What is Single Payer?

This election season Sen. Bernie Sanders has called for Medicare coverage for all Americans.  But what is single payer, or “medicare for all”?

According to the Physicians for A National Health Program, Single Payer is defined as:

“Single-payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.”

“The program would be funded by the savings obtained from replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer, and by modest new taxes based on ability to pay. Premiums would disappear; 95 percent of all households would save money. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.”

It is essentially the same way in which Medicare works currently in the US.  As discussed in this video:  “Single Payer Showdown P1-The Cost of Single Payer Health Care” by the Big Picture RT:

Part two of the video is below:








8 thoughts on “What is Single Payer?

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  1. Roseylinn, your several posts on healthcare have been very educational. Truth be told, while I would favor a system with single payor underpinnings, it would prove quite difficult to pass as Hillary found out back when her husband was President

    With that said, we have the opportunity to expand a single payor system with a public option under the ACA, especially in places where there is little competition and carriers are more exposed to adverse selection. It should be noted adding a public option would be deficit reductive per The Concord Coalition. A variation of this would be to expand Medicare to an earlier retirement age such as 55 or 62. Thanks for publishing these informative posts. Keith


    1. So just because it might be a difficult to pass, we shouldn’t even try? Single Payer Underpinnings?

      I’ve gone over Hillary Clintons Health Security Act of 1993. From what I read it’s ObamaCare + the states having the option to create single payer if they wanted and with board approval. Very similar to her proposal in 2008. The link is here: https://www.govtrack.us/congress/bills/103/s1757/text The sections to note: 1001, 1002, 1221. She might have started with the goal of single payer, but that wasn’t what the bill ended up being.

      In 1992 Senator Sanders requested a meeting with Hillary and brought with him two Harvard Medical School physicians. They advocated a single payer system to Hillary Clinton. To which the following exchange happened: “She said, ‘You make a convincing case, but is there any force on the face of the earth that could counter the hundreds of millions of the dollars the insurance industry would spend fighting that?’” recalled one of the physicians. “And I said, “How about the president of the United States actually leading the American people?’ and she said, ‘Tell me something real.’” Silly me I always thought that the job of the President of the U.S. was to not back down from any fight that was in the best interest of all of the American citizens, not just those with the money. Where would we as a country be if our President’s backed down when things seemed a little too tough? What is real is that the President is elected by the people to fight for the people. Not back down to “hundreds of millions of dollars” from the insurance lobby. Oh wait thats where a lot of her donors come from, silly me.

      In an interview with Kevin Sack of the New York Times in 2008 Hillary Clinton was asked how seriously she considered proposing a single payer system. She responded, “You know, I have thought about this, as you might guess, for 15 years and I never seriously considered a single payer system.” She goes on to say, “So I never really seriously considered it.” When asked by Mr. Sack “And if the choice is a single-payer system, that’s fine by you?” She answered, “You know, I think that would be highly unlikely. I think that, you know, there’s too many bells and whistles that Americans want that would not be available in kind of a bare-bones Medicare-like system but I think it’s important to have that competition.” As the 2008 article, “Hillary Clinton on single payer” by the Physicians for A National Health Program points out her proposal at the time was nothing like a single payer health system.

      The Public Option was part of the Affordable Care Act. President Obama even campaigned on it. Then a secret meeting happened between the President and financially able corporations and it was stripped out. Then all of a sudden the tune was “it wasn’t in there, we didn’t campaign on it, there is no political will…” When in fact they had the votes to pass it until the closed door meeting.

      Links in comment:





      Liked by 1 person

      1. Roseylinn, as per usual, you have done your homework. The initial marketing of the program which included Bill Clinton holding up a card referenced national healthcare. They may have deviated from that once the intital backlash occurred. Some of the Romneycare construct evolved from Bob Dole’s idea for healthcare expansion, which was based off a Heritage idea as a counter balance to Hillary Care. The ACA borrowed heavily with modifications from Romneycare as it was working pretty well.

        I do remember the public option being included in the initial ACA planning. It was defeated by the insurance lobbyists who did not want the no-profit margin competition. Per The Concord Coalition, if we added a public option it would save $158 Billion over the next ten years. Plus, it would help with the lack of competition is some areas.

        The uphill battle is the healthcare industrial complex and GOP would be extremely hard, if nigh impossible to overcome for a single payor system. That is why I advocate the public option, so that data can be used to determine if this a suitable route. My concern is the roll back of the huge progress of ACA which must fight its real challenges as well as misinformation from the GOP to improve.

        This is good discussion and many thanks for the links. I will check them out. Take care, Keith


  2. This is great information … It just points out that the need to generate huge ‘wealth’ for those in power (political and economic) will be paid for by the labor of the workers. I have the experience of seeing both sides of the issue. As an executive in an international corporation I saw how the need to ‘make the numbers’ forced people to make decisions that hurt poor people. I began my life as first generation American working in the berry patches as a young kid and now retired I am once again working with the laborers “illegal Mexicans” in the greenhouses of a local company. I see their struggles and their backbreaking hard work. Sure the rich will fight to keep their ‘golden goose’ … whether it be the health care folks or the insurance companies or the financial ‘hedge fund’ mangers etc. and it will always be paid for by the poor who are always one paycheck away from living in their car. My question is “what will it take for people to understand that Bernie is actually telling us the truth? That America cannot afford to keep turning a blind eye to the suffering that is going on because of the greed and pressure faced by executives who have to ‘make those numbers’ every quarter. I read supposed news stories which contain mostly garbage and then I find this stuff and say Wow why isn’t this being published for everyone …????

    Liked by 1 person

    1. In my research for these articles I found several comments posted that people only could “see” when they finally “saw” the impact on their own life. Until it was written in terms about how it impacted their bottom line it was abstract.

      At least Bernie Sanders is campaigning on a policy to have single payer; unlike Hillary Clintons maintain what we have now.


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