Explanation of Single-Payer

Improved Medicare for All

Non-profit national health insurance. The best national health insurance has only 1 payer and only 1 plan. The combination means a huge economic benefit for the United States in addition to all the other benefits.

Medicare for All = Single-Payer = One Payer of Medical Bills. “Single-payer” means having one public (insurance) agency that is reportable to the people. It is publicly accountable. People (who can, such as via employment income) pay into a single fund, from which the public agency pays medical bills. There are very little or no additional costs, and drug prices are negotiated to be much lower. Single-payer provides an efficient way to pay for health care and the best set of benefits for individuals, families and businesses. National health insurance is what other free-market countries have already implemented for their people, who have more physician visits, live longer, and minimize deaths due to preventable diseases far better than the United States. The use of single-payer will be at least as good, and most likely better, than the other various versions of national health insurance.

One Health Insurance Plan (not one for each state, like Canada has for its provinces) = Highest Degree of Efficiency. The best version of national health insurance is where there is not only a single-payer, but also one non-profit health insurance plan, like traditional Medicare. An improved Medicare for All will provide the best set of benefits with the least bureaucracy.

Huge Benefit for the U.S.A. The lowest risk and an excellent economic BONUS can be realized by the United States due to it having the largest population among free-market countries and its opportunity to implement one health insurance plan via U.S. House Resolution 676:
— Lowest risk of having major medical bills and hardships (due to 1 health insurance plan for over 300 million persons)
— Excellent economic BONUS: recovered manufacturing jobs, recovered health care jobs, the best negotiated prices (due to 1 public agency that replaces bureaucracy).

Additional Explanation

Single-payer efficiency: less government and no health insurance “middlemen”

The efficiency comes from:

1) the elimination of current government entitlement programs, such as the examples of Medicaid and SCHIP, replaced with a better plan. Also eliminated will be the privatized aspects of Medicare with its expensive Medicare Advantage and Part D Prescription Drug programs, the medical component of workers compensation, the hundreds or thousands of additional health care entitlement programs of cities, counties, and states.
Refer to: government bureaucracy.

2) the elimination of the use of over 1300 private health insurance companies for any services that are covered by the single-payer, as listed in the benefits of single-payer.
Refer to: health insurance companies’ bureaucracy.
The proposed single-payer legislation, H.R. 676, provides for generous support for the admin

3) the elimination of the bureaucracy that supports the other two types of bureaucracy.
Refer to: supporting bureaucracy.

Medicare for All = Improved Medicare for All

Single-payer is often called “Medicare for All.”

When you hear or read “Medicare for All” realize that it’s an improved Medicare for All that we want. We want Medicare to be improved to be like it was before 2003: before the politicians in the U.S. Congress established the law that has been privatizing Medicare.

First, there was the addition of so-called Medicare Advantage plans. Those plans are not Medicare and not an Advantage. They are a privatization of Medicare.

Then there was the addition of Part D, the so-called prescription drug benefit. That part of the law specifies that the U.S. cannot negotiate drug prices down to a reasonable price. That is also a privatization of Medicare.

We do want and can have Medicare for All, but it will be an improved version, even better than we had before 2003:

We will get more via expanded benefits.
We will pay less including much lower drug prices.
And everyone will be covered.

Single-payer, what the other countries did, and the opinion of Americans

Americans were being taught to fear national health insurance via the influence of the media.

In the meantime, the other free-market countries have been implementing … many doing it in the period between 1880’s and 1970’s. The United States is over 30 years behind.

Americans, in general, had never heard of “single-payer” prior to 2010. It is up to those who know about single-payer to explain single-payer and its benefits to other Americans.

Americans who live and work (or lived and worked) in other countries have documented and are documenting their real life stories about life with national health insurance, as per other free-market countries. Those Americans strongly favor the U.S. implementing single-payer.

Until the awareness of single-payer and its benefits is more established, we are faced with the reality that well-financed media campaigns can dramatically impact public opinion against single-payer.

Purposes of This Website and Million Letters for Health Care campaign

Knowledge. It is a main purpose of this website and to provide a foundation of reference information that will help Americans who use it be as solid as possible regarding single-payer. Americans need to trust that it did and does make sense that EVERY other high-income free-market country implemented national health insurance. It’s time for the U.S. to implement single-payer, the best type of national health insurance, via H.R. 676 to not only get the benefits, but to maximize those benefits.

Numbers. For people who are prepared for the change to single-payer, via the necessary knowledge and being comfortable, we need a million citizens to participate in the Million Letters for Health Care campaign:

Americans can sign up and realize the benefits by satisfying President Obama’s mandate (demand).

Additional Information

Single-Payer and the Typical American Worker
Overview of What Single-Payer Is
The Impact
The Overall Result
National Single-payer legislation with 1 plan: H.R. 676
State-based legislation with 50-56 plans: comparison to H.R. 676
Single-payer benefits
World View of the implementation of national health insurance

Single-Payer and
the typical American Worker

• What the typical worker GIVES
  • About 3 percent (3.3%) more out of each paycheck, as per the proposed legislation H.R. 676
  • Go to Cost and Savings for examples of the monthly costs
• What the typical worker RECEIVES
  • health care: all medically-necessary care from pre-natal through the end of our life, as seen at the H.R. 676 Benefits and Portability section.
  • more frequent visits per year to the doctor
    including getting more preventative care
  • longer life compared to our poor life expectancy performance
  • life with less pain and suffering due to better health throughout a longer life; how? by doctors preventing diseases much better (we 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
    • possible co-pays, as per debate in the U.S. Congress
    • much lower drug costs due to negotiated prices
  • no major medical bills
  • no worry about future health care costs

In other words, the typical 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! Read experiences of Americans in other countries.

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 the United States historical health care performance 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 spends much or all of their 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
    • lower cost of operation
    • lower cost of malpractice health insurance
  • 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:
  • See: Costs and Savings.

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 saving over $400 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. — Bob

Additional 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).