) for charity and bad debt expenses.

Right now 25% of every health care dollar spent is going towards administrative expenses

I've got an unusually close view of this, as my wife is the manager of budget and reimbursement at a largish urban hospital. Most of her job is dealing with Medicaid and Medicare, getting the hospital reimbursed for caring for these people. The reason that she spends most of her (and her department's) time on this is because of the illusion that M&M have efficient administration.

In reality, Medicare and Medicaid account for a huge portion of cases in an urban hospital. They're an 800-lb gorilla: since they account for so much of the hospital's business, the hospitals have little choice but to provide whatever administrative functions that M&M demand. For example, every year my wife must submit the dreaded "Medicare Cost Report". This is literally a crate of documents that my wife's team creates (it takes the team weeks) to document their Medicare charges over the past year. Some time later, the government audits them on this entire crate.

What I'm trying to illustrate is that the actual administrative expenses of Medicare and Medicaid are not really lower than our traditional model. It's just that the regulators force the participants to run it in such a way that the providers bear a large portion of the administrative burden. Since it's on the providers, the costs don't show up on M&M's reports as admin expenses. Instead, they contribute to higher prices billed for the underlying services.

When you look at the big picture, Medicare and Medicaid are certainly no more efficient than conventional providers, and possibly less so.

For example, one of the concerns in rising costs is unnecessary tests. However, M&M regulations tend to cause this. They will refuse to cover the costs associated with various types of infections (e.g., urinary infections) unless the provider can prove that the infection was already present when the patient was admitted. This effectively forces the hospital to test all patients for UTI at the time they're admitted, which is completely unnecessary for actual medical reasons.

Any expectation that total costs would go down due to some miracle of government administration is pure fantasy. Seriously: have you ever been to the DMV, or seen an Immigration office? Why would you believe that a private insurer, given the opportunity to increase profits by lowering their own admin expenses, would not do so? The idea that government-provided healthcare, or government-single-payer, would lower costs really is magic. Just like a belief in the magic of Tinkerbell and Harry Potter.

(Note: I lumped Medicare and Medicaid together for simplicity. While these are related, they're separate entities and anybody who knows the details will probably object. But there's only so much space here.)

You're joking, right?