Single-payer health insurance system attracts a heated debate as it has both supporters and opposers. It is a health insurance model designed to offer health care in a way that it provides access to everyone regardless of whether they have the ability to pay or not. Single-payer system is used to stand for government-run system of healthcare where instead of every person paying for their own healthcare, one person (the government) pays for it. IOM FON reports that the Affordable Care Act (ACA) has resulted in many Americans becoming insured, however, it cannot be considered as a single-payer system. In the single-payer insurance system, healthcare costs are financed by taxes. Therefore, American citizens do not bear the expenses of any extra costs going to hospitals to seek care. The single-payer health insurance makes health care available to everyone as opposed to serving only those who are eligible under the current law. Implementing the single-payer health insurance system is the best option compared to already available Medicare as it entitles every person to the essential health care. The study presents an analysis of single-payer health insurance system by exploring its merits and drawbacks.
Pros of Single-Payer Health Insurance System
Single-payer health insurance system main advantage is the entitlement to all members of the population to health care. All members of the population automatically qualify for the service and have access to free healthcare service from all hospitals (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine, 2011). The coverage provided by single-payer system is also continuous implying that no person loses coverage upon change of job or place of residence (Badger, 2018). People are eligible to the service regardless of their location in the United States and regardless of whether they work or not. It is an insurance system that ensures all the citizen’s healthcare needs are guaranteed throughout their lifetime. It is different from the Medicare program because it does not provide eligibility requirements. Despite Medicare providing universal health care, it fails to cover millions of United States citizens who are uninsured. Citizens of America who are jobless have to take care of the medical costs if they do not meet the eligibility requirements. Such groups of the population are forced to resort to other means that are less expensive to receive health care such as buying non-prescription drugs over-the-counter without undergoing tests to diagnose their problem ( Mason, Leavitt & Chaffee, 2007) . Entitlement to free health care services for the whole population would help improve the health status of the country.
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Single-payer health insurance creates affordability at the point of service. The health funding system does not require a person to pay any premiums or to pay for out-of-pocket costs before they can receive medical services (Blumberg & Holahan, 2019). The health insurance system thus makes healthcare affordable to everyone. It also covers a broad set of medical benefits that are offered to patients, including providing services for conditions that pre-exist. The payment of healthcare is made affordable because it is covered by tax. The burden of cost of care is spread across all the taxpayers, thus, relieving those with major problems from incurring the cost of care by themselves. It also helps in eliminating the segmentation of healthcare risks. A single-payer health insurance system thus results in expanded access to care. The patients do not have any barriers to accessing healthcare because of the elimination of out-of-pocket costs when at the hospitals (Blumberg, Holahan, Clemans-Cope, & Buettgens, 2016). People with modest incomes will no longer seek for alternative cheaper alternatives that put their health to risk. The system also includes other benefits that entail long-term service and support, vision and dental. It increases access to service even to the high-income earners. With improved access, the health of the population is also enhanced. People can seek medical services whenever they have a health problem without worrying about the costs.
Cons of Single-Payer Health Insurance System
Single-payer insurance system leads to a high increase in government revenues in terms of taxes. It is estimated that implementing the system could lead to an increased spending in federal health care by over 50 percent (Holahan & Blumberg, 2016). The government cannot bear the costs through the current system of taxation. It will thus have to increase the taxes to accommodate the increased spending necessitated by the insurance system. Households and employers will have to dig deeper into their pockets to fund the insurance system. It may also lead to cuts in other government spending, thus, leading to improved services in the healthcare sector at the expense of other government programs (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation & Institute of Medicine, 2011). Shifting from private funding to public funding could also lead to delays in remittances occasioned by the high number of payouts being executed by one entity.
Single-payer health insurance has the potential of resulting to other unintended consequences. The implementation of the system leads to a reduction in hospital revenues as well as physician incomes (Blumberg & Holahan, 2019). It thus has a high potential of affecting hospitals and the physicians, which could have negative implications in the entire health sector. Implementation of a single-payer system leads to substantial cuts compared to the current levels in private insurance. It, thus, leads to large distributional effects that cut across all the types of providers and geographic locations. Implementation of such a system makes it possible to set provider payments at levels that are inappropriate and do not reflect the actual payments that are made by private insurers. Besides, the disruption levels would also be dependent on the length of time that is permitted for decreases in the rate of payments to physicians, prescription drug manufacturers, hospitals, as well as medical device manufacturers. The success of the systems would also require monitoring of quality and access to services. The monitoring brings in additional expenses in terms of administrative spending. The system would also need real-adjustments in payment policy when needed which could turn out to be challenging.
Conclusion
The single-payer health insurance system has advantages and disadvantages. It has, thus, led to widespread debate over whether to adopt it or not. However, implementing the single-payer health insurance system is the best option compared to already available Medicare as it entitles every person to the essential health care. The disadvantages mentioned can be overcome with adjustments made into the system over time. Citizens stand to benefit more when it is implemented compared to when it is avoided. Given the current system of universal health insurance, most people are not eligible due to membership requirements that are spelt out in Medicare. However, a single-payer system automatically makes every citizen of the United States a beneficiary. It would lead to affordability at the point of service because all other forms of payment become obsolete. There are no premiums or out-of-pocket payments. It also leads to increased access to care.
References
Badger, D. (2018). Replacing Employer-Sponsored Health Insurance with Government-Financed Coverage: Considerations for Policymakers. Retrieved from https://galen.org/assets/Replacing-Empl-Spons-Insur-112618.pdf
Blumberg, L. J., & Holahan, J. (2019). The Pros and Cons of Single-Payer Health Plans. Retrieved from https://www.urban.org/sites/default/files/publication/99918/pros_and_cons_of_a_single-payer_plan.pdf
Blumberg, L. J., Holahan, J., Clemans-Cope, L., & Buettgens, M. (2016). Response to Criticisms of Our Analysis of the Sanders Health Care Reform Plan. Retrieved from https://www.urban.org/sites/default/files/publication/80666/2000793-Response-to-Criticisms-of-Our-Analysis-of-the-Sanders-Health-Care-Reform-Plan.pdf
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine (U.S.). (2011). The future of nursing: Leading change, advancing health . Washington, D.C: National Academies Press.
Holahan, J., & Blumberg, L. J. (2016). Estimating the Cost of a Single-Payer Plan. studies , 4.
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2007). Policy and politics in nursing and health care . St. Louis, MO: Saunders.
