About Single Payer - PNHP (2024)

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 combining our current, considerable sources of public funding (such as Medicare and Medicaid) with modest new taxes based on ability to pay. Over $500 billion in administrative savings would be realized by replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer.

Premiums would disappear, and 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.

The Medicare for All Act of 2021, H.R. 1976, based on PNHP’s AJPH-published Physicians’ Proposal, would establish an American single-payer health insurance system.

What about Obamacare?

The Affordable Care Act (“Obamacare”) aims to expand coverage to about 30 million Americans by requiring people to buy private insurance policies (partially subsidizing those policies by government payments to private insurers) and by expanding Medicaid. However:

  • About 30 million people will still be uninsured in 2023, and tens of millions will remain underinsured.
  • Insurers will continue to strip down policies, maintain restrictive networks, limit and deny care, and increase patients’ co-pays, deductibles and other out-of-pocket costs.
  • The law preserves our fragmented financing system, making it impossible to control costs.
  • The law continues the unfair financing of health care, whereby costs are disproportionately borne by middle- and lower-income Americans and those families facing acute or chronic illness.

This handy chart compares single payer and the ACA.

Ready to take action?

Let Congress know they should support single payer. Click here to send an editable letter in support to your representative.

For other steps you can take in support of single payer, check out our Take Action page.

More questions?

Over the past two decades, peer-reviewed research by PNHP leaders framed the debate on health care and focused it on the need for fundamental reform. Our proposals detail what a single-payer system in the U.S. could look like.

Further information is available on our Single Payer Resources and FAQ pages, as well as in our FAQ handout.

Información en Español

Acerca del seguro nacional de pagador único de salud “Single Payer”

About Single Payer - PNHP (2024)

FAQs

Why is single-payer healthcare a good idea? ›

In a single-payer system, the single-payer agency negotiates fair prices for services, supplies, and pharmaceuticals, using the purchasing power of the entire populace to make care more affordable for all. Single payer allows negotiations for medicines and medical devices.

Would a single-payer healthcare system benefit the majority of Americans? ›

YES: Single payer insurance would provide better and more affordable care for everyone. Single payer national health insurance would resolve virtually all of the major problems facing America's health care system today.

What is the idea behind a single-payer? ›

Expert-Verified Answer. The idea behind a "single-payer" system of (d) health insurance is that all health insurance goes through the federal government. In this system, the government is responsible for providing health coverage to all citizens, regardless of their ability to pay.

What are the arguments against a single-payer healthcare system? ›

Those pushing single-payer care, for now or later, say it would cover everyone, streamline an unwieldy bureaucracy and bring down costs. Opponents say it could lead to unacceptably high taxes, a flight of doctors to other states and a rationing of care as patients' needs overwhelm providers.

Why is single-payer better than multi payer? ›

Summary. Single-payer systems usually have an advantage over multi-payer systems in the efficiency of collecting revenues, overall cost control, and the capacity to subsidize health care for low-income individuals.

Which of the following is an advantage of a single-payer health system? ›

A single-payer health care system in California could help the state meet a number of goals — universality of health care coverage, comprehensiveness of coverage, greater equity, greater access and quality, improved affordability, lower administrative costs, and slower growth in health care costs.

Will the US ever get single-payer healthcare? ›

This has remained unlikely because the federal government would need to be the single-payer. The political will in the U.S. has not favored a system in which an individual citizen would be excluded from health coverage in this way, or reached a consensus on whether healthcare should be "free."

Should healthcare be free, pros and cons? ›

Universal healthcare provides medical care to all citizens of a nation regardless of their ability to pay. Proponents of universal healthcare say it increases equality in a society and provides more affordable care. Critics say it can increase waiting times to get care or may lower the quality of healthcare.

Who is the largest single-payer for health services in the US? ›

The Centers for Medicare & Medicaid Services (CMS) is the single largest payer for health care in the United States.

Who pays for single payer health care? ›

Within single-payer healthcare systems, a single government or government-related source pays for all covered healthcare services. Governments use this strategy to achieve several goals, including universal healthcare, decreased economic burden of health care, and improved health outcomes for the population.

How would a single-payer system affect the economy? ›

CBO estimates that, depending on the specifications of the single-payer system and the tax policy used to finance it: GDP would be approximately 1.0 percent to 10.0 percent lower by 2030 relative to current law, and ■ Aggregate nonhealth consumption per capita could increase by 3.0 percent or decline by 7.0 percent.

How does single-payer save money? ›

Lower Administrative and Drug Costs Would Be Main Drivers of Cost Savings. A single-payer healthcare system would save money over time, likely even during the first year of operation, according to nearly two dozen analyses of national and statewide single payer proposals made over the past 30 years.

What is the opposite of single payer healthcare? ›

In contrast, multi-payer systems operate with many different insurance plans, offering group and individual health insurance as the principal sources of health care financing.

Who should pay for healthcare for all? ›

WASHINGTON, D.C. -- A 57% majority of U.S. adults believe that the federal government should ensure all Americans have healthcare coverage. Yet nearly as many, 53%, prefer that the U.S. healthcare system be based on private insurance rather than run by the government.

What are some advantages and disadvantages of universal or single payer healthcare? ›

The pros and cons of universal health care
  • Pro: a healthier society. ...
  • Con: longer wait times. ...
  • Pro: people over profit. ...
  • Con: fairness vs freedom. ...
  • Pro: control over costs. ...
  • Con: limited budgets.
Apr 24, 2024

What are some advantages and disadvantages of universal or single-payer healthcare? ›

The pros and cons of universal health care
  • Pro: a healthier society. ...
  • Con: longer wait times. ...
  • Pro: people over profit. ...
  • Con: fairness vs freedom. ...
  • Pro: control over costs. ...
  • Con: limited budgets.
Apr 24, 2024

Why is universal healthcare a good idea? ›

Universal coverage would close the gap that presently leaves 2.7 million Californians uninsured and 12 million underinsured. Despite these advantages of universal coverage, hesitation remains at state and federal levels regarding universal healthcare.

Why should we get free healthcare? ›

UHC allows countries to make the most of their strongest asset: human capital. Supporting health represents a foundational investment in human capital and in economic growth—with good health, children can attend school and eventually reach their full potential, while adults are able to lead productive healthy lives.

What is the greatest advantage of group healthcare insurance? ›

The cost of group health insurance is usually much lower than individual plans because the risk is spread across a higher number of people. Simply put, this type of insurance is cheaper and more affordable than individual plans available on the market because more people buy into the plan.

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