What is single payer?

This article is brief and compares single payer healthcare to Obamacare. I would like to see all Americans covered like Canadians, Europeans and Israelis.



What is Single Payer?


Single-payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands.

Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.

The program would be funded by the savings obtained from replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer, and by modest new taxes based on ability to pay. Premiums would disappear; 95 percent of all households would save money.

Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.

The Expanded and Improved Medicare for All Act, H.R. 676, based on PNHP’s AJPH-published Physicians’ Proposal, would establish an American single-payer health insurance system.

What about Obamacare?

http://www.pnhp.org/facts/what-is-single-payer

 

Why just Americans? It seems to me that you'd want everybody covered like Canadians. The only problem is that not everybody wants it, or can afford it.

 

Maybe I should have said everybody in America.

 

There are lots of people all over the world that don't have access to single-payer insurance programs.

Why doesn't canada just open its health care doors to the world? That way, everybody can join in on the fun!

 

Healthcare should be local.

 

I agree. The problem is that America is pretty darned big, so nothing done at the federal level is local.

 

Political suicide in Australia is to threaten to change our single payer system. We also have mutual treatment agreements with many countries

 

So it works! What happens if you go to your family practice doc and he says he thinks you have kidney stones?

 

I love how it says covering the 327 million US Citizens will require only "modest" taxes LOL. It's only modest in the EU because of low military spending. In the US, it'd be an albatross. We'd actually downgrade from the ACA.

 

It would be well worth it.. US healthcare is the most expensive in the world, but not the best in terms of outcomes. Look at the infant mortality rate in Texas.

 

Maternal Mortality in Texas Is a "National Embarrassment" | Mother ...



www.motherjones.com/.../spike-rates-pregnancy-related-deaths-texas-nat...

Aug 24, 2016 - Maternal Mortality in Texas Is a "National Embarrassment" ... State one of the most dangerous places in the developed world to have a baby.

https://www.texastribune.org/2016/09/04/facing-surge-texas-maternal-deaths-researchers-fin/

More New Mothers in Texas are Dying; Experts Can't Say Why

 

Texas is pretty big, too. Maybe those lefties in the big Texas cities would like it, though. They should let their mayors know what they want.

 

It wouldn't save in taxes, but it would save hundreds of billions in overall costs and relive businesses from this heavy yoke and make them more competitive internationally.


Switching to a single payor (e.g. Medicare) for all could save over a trillion dollars a year in health care costs. The reasons are that the Govt operates with a much lower overhead than insurance companies, and the Govt's greater leverage means it can negotiate prices from health care providers like hospitals based on a percentage over costs, and not based on their absurd mark-ups. Medicare typically pays *much* lower rates to health care providers than insurers do.

Medicare operates with 3% overhead, non-profit insurance 16% overhead, and private (for-profit) insurance 26% overhead. Source: Journal of American Medicine 2007
http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm

I did a little research on the portion of health care that goes to seniors covered by Medicare (a single payor system) versus overall health care costs in the country.

In 2006, (the latest data I've found so far), those 65 and older (and covered by Medicare) account for 38% of all inpatient hospital visits.

By 2006, 38 percent of inpatients were aged 65 years and over, with those aged 75 years and over comprising 24 percent of all inpatients.
http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf page1

In 2003, one study reported that almost 44% of total hospital costs were spent on seniors:

Persons age 65 and older had more hospital stays than any other age group in 2003. While the elderly comprised about 12 percent of the U.S. population,* they accounted for one out of three hospital stays (13.2 million hospitalizations) and 43.6 percent of the national hospital bill—nearly $329 billion.
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb6.pdf [2003]

I have not found data that details variations in procedures, but the typical stay of those 65 and older is longer than that of other age groups:

The average length of stay for those aged 65 years and over was 5.5 days; for those aged 45–64 years, it was 5.0 days; for those aged 15–44 years, it was 3.7 days; and for children under age 15 years, it was 4.8 days.
http://www.cdc.gov/nchs/data/nhsr/nhsr005.pdf page1

The mean length of stay for patients 65 and older was 1.7 days longer and mean hospital charges were 46 percent higher than non-elderly hospital stays, but there was no difference in mean charges per day.
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb6.pdf

Furthermore, "The federal government estimates that 70 percent of health-care expenditures are spent on the elderly, 80 percent of that in the last month of life"
http://www.mercurynews.com/opinion/ci_19905093

This data suggests it is unlikely that the hospital visits by seniors on average are less costly than those of younger people.

In 2006, total US health spending was $2.1 trillion.
http://content.healthaffairs.org/content/27/1/14.abstract

Medicare spending in 2006 was $373.6 billion.
Source: CBO Historical budget data. http://www.cbo.gov/publication/42911 Table F-5.

So what this means is that although Medicare covered 38% of inpatient hospital care (and probably a higher percentage of total health care cost), it spent only 18% of total health care costs.

Now, I don't know for sure whether hospitalizations is a perfect substitute for total health care costs, but it seems reasonable, and the 43% from 2003 suggests that if anything, the total health care cost incurred by seniors is proportionately higher. The data suggests that the proportion of total use of health care procedures on seniors would be a little higher that the proportion of inpatient hospital stays.

But if we assume that the proportion of total health care use by seniors is equivalent to the proportion of hospital stays, and that the cost of services used would equivalent, then, extrapolating the data, we can say that if Medicare covered 100% of health care, the cost would be $938 billion. Or a savings of over $1 trillion compared to the $2.1 trillion total health care cost in 2006.

The vast bulk of Americans (and certainly most seniors) like Medicare, and the data suggests that it provides health care coverage far more efficiently than the private system. Essentially making the Medicare system available to all Americans, and reap huge overall cost savings, certainly makes some sense to me.

 

The healthcare industry doesn't want single payer because it kills their cash cow. The U.S. is paying about double what every other industrialized country in the world is paying for healthcare.

 

Single payer is total government run health care. The federal gov pays for everyone's heathcare and determines what kind of treatments people can get and how much they will pay the doctors and hospitals. It was formerly known as socialized medicine (for the commoners at least, elites still get their Cadillac health plans).

 

Most of the healthcare dollar is spent for premature babies, seniors and those with chronic diseases. I saw a chart somewhere.

- - - Updated - - -

Single-payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands.

Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.

 

It's not insurance if everybody with a pulse is covered and the government is paying for it, sorry. Why would they call that national health insurance?


.

 

Because everyone in the nation is covered.

 

The essence, the most important aspect of this is that it is a welfare kind of social program- where the government takes money from the people by force and re-distributes those benefits to suit it's own purpose. This is a direct contradiction to the basis of freedom, and the idea that each person has the opportunity to control their own lives. Worst of all- it is in the control of government, which has always tainted everything it has touched with some level of corruption, always with a great degree of inefficiency and injustice- and generally is the worst choice of methods to do anything.

GRANTED that American medical care desperately needed and still needs a better managing concept. However-

The problem 10 years ago was described as people not being able to get insurance and not being able to afford insurance. Little was discussed about the exorbitant cost of our system. Americans pay as much as 10 times what people in other industrial nations do for equal care. I personally have had to use a medication which sells for $5 a pill here- but $0.25 overseas. Insurance affordability relates directly to the cost, which relates directly to the bills of the medical services it covers. Lower the ludicrous medical expenses, the cost of insurance falls, and- Insurance becomes affordable. Nobody paid any attention to that view of the issue. Instead, we forced people who did not need or want high-cost insurance to buy it or be fined.

WHY are medical costs so high compared with the rest of the world, when the quality of care and outcomes rate lower than that of many other nations?

In large percentage- government management. Watch a TV commercial for a prescription medication, and it's half warnings of side effects. The ads- in the past, not allowed- drive consumers to their doctors demanding specific products that frequently they don't need at all. That is the pharma industry promoting it's own interests. This ad is followed by lawyers advertising that if you took that drug and burped unexpectedly, somebody owes you money! Call now and get your share. This is followed by lawyers filing case or class actions against the pharma or medical system, with a charge that may or may not have any validity at all. Sometimes, those charges destroy manufacturers. Dow-Corning was wiped out with the rage over silicone breast implants, despite very poor evidence which has since been proven totally wrong. Other companies look at the cost of defending such a case and make big settlements, just to make it go away. Of course, that settlement and all the turmoil it causes are still expenses the company must insure against, and the cost of product liability insurance goes into- the price consumers pay for their medical product.

In our civil legal system, the driving element is not justice- it is profit. Lawyers always find that the people with the deepest pockets are the ones responsible for their clients injury- even for their clients stupidity. Even if the injury is vague and the plaintiff loses- the defendant loses too, fighting the case with $300 an hour legal costs. While in most countries the losing side pays the legal bills of the winning side- (greatly discouraging the sue-for-profit motive) America does not do that, and as a result the practice of legal extortion with little risk of loss continues... and the costs of all this trickle down to the consumer in the forms of medical and insurance costs.

Government can fix the things that cause excessive costs rather than make things worse by deciding to control everything but that. It probably won't because there are too many powerful entities that are profiting from this mess- and because government loves power. Any kind of power, over anybody, any industry. Power is control, and they fear nothing more than not being in full control of the people from cradle to grave.

Single payer might be somewhat less offensive- but the power would be even more firmly in the hands of the primary offender. Best thing government could do for the people is to get the hell out of the way.

 

I was talking about the insurance part. Insurance is people pooling their money voluntarily so as to share the risk of losses and expenses. Forcing people into a government run healthcare system isn't what I call insurance.

 

False. Under Medicare, private hospitals, clinics, and doctors are used.

Medicare has gigantic savings because the government has the leverage and resource to keep Big Health from totally screwing the people, and it cuts the fat insurance market out.

Universal Medicare would save our country hundreds of billions and free our businesses to compete better.

 

Yes, it would..

Wonder what Trump is going to do?

 

How is it not insurance?

Just like SS is insurance.

 

SS insurance isn't insurance either. Unless your def of insurance includes you pay into it or go to jail (Note: illegals don't have to pay into SS but they can collect on it). If you think insurance is when the gov takes money out of your paycheck and promises to pay you back some of it later then I guess you could say that's insurance.







Edit: Corrected spelling error. This forum doesn't give you even one correction.