What Is Single Payer?

The Current Health Care System in the United States is highly fragmented, with some people belonging to private insurance plans through their workplace, others getting public insurance through plans such as Medicare and Medicaid, and millions lacking health insurance altogether. People have very different coverage: some have plans that don’t cover important services such as prescription drugs, and what you pay out-of-pocket when you actually access care varies as well (different levels of copayments, coinsurance, and deductibles). Lastly, many people have restricted “networks” – they can only seek care from certain doctors or go to certain hospitals.

The way we currently organize health insurance:

  • Is Expensive: The United States spends more per person than any other country in the world on health care.
  • Has No Capacity to Control Costs: Our costs are not only high, but rising faster than those of other developed countries.
  • Is Financially Ruinous for Many Households, Businesses, and Government Budgets: These catastrophic costs are paid disproportionately by low-income people and small businesses.
  • Leads to Very Poor Health Outcomes: Under this system we actually live shorter lives, and receive much less of the care we need.
  • Is Highly Discriminatory: Health Care disparities along lines of race, ethnicity, class, gender, and age are unmatched in the developed world.

Single Payer Health Care Systems cover everyone under a single, publicly financed insurance plan that provides comprhenesive health care. Almost all developed nations have some form of universal, publicly financed health care.

Countries who have covered their population under single-payer plans have managed to achieve universal, comprehensive coverage while at the same time actually realizing enormous savings, which is not what you might expect from insuring more people with better coverage. Having a single plan for the whole population also means there aren’t different provider networks for different insurance plans, and everyone is free to choose the doctors, hospitals, and community health centers they use.

Here’s how Single Payer does it:

  • Access to Prevention: Giving everyone access to primary care without cost barriers reduces how many people get sick in the first place.
  • Early Intervention: Allowing everyone to have a regular source of care, without cost barriers, allows us to catch illness and injury before it becomes serious (and expensive to treat).
  • Reducing Insurance Overhead: Private insurance companies spend from 10% to 30% of every health care dollar on overhead: public insurance less than 5%. Single payer plans don’t need to advertise or compete on a market.
  • Reducing Provider Overhead: When hospitals and physicians send all their bills to one payer (the public insurance plan), they don’t need a billing department to juggle different forms for hundreds of insurance companies, and each doctor and each health care practitioner wastes less of their time on paperwork and devotes more time to actual care.
  • Bulk Purchasing Power: When there is only one payer for basic medical services and goods, that payer can bargain the best possible prices, and make sure that middle-men aren’t overcharging patients. This in particular drives down the cost of prescription drugs.