Teaching and community hospitals, usually operated as nonprofit institutions, likewise have a philanthropic obligation to provide emergency care. Special groups in our society, such as dependents of the military, veterans, native Americans living on reservations, and the retired military, have access to designated federal medical facilities and health care systems. The long-term advocates of National health insurance (NHI) perceived Medicare as the breakthrough that would pave the way for the establishment of a system of universal health insurance. The passage of Medicare and Medicaid went a fair distance in enabling the United States to correct deficiencies in the system of private health insurance. In order to determine the likelihood that NHI will provide a partial, response to the problems of the health care system, an assessment of the ability of such a basic financing reform to address the issues of excessive expenditure, administrative waste, ineffective professional practice, and access for all is needed.