What would a single payer system look like?

  1. So as we enter 2016 we have a democratic candidate opting for a single payer system or rather "Medicare for all". Now whether something like this could or should pass, what would the healthcare system look like with this in place. Please note that this is not a political argument as far as democrat vs republican or anything like that. I am simply curious to see how the system would change and if the change would be better, worse, or the same. Please feel free to post your thoughts!
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  2. 144 Comments

  3. by   Eru Ilúvatar
    Quote from Xlorgguss
    So as we enter 2016 we have a democratic candidate opting for a single payer system or rather "Medicare for all". Now whether something like this could or should pass, what would the healthcare system look like with this in place. Please note that this is not a political argument as far as democrat vs republican or anything like that. I am simply curious to see how the system would change and if the change would be better, worse, or the same. Please feel free to post your thoughts!
    As with everything in life... It depends. I don't foresee a single payer system for the US healthcare in the foreseeable future. The size and power of the many parties involved with our current system will push back.
    Now would a one payer system make our healthcare system better and cheaper... Maybe. It would create cost controls and standardization of costs for procedures and interventions. I dont like centralization or consolidation of powers or agencies, it ends in most of the cases in causing terrible red tape and inefficiency, and with lack of competition comes complacency. I advocate more for universal access to healthcare or health insurance , than for a one layer system.
    If you want more data on one payer system i would say to check Canada's one payer system. I am not too familiar with it but it would be the perfect example of the pros and cons of what such a system would have.
    But i do believe access to healthcare should be a right not a privilege, in the long run, by having everyone checked and with better health, huge costs of acute or emergency diseases could be saved. Would you rather cover the costs of a couple of checkups now, than cover the costs of many surgeries/ emergency interventions later on?
  4. by   Not_A_Hat_Person
    It would probably look like Medicare.
  5. by   elkpark
    Canada. Medicare.
  6. by   Rose_Queen
    More affordable because the middleman out looking for a profit gets cut?
  7. by   MunoRN
    Single payer only refers to how we pay our healthcare costs, it doesn't change who we receive care from. I think sometimes it gets confused with "government run healthcare" which is much different. The UK and Canada for instance have government run healthcare, which means healthcare delivery as well as the payment system is run by the government.

    The basic idea is that instead of using a tangled web of for-profit insurers, which essentially only serve the function of collecting and then paying back out money, we all pool that shared risk and then pay those costs out of a single entity, which makes that same service much cheaper and more effective.
  8. by   elkpark
    Quote from MunoRN
    Single payer only refers to how we pay our healthcare costs, it doesn't change who we receive care from. I think sometimes it gets confused with "government run healthcare" which is much different. The UK and Canada for instance have government run healthcare, which means healthcare delivery as well as the payment system is run by the government.
    I thought that Canada does have a single-payer system, in which the government pays for healthcare which is provided by private (nongovernmental) providers (like Medicare), as opposed to England, which has a socialized system in which the hospitals and other healthcare facilities are owned and operated by the government (like the VA system). Have I been wrong about that all these years? Has something changed in Canada recently?
  9. by   NOADLS
    Canada's model would be pretty close to this. From my understanding, healthcare is administered by each province, but funded by the country (ie each province can run it how they choose as long as they are providing "public" healthcare)

    This system has some positives and some negatives. Depending on your political views, the subsidization of healthcare can be perceived as a positive or negative, so I won't touch that. One of the biggest positive points is increased employment within the healthcare sector. If more people have access to healthcare, more providers will be required. In turn, wages would likely rise for us.

    The biggest downside I can think of is personal accountability. If you decide to make poor choices and either fatten up or / and succumb to "diabeetus," the taxpayer is paying for your bad decisions. This would encourage people to make poor decisions related to their own health. There is also a side effect that a lot of people wouldn't think about. If the obesity or overweight % of population increases, people who like skinny women would plunge into a state of depression because there would be less of them around. The costs associated with depression would also be flung at taxpayers.
  10. by   Farawyn
    *facepalm* ^
  11. by   MunoRN
    Quote from elkpark
    I thought that Canada does have a single-payer system, in which the government pays for healthcare which is provided by private (nongovernmental) providers (like Medicare), as opposed to England, which has a socialized system in which the hospitals and other healthcare facilities are owned and operated by the government (like the VA system). Have I been wrong about that all these years? Has something changed in Canada recently?
    In the UK, hospitals are operated at the Federal level, in Canada they are generally operated by local public entities (province or "health authorities"), but are still non-profit publicly operated entities.
  12. by   MunoRN
    Quote from NOADLS
    The biggest downside I can think of is personal accountability. If you decide to make poor choices and either fatten up or / and succumb to "diabeetus," the taxpayer is paying for your bad decisions. This would encourage people to make poor decisions related to their own health. There is also a side effect that a lot of people wouldn't think about. If the obesity or overweight % of population increases, people who like skinny women would plunge into a state of depression because there would be less of them around. The costs associated with depression would also be flung at taxpayers.
    How do you think that would be different than how it already works? If someone doesn't adequately treat their "diabeetus" and ends up needing treatment for DKA, for heart attack, stroke, etc, who do you think pays for that now? That cost is already shared by everybody else. The only difference with universal coverage would be that people would at least have the opportunity to get the treatment that would avoid those far more costly treatments in the first place.
  13. by   NOADLS
    Quote from MunoRN
    The only difference with universal coverage would be that people would at least have the opportunity to get the treatment that would avoid those far more costly treatments in the first place.
    Preventative treatment delays the "when." And with diabeetus, it isn't a matter of "if," it's a matter of "when." Either way, the "when" has to be accounted for. The preventative treatment is simply an added expense.

    I would also advise against universal coverage because the added taxes would make the cost of living too high for some of the middle class. I consider myself to be in the upper middle class and am fortunate enough to comfortably afford my own place. My Canadian counterparts to the north aren't so fortunate since they live in igloos.

    I believe that because Canadians live in igloos and we 'Muricans live in houses, universal healthcare is detrimental to the quality of lives of North Americans.
  14. by   Xlorgguss
    How would the system deal with individuals who do not care about their health? Is there any incentive to having good health? Would this system ultimately be cheaper? I have read mixed reviews. As a young healthy adult it would be nice to not have my money go towards a high deductible plan. I personally would rather have useable insurance. Would having this sort of system ensure that copays and FSA and HSA wouldn't be needed? How would things like acupuncture, chiropractic, or massage work? I was reading how the wait time for surgery in Canada is about 4 weeks. Would this be realistic for a US system?

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