As healthcare costs increase, more Americans struggle to afford healthcare. Even after improvements under the Affordable Care Act have taken place, 30 million remain uninsured while an increasing number of individuals face out-of-pocket expenses. As a result, there has been renewed pushes for universal coverage in America and calls for single payer health care systems as an answer. But what exactly are single payer plans and what differences they pose from current systems?
Single payer healthcare refers to an alternative healthcare model wherein government serves as the sole provider of health services. This differs from our current healthcare system which blends public plans like Medicare and Medicaid with employer-sponsored and privately purchased plans such as private health insurance. A single-payer system would reimburse clinicians for most medical expenses directly.
There are various proposals for single-payer healthcare plans, but most share certain characteristics in common. They typically define who qualifies, decide what services are covered, collect funds to cover plan costs, administer them effectively and limit private insurers’ roles in providing care.
Though similar in concept, no universal definition exists of what defines a single-payer system. Proposals vary widely in scope, funding structure, benefits design and implementation timing – regardless of their specific details, most single-payer proposals seek to remove barriers to healthcare access while managing rising costs.
Multiple factors have hindered previous efforts to reform our flawed healthcare system, including for-profit interests in the health industry and political process, cost pressures, access issues, and access limitations. Achieve sustainable healthcare will require changing incentives so patients seek value with their money while increasing competition among providers; additionally it requires taking an integrative approach by investing in education and prevention programs for preventable illnesses.
Success for healthcare reform lies in changing the balance of power and building trust between citizens and their representatives in Congress, such that everyone understands what’s at stake – with this article serving as an answer to what single payer health care means.
This blog post was composed by staff of UCSF’s Center for Global Health Policy. As an independent nonpartisan research institution, this Center analyzes health policy issues impacting all members of society with particular attention paid to minority and vulnerable populations. Their staff includes experts in health policy, finance and epidemiology – for more information about them please visit their website.
Editor’s note: Media outlets often refer to single payer as an umbrella term encompassing various systems of health insurance in countries with varied delivery and financing structures, but The Center for Global Health Policy strives to present an accurate and complete depiction of this concept through its articles.