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A Primer on Single-Payer Healthcare

Since this is becoming a more and more prominent topic, here’s a good summary of what “single-payer” means (and what it doesn’t mean).

This is one where the devil is in the details, but I firmly believe in the principle being sought in the single-payer debate: the idea that basic, essential medical care should be available to all; the the mechanism used to make it happen is an implementation detail that should be discussed against that context.

It’s going to be a very interesting decade ahead while the US continues to thrash this all out.




What The Heck Is Single-Payer Healthcare, Anyway?
Health coverage has been in the news in a big way this year, thanks to Republican-led efforts in Congress to repeal the Affordable Care Act (ACA) throughout the spring and summer. That plan ultimat…

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17 thoughts on “A Primer on Single-Payer Healthcare”

  1. I do wish news outlets wouldn't cover ground that has already been done better elsewhere.

    So single payer is the Beveridge Model which is what the U.K. uses.

    The Bismarck Model, which most of Europe uses, would be better since it would force all the health insurance companies and hospitals to become KP.

  2. Legally, is the Preamble to the Constitution considered to be part of the Constitution? Certainly the reference to "general Welfare" could dictate the thesis that health of the population is a responsibility of the Government.

  3. I'm probably going to add this on to any healthcare thing I see in the near future….Medicare as it currently stands is not single payer, and does not cover most things. Medicare for All, the bill just introduced is a single payor system with no cost sharing and replaces Medicare, Medicaid, ChIP and any vision and dental coverage. So there you go (I think there are issues..it also promises to pay back any for profit company the gets a loss in the conversion…that probably not doable and could stop the bill from ever starting)

  4. +Stan Pedzick I think it's a reasonable discussion to the level that most folk are approaching this topic. Discussing "Beveridge" vs "Bismarck" models would draw glassy, unengaged stares from most folk. I believe most of the citizenry hear "single-payer," scratch their heads, and say, "Is that Communism?"

  5. +Dave Hill which is part of the problem, if you put a name and a country in which the system has existed for many decades, then the "is it communism" question gets removed from the equation. It is really past time for Americans to stop being so stupid and be engaged in the world.

  6. “So single payer is the Beveridge Model which is what the U.K. uses.”

    No, the Beveridge Model is Britain’s National Health Service (which I would prefer over single-payer). Single-payer aka Canadian Medicare, might be called the Douglas Model after Tommy Douglas, the politician who was most responsible for getting it implemented (and who not coincidentally was selected as “The Greatest Canadian” in a 2004 national survey).

    “The Bismarck Model, which most of Europe uses, would be better since it would force all the health insurance companies and hospitals to become KP.”

    I assume you meant “NP/Non-Profit”. We already had that in the US pre-Reagan… part of the reason US healthcare used to be more affordable. There’s no reason at all we can’t have non-profit hospitals under single-payer. And I don’t think a complex private/public system is workable in the US — both our politics and our medical industry are much too corrupt & profit driven for such a system to be stable.

    Note that Switzerland and Holland which have the most market-based systems are also the most expensive. After the US of course (Britain spends a third of what we do, most others around half). We’re number one by a long margin… in the amount of money we spend, not in healthcare outcomes.

    FUN FACT: the first movie in the famous “Dr. Kildare” series (1937, with Barbara Stanwyck & Joel McCrea) was titled Internes Can’t Take Money.

    1. @Paintedjaguar — Actually, I suspect by “KP” he meant “Kaiser Permanente” … which, as a non-profit HMO and medical group still fits in with what you indicated.

      It’s noteworthy how the non-profit medical system has substantially dwindled just down to KP, after the conversion to for-profit status of Blue Cross/Blue Shield (into Anthem).

  7. It's an ignorant question anyway. Giving everyone basic healthcare because it's the right thing to do resembles some of the tenets of Communism. Who fucking cares?

    Get rid of everything that does, and you don't have multi-story buildings, roads, parks, art, museums, libraries, schools, churches, telecommunications, a space program, charities…

    Incidentally, I think the same thing about food and housing. A minimal ("basic living") amount of food and shelter should be a fundamental human right. There is no excuse for anyone to go hungry or cold in the 1st world. Yes, yes. Can of worms. Blah blah.

  8. It’s also worth noting that even back in the nineties, non-profits like Kaiser had started to behave like for-profit corporations. This was in the news at the time and there was some sort of justification advanced (“Competition”, blah, blah) but it never made any sense to me.

    Since then we’ve seen a lot a NGOs go down this road, as neoliberal philosophy has permeated the entire society. Markets uber alles.

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