Health Insurance: What is a Single Payer System?

Healthcare reform in the United States has been a talking point for decades, particularly as hospital and prescription drug expenses increase. Unfortunately, there is a lot of misinformation regarding single payer health care, universal healthcare and socialized healthcare. Oftentimes, these terms are used interchangeably in spite of the fact that they have some major differences. Understanding what each system is and just as importantly, what each system is not, is important for keeping up with the ongoing debate.

Single Payer Health Insurance

Unfortunately, for many, health insurance is a significant cost burden. Even those who have access to an employer-sponsored plan may have a hard time affording their monthly premium. The cost of healthcare is continuing to climb, and there is a lot of talk about what can be done to keep costs affordable for the average American. As the U.S. government works to find a solution to the country’s healthcare problem, one of the phrases that have been tossed around a lot is “single-payer health care system.”

With a single payer system, there is one entity that collects all healthcare fees and pays for all healthcare costs. Rather than multiple competing health insurance companies, there is one public or quasi-public agency that finances healthcare for everyone in the system. Essentially, everyone would have the same health insurance plan from the same health insurance company. In countries with single payer health insurance, citizens have access to all necessary medical care, including vision care, dental care, doctors and prescription drugs and are able to choose where to receive care. This system is similar to our current Medicare system.

The primary benefit of single payer health insurance is that it is associated with significantly fewer administrative costs. Because fewer entities are involved, overall expenses and wasteful spending are easier to control. Currently, there are 17 countries with single payer health insurance, including Japan, the United Kingdom, Finland, Spain and Iceland.

Is a Single-Payer System the Same as Socialized Medicine?

With socialized medicine, the government owns the hospitals, purchases the technology, such as MRI scanners and X-ray machines, and employs doctors, nurses and specialists. This system is used around the world with varying degrees of success.

Single-payer health care, however, is not the same thing as socialized medicine. While there is one payer in charge of purchasing a majority of the medical care, that payer does not own the technology or the hospitals, and it does not employ the medical care providers. In addition to this, the payer is not necessarily the federal government; in theory, it could be the state or even a health insurance company that managed to secure 100 percent of the market share.

Medicare is an Example

Medicare is an example of a mostly single-payer health care system that we currently have in place. Medicare beneficiaries have private insurers to choose from, but the government is the main purchaser.​

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