A National Health Care Plan

 A Government Insurance Program

There are Three Basic Single-payer Health Care Systems in the World.

1. Canada, Denmark, Norway and Sweden have a single-payer system where insurance is publicly administered and most physicians are private practice.
2. Great Britain and Spain have a single-payer system where salaried physicians predominate and hospitals are publicly owned and operated.
3. Germany and France have a dual payment system that is highly regulated, which pays for health care through a sickness fund.  Private (non-profit, government controlled) insurance for necessary care is allowed and covers about 5-9 percent of the population who can afford it.

The Characteristics of a Single-Payer System:

1. Affordability and Cost Efficiency
2. Comprehensive--universal-- covers all with necessary health care
3. Prevention and early intervention
4. Mental health parity
5. Eliminates disparities in access
6. Addresses special needs and underserved populations
7. Promotes quality
8. Provides adequate and timely payments to providers
9. Addresses need for adequate number of qualified health care providers
10. Fosters a strong network of health care facilities
11. Ensures continuity of coverage and care
12. Maximizes consumer choice of physicians and health care providers
13. Is easy to use and reduces paperwork
14. Provides free education and training for health care providers
15. Portability--you are covered where ever you go--change jobs, travel,etc--private insurance cannot provide you with this very important health care coverage.

 A Single Payer System - Similar to

"Medicare for All"

Medicare - is a single payer system. It has very low overhead (3 percent), and is universal and comprehensive for everybody over 65. If we adopt Medicare for everyone then all would be covered. And if we eliminate waste, fraud, and overhead by eliminating necessary care from the private health care system; it could easily cover prescription drugs, dental, and eye care.  Under a National Plan for everybody Medicare would be very much improved.

- Its Universal- Meaning equitable access to health care for everyone.

- It's Comprehensive - Including the full range of services to promote and maintain health, both physical and mental, and combat disease. Those essential services deemed necessary by our health care providers. Includes preventive medicine.

- It’s High Quality - Providing appropriate care in a timely manner.

- It's Affordable - Both for the individual, because financial barriers to needed care are removed, and for society as a whole because waste is cut out (Fraud, High Administrative Cost, and Profits ).

-It's Publicly Accountable - To the communities it serves and for the public dollars, which are the main source of its support, it is an accountability best accomplished by excluding for-profit corporations from the management and delivery of care.

- It Has Portability - Meaning you are covered wherever you go. Even foreign countries.

The key features of a single-payer reform are:

1. Universal and comprehensive coverage, which avoids most of a two-tier system and it  also minimizes administrative expense.

2.No out-of-pocket, co-pay, and deductible payments.

3. A single insurance plan in each region, administered by a public or quasi-public agency - prevents private insurance duplication public coverage, driving costs up.

4. Global operating budgets for hospitals, nursing homes, HMOs and other providers, with separate allocation of capital funds.

5. Free choice of providers

6.Public accountability, not corporate or bureaucratic dictates - medical decisions made by patients and providers.

7. A ban on for-profit health care providers disallow diversion of health care resources.

8. Protect the rights of health care and insurance workers - Guarantee.

** HR 676 A Single-Payer Health Care Bill has been reintroduced in 2007 See Updates.  

Universal Health Care or "Medicare for All" A "Single-payer System"

A National Health Insurance Program (NHI) is the only affordable option for universal, comprehensive coverage. Under the current system, expanding access to health care inevitably means increasing costs, and reducing costs inevitably means limiting access. But an NHI could both expand access and reduce costs. It would squeeze out bureaucratic waste and eliminate the perverse incentives that threaten the quality of care and the ethical foundations of medicine.

We endorse a fundamental change in America's health care - the creation of a comprehensive National Health Insurance (NHI) Program. Such a program - which in essence would be an expanded and improved version of Medicare - would cover every American for all necessary medical care, including dental care, eye care and prescription drugs. Hospitals and clinics would receive a global budget from the NHI to cover all operating expenses annually. Investor-owned facilities would be converted to not-for-profit status, and their former owners compensated for past investments. Physicians could continue to practice on a fee-for-service basis, or receive salaries from group practices, hospitals or clinics.

A National Health Insurance Program would save at least $200 billion (some say $300 billion) annually by eliminating the high overhead and profits of the private, investor-owned insurance industry and reducing spending for marketing and other satellite services. Doctors and hospitals would be freed from the accompanying burdens and expenses of paperwork created by having to deal with multiple insurers with different rules - often rules designed to avoid payment. During the transition to an NHI, the savings on administration and profits would fully offset the cost of expanded and improved coverage. [NHI] would make it possible to set and enforce overall spending limits of the health care system, slowing cost growth over the long run. Other savings by implementing a "Medicare for All" system:

1. By eliminating the uninsured and the underinsured everybody would have a primary doctor who knows their history. These people would no longer have to use expensive emergency room care and get expensive repetitive test.

 2. By elimination of for-profit health care we would reduce much of the fraud associated with the health care industry. Cost shifting by hospitals would be eliminated. Cost shifting is the reason that people with insurance pay $10 dollars for an aspirin.

3. A NHI would be able to bargain for lower prescription drug prices, which the current system has no way of doing now.

4. Malpractice costs would be lower. Canadian doctors only spend about $3000 or $4000 annually on malpractice insurance. With a universal health care system most of the high payments for malpractice would not be needed.  Health care needs would be covered for life.

5. Physician's salaries could be renegotiated giving them fair and just compensation.

. 6. We lose anywhere from $65 billion to $135 billion on productivity by not having a sound preventive health care system, and not covering the uninsured and underinsured workers. The price tag, in terms of lost wages and benefits and shorter lifespan, is between $1,645 and $3,280 a year per uninsured person. Providing coverage for the uninsured "is likely to be a cost-effective strategy that pays not only in lives saved and better health, but also in economic dividends.

Medicare operates at a much lower administrative costs. Mountains of paper work from 1500 insurance companies and 300 HMOs accounts for enormous amount of costly oversight. Medicare is able to drive a much harder bargain with hospitals, doctors, and prescription drugs.

Medicare is, after all, a government-financed single-payer system. It's by far the most efficient part of our health-care system, with overhead costs of less than 3 percent, and it covers virtually everyone over the age of 65. "Medicare-for-All" would cover all with necessary care including dental care, eye care, and prescription drugs.

We now spend over $7000 a year on health care for each American - more than twice the average of other advanced countries. But nearly half that amount is wasted. We now pay for health care in multiple ways- through our paychecks, the price of goods and services, taxes at all levels of government, and out-of-pocket fees. It makes more sense to pay just once with a income tax or payroll tax like we do for Medicare.

Nothing could be more onerous (troublesome, oppressive, burdensome) for patients and providers than the multiple, intrusive regulations imposed on them by the private insurance industry today. Why is the U.S. so different then the other advanced countries? The answer is that we alone treat health care as a commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need. In our market-driven system, investor-owned firms compete not so much by increasing quality of lowering costs, but by avoiding unprofitable patients and shifting costs back to patients or to other payers (like tax-payers). This creates a paradox of a health care system based on avoiding the sick.

It is sometimes argued that there would be waiting lines. This misconception is based on the fact that there are indeed waits for elective procedures in some countries with national health systems like Great Britain and Canada. But that's because they underfund their health care system. These two countries are in the process of spending more money (nothing like we do) to improve their system to reduce waiting and increase technology, but in other respects they are far better off than we are. They would never go back to a for-profit health care system where they saw half their population uninsured. Everybody is covered in these countries. They have a lower infant mortality rate and a higher life expectancy.  Countries like Germany, France and Japan do not have waiting lines so waiting lines are not inherant in a single-payer system.

We can well afford to provide quality health care for everybody. We live in a country that tolerates enormous disparities in income, material possessions and social privilege. That may be inevitable in a free-market economy, but those disparities should not extend to essential services like education, clean water and air and protection from crime, all of which we already acknowledge are public responsibilities. The same should be true for medical care. Our responsibility is to insure everyone and end the waste and profiteering of our market-based system.

We can Implement Our Single-Payer

Health Care System much Sooner