DEAR READER: Single-payer health care is a term used to describe a single, unified health care insurance system. It means that all of your medical and health care expenses are covered by one organization -- the government.
But a single-payer system does not mean that the health care professionals (like doctors) and institutions (like hospitals) are owned and run by the organization that pays for care. Most single-payer systems proposed for the
In contrast, the existing health care system in
And, of course, 30 million people have absolutely no health insurance, government or private. That's true even though the Affordable Care Act (ACA) -- informally called Obamacare -- has provided insurance to more than 20 million previously uninsured people. But it was never designed to cover everyone, and it hasn't.
In a single-payer health care system, a single public or semi-public agency finances health care. In most models of a single-payer system, everyone is covered. This generally includes expenses for doctors, hospitals, long-term care, prescription drugs, dentists and vision care.
Some people think the
In countries with single-payer systems, the administrative expenses are much lower. In other words, more of their health care dollar actually pays for what it's supposed to: health care.
Opponents of a single-payer system are concerned about two things. First, they are worried that the total costs of health care might rise. That's because, they argue, the current multi-payer system encourages competition, and competition drives down costs.
Second, they worry that the quality of health care might suffer, because competition also drives improved quality of care. Whether these concerns are valid is the subject of heated debate among health experts.
For us as individuals, would a single-payer system cost us more or less? It surely would require higher taxes, since the government needs the revenue to pay our health expenses. But today most of us get health insurance through our employers, and those expenses would be reduced. Several single-payer proposals calculate that taxpayers would actually save money. That could be true, but the devil is in the details.