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Feb
25

What is “Single Payer” healthcare?

You’re going to hear a lot about Single Payer over the next 20 months – mostly from people who a) have an opinion about it and b) don’t even know what “Single Payer” is.

Before you get sucked into that discussion/argument, here’s a primer.

“Single Payer” – by definition – is government-financed and government-managed health insurance.

Beyond that, pretty much every country with Single Payer is unique, each with its own nuances. For example,

  • most don’t have government-employed healthcare providers; in many single payer systems, physicians, therapists, hospitals and other providers are private.
    • The UK is an exception; providers are (mostly) employed by the government
  • many are not government-operated; in many systems private insurers contract with the government to handle administration of health insurance – similar to our Medicare
    • Again the UK is an exception

Typically:

  • the government sets pricing/reimbursement policy and actual prices – similar to our Medicare
  • funding comes from some combination of employee, employer, and other taxes; in some countries, insureds pay some form of premiums – similar to our Medicare
  • it covers everyone
  • there is little to no paperwork for patients/consumers; all that is handled by the administrative agency
  • there are minimal or no deductibles, copays, or co-insurance requirements
  • people can buy into supplemental insurance through private insurers

What does this mean for you?

You are now more knowledgeable than most everyone else about Single Payer.


Joe Paduda is the principal of Health Strategy Associates

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