What Are the Pros and Cons of a Single-Payer Health System?

Vermont is working on initiating a single-payer health insurance system. It’s been in the news a lot lately, because if it does happen it will be the first of its kind in the U.S. But what is a single payer system, and what are its benefits and disadvantages?

A single payer system is an insurance process where there is only one group or body which is responsible for procuring funds for and dispensing payments to the medical system. Frequently it’s a government which is the single payer. They collect taxes and fees for any medical services from the citizenry and businesses and funnel that money back into the system. They regulate drug costs, medical provider fees, and all other elements of coverage. Most European countries are single payer systems, as are some of the most successful Asian nations such as Taiwan, Singapore, Hong Kong, Japan and Korea. It must be noted that all these nations have better health care on average and much lower costs than the multi-payer United States does.

The pros of a single payer system are this:

  1. Universal care. Every man, woman and child has their own health insurance coverage, no matter their economic status or any other factors.
  2. Doctors and other medical professionals can do their jobs without stressing over all the paperwork of filing claims like in a multi-payer system like ours is now. This reduces overhead costs dramatically and liberates a lot of their time for actual patient care.
  3. Doctors might get incentives for keeping their patients healthy through preventive care, rather than getting bonuses from insurers for cutting back on care or processing large numbers of patients. In the UK, for example, doctors get bonuses when their patients lose weight or stop smoking.
  4. Costs would be substantially reduced in the absent of a for-profit motive. CEOs and other corporate employees draw huge salaries and employ large staffs that contribute nothing to actual patient care. That money could be directed back into the health care system.
  5. No discrimination against conditions or spending caps on procedures. Millions of Americans go without insurance now because they have pre-existing conditions…something which is defined as the insurer likes and can actually be anything. Many people have serious health conditions which require frequent care and ongoing treatment, but in our country they reach a spending cap and have to pay out of pocket or not get the care. Even though they paid premiums every month, that doesn’t matter. The spending cap does.
  6. No insurance premium payments! Because single-payer systems are normally funded by taxes, premiums are a thing of the past. Yes, the monthly hit on your paycheck would be more for taxes, but think about how much more you’d have to spend if that expensive monthly premium was eliminated?

What are the cons of a single payer system?

  1. Increased government supervision/intervention. This is repugnant to many hard-line capitalist conservatives; the idea of the government regulating daily life in this way seems to smack of socialism—but it doesn’t have to. Just because insurance would be funded through taxes, it’s not paving the way for a socialistic society. It is, however, a much more fair, equitable and cost-effective way to run things, by eliminating corporate greed and price-gouging.
  2. Doctor salaries are limited, as they are basically government employees. This is not exactly a bad thing. Doctors would still be paid according to their level of education and professionalism, and would receive bonuses for positive outcomes and prevention. Also, many single-payer systems do have private medical care, where doctors and other professionals “moonlight” on the side for themselves. Although more expensive, private care is often more personalized in a single payer system.

That’s…basically it. It seems to me, when weighed like this, that it’s a no-brainer kind of thing. But that’s just my opinion.