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Single-Payer? What is it good for?

You might have seen the phrase “Single-Payer” tossed around by me and others talking about Health Care reform.  I often forget to stop and explain the term which frustrates readers and embarrasses me.

So (since I’m not going to stop talking about it) this post will serve as a handy shortcut to Single-Payer resources.  And life will be a little bit easier for all of us.

My favorite go-to site for single payer facts is the Physicians for a National Health Care Plan:

Physicians for a National Health Program is a single issue organization advocating a universal, comprehensive single-payer national health program. PNHP has more than 16,000 members and chapters across the United States.

Since 1987, we’ve advocated for reform in the U.S. health care system. We educate physicians and other health professionals about the benefits of a single-payer system–including fewer administrative costs and affording health insurance for the 46 million Americans who have none.

And they’ve got virtually REAMS of educational information! From their “New to Single-Payer” page they offer this description:

Single-Payer National Health Insurance

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 45.7 million completely uninsured and millions more inadequately covered.


Under a single-payer system, all Americans 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. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

On their FAQ page they answer common questions (and squash common lies):

Is national health insurance ‘socialized medicine’?

Won’t this result in rationing like in Canada?

Won’t this just be another bureaucracy?

What will happen to physician incomes?

And the 1 Trillion dollar question:

Would a “public plan option” at least be a step in the right direction? Simple answer: No. But this one deserves a whole post of it’s own.

(slapping my fingers) I could keep going for days echoing bits and pieces from this website but, I’ll spare you.

Other Sites of interest (and frequent links) are:

Corrente: They have updates to Health Care activities nearly every day.

1Payer.net: With spokesman Mike Farrell’s ads they are building awareness of Single-Payer as the most credible health care reform option.  AND as the inventors of the ongoing FAX Campaign there is always something exciting to discover at their site. (see Single-Payer Heros)

Medicare for All:  Everybody in/Nobody Out

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59 Responses

  1. Medicare for all would leave us with huge bills for medication. Part D bites

    • I think they’re hoping/planning that medicare would be revamped to handle prescriptions and more (from above) :

      Under a single-payer system, all Americans 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.

      I agree that without doing something about prescriptions, it’s not too good.

      I’m actually working on another post expanding on that (a bit of a rant, really). But, got sidetracked by the definition stuff. And thought it (the definition) needs to stand alone.

      • What bites more is NO insurance and the inability to buy it or get it. Lack of health insurance is the #1 reason for bankruptcies in America. We must do some thing about it, because the employers are not able to handle the constant rate increases and employees can’t handle the 50% participation, nor any participation for their dependents. We are the last major Western country that doesn’t have Universal Coverage for its citizens…where are the priorities.

      • My neighbor was diagnosed with diabetes the end of last year. She didn’t have any family or friends to advocate for her so I picked up the slack. Her medication without any help whatsoever runs about $400 a month. The medicare D supplemental leaves her covering that $400 a month 5 months of the year. I was absolutely apalled.

        If they do a medicare for all they definitely need to revamp D. I also am a little uneasy about the Medicare route because there is talk about getting rid of supplementals. Some from what I understand are rip offs but others actually do help bridge costs for hospitalization.

        I definitely would love to see a complete primer. I am totally on board revamping health care to make it workable. We have another neighbor who is self employed and her and her husband pay $600 a month for coverage. That is a huge chunk of change for the average household and I’ve heard horror stories where the numbers are even higher. We have been fortunate so far. Hubby is union, so we have excellent coverage for 6 of us for less than$200 a month. When he worked at Danaher we were paying a little over $350 a month for co pay insurance which was bearable with what he made. That being said he made a substantial bit more than a minimum wage.

        I’d definitely like

    • It was much better the first year. Now I am paying more monthly and hit the donut hole in May.

    • Part D was better the first year. With each passing year my premium rises and my coverage ditches further.

      • Did you see SICKO…and who went over to the DARK SIDE of the Health Insurance during the implementation of Medicare Part D? Truly telling…I think there should be a 5 year legal requirement that prevents, any congressperson or senator from working with any lobbying group or big companies that had legislation before them.

        Look at Daschle (sp), that was a bit shocking to learn, about his little consultation work. 😯

  2. That’s great for all the single people. But what about married people? Who pays for them? Just messing with your head KB… 🙂 Nice idea to lay out the definition. Handy for reference in future articles.

  3. If you think single-payer will pass anytime soon, think again.

    Here’s a hint why:

    Specter Backs Coleman for Senate

    • Personally I am holding Obama to his: “My plan is the same as Hillary’s”. He said there was NO difference between him and Hillary and that is why we had so many jump on over to make history…with tingles up their legs…NOW we will see if it was all talk…JUST WORDS.

      • I don’t think Hillary’s plan was “get elected then screw the voters”

        • (sadly) I don’t think so either.

          • Well, my point is, if he is going to do us, I am going A kicking and A screaming and telling ’em all IT WAS ALL LIES…CHANGE MY FOOT! I know he already gave the big boyz in Wall Street the Money, when he could have had an impact on all Americans by implementing Universal Health Care and covering it in the stimulus.

  4. katiebird,

    This is an awesome post! I really encourage everyone to visit all the links.

    Private insurance companies, and the media outlets and politicians they pay for (including our president) put out so much misinformation regarding health care, it’s important to go to sources such as these to get real facts.

    • Thank you so much! I’m getting a ton of ideas for more posts from the comments….

      • Katie,

        I am also tired of paying the thousands in hidden profits, because we have to pay for my youngest at the same rate as my husband and he is older than any of us. The system doesn’t allow us to pay for a plan for said child and the bilk us monthly with the blessing of our elected officials. I think this is like a hidden profit tax for the companies as a plan would only be $100. or 120. a month, but we can’t get one, as the dependent qualifies under us. 😯 Legal robbery is what it is.

  5. Single payer protesters disrupt senate hearing

    (h/t TGW)

    • This actually inspired the title of the post I’m working on for tomorrow.

      My mom saw it happen in real time so I went looking for it.

    • We won’t get anything with these guys, they think they are in the House of Lords, like Biden who was there over 26+ years and did NOTHING for the working folks in regards to Universal Health Care. There laughter is indicative of how easily they can dismiss the voters once they are in. TERM LIMITS OR BUST! These guys are sicking to watch.

      I am glad some honest AMERICANS care enough for other Americans as to show up and let them know that people are losing their lives while they sit there doing the bidding of their friends. It is heartening to see these protesters…God Bless them and may their voices never be silent.

      Kerry, was so impolite…but he is rich and he has Health Coverage. They should all be ashamed and give up their coverage until the people get coverage to.

    • From an email message I just got:

      HealthJustice Action Alert
      Baucus’ Incredible Arrogance Makes Me Angry
      Dear katiebird, Today Mad Max Baucus showed us what he means when he says ‘single payer is off the table.’ When single payer advocates politely asked for a seat at the table, where 15 insurance flunkies were waiting to testify to his Senate committee, Sen. Baucus sneered at them and told them they would get more police. That gave all of Baucus’ fellow insurance flunkies (and all the other clowns in the hearing room) a big laugh. Then Baucus hypocritically told the audience how much he respected single payer, as the police were arresting eight people who just wanted to present a point of view. I am angry about this arrogant abuse of power. If you are angry, now is your chance to tell Baucus. Call 800-578-4171, choose option 1, and connect to his office. if no one answers, it probably is because Baucus is too chicken to even listen to the angry messages.
      Alternatively, call each one of his offices in Montana. Here are the phone numbers: Billings
      (406) 657-6790; Bozeman (406) 586-6104; Butte (406) 782-8700; Great Falls (406) 761-1574, (406) 452-1117 (TDD); Helena (406) 449-5480; Kalispell (406) 756-1150;Missoula (406) 329-3123; Washington D.C. (202) 224-2651(Office),(202) 224-9412 (Fax)

  6. I’ve heard it said a couple of times lately a problem with UHC would be a shortage of doctors/other healthcare workers. Does anyone know if this is true or just a right wing talking point? One guy who said it was my doctor’s husband, so I’m not sure of his angle. I didn’t see it addressed in the links, unless I missed it.

    • We already have a doctor shortage in Nevada, and here and in California, more doctors are opting for cosmetic practices where they can be sure their patients/clients can afford to pay and don’t have to bother with insurance forms, Medicare and private. This article from 2006 says that by 2020 5 western states won’t have enough primary care physicians.


    • Lord knows. Some physicians have social consciences, some don’t. We have a dearth of primary care physicians and pediatricians which are the lower paying specialties now.

    • Don’t believe the lies, it is all lies. My father in-law is a doc and so is my brother in-law and they live in a country that has Universal Health Coverage and there is no darn shortage. In fact they have raised the bar of doctors (foreign ones), in having to pass a higher standard, to make sure that they aren’t flooded and that only the best are allowed in.

      • My father-in-law is a recently retired French dentist (a small-town dentist to boot — how charmant is that???). No shortage in that UHC country. We are actually crossing our fingers for a French nursing shortage, though, so we can go back when hubby finishes nursing school.

    • It’s not addressed directly but, is sort of covered in the questions about rationing & doctor’s compensation.

      On the rationing they point out that we already ration based on ability to pay. On the compensation they Say,

      “The increase in patient visits when financial barriers fall under a single-payer system will be offset by resources freed up by a drastic reduction in administrative overhead and physicians’ paperwork. Billing would involve imprinting the patient’s national health program card on a charge slip, checking a box to indicate the complexity of the procedure or service, and sending the slip (or a computer record) to the physician-payment board.”

  7. Katiebird, I’m working on a post about the bogus healthcare reform BS they’re pushing in Congress, too. I think we should all stay on top of it. This is what Baucus has to say about it, he claims computerizing records will cut costs. As long as they get away with “affordable healthcare” as a rallying cry, all we’re gonna get is slight insurance company modifications to the current system, i.e., screwed. The truth is, health care is not currently affordable to most people, insured, or not.


    • I hope you’ll be posting it here too, Cinie.

      What you say about health care not being affordable is really true. I know from personal experience. Our Health insurance premium went up $88/mo for the two of us to $882/mo — for 2 people. It’s too much really. But, we can just barely afford it. If it goes up that much next year, we’ll be dropping it.

      I just remembered. They used to take the whole health insurance premium out of our first paycheck of the month. A few years ago they realized that some people (ha! the clerks) couldn’t get insurance because the premiums were wiping out a whole paycheck. Funny. What a laugh.

      • Katie,

        You are correct. I had one employee who couldn’t pay the %50 because she was into her sixties and well I picked it up and the shocking thing is it was the most affordable, at $770 a month. Ouch!

        It is clear that they simply want older folks out on their bums, risking all their life’s work and ending up in bankruptcy court. How can they stand their war mongering while Americans don’t have health care??? It is just unconscionable!

    • Spot on Cinie!

      Go Cinie Go…let ’em have it, as it is the poor that suffer as always. If they lost their coverage they would stop congress and call it a national emergency.

    • The “computerization” of records is no big deal and just a money maker for software firms. Most of the records are already computerized (Hillary has been working on this for years now) and the whole “reinventing the wheel” charade is going to be expensive and do nothing to solve the crisis of the uninsured.

      • Only some, not all and most are on Epic
        and that isn’t all it is cracked up to be in my opinion. The medication lists, always require someone to go over them (OK, so wasn’t that suppose to help with duplication and errors), and it prints out the list in a letter form which is hard for seniors and most people to read… Any hoo, it has a lot to be worked on and there are other components that need to be addressed, like chronological order of events, but it has been a help.

        I most recently got a team to go along with a medication use/change (the UK is on it already…more efficient) and one team member didn’t know it was me, that complained and spilled the beans, that the doctors were resistant to the change. Oh, and I make up my own doc.s to track it (changes…use etc), and I often wonder what happens to others that can’t.

  8. There may or may not be a further shortage. There are shortages in primary care and pediatrics now.

  9. Is anyone else having trouble posting?

  10. Great post, Katiebird! Your health care posts are so informattive. Keep it up, please!

    • (blushing)

      Thanks BostonBoomer. This subject is too depressing (that whole Baucus thing)

      • Katie,

        Honestly your post keep me here (I don’t know if I should admit to that…but I think you have figured it out by now) and am an avid reader of yours and your Health Care Posts. 🙂

  11. The range of opinion and knowledge and compassion showcased in this post and the comments is astonishing. It’s amazing to me that all these people came together in the same place:


    • I am still a ‘premium’ member but have only been there to post within the last four months about twice. I get their e-mails on the special articles and get their other e-mails and once got contacted for my comments on their web design (you know, me always giving feed back).

      • I was a premium subscriber for years. But, I dropped it last year at the height of their Obama-Love-a-Thon.

        I’m just now starting to visit it again once in a while.

  12. Hi KB — I know this subject interests you. You may find the document at this link of value.


    • It is all propaganda hoo haa, to keep their profits rolling in, while Americans die. I say lets cancel all the legislators policies and see how fast they get to work on the problem.

      We are the wealthiest country, yet we don’t have Universal Health Care? 😯

      • Yes, if you look in that document’s stats, the higher performing health systems are almost exclusively 100% gov’t paid.

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