What is Meant by “Single-Payer” in the Current Discussion of Health Care Reforms During the Primaries?

CounterPunch, March 10, 2016
by Vincent Navarro

Vincent Navarro, MD

Vincent Navarro, MD

Professor Navarro has taught at the Johns Hopkins University for many years. He is the Director of the JHU-UPF Public Policy Center and has been advisor to many national organizations and international organizations, including the WHO and the UN. He was a member of the White House Health Care Task Force in 1993 and Senior Advisor to Jesse Jackson’s Campaign in the Democratic Primaries in 1984 and 1985.  

Single-payer means that most of the funds used to pay for medical care are public, that is, they are paid with taxes. The government, through a public authority, is the most important payer for medical care services and uses this power to influence the organization of health care. The overwhelming majority of developed countries have one form or another of a single-payer system. The US is the only country that does not have a single-payer system. This is one reason why medical care is so expensive (the US spends $9,698 per capita in medical care, much more than any other country; Sweden spends $5,000, Germany $4,720, Canada $4,430, France $4,120, the UK $3,240, and Japan $3,240); inefficient (by far, the US has the highest percentage of unnecessary medical procedures, including surgery, in the developed world); and extremely unpopular (nearly 40% of the US population believes the country’s medical care should be reformed completely, vs. only 12% of Canadians and British). US medical care is also extremely cruel and insensitive. Almost 40% of people with terminal conditions, which means they are dying, worry about how they or their families are going to pay for their care.

Why is the US in this situation?
The usual answer is that the majority of funding is private: 48% of funding is public and the majority, or 52%, is private. These percentages, however, are misleading. David Himmelstein and Steffie Woolhandler, founders of Physicians for a National Health Program, have shown that taking into account the subsidies the government pays to health insurance companies through tax exemptions for their premiums, the overwhelming funding of health services is public.


A Fiscally Conservative Argument for Universal Health Care

IVN News, March 4, 2016
by Craig Berlin

With problems ranging from millions uninsured to unsustainable liabilities, there are many obstacles to resolving the health care crisis. The passage of the Patient Protection and Affordable Care Act (Obamacare) along partisan lines has been a savior for some and a nightmare for others, generally indicating that it’s less than ideal.

The United States is one of the few developed countries that doesn’t offer some sort of universal health care and yet, even discussing such a system generates partisan bickering.

The debate is not new. Serious proposals for national health insurance or an individual mandate date back to the Nixon administration with some curious twists and turns.

A far cry from a simple mandate, Obamacare has generated a great deal of controversy and doesn’t provide universal coverage; in fact, it’s clear there are winners and losers.

As an aside, I am one of many people who has seen his private coverage skyrocket in price followed by cancellation and ultimately been left with a choice of only grossly overpriced or lousy coverage.