public healthcare was delegated to the different autonomous communities in the country. While previously this was not the case, in 1997 it was established that public authorities can delegate management of publicly funded healthcare to private companies. Additionally, in parallel to the single-payer healthcare system there are private insurers, which provide coverage for some private doctors and hospitals. Employers will sometimes offer private health insurance as a benefit, with 14.8% of the Spanish population being covered under private health insurance in 2013. In 2000, the Spanish healthcare system was rated by the World Health Organization as the 7th best in the world. Spain's healthcare system ranks 19th in Europe according to the 2018 Euro health consumer index. United States Medicare in the United States is a public healthcare system, but is restricted to persons over the age of 65, people under 65 who have specific disabilities, and anyone with end-stage renal disease. A number of proposals have been made for a universal single-payer healthcare system in the United States, among them the Medicare for All Act originally introduced in the House in February 2003 and repeatedly since. On July 18, 2018, it was announced that over 60 U.S. House Democrats would be forming a Medicare for All Caucus. On March 17, 2021, exactly a year after COVID-19 had appeared in every U.S. state, House Democrats introduced the Medicare for All Act of 2021 with 112 supporters. Advocates argue that preventive healthcare expenditures can save several hundreds of billions of dollars per year because publicly funded universal healthcare would benefit employers and consumers, that employers would benefit from a bigger pool of potential customers and that employers would likely pay less, would be spared administrative costs, and inequities between employers would be reduced. Prohibitively high cost is the primary reason Americans give for problems accessing health care. At over 27 million, the number of people without health insurance coverage in the United States is one of the primary concerns raised by advocates of health care reform. Lack of health insurance is associated with increased mortality – about sixty thousand preventable deaths per year, depending on the study. A study done at Harvard Medical School with Cambridge Health Alliance showed that nearly 45,000 annual deaths are associated with a lack of patient health insurance. The study also found that uninsured, working Americans have a risk of death about 40% higher compared to