10 Reasons Americans Need Single Payer

With a system that is highly dependent on employer-based, for-profit health insurance, millions of Americans have no or inadequate coverage. The patchwork of expensive, unequal insurance plans has contributed to bankruptcy, homelessness, preventable disease, and death.

Inflated insurance and health care costs place unfair demands on businesses and taxpayers. By making high-quality health care for all as cost-effective as possible, a single-payer system meets the health needs of the public and contributes to a healthy economy.

1. Patients and doctors make health care decisions.

   You choose your doctor. You and your doctor decide what is best for you. You take the medications that you and your doctor agree are appropriate for you.

   Insurers currently impose restrictions on the kinds and amount of care covered. Such restrictions interfere with the rights of doctors and patients to choose care based on an individual’s needs. Many insurance plans also restrict an individual’s choice of health professionals.

   A single-payer system allows choice of licensed health care professionals and accredited facilities and automatically covers all medically necessary care, with a focus on preventive care. It includes alternatives supported by evidence, including chiropractor and acupuncture services, and gives equal consideration to physical and mental health needs. Decisions on treatment are left to the patients and their doctors.

2. Everybody in.

   Single payer covers all of us. Every resident of California is in the system and can receive health care when we need it.

   Make the “best health care in the world” available to all in California. While we have the resources – excellent medical schools and research centers, dedicated health care professionals, and the latest technology – our current approach to financing health care skews delivery. It keeps millions of people from being able to contribute responsibly and leaves millions without needed care. The pieces of a potentially excellent system cannot form a coherent whole.

   A single-payer system puts in place the financing mechanism and the cost and quality parameters necessary to achieve sustainable universal health care so that everyone has the care they need when they need it, at a price they can afford.

3. Never lose coverage again.

   Single payer is the ultimate freedom to choose. You can choose to go to school, change jobs, start a new business, retire, or stay home and care for children and parents. Through all life’s twists and turns, you’ll never have to worry about losing access to health care again.

4. Stop waste.

   The insurance-hospital industry now spends more than 30% of each health care dollar on administration, marketing, and paperwork. When single payer eliminates this costly 30%, your doctor will not have to spend oodles of time on the phone to get permission from your insurance for your ruptured appendix surgery.

   Billions of dollars spent on insurance now go toward administering multiple plans, packaging and marketing the plans, excessive profits and executive compensation, lobbying for policies that detract from health care, and for campaign donations.

   Single payer streamlines administration by having one agency handle all financing and by giving everyone the same benefits.  With “everyone in and nobody out”, money will no longer be wasted on marketing, underwriting, and administration of multiple health insurance plans. Health care professionals will no longer incur the cost of dealing with so many different plans, rules, and forms.

5. Stabilize costs.

   Costs are rising at rates far beyond inflation. Charges for health insurance premiums and care vary dramatically and are difficult to justify. Reimbursement for services and supplies is unpredictable. People who cannot afford regular care misuse expensive hospital emergency rooms when problems arise and require more expensive treatment when conditions worsen.

   In a single-payer system, the single-payer agency negotiates fair prices for services, supplies, and pharmaceuticals, using the purchasing power of the entire populace to make care more affordable for all.

   Single payer allows negotiations for medicines and medical devices. You’ve heard of the flagrant increased costs for insulin and EpiPen. Single payer gives the government the power to negotiate pricing for medications.

   Preventive care and timely intervention has the potential for keeping health problems from developing or worsening, making the need for expensive treatment less likely. Access to regular care reduces costly use of emergency rooms.

   Single payer means no co-payments, deductibles, or premiums. For most of us, the total bottom line for single payer, which will likely be paid for through progressive taxes, will be significantly less than the total bottom line we now pay. This is how we pay for other public goods and services: schools, roads, fire, and libraries.

6. Stop medical bankruptcy.

   Medical debt is the number one reason for personal bankruptcy in the United States. Almost 80% who went through bankruptcy had some form of health insurance. That insurance was clearly insufficient.

7. End financial rationing.

   Single payer ends health care rationing based on how much money you have or don’t have. Some of us are forced to make financial decisions when we need health care if we are uninsured or underinsured. We may have to choose between health care and food. Single payer ends these no-win choices.

8. Businesses can focus on their core mission.

   Businesses will no longer be burdened with health plans for employees. Lower health costs make businesses more competitive, both domestically and internationally, and earn more for employees and shareholders. Single payer makes it easier to start a new business without the complications, costs and worries of obtaining employee insurance benefits.

9. Maintain an excellent health care delivery network.

   Emergency rooms and entire hospitals are closing, and doctors are prematurely giving up their practices because financing of health care has become so expensive and frustrating. The number of primary care physicians is in dangerous decline because the services of these doctors are not sufficiently valued and compensated. Health professionals treating patients in under-funded government programs are difficult to recruit and retain.

   In a single-payer system, licensed health care professionals and accredited facilities negotiate fees and budgets and receive timely payment. Their services continue to be part of the valuable network we depend on.

10. Peace of mind.

    No more surprise bills. No more “out of network” sticker shock. No more staying in a bad job just for the benefits. Single payer is the peace of mind that no matter your life circumstances, when you need health care, you will receive it.

Why Californians Need Single Payer

California needs single payer for all the reasons that our whole nation needs it. We are afflicted by all the harms that are an inevitable outcome of our current fragmented, profit-driven system, and as a result several million of us do not receive the care we require and deserve. Others are terribly burdened, even to the point of bankruptcy in their struggle to receive care.

California has a population comparable to Canada, where the single-payer system began in a single province, and then spread to the rest of that country.

Advocates in California believe that achieving a single-payer system for the state is more achievable politically, and given the size of the state it would serve as a demonstration project and model for the rest of the country. We hope by showing the way, as California often does, we can speed the transition to health care justice for the entire nation.