Why hasn't the United States moved into a single payer system?

wooh, BSN, RN · Mar 18, 2012

Because single payer would run the insurance companies out of the majority of their business. And the insurance companies have a lot of money to spend to convince us that single payer is "socialism" that results in "death panels" and we'll all be waiting in line for years to be cardioverted like they supposedly are in Canada and every other first world country that sees healthcare as a human right rather than a privilege.

rita359 · Mar 18, 2012

In my view there are several reasons.

1. America was founded with an ideal of individualism. In the day everybody had to look out for themselves. Good medical care is a very recent developement from a historical perspective.

2. Cost. Remember the Boston Tea Party. Americans have never liked paying taxes which is what supports universal health. Even with medicare how often do we hear about cutting back on benefits and if you listen you hear it a lot. With baby boomers coming into medicare 10,000 strong per day it will strain the system already in place. So think about what having everybody on board will do.

3. How much of your income are you willing to sacrafice to pay for this? It won't just be the rich paying for it. Its not like everybody pays taxes now. I've heard estimates of up to 50% do not pay any taxes so if you earn money can the government spend that money better than you can?

nurse2033, MSN, RN · Mar 18, 2012

Also the AMA always fights it tooth and bone because it reduces the income for physicians.

tntrn, ASN, RN · Mar 18, 2012

Because we want to preserve a modicum of choice is what our health care looks like.

KelRN215, BSN, RN · Mar 19, 2012

The United States is afraid of communism and healthcare is a business.

dirtyhippiegirl, BSN, RN · Mar 19, 2012

Because OMG death panels.

My husband's mother is a PCP in Canada. She makes *significantly more money * than my father who is an ER doc here in the states.

Food for thought?

tntrn, ASN, RN · Mar 19, 2012

I make more than nurses who work other states.....

dirtyhippiegirl, BSN, RN · Mar 19, 2012

I make more than nurses who work other states.....

Probably not an extra $200,000 to $300,000 more a year.

And, yeah, a lot of the fight against single pay is that docs will suddenly start making much less money.

MunoRN, RN · Mar 19, 2012

I think people confuse Federally provided universal healthcare and single-payer healthcare. In a simple single-payer system, hospitals, Physicians, labs, etc can still be private and for-profit, single payer reduces overhead costs significantly while allowing for more competition and more choice for consumers. Single payer has been endorsed by the ANA, NNU, and the AMA among others.

In our current system, most of the money meant for healthcare gets filtered through insurance systems. The service insurance systems provide is to collect bills, store that money, and then pay bills. A fairly simple service for which they take between 14% and more than 20% of the money that gets filtered through them. Based on non-profit payer systems we know that the cost of providing this service is between 1.5% and 2%, meaning they skim an additional 12-20% for profit. Single payer would only keep this 12-20% within the system (most likely as cost savings to consumers) and would not your options in what Doctor or Hospital you go to, in fact it would do away with the "preferred provider" lists that most insurance customers are currently limited to that limit choice in not only Physicians, but also hospitals, labs, etc.

The company I work recently put a smaller competitor out of business by cutting a deal with a couple local plan providers to discourage those who use that plan from using that lab's services, effectively limiting competition and choice for patients in my area, something that wouldn't be possible in a single payer system.