What is Single Payer?
Monday, August 30th, 2004 at 1:33 pm
Found over at Gross Anatomy, this animation explains the concept of a single payer health care system. While not perfect, a single payer system is better than what we have today. Which is 45 million uninsured, millions more under-insured. Hospitals overcharging the insured to cover expenses of the uninsured. HMO's telling doctors how to practice, and denying everything for any reason they can think of. Spending the most money of industrialized nations yet having similar or even worse health indicators.
Health care is a right and not a privilege of those whose employer feels like providing insurance. Back in 19th century Germany, Otto von Bismark initiated versions of the first national health insurance scheme in an effort to subvert the influence of the Communist party. Too bad the Cold War is over.
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So I watched that animation. And the thing is, if one person in this pool gets really sick and requires lots of $$ for their care, won’t the rest of the people get short-changed? I mean, there’s a finite amount of money in this pool. Granted, insured people now “help” pay for the uninsured, but they still have all the bounds of their insurance in case they get really sick. In the single-payer system, if there’s one person using the majority of the funds, and another person gets really sick, where will the additional money for their care come from?
The same thing happens now though. The trauma center down the street from the hospital where I used to worked always was operating in the red because of its trauma program - since it was the only one in the entire region, it was mandated to provide that care, whether it was paid or not. And a great majority of the patient population requiring trauma care did not have insurance. So what does the hospital do? Charge everyone else more. The same would happen with single-payer. If there were more sick people requiring more resources, then everyone’s premium/taxes would have to go up. However, distributed over a larger population means they would rise less than a single HMO. Also, no one said single-payer is “all-you-can-eat.” Some interesting studies have shown that the more health care is available, the more people will consume it, whether they need it or not. Even in a single-payer system, there will need to be limits. Especially for end-of-life care, where we spend the majority of our resources for rather poor outcomes, but that’s a topic for another day.