Single-Payer Reform Health System


Health care insurance has sparked a lot of controversies in the United States which have more than one payer system. The result has been increasing costs of healthcare, problems handling of information, as well as problems of overall coverage for the citizens. Many people are not yet covered in the current system because of difficulty with affordability. A unified health care plan would provide opportunities such as those in cutting the costs by cutting on unnecessary expenditures, improving in handling of information because of easier and unified data collection, and providing extensive coverage because it would be affordable.

The Health Care Plans

Some problems have arisen through the present system. Employer-based insurance provides coverage for most Americans. There is no assurance for coverage in the present system even after employment has been acquired. Many Americans have lacked insurance cover, with the figure rising to 46 million in 2007. The population included about 90 million who were aged below 65. There has also been reported a rise in the number of those who have lost insurance in the current system (1.3 million in 2006), exposing further the dangers of the present system. Rising premiums (e.g. 120% more than four times the wage growth rate), has been blamed for problems associated with coverage. It was estimated that a family of about four would spend about $12,700 in health insurance in 2008 with an individual spending an estimated $4700 with the exception of the older adults and those with a poor health history who would have the possibility of spending a higher figure. The present system has been dogged with issues of “rising insurance costs” with the figure of $2.4 trillion or $7900 per capita being recorded in 2007 and projections hitting $4.3 trillion or 20% of GDP (Lendman). This situation is dangerous considering the already high rates of infant mortality in America. The importance of having a good healthcare system lies in the fact that America is faced with big number of deaths as a result of respiratory, cancer and heart diseases, in addition to infant mortality. A good healthcare system will help the country reduce such deaths and any other associated risks. Cost is one factor that also contributes failure to seek medical intervention. One of the causes of rising healthcare costs has been entry into the profit-based insurance covers.

Some other problems have also been projected for the market-based healthcare program; that it risked being dominated by the financially well up and not medical quality. This is because there was growing trend where large number of share of medical practice was being controlled by a few giant firms. This would have an impact of reducing options for patients and physicians in the market and giving a situation where doctors would be shut out if they did not fit corporate needs. There has been use of economic criteria as a way to delist thousands of physicians in the California managed care plan, and hundreds of psychiatrists have also been delisted in Massachusetts. BayState HMO has argued that they needed to have “cost cutting measures” through the aforementioned delisting (Himmelstein & Steffie). Healthcare costs the United States “twice as much per capita” than other industrialized countries (Wirt).

Single-payer system was introduced through the legislation. The United States National Health Care Act was formulated this year provided for a “comprehensive” coverage for all Americans with a health insurance (Lendman). Free health coverage for all residents and territories in the United States would be provided through the United States National Health Care (USNHC). The program components would also feature vision care, dental attention, emergency and long-care, as well as preventive and primary care among others. The program was open for public and non-profit institutions. This act was supposed not to be duplicated by the private insurance. The system establishes some things and is financed by government revenues through the USNHC Trust Fund. Stock and bond transactions will be taxed (Tobin-type tax) and top 5% of earners would have an increased personal income tax charged on them were also introduced. Single-payer insurance would be self-paying and no “new sources” of revenue are required (Lendman). A single-payer system would eliminate the “middlemen” in the channels, because it would involve the government paying “directly” to all providers. Taxes would be the appropriate source of the money used to pay for the system (State of disbelief).

A single-payer reform has been projected to bring solution in the healthcare of the United States. It would help the country reduce the mortality rates, as well as improve care for the aforementioned diseases and illnesses. A single-payer plan would be available for “all people” of all diagnosis, employment, income and age (Schiff, 1). This system would present a better system to the Americans because its quality would be kept high enough so that it may be acceptable to all citizens. Patients would be able to be attended to and diagnosed by the same doctor and nurses even if they changed financial status or jobs. Health care would be accessible and affordable to all under the single-payer reform and would ensure there is less wastage under administrative costs to shift such expenses to providing coverage for the Americans. Prevention of health risks would be enhanced or facilitated in the single-payer system which is not easy thing in the current market-oriented system where many preventative efforts “fall by the wayside” (Schiff, 1). This is because the market-oriented solutions prefer systems that are paying quickly yet the prevention interventions have very immediate returns.

The single-payer system would facilitate the development of a computerized medical data that is unified and more confidential. Information complexity has been on the focus in the current healthcare system because of presence and dominance of multiple private insurance companies. Thus the focus of the information system has been on billing rather than clinical care. Handling of information would be enhanced by collecting data at one place through the single-source financing rather than the multifaceted approach to health insurance. Much money is utilized under the current system in the paying of software development and research since every system has its computer systems. In appropriate data collection by plans has facilitated false reporting. Because single-payer provides a unified database, management and monitoring of quality of care delivered by physicians without engaging with issues of privacy between the physician and the patient, becomes easier. Tracking the quality of the health care provided by physicians in the current system is through requiring the latter to justify every test and treatment decision to an insurance clerk. This is a strategy consumes time and thus denied the public the valuable time required to attend to their cases. In addition, it is very expensive and a frustrating. The system can be avoided through the enactment of a single-payer system which can track the performance easier; for example identifying poorly performing physicians who order excessive number of tests.

Through the single-pay system, it would be possible to account for available resources and guide practices that would facilitate optimal generic treatment strategies. A market-oriented payer system limits the provision of services as related to the finances. It has been a practice, for example, to penalize physicians against the patients needing expensive tests, referral or procedure, and therefore care is limited. Thus medical decisions that are characterized by financial conflicts are observable, and single-payer system would reduce this likelihood.

Single-payer strategy is the best suited to reducing injuries at work place and ensuring continuous quality improvement (CQI), because as it would free health providers from billing distractions and shift costs elsewhere, efforts are shifted to making the workplace better. It presents a chance of broadening the focus on malpractice causing injuries, from concern on who to pay for it, to learn how to avoid mistakes and prevent them. This is because victims of medical injury will have future medical expenses covered for them routinely. In addition, the rampant incidences and “disgraceful practice” in healthcare such as refusal by insurance companies to pay for medical treatment and others which deter patients seeking medical interventions would disappear under the single-payer system (CAN/NNOC). The research by the IHSP has indicated that utilization of a single-payer system would create 2.6 million new jobs and $100 billion in wages and thereby help boost the U.S. economy, as well as injecting into businesses and public revenues $317 billion. About 2, 613,495 million new permanent good-paying jobs would be created by adopting a single-payer system that encourages expansion of coverage to the uninsured and those with limited Medicare, as well as coverage of the uninsured on Medicaid and people with employer-based health plans. In addition to increasing the number of those who were employed, the system would lead to loss of other jobs that were unnecessary in the market-based system. As captured by Thoreau “If a man walks in the woods for love of them half of each day, he is in danger of being regarded as a loafer; but if he spends his whole day as a speculator, shearing off those woods and making earth bald before her time, he is esteemed an industrious and enterprising citizen. As if a town had no interest in its forests but to cut them down!”. The employees would benefit through compensation with $100 billion also as a result of the expansion. A single-payer healthcare reform would boost the number of the jobs beyond 45 million in healthcare as well as other industries. In addition, the amount of money contributed to the federal tax revenues would rise above 25% of the current value.

Increase in job and wages would also result from a single-payer system because economic benefits arise as a result of actual delivery and provision of healthcare not the purchase of insurance. People would also not lose coverage if unemployed whereas age and health status would not be a reason for denying anyone health status. All the “medically necessary services” would be covered in the single-payer system including long and short-term care, in patient and outpatient, treatment for drug abuse among others (Wirt). Single-payer system would also be best suited to deal with health conditions associated with the “social and physical environments” which influence behavior (Committee on Health and Behavior: Research, Practice and Policy, Board on Neuroscience and Behavioral Health; 241).


The market-based healthcare system has presented several difficulties, among them issues to do with high costs of insurance, health insurance coverage and the quality of the health care services provided. The health care system in the United States has shifted to employer-based insurance system in history. Some citizens in the United States have suffered a loss for insurance coverage as premiums and costs of coverage increases. Market-based system has come up with problems of reducing the available options for the physicians and patients. In addition, the position of physicians has been risked as they would lose the position if they were never compelled to the system. Single-payer system has been touted as the solution for the American healthcare insurance since it carried the opportunity for increasing job opportunities amongst them permanent opportunities. In addition, because it comes with centralized data management, it presents the opportunity for better tracking of physician performance, and reducing the time wasted in data processing rather than patient attention. Expansion of the coverage would increase employee compensation, and also would boost the economy through increased wage of employment among other things. Information management which has been complicated by several interventions in insurance would be improved through single-payer system. This is because every provider has his computer system and databases. Other problems that would be alleviated through usage of the single-payer system include the likelihood of physicians denying patients health because the providers would be paid by the government. Health costs would be reduced because the intermediaries between the government and the subscribers to the healthcare plan would be removed. Other benefits that the single-payer system would present include the likelihood of reducing injuries at the workplace because it tends to shift costs to the workplace management to the extent that they would initiate measures that would reduce costs of paying for the victims. In addition, the system would help to ensure continuous quality improvement (CQI) because efforts are shifted to making the workplace better. After all, it would free health providers from billing distractions and shift costs elsewhere.


California Nurses Association/National Nurses Organizing Committee. “First-of-Its Kind Study: Medicare for All (Single-Payer) Reform Would Be Major Stimulus for Economy with 2.6 Million New Jobs, $317 Billion in Business Revenue, $100 Billion in Wages”. 2009. Web.

Committee on Health and Behavior: Research, Practice and Policy, Board on Neuroscience and Behavioral Health. “Health and Behavior: The Interplay between the Biological, Behavioral, and Societal Influences.” 2001. Web.

Himmelstein David, & Woolhandler Steffie. “Why the US Needs a Single Payer Health System.” 2009. Web.

Lendman Stephen. “Real Health Care Reform – Universal Single-Payer.” 2009. Web.

Schiff, Gordon D., Bindman, Andrew B., Brennan, Troyen A. “A Better Quality Alternative: Single-Payer Health System Reform.” Journal of the American Medical Association. 1994.

State of disbelief. “Healthcare reform: Universal healthcare versus single-payer and the “uniquely American” solution (Updated)”. 2009. Web.

Thoreau Henry. Civil disobedience, 2009

Wirt Daniel. “Removing the foxes from the henhouse: Single-Payer Health Care Reform.” 2009. Web.

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