Health care programmes currently do not offer equality of care  The United States as a whole spends 14% of GDP (total income) on health care. This includes the amount spent by the federal government, state governments, employers and private citizens. Many studies have found that a single-payer system would cut costs enough to allow everyone in the USA to have access to good health care without the nation as a whole spending more than it does at the moment. Medicare, a government-run health care program, has administrative costs of less than 2% of its total budget.  The current system of health maintenance organisations (HMOs) has destroyed the doctor-patient relationship and removed patients’ ability to choose between health care providers. Patients find that their doctors are not on their new plan and are forced to leave doctors with whom they have established a trusting relationship. Also, patients must get approval to see specialists and then are allowed to see only selected doctors. Doctors usually can’t spend enough time with patients in the HMO plans. By contrast a universal health system would give patients many more choices.  In the current system the employee and the employee’s family often depend on the employer for affordable health insurance. If the worker loses their job, the cost of new health insurance can be high and is often unaffordable. Even with current federal laws making insurance more movable, the costs to the employee are too high. With a single-payer, universal health care system, health insurance would no longer be tied to the employer and employees would not have to consider health insurance as a reason to stay with a given employer. This would also be good for the economy as a whole as it would make the labour market more flexible than it has become in recent years.