Bringing all the state's residents under a single health insurance plan would mean a complete overhaul of the existing system, including the elimination of those companies now providing coverage and making big profits.

Chuck Pennacchio, executive director of HealthCare4ALLPa in Levittown, is leading the charge to bring about a single-payer plan that he claims would mean not only reform but a cost savings in health care.

With 86 percent of the state's insurance market controlled by the Blues insurers, it's time to bring integrity back into the health industry, he said.

"It's a $100 billion industry in Pennsylvania," he said.

Private insurers, he said, are responsible for driving up costs, which includes large overhead in the way of administration and bureaucracy, part of which is tied to insurers making patient decisions on medical care.

"They create their own bureaucracies to interface with the health care industry," he said.

With one-third of the population either uninsured or underinsured, it's time for reform, he said.

As it now stands, businesses are overly burdened by health insurance costs and simply do not want to be in health care.

"Employers are paying more every year and getting less," he said.

Pennacchio's citizens advocacy group is backing legislation known as the Family and Business Health Security Act that calls for elimination of insurance premiums, co-pays and deductibles.

The plan would be funded through a 10-percent business payroll "health and wellness tax" and a 3-percent personal income tax.

Those fees, he said, would go into the Pennsylvania Health Trust and be used exclusively for health care delivery, including just 5 percent for administrative costs.

The plan also calls for eliminating waste and inefficiency in health care and promoting education.

The legislation, he said, has been introduced three times in the past four years without getting passed but increasingly is gaining more support from lawmakers from both parties.

He agreed that the big losers in such a plan would be private insurers.

"Insurance companies are going to throw everything at this to defeat it," he said.