Health care has emerged as one of the flash points in the Democratic presidential race. Sen. Bernie Sanders calls for “Medicare for All,” a health system that falls under the heading of ‘Single-payer”.
Photo Cred: Phil Roeder
Just to be clear, a Single-payer system is not the same thing as socialized medicine. In truly socialized medicine system, the government not only pays the bills, but also owns the health care facilities and employs the professionals who work there.
The Veterans Health Administration (VA) is an example of a socialized health system run by the government. Medicare, on the other hand, is a single-payer system in which the federal government pays the bills for those who qualify, but the hospitals and other providers remain private.
Which Countries have Single-payer?
Fewer than money people think. Most European countries never had or no longer have single-payer systems. “Most are basically what we call social insurance systems,” according to G. Anderson, professor at Johns Hopkins. Social Insurance programs ensure that almost everyone is covered. There are really only two countries that have true single-payer systems, Canada and Taiwan.
Are Single-Payer Plans Less Expensive?
Not necessarily. True, eliminating the profits and duplicative administrative costs would reduce spending but then that savings would maybe be only 10% and changing the system would be drastically disruptive to the market.
Would Medicare for all be just like the Existing Medicare Program?
Probably not. Private insurers today are fully integrated into Medicare, handling most of the claims processing and providing supplemental coverage through “Medigap” plans. In addition, nearly a third of Medicare beneficiaries are enrolled in private managed care plans called Medicare Advantage.
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