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More toward the health debate .. Single-payer health care

Single-payer health care is the payment of doctors, hospitals, and other health care providers from a single fund and is one of the systems used with universal health care. The administrator of the fund is usually the government. Australia's Medicare, Canada's health care system, the United Kingdom's National Health Service, and the United States' Medicare, Medicaid, and TRICARE are examples of single-payer health care. Single-payer universal health care on a national level is sometimes referred to in the U.S. as Medicare for All.

According to the National Library of Medicine's Medical Subject Headings (MeSH) thesaurus, a single-payer system is:

An approach to health care financing with only one source of money for paying health care providers. The scope may be national (the Canadian System), state-wide, or community-based. The payer may be a governmental unit or other entity such as an insurance company. The proposed advantages include administrative simplicity for patients and providers, and resulting significant savings in overhead costs.

Some argue that the single-payer is the government, but the preceding definition, as well as some single-payer proponents in the U.S., leave the government's role open to interpretation. However, the term single-payer is never used to indicate that the patient bears sole responsibility for all payment.

Single-payer health care pays health professionals that are either in the private or public
sector. It is also used to pay both privately and publicly owned health care facilities.

Single-payer is one alternative proposed for reforming the U.S. health care system. Supporters argue that it would provide universal coverage with at least the same quality and greatly lower costs. Some opponents, such as the conservative Heartland Institute, promote for-profit, free market approaches.

Contents .. 1 Types and variations .. 1.1 Canada .. 1.2 United States .. 1.2.1 State proposals .. and more .. and links ..

The United States, Canada and Australia have single-payer health insurance programs named Medicare; however, Australia's program provides universal health care, while U.S. Medicare is only for senior citizens and some of the disabled. Government is increasingly involved in U.S. health care spending, paying about 45 percent of the $2.2 trillion the nation spent on medical care in 2004.

According to Princeton University health economist Uwe E. Reinhardt, Medicare, Medicaid, and SCHIP represent "forms of 'social insurance' coupled with a largely private health-care delivery system" rather than forms of "socialized medicine." In contrast, he describes the Veterans Administration healthcare system as a pure form of socialized medicine because it is "owned, operated and financed by government."

The Veterans Administration is a single-payer system and provides excellent quality, said Reinhardt. In a peer-reviewed paper published in the Annals of Internal Medicine, researchers of the RAND Corp. reported that the quality of care received by Veterans Administration patients scored significantly higher overall than did comparable metrics for patients in the rest of the U.S. health system

Some writers describe publicly administered health care systems as "single-payer plans." Some writers have described any system of health care which intends to cover the entire population, such as voucher plans, as "single-payer plans," although this is an uncommon usage.

Canada .. Main article: Medicare (Canada) .. See also: Canadian and American health care systems compared

Canada's system is an example of single-payer health care. The national government provides part of the funding, provincial governments manage the hospitals (and provide the brunt of the funding), and doctors in private practice contract with the government for fee-for-service payments. Many Canadian citizens have supplemental health insurance, which covers expenses not covered by Canadian Medicare. Fees for doctors, hospitals and other providers are set by negotiations among doctors' associations, provincial or regional governments, and the national government. Global budgets eliminate the cost of billing individually for huge numbers of products and services.

The provision of health care in Canada is done mostly via private practitioners, although
most hospitals are public. Patients may go to any doctor or hospital in the country.

United States .. See also: Health care reform in the United States and Health care in the United States

Health care in the United States .. Government

Centers for Medicare and Medicaid Services .. Medicare .. Medicaid .. Military Health System ..
TRICARE .. Department of Veterans Affairs (VA) .. Indian Health Service .. State Children's
Health Insurance Program (SCHIP) .. EMTALA .. Federal Employees Health Benefits Program

Reform .. Reform advocacy groups .. Private .. Health maintenance organization
(HMO) .. Managed care .. Medical underwriting .. Preferred provider organization (PPO)

Private consumer driven .. Flexible spending account (FSA) .. Health Reimbursement Account
.. Health savings account .. High Deductible Health Plan (HDHP) .. Medical savings account

Physicians for a National Health Program (PNHP) supports a single-payer system which would be an expanded and improved version of U.S. Medicare, and would cover every American for all necessary medical care. In 2007, The American College of Physicians, the second largest group of physicians in the USA, called for legally mandated coverage of all Americans and urged lawmakers to consider a single payer system as one option for achieving that goal. The American Medical Student Association also supports single-payer.

In Congress, Rep. John Conyers, Jr. (D-MI) has introduced the United States National Health Insurance Act (HR 676).

Converting to a single-payer system is seen by proponents as a solution to the flaws in the current U.S. system. The U.S. health care system is the most expensive in the world on both a per-capita basis and as a percentage of GDP. Despite this expenditure, the current U.S. system fails to provide universal coverage. More than 45 million Americans, about 15 percent of the population, lacked health insurance in 2007.[17] The lack of universal coverage contributes to another flaw in the current U.S. health care system: on most dimensions of performance, it under performs relative to other industrialized countries.

In a 2007 comparison by the Commonwealth Fund of health care in the U.S. with that of Germany, Britain, Australia, New Zealand, and Canada, the U.S. ranked last on measures of quality, access, efficiency, equity, and outcomes.


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http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=482678

For example, U.S. ranks 22nd in infant mortality, between Taiwan and Croatia, 46th in life expectancy,
between Saint Helena and Cyprus, and 37th in health system performance, between Costa Rica and Slovenia.

The U.S. system is often compared with that of its northern neighbor, Canada (see Canadian and American health care systems compared). Canada's system is largely publicly funded. In 2005, Americans spent an estimated US$6,401 per capita on health care, while Canadians spent US$3,326.[22] This amounted to 15.3% of U.S GDP in that year, while Canada spent 9.8% of GDP on health care.

A 2007 review of all studies comparing health outcomes in Canada and the U.S. found that "health outcomes
may be superior in patients cared for in Canada versus the United States, but differences are not consistent."

Proponents of health care reform argue that moving to a single-payer system would reallocate the money currently spent on the administrative overhead required to run the hundreds of insurance companies in the U.S. to provide universal care. An often-cited study by Harvard Medical School and the Canadian Institute for Health Information determined that some 30 percent of U.S. health care dollars, or more than $1,000 per person per year, went to health care administrative costs.

Advocates say that a U.S. single-payer health care system would provide universal coverage, give patients free choice of providers and hospitals, and guarantee comprehensive coverage and equal access for all medically necessary procedures, without increasing overall spending. Shifting to a single-payer system would eliminate oversight by managed care reviewers, restoring the traditional doctor-patient relationship.

State proposals

California's Legislature has twice passed a state-level single payer bill, SB-840, "The California Universal Healthcare Act" (authored by Sheila Kuehl), in 2006 and again in 2008. Both times, Governor Arnold Schwarzenegger vetoed the bill. State Senator Mark Leno plans to introduce The California Universal Healthcare Act again, in 2009. In April 2008, the Illinois House of Representatives' Health Availability Access Committee passed the single-payer bill HB 311, "The Health Care for All Illinois Act,"[33] favorably out of committee by an 8-4 vote.

Several single-payer referendums have been proposed at the state level, but so far
all have failed to pass: California in 1994, Massachusetts in 2000, and Oregon in 2002.

http://en.wikipedia.org/wiki/Single-payer_health_care

Another on single payer systems
http://www.pnhp.org/facts/single_payer_resources.php