Single-payer health care
Encyclopedia
Single-payer health care is medical care
funded from a single insurance pool, run by the state
. Under a single-payer system, universal health care
for an entire population can be financed from a pool to which many parties employees, employers, and the state have contributed. Single-payer is form of monopsony
: a market in which one buyer faces many sellers; in all existing and proposed cases that buyer is the state or large organization.
Single-payer health insurance collects all medical fees, and then pays for all services, through a "single" government (or government-related) source. In wealthy nations, this kind of publicly managed insurance is typically extended to all citizens and legal residents. Examples include the United Kingdom's National Health Service, Australia's Medicare
, Canada's Medicare
, and Taiwan's National Health Insurance
. Medicare in the United States
is an example of a single-payer system for a specified, limited group of persons.
Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the UK). The term "single-payer" thus only describes the funding mechanism—referring to health care financed by a single public body from a single fund—and does not specify the type of delivery, or for whom doctors work. Although the fund holder is usually the state, some forms of single-payer use a mixed public-private system.
. Alternatively the government may purchase healthcare services from outside organizations. This is the approach taken in Canada.
Some writers describe publicly administered health care systems as "single-payer plans." Some writers have described any system of health care which intends to cover the entire population, such as voucher plans, as "single-payer plans," although this is an uncommon usage. The standard usage refers to health insurance, as opposed to healthcare delivery, operating as a public service,
like fire departments, community libraries, and other publicly-funded
services, offered to citizens and legal residents towards providing near-universal or universal health care
. The fund can be managed by the government directly or as a publicly owned and regulated agency.
is an example of single-payer health care. The national government provides part of the funding, provincial governments manage the hospitals and provide the bulk of the funding, and doctors in private practice contract with the government for fee-for-service payments. Although many Canadian citizens have supplemental private insurance from their employers, this covers non-medically necessary expenses not covered by Canadian Medicare, and accounts for 12% of national health care spending.
Fees for doctors, hospitals and other providers are set by negotiations among doctors' associations, provincial or regional governments, and the national government. Global budgets eliminate the high potential costs (as is the case in the U.S.) of billing individually for huge numbers of products and services.
Health care provision in Canada is a mix of private and public services, although most hospitals are public. Patients may go to any doctor or hospital in the country.
Canadians do wait for some treatments and diagnostic services. Survey data show that the median wait time to see a special physician is a little over four weeks with 89.5% waiting less than three months. The median wait time for diagnostic services such as MRI and CAT scans is two weeks, with 86.4% waiting less than three months. The median wait time for surgery is four weeks, with 82.2% waiting less than three months. In addition, there is concern of a "brain drain" as high-quality medical graduates leave Canada for better-paying careers in the U.S.
, The American College of Physicians
and the American Medical Student Association.
In Congress, Rep. John Conyers
, Jr. (D-MI), and Rep. Dennis Kucinich
(D-OH) have introduced the United States National Health Care Act (HR 676). The bill has been introduced in every term of Congress under the same name since it was first introduced in 2003 in the 108th Congress with 38 cosponsors.
is a single-payer healthcare system, but is restricted to only senior citizens and certain other classes of people. Government is increasingly involved in U.S. health care
spending, paying about 45% of the $2.2 trillion the nation spent on individuals' medical care in 2004. However, studies have shown that the publicly-administered share of health spending in the U.S. is closer to 60%.
According to Princeton University
health economist Uwe E. Reinhardt, U.S. Medicare, Medicaid
, and State Children's Health Insurance Program
(SCHIP) represent "forms of 'social insurance
' coupled with a largely private health-care delivery system" rather than forms of "socialized medicine
." In contrast, he describes the Veterans Administration healthcare system
as a pure form of socialized medicine because it is "owned, operated and financed by government."
The Veterans Administration
is a single-payer system and provides excellent quality, said Reinhardt. In a peer-reviewed paper published in the Annals of Internal Medicine, researchers of the RAND
Corp. reported that the quality of care received by Veterans Administration patients scored significantly higher overall than did comparable metrics for patients currently using U.S. Medicare.
in 2000, and Oregon
in 2002.
In 2009 the House of Representatives Education and Labor Committee approved an amendment to the House health care bill, which would allow individual states to adopt a single-payer Medicare-for-all-style health plan. The amendment was proposed by Democratic Congress member Dennis Kucinich of Ohio. The Kucinich Amendment received support from some conservatives supporting states rights as it would allow states more freedom to explore various models including, but not limited to, single payer.
candidate does not support such a measure (two of the candidates interviewed that indicated they would not have since left the race).
has twice passed a state-level single payer bill, SB 840, "The California Universal Healthcare Act" (authored by Sheila Kuehl
), in 2006 and again in 2008. Both times, Governor Arnold Schwarzenegger vetoed the bill. State Senator Mark Leno later re-introduced "The California Universal Healthcare Act" in March 2009, newly renumbered as SB 810, and in January 2010, the California Senate passed SB 810. On the last day of the 2010 legislative session, the Democrats pulled SB 810 from the Assembly floor as Governor Arnold Schwarzenegger said he would veto it a third time, with Senator Mark Leno
announcing he would reintroduce the bill again in January of the 2011 legislative session as Jerry Brown
is sworn in as the new Governor of California. The bill has received support from the California Nurses Association/National Nurses United.
regardless of age, state of health or employment status, by creating a single payer health insurance system like Medicare that is comprehensive, cost effective, and publicly provided to all residents of Massachusetts?" With 222 of 228 precincts reporting, in all 14 districts, including five in which majorities had voted for Republican Senator Scott Brown
, Question 4 passed, with 63.5% of the overall votes being cast in favor of the ballot referendum for establishing a Massachusetts single payer system.
, including both the Democratic and Progressive Party
, endorses single payer health care and has hired William Hsiao
, the designer of Taiwan's single payer health care system, to design three possible systems of universal health care, one being a single payer model. Governor Peter Shumlin supports this move.
The Vermont health bill, H.202, has led to the creation of Green Mountain Care, a private/public single payer exchange system that will give universal coverage to Vermonters and create an electronic system of medical records in an effort to make the system efficient and accessible. In April 2011, it passed the Vermont Senate. In May 2011, the governor signed it into law, making Vermont the first state to have a single payer health care system.
the American Medical Student Association
and the California Nurses Association are among those that have called for the introduction of a single payer health care program. In Congress, Rep. John Conyers
, Jr. (D-MI) has repeatedly introduced The United States National Health Care Act (HR 676). As of August 2008, HR 676 had 91 co-sponsors.
The Congressional Budget Office
and related government agencies scored the cost of a universal health care system several times since 1991, and have uniformly predicted cost savings, probably because of the 40% cost savings associated with universal preventative care.
The issue has often been debated, most recently in the 2008 presidential elections. A CBS News/New York Times poll published in February 2009 reported that 59% say the government should provide national health insurance (up from 40% thirty years earlier) A study published in the Annals of Internal Medicine concluded that 59% of physicians "supported legislation to establish national health insurance" while 9% were neutral on the topic, and 32% opposed it.
, a 1987 New York Times/CBS poll showed 78% of people saying that the "government should guarantee medical care to everyone." Between 2003 to 2009, 17 opinion polls showed a majority of the public supports various levels of government involvement in health care in the United States. Many polls, such as ones administered through CNN, AP-Yahoo, New York Times/CBS News Poll
, and Washington Post/ABC News Poll
, Kaiser Family Foundation
showed a majority in favor of a form of national health insurance, often compared to Medicare. The Civil Society Institute and Physicians for a National Health Program have both found majorities in favor of the government offering guaranteed insurance, and a Quinnipiac
poll in three states in 2008 found majority support for the government ensuring "that everyone in the United States has adequate health-care" among likely Democratic primary voters.
In contrast, a October 2011 Rasmussen Reports
poll of registered voters showed only 35% of respondents in favor of single-payer health care, with a plurality (49%) opposed. Politifact rated a statement by Michael Moore
"false" when he stated that "[t]he majority actually want single-payer health care." Responses on these polls largely depend on the wording. For example, people respond more favorably when they are asked if they want a system "like Medicare," less favorably when stated as "socialized."
Articles, books, and broadcast programs
FAQ and summaries by NGOs favoring single payer
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
funded from a single insurance pool, run by the state
State (polity)
A state is an organized political community, living under a government. States may be sovereign and may enjoy a monopoly on the legal initiation of force and are not dependent on, or subject to any other power or state. Many states are federated states which participate in a federal union...
. Under a single-payer system, universal health care
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
for an entire population can be financed from a pool to which many parties employees, employers, and the state have contributed. Single-payer is form of monopsony
Monopsony
In economics, a monopsony is a market form in which only one buyer faces many sellers. It is an example of imperfect competition, similar to a monopoly, in which only one seller faces many buyers...
: a market in which one buyer faces many sellers; in all existing and proposed cases that buyer is the state or large organization.
Single-payer health insurance collects all medical fees, and then pays for all services, through a "single" government (or government-related) source. In wealthy nations, this kind of publicly managed insurance is typically extended to all citizens and legal residents. Examples include the United Kingdom's National Health Service, Australia's Medicare
Medicare (Australia)
Medicare is Australia's publicly funded universal health care system, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all resident citizens and permanent residents except for those on Norfolk Island...
, Canada's Medicare
Medicare (Canada)
Medicare is the unofficial name for Canada's publicly funded universal health insurance system. The formal terminology for the insurance system is provided by the Canada Health Act and the health insurance legislation of the individual provinces and territories.Under the terms of the Canada Health...
, and Taiwan's National Health Insurance
Healthcare in Taiwan
Healthcare in Taiwan is administrated by the Department of Health of the Executive Yuan. As with other developed economies, Taiwanese people are well-nourished but face such health problems as chronic obesity and heart disease. In 2002 Taiwan had nearly 1.6 physicians and 5.9 hospital beds per...
. Medicare in the United States
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
is an example of a single-payer system for a specified, limited group of persons.
Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the UK). The term "single-payer" thus only describes the funding mechanism—referring to health care financed by a single public body from a single fund—and does not specify the type of delivery, or for whom doctors work. Although the fund holder is usually the state, some forms of single-payer use a mixed public-private system.
Types and variations
Canada, Australia, Taiwan, and the United Kingdom have single-payer health insurance programs. These programs provide universal health care. Single-payer healthcare may be operated in a number of ways. In some cases doctors may be employed, and hospitals run by, the government. This is the case in the United Kingdom, and is referred to in the US as socialized medicineSocialized medicine
Socialized medicine is a term used to describe a system for providing medical and hospital care for all at a nominal cost by means of government regulation of health services and subsidies derived from taxation. It is used primarily and usually pejoratively in United States political debates...
. Alternatively the government may purchase healthcare services from outside organizations. This is the approach taken in Canada.
Some writers describe publicly administered health care systems as "single-payer plans." Some writers have described any system of health care which intends to cover the entire population, such as voucher plans, as "single-payer plans," although this is an uncommon usage. The standard usage refers to health insurance, as opposed to healthcare delivery, operating as a public service,
like fire departments, community libraries, and other publicly-funded
services, offered to citizens and legal residents towards providing near-universal or universal health care
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
. The fund can be managed by the government directly or as a publicly owned and regulated agency.
Canada
Health care in CanadaHealth care in Canada
Health care in Canada is delivered through a publicly-funded health care system, which is mostly free at the point of use and has most services provided by private entities. It is guided by the provisions of the Canada Health Act. The government assures the quality of care through federal standards...
is an example of single-payer health care. The national government provides part of the funding, provincial governments manage the hospitals and provide the bulk of the funding, and doctors in private practice contract with the government for fee-for-service payments. Although many Canadian citizens have supplemental private insurance from their employers, this covers non-medically necessary expenses not covered by Canadian Medicare, and accounts for 12% of national health care spending.
Fees for doctors, hospitals and other providers are set by negotiations among doctors' associations, provincial or regional governments, and the national government. Global budgets eliminate the high potential costs (as is the case in the U.S.) of billing individually for huge numbers of products and services.
Health care provision in Canada is a mix of private and public services, although most hospitals are public. Patients may go to any doctor or hospital in the country.
Canadians do wait for some treatments and diagnostic services. Survey data show that the median wait time to see a special physician is a little over four weeks with 89.5% waiting less than three months. The median wait time for diagnostic services such as MRI and CAT scans is two weeks, with 86.4% waiting less than three months. The median wait time for surgery is four weeks, with 82.2% waiting less than three months. In addition, there is concern of a "brain drain" as high-quality medical graduates leave Canada for better-paying careers in the U.S.
Taiwan
Taiwan instituted a single-payer system, called the National Health Insurance (NHI), in 1995. In a 2009 interview, Dr. Michael Chen, Vice President and CFO of Taiwan's National Health Insurance Bureau, explained that before NHI was instituted, Taiwan "sent our people around the world to learn their programs, including the United States" to compare models. Dr. Chen indicated that Taiwan's single-payer NHI program "is modeled after (U.S.) Medicare. And there are so many similarities — other than that our program covers all of the population, and Medicare covers only the elderly. "Proposals in the United States
A number of proposals have been made for a universal single-payer healthcare system in the United States, none of which has achieved significant political support, with polling showing support for various levels of government involvement depending on wording. Proposers include Physicians for a National Health ProgramPhysicians for a National Health Program
Physicians for a National Health Program , is an advocacy organization of some 17,000 American physicians, medical students, and health professionals founded by Quentin Young who support a single-payer system of national health insurance....
, The American College of Physicians
American College of Physicians
The American College of Physicians is a national organization of doctors of internal medicine —physicians who specialize in the prevention, detection, and treatment of illnesses in adults. With 130,000 members, ACP is the largest medical-specialty organization and second-largest physician group in...
and the American Medical Student Association.
In Congress, Rep. John Conyers
John Conyers
John Conyers, Jr. is the U.S. Representative for , serving since 1965 . He is a member of the Democratic Party...
, Jr. (D-MI), and Rep. Dennis Kucinich
Dennis Kucinich
Dennis John Kucinich is the U.S. Representative for , serving since 1997. He was furthermore a candidate for the Democratic nomination for President of the United States in the 2004 and 2008 presidential elections....
(D-OH) have introduced the United States National Health Care Act (HR 676). The bill has been introduced in every term of Congress under the same name since it was first introduced in 2003 in the 108th Congress with 38 cosponsors.
Current programs
Medicare in the United StatesMedicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
is a single-payer healthcare system, but is restricted to only senior citizens and certain other classes of people. Government is increasingly involved in U.S. health care
Health care in the United States
Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector...
spending, paying about 45% of the $2.2 trillion the nation spent on individuals' medical care in 2004. However, studies have shown that the publicly-administered share of health spending in the U.S. is closer to 60%.
According to Princeton University
Princeton University
Princeton University is a private research university located in Princeton, New Jersey, United States. The school is one of the eight universities of the Ivy League, and is one of the nine Colonial Colleges founded before the American Revolution....
health economist Uwe E. Reinhardt, U.S. Medicare, Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
, and State Children's Health Insurance Program
State Children's Health Insurance Program
The State Children's Health Insurance Program – later known more simply as the Children's Health Insurance Program – is a program administered by the United States Department of Health and Human Services that provides matching funds to states for health insurance to families with children...
(SCHIP) represent "forms of 'social insurance
Social insurance
Social insurance is any government-sponsored program with the following four characteristics:* the benefits, eligibility requirements and other aspects of the program are defined by statute;...
' coupled with a largely private health-care delivery system" rather than forms of "socialized medicine
Socialized medicine
Socialized medicine is a term used to describe a system for providing medical and hospital care for all at a nominal cost by means of government regulation of health services and subsidies derived from taxation. It is used primarily and usually pejoratively in United States political debates...
." In contrast, he describes the Veterans Administration healthcare system
Veterans Health Administration
The Veterans Health Administration is the component of the United States Department of Veterans Affairs led by the Under Secretary of Veterans Affairs for Health that implements the medical assistance program of the VA through the administration and operation of numerous VA outpatient clinics,...
as a pure form of socialized medicine because it is "owned, operated and financed by government."
The Veterans Administration
United States Department of Veterans Affairs
The United States Department of Veterans Affairs is a government-run military veteran benefit system with Cabinet-level status. It is the United States government’s second largest department, after the United States Department of Defense...
is a single-payer system and provides excellent quality, said Reinhardt. In a peer-reviewed paper published in the Annals of Internal Medicine, researchers of the RAND
RAND
RAND Corporation is a nonprofit global policy think tank first formed to offer research and analysis to the United States armed forces by Douglas Aircraft Company. It is currently financed by the U.S. government and private endowment, corporations including the healthcare industry, universities...
Corp. reported that the quality of care received by Veterans Administration patients scored significantly higher overall than did comparable metrics for patients currently using U.S. Medicare.
State proposals
Several single-payer state referendums and bills from state legislatures have been proposed, but so far all have either failed to pass both legislatures or were vetoed by the governor, including (states where the debate is also current) California as early as 1994, MassachusettsMassachusetts
The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...
in 2000, and Oregon
Oregon Ballot Measure 23 (2002)
Measure 23 was a legislatively-referred state statute that would have created a single-payer health care system to provide health care to every person in Oregon. The proposal would have merged all the various funding streams—personal and employer taxes, federal health programs, and the state...
in 2002.
In 2009 the House of Representatives Education and Labor Committee approved an amendment to the House health care bill, which would allow individual states to adopt a single-payer Medicare-for-all-style health plan. The amendment was proposed by Democratic Congress member Dennis Kucinich of Ohio. The Kucinich Amendment received support from some conservatives supporting states rights as it would allow states more freedom to explore various models including, but not limited to, single payer.
Minnesota
In Minnesota, the Minnesota Health Act, which would establish a state-wide single payer health plan, has been presented to the Senate as SF118 and to the House as HF135, in identical language. This bill was passed by several critical committees in both houses, has been designated as a two-year bill, and awaits a second reading in the House Health Care and Human Services Policy & Oversight Committee. Two out of three of the 2010 Democratic-Farmer-Labor Party candidates for governor have indicated they would sign the bill, if passed; the Republican PartyRepublican Party of Minnesota
The Republican Party of Minnesota is the Minnesota branch of the United States Republican Party. Elected by the party’s state central committee in June 2009, its chairman is Tony Sutton, and its deputy-chairman is Michael Brodkorb.-Early history:...
candidate does not support such a measure (two of the candidates interviewed that indicated they would not have since left the race).
California
The California State LegislatureCalifornia State Legislature
The California State Legislature is the state legislature of the U.S. state of California. It is a bicameral body consisting of the lower house, the California State Assembly, with 80 members, and the upper house, the California State Senate, with 40 members...
has twice passed a state-level single payer bill, SB 840, "The California Universal Healthcare Act" (authored by Sheila Kuehl
Sheila Kuehl
Sheila James Kuehl is an American politician, and a former child actress. She most recently served as a Democratic member of the California State Senate, representing the 23rd district in Los Angeles County and parts of southern Ventura County...
), in 2006 and again in 2008. Both times, Governor Arnold Schwarzenegger vetoed the bill. State Senator Mark Leno later re-introduced "The California Universal Healthcare Act" in March 2009, newly renumbered as SB 810, and in January 2010, the California Senate passed SB 810. On the last day of the 2010 legislative session, the Democrats pulled SB 810 from the Assembly floor as Governor Arnold Schwarzenegger said he would veto it a third time, with Senator Mark Leno
Mark Leno
Mark Leno is an American politician, representing California's 3rd Senate district, which includes parts of San Francisco and Sonoma County, as well as the entirety of Marin County. He was elected in 2008 and is the first openly gay man to serve in the Senate...
announcing he would reintroduce the bill again in January of the 2011 legislative session as Jerry Brown
Jerry Brown
Edmund Gerald "Jerry" Brown, Jr. is an American politician. Brown served as the 34th Governor of California , and is currently serving as the 39th California Governor...
is sworn in as the new Governor of California. The bill has received support from the California Nurses Association/National Nurses United.
Illinois
In April 2008, the Illinois House of Representatives' Health Availability Access Committee passed the single-payer bill HB 311, "The Health Care for All Illinois Act," favorably out of committee by an 8–4 vote.Pennsylvania
In February 2010, the 301-member Pennsylvania Democratic State Committee unanimously endorsed a resolution calling for passage of single payer healthcare, Senate Bill 400 and House Bill 1660, also known as the "Family and Business Healthcare Security Act."Montana
In September 2011, Governor Brian Schweitzer did a news interview discussing his desire to obtain a waiver from the federal government similar to the waiver Vermont used, and set up their own universal health care system similar to what was established in the Canadian provence of Saskatchewan.Massachusetts
In Massachusetts, Question 4, a nonbinding referendum was on the ballot in 14 districts in November 2010, asking voters, "Shall the representative from this district be instructed to support legislation that would establish health care as a human rightRight to health
The right to health is the economic, social and cultural right to the highest attainable standard of health. It is recognised in the Universal Declaration of Human Rights and International Covenant on Economic, Social and Cultural Rights.- Definition :...
regardless of age, state of health or employment status, by creating a single payer health insurance system like Medicare that is comprehensive, cost effective, and publicly provided to all residents of Massachusetts?" With 222 of 228 precincts reporting, in all 14 districts, including five in which majorities had voted for Republican Senator Scott Brown
Scott Brown
Scott Brown is a United States senator.Scott Brown may also refer to:-Sportsmen:*Scott Brown , American college football coach of Kentucky State...
, Question 4 passed, with 63.5% of the overall votes being cast in favor of the ballot referendum for establishing a Massachusetts single payer system.
Vermont
The legislature of VermontVermont
Vermont is a state in the New England region of the northeastern United States of America. The state ranks 43rd in land area, , and 45th in total area. Its population according to the 2010 census, 630,337, is the second smallest in the country, larger only than Wyoming. It is the only New England...
, including both the Democratic and Progressive Party
Vermont Progressive Party
The Vermont Progressive Party is an American political party. It was founded in 1999 and is active only in the U.S. state of Vermont. In terms of the dominant two parties in the United States, it enjoys support from "traditional liberal" Democrats and working class Republicans. The party is...
, endorses single payer health care and has hired William Hsiao
William Hsiao
William C. Hsiao an American economist, is the K.T. Li Professor of Economics at the Harvard School of Public Health in Boston, Massachusetts...
, the designer of Taiwan's single payer health care system, to design three possible systems of universal health care, one being a single payer model. Governor Peter Shumlin supports this move.
The Vermont health bill, H.202, has led to the creation of Green Mountain Care, a private/public single payer exchange system that will give universal coverage to Vermonters and create an electronic system of medical records in an effort to make the system efficient and accessible. In April 2011, it passed the Vermont Senate. In May 2011, the governor signed it into law, making Vermont the first state to have a single payer health care system.
Other proposals
Physicians for a National Health ProgramPhysicians for a National Health Program
Physicians for a National Health Program , is an advocacy organization of some 17,000 American physicians, medical students, and health professionals founded by Quentin Young who support a single-payer system of national health insurance....
the American Medical Student Association
American Medical Student Association
The American Medical Student Association , founded in 1950 and based in Washington, D.C., is the oldest and largest independent association of physicians-in-training in the United States. AMSA is a student-governed, national organization...
and the California Nurses Association are among those that have called for the introduction of a single payer health care program. In Congress, Rep. John Conyers
John Conyers
John Conyers, Jr. is the U.S. Representative for , serving since 1965 . He is a member of the Democratic Party...
, Jr. (D-MI) has repeatedly introduced The United States National Health Care Act (HR 676). As of August 2008, HR 676 had 91 co-sponsors.
The Congressional Budget Office
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
and related government agencies scored the cost of a universal health care system several times since 1991, and have uniformly predicted cost savings, probably because of the 40% cost savings associated with universal preventative care.
The issue has often been debated, most recently in the 2008 presidential elections. A CBS News/New York Times poll published in February 2009 reported that 59% say the government should provide national health insurance (up from 40% thirty years earlier) A study published in the Annals of Internal Medicine concluded that 59% of physicians "supported legislation to establish national health insurance" while 9% were neutral on the topic, and 32% opposed it.
Public opinion in the United States
According to the media criticism organization Fairness and Accuracy in ReportingFairness and Accuracy in Reporting
Fairness & Accuracy In Reporting is a progressive media criticism organization based in New York City, founded in 1986.FAIR describes itself on its website as "the national media watch group" and defines its mission as working to "invigorate the First Amendment by advocating for greater diversity...
, a 1987 New York Times/CBS poll showed 78% of people saying that the "government should guarantee medical care to everyone." Between 2003 to 2009, 17 opinion polls showed a majority of the public supports various levels of government involvement in health care in the United States. Many polls, such as ones administered through CNN, AP-Yahoo, New York Times/CBS News Poll
CBS News
CBS News is the news division of American television and radio network CBS. The current chairman is Jeff Fager who is also the executive producer of 60 Minutes, while the current president of CBS News is David Rhodes. CBS News' flagship program is the CBS Evening News, hosted by the network's main...
, and Washington Post/ABC News Poll
ABC News
ABC News is the news gathering and broadcasting division of American broadcast television network ABC, a subsidiary of The Walt Disney Company...
, Kaiser Family Foundation
Kaiser Family Foundation
The Henry J. Kaiser Family Foundation , or just Kaiser Family Foundation, is a U.S.-based non-profit, private operating foundation headquartered in Menlo Park, California. It focuses on the major health care issues facing the nation, as well as the U.S. role in global health policy...
showed a majority in favor of a form of national health insurance, often compared to Medicare. The Civil Society Institute and Physicians for a National Health Program have both found majorities in favor of the government offering guaranteed insurance, and a Quinnipiac
Quinnipiac
This article is about the Native American nation. For the university, see Quinnipiac University.The Quinnipiac — rarely spelled Quinnipiack — is the English name for the Eansketambawg a Native American nation of the Algonquian family who inhabited the Wampanoki This article is about the Native...
poll in three states in 2008 found majority support for the government ensuring "that everyone in the United States has adequate health-care" among likely Democratic primary voters.
In contrast, a October 2011 Rasmussen Reports
Rasmussen Reports
Rasmussen Reports is an American media company that publishes and distributes information based on public opinion polling. Founded by pollster Scott Rasmussen in 2003, the company updates daily indexes including the President's job approval rating, and provides public opinion data, analysis, and...
poll of registered voters showed only 35% of respondents in favor of single-payer health care, with a plurality (49%) opposed. Politifact rated a statement by Michael Moore
Michael Moore
Michael Francis Moore is an American filmmaker, author, social critic and activist. He is the director and producer of Fahrenheit 9/11, which is the highest-grossing documentary of all time. His films Bowling for Columbine and Sicko also place in the top ten highest-grossing documentaries...
"false" when he stated that "[t]he majority actually want single-payer health care." Responses on these polls largely depend on the wording. For example, people respond more favorably when they are asked if they want a system "like Medicare," less favorably when stated as "socialized."
See also
- Health care compared – tabular comparisons of the US, Canada, and other countries not shown above.
- Health care reform debate in the United StatesHealth care reform debate in the United StatesThe health care reform debate in the United States has been a political issue for many years, focusing upon increasing coverage, decreasing the cost and social burden of healthcare, insurance reform, and the philosophy of its provision, funding, and government involvement...
- Kucinich Amendment to Health Care Bill HR 3200 grants states rights to single payer health care at the state level.
- MonopsonyMonopsonyIn economics, a monopsony is a market form in which only one buyer faces many sellers. It is an example of imperfect competition, similar to a monopoly, in which only one seller faces many buyers...
- National health insuranceNational health insuranceNational health insurance is health insurance that insures a national population for the costs of health care and usually is instituted as a program of healthcare reform. It is enforced by law. It may be administered by the public sector, the private sector, or a combination of both...
- Publicly funded health care
- Public opinion on health care reform in the United StatesPublic opinion on health care reform in the United StatesPublic opinion on health care reform in the United States is mixed. Many Americans express a desire for health care reform because they see health care as too expensive and because they perceive that insurance companies avoid meeting health costs through coverage exclusions, caps, and co-pays...
- Public health insurance optionPublic health insurance optionThe public health insurance option is a proposed government-run health insurance agency which competes with other health insurance companies. It is not the same as Publicly-funded health care. Called the public insurance option or public option, for short, it was a proposed health insurance plan...
External links
Citizen action or resource groups- Single-Payer Healthcare Resources. A collection of links to primers, national/state resources, comparisons to other nations, bills/terminology, etc.
- Healthcare-NOW!. A nonprofit advocacy group for single-payer healthcare.
- Progressive Democrats of America Advocates for single-payer system.
- Physicians for a National Health Program. Advocates for single-payer system. Extensive source material from peer-reviewed journals.
- Single Payer Action. Activist nonprofit organization supporting single-payer universal healthcare.
- Single Payer Central. An independent/unaffiliated central clearing house of information (groups, legislation, etc.), for single-payer.
Articles, books, and broadcast programs
- Five myths about health care around the world "For people over 65, we're Canada ... for the tens of millions without insurance coverage, we're Burundi or Burma" by T.R. Reid, a former Washington Post reporter.
- Institute of Medicine Committee on the Consequences of Uninsurance. Hidden costs, value lost: uninsurance in America. Washington, D.C.: National Academies Press, 2003. Frequently-cited monograph.
- Sick Around the World: Can the U.S. learn anything from the rest of the world about how to run a health care system? from Frontline, PBS.
- Single Payer Healthcare Now. An activist blog supporting single payer healthcare
- States Moving Towards Comprehensive Health Care Reform in the U.S., The Henry J. Kaiser Family Foundation.
- The Case For Single Payer, Universal Health Care For The United States
- The Socialists Are Coming! The Socialists Are Coming! by Phillip Boffey. Editorial on U.S. "socialized medicine" in the military, the Veterans Health Administration, and Medicare, The New York Times, September 28, 2007.
- Whither a health-care solution? Oh Canada BusinessWeek, March 21, 1994 by William C. Symonds, article in a business journal writing favorably about single payer.
FAQ and summaries by NGOs favoring single payer
- Get the Facts on Health Care Reform Single-payer solution myths and facts from Public Citizen.
- Report Card on Single-Payer and Public Option from PDA and Healthcare-now comparing, contrasting, and grading the two proposals.
- Single-Payer Myths; Single-Payer Facts summary from PNHP.
- What is Single-Payer Healthcare? from Healthcare-Now.org (expanded from PNHP with additional information)