Explanation of Single-Payer

Single-Payer and the Average American Worker
Overview of What Single-Payer Is
The Impact
The Overall Result

Single-Payer and
the Average American Worker

• What the typical average worker GIVES

  • About 3 percent (3.3%) more out of each paycheck, as per the proposed legislation H.R. 676

• What the average worker RECEIVES

  • health care: whatever is needed through the end of our life
  • more frequent visits per year to the doctor
    including getting more preventative care
  • longer life (U.S. dropped from 27th to 30th in life expectancy)
  • life with less pain and suffering due to better health throughout a longer life; how? by doctors preventing diseases much better (we recently dropped from 15th to 19th out of 19 countries)
  • payments automatically covered to the doctors and hospitals by the “single-payer”
  • national health card that gives us health care access
  • additional payments: very little or nothing
  • no major medical bills
  • no worry about future health care costs

In other words, the average worker will receive excellent benefits plus the peace of mind similar to what citizens in other countries have had for decades.

This is realistic! It’s been demonstrated for decades in other countries! This IS the way it works in the other countries that pay less than half per person with full medical benefits!

Overview

• Single-payer national health insurance is financing health care …
  • with the simplicity and efficiency of using one public agency, the non-profit single-payer
  • without multiple government programs and the use of hundreds of for-profit health insurance companies
• The public agency will set policies and administer the system.
  • The public good will be the focus of the public oversight, via the agency. The agency will be set up to operate separately from the day-to-day influence of politicians.
  • The maximizing of profits for stockholders will no longer be part of health care financing, since the financing will be non-profit, replacing the involvement of over 1300 private health insurance companies.
    • Private health insurance companies will only be involved with insurance for services that are not medically necessary, such as cosmetic surgery when it is not medically necessary.
• The regional offices of the United States National Health Insurance Program will replace all regional Regional Medicare offices according to H.R. 676.

Impact

• Everyone has access to all medically necessary care from cradle (pre-natal care) to grave (nursing home care and home-based care)
  • See What Single-Payer Provides
• The problems of unnecessary deaths and other very serious problems will finally be eliminated.
  • See What Single Payer Eliminates.
• Private medical practices remain private but have dramatically simplified administration requirements, allowing medical professionals to focus more of their time on the health of their patients
• Patients choose any physician and any hospital or other facility
  • A selection can based on performance
• Everyone gets access to health care without this partial list of restrictions
  • Pre-existing conditions
  • In-network and out-of-network physicians and facilities
  • Ability to pay
  • See the more complete list of restrictions with more details — plus a 3-minute audio and full transcript — at Rationing in the Unites States
• As a result of the lack of restrictions, medical professionals and the patients make the decisions about the patient’s health without interference by the activities of the billing personnel, who no longer need to ask for the permission of private health insurance companies in order to provide the chosen care.
• Based on historical health outcomes the quality of life in terms of health in the United States has an outstanding chance of improving significantly due to the significantly improved access to health care.
  • This reality of improved health is why the American Cancer Society is currently spending their entire advertising budget on educating people about the critical need for all U.S. citizens to have access to health care.
• Physicians:
  • are assured a fair and timely payment for services
  • can focus more on health care of patients due to the dramatic simplification of the administration aspects of their private practices
  • will send bills to the single-payer under a “fee for service” basis
  • will be paid salaries in some cases, such as within the global budgets mentioned in the next bullet point
• Administrative staff. Employees who have administrative positions in the current financing of health care will find new employment, such as these possibilities:
  • Position within the new system
  • Position within the U.S. health care of an expanded number of people
  • Position in a new career
  • Note: via unemployment benefits, job transition support dollars are provided in the single-payer legislation:
    • As per H.R. 676: “The Program shall provide that clerical, administrative, and billing personnel in insurance companies, doctors offices, hospitals, nursing facilities, and other facilities whose jobs are eliminated due to reduced administration– (1) should have first priority in retraining and job placement in the new system; and (2) shall be eligible to receive 2 years of unemployment benefits.”
• Facilities, for example hospitals, are supported via global budgets, supported via monthly payments
• Financing is dramatically simplified via a dramatic improvement in efficiency
  • Sources of funding
    • Existing federal spending on health care
    • Increase in personal income tax on the top income earners: 5% on top 5%; 10% on richest 1%.
    • Modest, progressive excise tax on payroll and self-employment income: proposed to be 4.75% on employees and employers
    • Closing of corporate tax loopholes
    • Repeal of Bush tax cut for highest 1% of wage earners
    • Small tax of 0.25% on stock and bond transactions
    • National bulk procurement of medications
  • What is not included in the financing of health care for medically necessary care
    • Health insurance premiums
    • Co-pays
    • Deductibles
    • Percentage not covered by insurance, since the total cost is covered for medically necessary procedures, including surgery
    • Costs after the lifetime limit exceeded
    • Credit card interest
    • Government tax incentives that are out of the pockets of citizens via taxes and often into the hands of insurance companies
    • Government making payments made directly to private health insurance companies
    • Government, federal and state, needing to manage the medical component of multiple systems:
      • Medicaid programs in 50 states
      • Workers compensation programs in 50 states
      • Auto insurance, applicable in some states
• Additional improvements to U.S. health care that will best be achieved after simplifying the financing and having the focus of health care activities be on the public good:
  • Achieving and maintaining wait time management: procedures and practices that manage resources in such a way to maximize performance while minimizing costs
  • Cost reductions in payments to suppliers:
    • Negotiated prices for prescription drugs
    • Negotiated prices for durable medical equipment
  • Electronic record-keeping, especially medical records of individuals
• The resulting positive financial impact on the average business and family
  • Businesses: In 2005, businesses contributed $2,600 per employee, or $217 monthly. Under H.R. 676, employers’ average cost in payroll taxes would be $1,425 annually, or $119 monthly.
  • Families: families will see their costs and their risks both reduced.
    • Current costs: an average of $12,106 per year plus the potential of huge financial losses and suffering
    • Cost with single-payer: $2,500 per year with peace of mind knowing that no large medical bills will ever occur
    • See the details of an average Family’s Total Cost.

Overall Result

• Better health due to better access to health care and more focus on prevention.
• Financially we win three times regarding elimination of bureaucracy:
  for-profit bureaucracy, government bureaucracy, and supporting bureaucracy
• The average financial benefit per family is cost for health care that is less than half.
  • More important is what comes in parallel and cannot be measured:
    • Peace of mind for all
    • Lower stress level for all
• There will be a massive shift of dollars into health care due to the previous $350 billion in administrative costs.
• For the U.S. overall per person, no cost increase is expected, but cost savings is possible. Based on the experience of Taiwan, which shifted from a private health care model and based on many national and state studies in the United States, the result is likely either no increase in cost or a possible cost savings. See the web page about Improved Efficiency.
• Note: the potential savings will be delayed during the implementation in order to provide up to two years of unemployment support, where and as needed, for clerical, administrative and billing personnel.

References:

• United Stated House Resolution 676: United States National Health Insurance Act (or the Expanded and Improved Medicare for All Act) – H.R. 676
• American Cancer Society provides a list of current facts and links to video explanations about the importance of health care access.

Disclaimer with Important Notice about Citizen Monitoring: Refer to the complete text of H.R. 676 for the full descriptions of what I have provided above, which is simply my summary of parts of H.R. 676. Final details of how the single-payer health care financing will work are based on the process of legislative debates toward passage of H.R. 676. It is very worthwhile for some citizens to pay attention to the legislative process and help ensure that the final legislation is appropriate. I plan to be one of the citizens who observes, at least via all communications available via the internet and other media. I plan to give input to that process, and we need additional citizens to do the same. Become familiar with H.R. 676.

List of Sources

• Number of Health Insurance Companies. Although the number would not necessarily reflect the total number of health insurance companies, we do know this about “the nation’s most proactive … health care association”: “America’s Health Insurance Plans (AHIP), the voice of America’s health insurers, represents nearly 1,300 member companies” – from their web site’s membership web page (deliberately not linked).