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Sat Nov 9, 2013, 09:53 PM

Can someone explain (in simple english) what is meant by the "Single Payer" option.

I really don't understand it and I'm sure I'm not the only one. Also if you'd like to include the pro's and con's, that would be great!
Thanks!

43 replies, 3277 views

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Reply Can someone explain (in simple english) what is meant by the "Single Payer" option. (Original post)
Unrepentant Fenian Nov 2013 OP
kestrel91316 Nov 2013 #1
Laura PourMeADrink Nov 2013 #26
mattclearing Nov 2013 #32
Laura PourMeADrink Nov 2013 #38
brush Nov 2013 #34
Agnosticsherbet Nov 2013 #2
SharonAnn Nov 2013 #3
Shrike47 Nov 2013 #4
RKP5637 Nov 2013 #7
chillfactor Nov 2013 #8
Hoyt Nov 2013 #14
ChazII Nov 2013 #22
Hoyt Nov 2013 #24
bravenak Nov 2013 #5
pipoman Nov 2013 #17
Loudly Nov 2013 #19
bravenak Nov 2013 #23
pipoman Nov 2013 #25
CTyankee Nov 2013 #40
Freddie Nov 2013 #6
gopiscrap Nov 2013 #20
Arugula Latte Nov 2013 #21
gopiscrap Nov 2013 #29
Arugula Latte Nov 2013 #33
BlueStreak Nov 2013 #35
Galileo126 Nov 2013 #9
PoliticAverse Nov 2013 #10
Name removed Nov 2013 #11
Hoyt Nov 2013 #15
BlueStreak Nov 2013 #36
pipoman Nov 2013 #16
Warpy Nov 2013 #12
panader0 Nov 2013 #13
Chan790 Nov 2013 #18
Hoyt Nov 2013 #27
eridani Nov 2013 #39
aikanae Nov 2013 #28
NoOneMan Nov 2013 #30
libdem4life Nov 2013 #31
CTyankee Nov 2013 #41
TorchTheWitch Nov 2013 #37
B Calm Nov 2013 #42
ConcernedCanuk Nov 2013 #43

Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 09:56 PM

1. Google is your friend. If you have questions after reading this, we'd be happy to help.

 

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Response to kestrel91316 (Reply #1)

Sun Nov 10, 2013, 12:05 AM

26. not nice. just saying. Wikipedia is the LAST source for quick, concise information. For the

time it took you to get that link, you could have answered kindly and respectfully.

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Response to Laura PourMeADrink (Reply #26)

Sun Nov 10, 2013, 12:52 AM

32. No, asking a message board a question you can google yourself isn't nice.

Hi people who know things because you search the Internet, tell me the things you know, because I can't search the Internet!

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Response to mattclearing (Reply #32)

Sun Nov 10, 2013, 07:24 AM

38. Agree. But DU is filled with people who love to share their knowledge. nt

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Response to kestrel91316 (Reply #1)

Sun Nov 10, 2013, 01:09 AM

34. We all support the government thru our taxes then government pays for health care

Last edited Sun Nov 10, 2013, 01:45 AM - Edit history (2)

And by "all" I mean all, which includes the rich as well as the poor.

And poor people DO pay taxes when they buy goods and services.

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Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 09:58 PM

2. It refers to one entity acting as administrator, or “payer.” In the case of health care,

It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs.


http://www.pnhp.org/facts/what-is-single-payer

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Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 10:00 PM

3. Medicare.

We have various kinds of health insurance in the US.

Private Insurance
Employer provided insurance
Medicaid - Through the states, partially paid by Federal $ - Single Payer
Medicare - Through the Federal government along with Medicare Supplemental and Medicare Part D - Single Payer
Veterans Administration - Provided by medical staff who work for the federal government Veteran's Administration - Socialized medicine

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Response to SharonAnn (Reply #3)

Sat Nov 9, 2013, 10:03 PM

4. This is what I was going to say.

Medicare is single payer and seems to be working OK for seniors.

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Response to Shrike47 (Reply #4)

Sat Nov 9, 2013, 10:12 PM

7. Yep, it works extremely well! n/t

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Response to Shrike47 (Reply #4)

Sat Nov 9, 2013, 10:22 PM

8. I am a senior on Medicare....

and I LOVE it! I have a supplement with no premium attached and the only "bills" I get in the mail are paid ones!

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Response to chillfactor (Reply #8)

Sat Nov 9, 2013, 11:07 PM

14. You must be in a Medicare Advantage Plan, which is probably what I wil do.

But some folks will be shocked to learn those are run by private insurance companies under Federal rules. Medicare without a supplement is a ticket to the poor house.

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Response to Hoyt (Reply #14)

Sat Nov 9, 2013, 11:55 PM

22. That is the plan my dad has

and as his caretaker I am thankful he selected that one. He worked for the phone company for over 30 years and also has insurance from them as his secondary.

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Response to ChazII (Reply #22)

Sat Nov 9, 2013, 11:57 PM

24. I get it. Apparently a lot here don't.

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Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 10:04 PM

5. Bless yr. heart.

 

Medicare.

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Response to bravenak (Reply #5)

Sat Nov 9, 2013, 11:16 PM

17. Medicare isn't "single payer"...the patient has significant responsibility..

 

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Response to pipoman (Reply #17)

Sat Nov 9, 2013, 11:34 PM

19. Ha ha, yes that's very true.

 

The two payers under our version of single payer are the United States government and the patient.

With an allowance for for-profit barnacles being those purveyors of Medi "gap" coverage.

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Response to pipoman (Reply #17)

Sat Nov 9, 2013, 11:55 PM

23. No ins company in the way.

 

Unless you like it that way.

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Response to bravenak (Reply #23)

Sun Nov 10, 2013, 12:03 AM

25. Unless one doesn't have the means to self insure

 

but still has savings or assets of any kind..people don't have medicare supplement insurance because they "like it that way". By that definition, there is no insurance company in the way of anyone as it is right now..one can self pay..

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Response to bravenak (Reply #23)

Sun Nov 10, 2013, 07:49 AM

40. Medicare Part B pays only 80% of what it covers.

The other 20% is up to YOU. That 20% can add up to a LOT. And some people don't want to pauperize themselves and have to go onto Medicaid. For instance, my husband needed 3 weeks intensive rehab after spinal surgery a couple of years ago. Our Medi-gap policy covered the 20% (as long as it was Medicare covered for the other 80%). He was in an outpatient facility because he literally could not get up and down the stairs in the house. The difference in what he owed was over $100 per day. Our insurance is $200 per month per person. We could get less coverage that is not at the full 20% but we are fearful of catastrophic health events...

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Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 10:05 PM

6. No insurance companies

The single payer is the government. Physicians have private practices.
In "socialized medicine" (England) hospitals and practices are run by the government and health care professionals are government employees.

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Response to Freddie (Reply #6)

Sat Nov 9, 2013, 11:44 PM

20. exactly as it should be!

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Response to gopiscrap (Reply #20)

Sat Nov 9, 2013, 11:48 PM

21. Yes indeed. For-profit healthcare is a sick, sick system!

 

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Response to Arugula Latte (Reply #21)

Sun Nov 10, 2013, 12:36 AM

29. yes it is and so is for profit

law enforcement, fire protection, incarceration and probations service, education and transportation.

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Response to gopiscrap (Reply #29)

Sun Nov 10, 2013, 12:57 AM

33. Agree.

 

Privatization sucks.

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Response to Freddie (Reply #6)

Sun Nov 10, 2013, 01:12 AM

35. No, that is mixing government run HC with SP

 

Government-run health care would have every hospital owned by or under contract to the government, and every doctor effectively an employee of the government.

Single payer has nothing to do with providing services. It is only about managing the payments for the services. There is a single entity that collects premiums (or taxes) from everybody and pays all the health care bills. In effect, it puts the entire population into one big risk pool, which reduces the risk to its lowest possible level. In a population the size of the US, there is effectively no risk management at all. That is to say, if 1000 people contract leukemia, that is a rounding error. It doesn't put the pool at risk. They simply have to set the tax rate at a level to cover the average cost of care. And we know from Medicare that the administrative overhead is under 3%, with no shareholders taking dividends and no executives taking exorbitant salaries. That is single payer. It is the most efficient way to handle payments (i.e. "insurance"

The "public option" is a way of making sure that the PRIVATE insurance system is competitive. A "public option" would say that if you looked on the exchange in your area, you might see some policies from Anthem, some from Kaiser, some from a no-name brand. But you would also see a policy managed by Medicare, which would establish a baseline price for actually providing this service. People would be free to choose to pay Anthem's CEO her $31,700,000 salary, or they could select the policy administered by Medicare. It is the buyer's OPTION.

http://articles.courant.com/2013-04-08/business/hc-anthem-wellpoint-former-ceo-pay-20130408_1_braly-wellpoint-executives-new-ceo

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Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 10:30 PM

9. Cool

I was either (a) too lazy, or (b) too embarrassed - to ask the same question.

Often, memes and monikers pervade the news and internet, but without explanation. It's very common for people to use abbreviations and phrases to tell a story without first defining the term(s).

In science, the norm is when you use an abbreviation or term, one must first define it first. Only then, can one use the abb/term.

I find that blogs are terribly guilty of this practice of not doing so, as if "everybody knows what I'm talking about, so why define it?"

Well, some of us don't.

I may have a PhD, but I'm not one of the cool political kids. For those that are, PLEASE define the terms/phrases that support whatever cause you are speaking to.

Science is not about facts, it's about communication... as my quantum physics teacher once said. "If once can't communicate the facts, then the facts are nothing more than bullshit." (His quote, not mine.)



Just my 2 cents,
-g

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Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 10:30 PM

10. Actually you mean "public option" or "single payer" - they are 2 different things. n/t

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Response to Unrepentant Fenian (Original post)


Response to Name removed (Reply #11)

Sat Nov 9, 2013, 11:12 PM

15. Today, 30% of Medicare beneficiaries choose Medicare Advatage Plans, owned by private

Last edited Sun Nov 10, 2013, 12:00 AM - Edit history (1)

insurance companies. Even traditional Medicare is administered on local level by private insurance companies. Part D - drugs- yep again private insurance companies operating under federal rules, sort of like ACA.

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Response to Hoyt (Reply #15)

Sun Nov 10, 2013, 01:15 AM

36. And I see nothing at all wrong with single payer for BASIC HC

 

and private insurance for those that want more than the basics.

For example, if you want to be sure you will have a private room if you must be hospitalized, a private policy could do that for you. If you wanted to be flown to the Mayo clinic whenever you get a stuffy nose, I guess a private policy could do that.

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Response to Name removed (Reply #11)

Sat Nov 9, 2013, 11:15 PM

16. There is profit involved..

 

medicare doesn't pay the whole bill, just enough of it to make private insurance affordable by fixing the risk...medicare isn't actually "single payer".

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Response to Unrepentant Fenian (Original post)

Sat Nov 9, 2013, 10:45 PM

12. Single payer means the government is the sole insurance company,

the insurance funded as pay as you go, either by taxes or premiums.

Medicare is an example of single payer, a very limited plan supplemented by a premium plan (parts A and B).

The reason we push for it is that Medicare has about a 3% overhead while for profit insurance is typically at least ten times that amount.

It also helps providers from doctors to hospitals to free standing labs because there is only one standard paperwork that has to be done when claims are submitted. If you get sick and need medical care, you just show them your number and that's it, you get the care and then go home, no visits to or from bean counters needed, no fights over the phone about something that was arbitrarily denied and no lifetime cap if you get really, really sick.

Insurance companies do provide some of the infrastructure for Medicare, their facilities doing the paperwork and authorizing payment. They will stay in business in this way but they'll no longer be a cash cow, milking the sick and injured for whatever they can get before throwing them off the rolls to crawl off and die.

This is why we all want single payer.

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Response to Warpy (Reply #12)

Sat Nov 9, 2013, 10:58 PM

13. rec

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Response to Warpy (Reply #12)

Sat Nov 9, 2013, 11:16 PM

18. Personally I'd like a socialized medicine option but I'm not holding my breath.

 

I've known for years I wanted that, enough so that I tried repeatedly to join the Navy solely for that reason. The Navy doesn't want me.

I think an American NHS would be the best healthcare system in the world, bar none.

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Response to Chan790 (Reply #18)

Sun Nov 10, 2013, 12:07 AM

27. I think a public option (whatever you call it) should be next step.

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Response to Chan790 (Reply #18)

Sun Nov 10, 2013, 07:32 AM

39. Britain got NHS the hard way--by having its infrastructure trashed in WW II

The government was the only real possibility for providing health care. We are much more like Canada than we are like Britain--provinces and states have far more autonomy. That's why states here can lead the way to single payer. Of course that could be combined with expanding government run community clinics and such.

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Response to Unrepentant Fenian (Original post)

Sun Nov 10, 2013, 12:26 AM

28. Medicare - for - All

The administration, paperwork are centralized. Everything else remains private. Doctors have one form and one address to fill out and send in. There could even be single doctor private practices again.

Right now they have hundreds to fill out. It takes 7 full time staff per one doctor. None of the insurance companies play by the same rules or play by any rules at all. Often doctors have to offer treatment without guarantee of payment even if they get an approval from the insurance. I could go on for quite awhile about how bad this system is.

One of the worst effects from having a fractured system like this is that there is no way to get data on outcomes from various treatments. Most is derived from Medicare traditional using seniors. That's it. The best health information is coming from nations with national systems and they also have more interest in long term results. As long as profit remains a higher motive, the US health care system will only see interest in short term results, only now most of the utilization standards will also be hidden and controlled by private interests.

A side effect of not having a robust public health care system is there is no way to guage the health of the population. The Mexican Flu outbreak a couple of years ago, turns out that it was identified in Mexico City (universal health care system) and the origin was probably in the US about 6 months earlier - and went unidentified. That should spook people. Without a public heath system, I'm not sure the US could contain / control / react to a serious public health crisis. I can bet that a profit insurance system wouldn't want to be left holding the bag for massive treatment or containment.

Like I said, I could go on forever about how our system sux and many of these problems could have been contained or avoided or eliminated using a single payer system.

Canada's system was developed based on the US Medicare traditional model because it was cost effective and worked. Mexico's system is also. At one time, a non-citizen could sign up for Mexican insurance for under $500/year with no citizenship requirement. Now it's over $1300/year and there's a long list of common pre-existing conditions that are not treated for non citizens.

Every health care system in the world has had to tighten up due to "illegals" infiltrating for medical care. The US had become the world's illegals when it comes to medical care. The "best medical care" in the world is not found here. Back surgery? Go to Thailand or Philippines or Hong Kong. Cancer treatment? Not in the US.

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Response to Unrepentant Fenian (Original post)

Sun Nov 10, 2013, 12:39 AM

30. In Canada, a single crown corporation in each province pays for all necessary medical procedures

 

No deductible. No copay. That crown corporation negotiates all rates with providers. It pays out all monies. It is funded through taxes, which are paid proportionally by the rich.

The pros are that everyone has equal access to care and nothing to induce self-rationing. Its full equality. It keeps costs down by eliminating profit, using leverage of its size, eliminating complicated paperwork and nipping problems in the bud.

The cons are that everyone has equal access to care and nothing to induce self-rationing, which means more people are in the queue requiring ample funding to ensure resources do not impact access

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Response to Unrepentant Fenian (Original post)

Sun Nov 10, 2013, 12:49 AM

31. The options are as varied as every other "civilized" country. They have all worked it out. Other

 

than policing them militarily or politically or making fun of them, we've not gotten the memo, as it were. We're busy beefing up our military and NSA and such, while their people have health care.

Easy answer is...no insurance companies. Medicare for all. Non profit. It works. The insurance companies only push paper...they provide absolutely nothing else to the health care conversation.

Very expensive paper pushers. Ultimately, we'll get rid of them.

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Response to libdem4life (Reply #31)

Sun Nov 10, 2013, 07:59 AM

41. I'd be happy with a system of most western european countries where a

variety of private non-profit organizations deliver the health care, but the payer is single in that it is largely the government via the tax system. The private organizations are forbidden to make a profit. However, they seem to exist to provide variety and choice for people. The only private for profit insurance would be for those extras like a single hospital room.

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Response to Unrepentant Fenian (Original post)

Sun Nov 10, 2013, 04:37 AM

37. I wish that phrase wasn't used

As it doesn't define who that single payer is which can mean it's you personally or the government on behalf of everyone personally. Besides, most people have no idea what it is that's being advocated by that phrase. Even saying the whole phrase single payer universal health care doesn't clear it up any better and for the same reason, and technically it doesn't even make sense since there are two payers - the citizenry pays the government, and the government pays the health care bills of the citizenry. What it is apparently supposed to mean is national health care... where the citizenry pays taxes to the government, and the government then pays everyone's health care bills. The government also pays for the building and running of hospitals, nursing homes, rehab clinics, etc. Whether it's a regular check up, an emergency room visit, surgery and recovery or end of life care everyone's health care is paid for by the government whether each citizen is able to pay into the taxes pool for it or not... everyone in/nobody out as long as you're a citizen.

It's the most sensible, humane and most financially sound system of health care there is, yet the US won't implement it as every other civilized country has because of the financial interest the health care businesses and our politicians have. This is never going to change as long as that financial marriage between business and government is allowed to exist. And since it benefits both businesses and government it will take drastic measures by the rank and file citizenry to change.

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Response to Unrepentant Fenian (Original post)

Sun Nov 10, 2013, 08:02 AM

42. It's basically health care without the insurance companies raking in 20% profit!

 

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Response to Unrepentant Fenian (Original post)

Sun Nov 10, 2013, 08:27 AM

43. Kestrel's link is quite accurate re single payer

 

.
.
.

The first paragraphs explain the term quite well

"Single-payer health care is a system in which the government, rather than private insurers, pays for all health care costs.[1] Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). The term "single-payer" thus only describes the funding mechanism—referring to health care financed by a single public body from a single fund—and does not specify the type of delivery, or for whom doctors work. Although the fund holder is usually the state, some forms of single-payer use a mixed public-private system."

/snip/

Single-payer health insurance collects all medical fees, then pays for all services, through a "single" government (or government-related) source.[2] In wealthy nations, this kind of publicly managed insurance is typically extended to all citizens and legal residents. Examples include the United Kingdom's National Health Service, Australia's Medicare, Canada's Medicare, and Taiwan's National Health Insurance.

The standard usage of the term "single-payer health care" refers to health insurance, as opposed to healthcare delivery, operating as a public service and offered to citizens and legal residents towards providing near-universal or universal health care. The fund can be managed by the government directly or as a publicly owned and regulated agency.[2] Some writers describe publicly administered health care systems as "single-payer plans". Some writers have described any system of health care which intends to cover the entire population, such as voucher plans, as "single-payer plans",[3] although this is uncommon usage.

http://en.wikipedia.org/wiki/Single-payer_health_care
__________________________________________________________________________________________

Should really be called no-pay - because patients pay nothing in most single payer systems.

I never ever see a bill, they swipe my health card, do whatever to/for me and out I go.

Most medications I have to pay for myself (not meds administered while in the hospital), but when I was on Welfare, I had a special card to present to the pharmacy to pay for my medications. I only had to pay $2 per script, whether the actual cost was $5 or $50, only $2 per scrip.

Also, we have a subsidy program that pays for travel to specialized hospitals/doctors if recommended by the attending physician.

Travel is subsidized whether one is on Welfare or not.

USA is bowing to the mega billion dollar insurance companies -

That will never work well.

never.

CC

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