What would a single payer system look like?

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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!

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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Specializes in Critical Care.
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.

You believe that regardless of how well a person manages their diabetes their risk of stroke, DKA, etc is exactly the same?

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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.

You always end up finding a way of cracking me up NOADLS. The end of your post was really funny lol [emoji23]

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You always end up finding a way of cracking me up NOADLS. The end of your post was really funny lol [emoji23]

I know, right?! I'm reading, and thinking, nope, totally disagree...and then, igloos. :roflmao:

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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.

Igloos...OMG, I nearly fell out of my chair. :roflmao:

About the cost to the middle class--I don't know, but the added taxes might be comparable to the cost of private insurance, especially for a family. I think the insurance system is wasteful--it funnels money into an industry that produces absolutely nothing, functioning as an unnecessary middleman. Before Obamacare imposed some badly needed rules, they made a lot of that money by shortchanging the consumer--refusing to insure some people, insuring others but kicking them out when they became sick or had been sick too long. It's way past time to kick the bloodsuckers to the curb--the government isn't perfect, but it seems to do OK with Medicare, which most 'Muricans are quite happy with.

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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?

Ah, usable insurance--you mean cheaper? Keep in mind that you really do get what you pay for.

The wait time for surgeries probably depends on the surgery--I mean, people who need a triple bypass or a broken hip reduction probably don't wait at all. Elective surgeries always wait, in Canada and the U.S.

Incentives for good health are an excellent idea--maybe a year-end bonus for those who meet certain standards?

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I know, right?! I'm reading, and thinking, nope, totally disagree...and then, igloos. :roflmao:

I was about to argue then i saw the nonsense he put and was like "yep he is just pulling my strings" haha [emoji23]

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Ah, usable insurance--you mean cheaper? Keep in mind that you really do get what you pay for.

The wait time for surgeries probably depends on the surgery--I mean, people who need a triple bypass or a broken hip reduction probably don't wait at all. Elective surgeries always wait, in Canada and the U.S.

Incentives for good health are an excellent idea--maybe a year-end bonus for those who meet certain standards?

It's just crazy some of the high deductible plans I have had before. Like at times I had a plan that had a deductible that was nearly half my income for the year. On top of that it was still costing me upwards of 40$ a pay period. Now that sounds relatively cheap compared to some of the family plans, but the fact was it was only crisis insurance. There was nothing practical about it by any means.

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Sometimes I wish we could go to something like this. I would gladly pay the tax it would bring than the $400 a month insurance that I can't even afford to use because the deductible is $3,300 and the total out-of-pocket is $6,600. My employer claims they pay for my insurance, but once I opted into it, they sure dropped my paycheck as fast as they could to cover the payments...

If it wasn't for my HSA, I probably wouldn't be able to go to the dentist or get my vision checked each year.

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Specializes in Psych, Addictions, SOL (Student of Life).
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?

In may last two jobs since health care reform became law in the US I was told that if you have a medical condition and are deemed non-compliant by your doctor your insurance can raise your rates or penalize you by tacking an additional premium onto your insurance cost through payroll deduction. I don't know for sure if this is true but I have seen that person's who smoke which I don't are being charged as much as $24.00 a week if they refuse to quit. Again I have not had time to research this thoroughly so I'm not saying the ACA is responsible for this but I do see it as an infringement on individual freedom since smoking while seriously bad for you is completely legal. What happens if you engage in any behavior the powers that be determine to be risky..........?

Hppy

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Specializes in Critical care, tele, Medical-Surgical.

About single-payer national health insurance: Single-Payer National Health Insurance | Physicians for a National Health Program

Key Features of Single-Payer

  • Universal, Comprehensive Coverage Only such coverage ensures access, avoids a two-class system, and minimizes expense
  • No out-of-pocket payments Co-payments and deductibles are barriers to access, administratively unwieldy, and unnecessary for cost containment
  • A single insurance plan in each region, administered by a public or quasi-public agency A fragmentary payment system that entrusts private firms with administration ensures the waste of billions of dollars on useless paper pushing and profits. Private insurance duplicating public coverage fosters two-class care and drives up costs; such duplication should be prohibited
  • Global operating budgets for hospitals, nursing homes, allowed group and staff model HMOs and other providers with separate allocation of capital funds Billing on a per-patient basis creates unnecessary administrative complexity and expense. A budget separate from operating expenses will be allowed for capital improvements
  • Free Choice of Providers Patients should be free to seek care from any licensed health care provider, without financial incentives or penalties
  • Public Accountability, Not Corporate Dictates The public has an absolute right to democratically set overall health policies and priorities, but medical decisions must be made by patients and providers rather than dictated from afar. Market mechanisms principally empower employers and insurance bureaucrats pursuing narrow financial interests
  • Ban on For-Profit Health Care Providers Profit seeking inevitably distorts care and diverts resources from patients to investors
  • Protection of the rights of health care and insurance workers A single-payer national health program would eliminate the jobs of hundreds of thousands of people who currently perform billing, advertising, eligibility determination, and other superfluous tasks. These workers must be guaranteed retraining and placement in meaningful jobs.

from the American Journal of Public Health January 2003, Vol 93, No.1

Key Features of Single-Payer | Physicians for a National Health Program

Medicare For All | National Nurses United

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Thank you for this! So I'm a way of we transition to a single payer system, there would also be impact on the way that healthcare is administered in the US? I am thinking that there would be an increase in the need for all areas of healthcare since more people would be insured or no longer under-insured

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