What Is Single-Payer Health Care?

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After the GOP’s first Affordable Care Act replacement fail on March 24, Bernie Sanders said he would introduce a bill that proposes a single-payer healthcare system in the United States, a position he also maintained throughout his 2016 presidential campaign.

But what exactly does a single-payer healthcare program entail? Sanders’s definition aligns with how European countries have instituted public health care, though there are variations. “Bernie’s plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans,” his campaign site still reads.

On a most basic level, single-payer means a healthcare system that is entirely financed by one party (the government), but care remains in the hands of private hospitals and doctors. Insurance would be a guarantee and a public right as opposed to being based on employment; unlike some insurance obtained by Obamacare, there would be no premiums or copays.

“Bernie’s plan will cover the entire continuum of health care, from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments,” Sanders’s plan details.

And what does a single-payer healthcare system look like? The United Kingdom has a nationalized health service that provides free care to all of its citizens. Privatized health care still exists, but at a cost — if a citizen wants to pay for treatment from a doctor outside the public health system, they can; however, it is expensive. Allowing private medical practices to exist means that the healthcare provider receives payment directly rather than going through insurance.

Another stipulation, and perhaps a perceived pitfall, of a single-payer healthcare system is higher taxes. Sanders concedes that taxes would likely rise for a few brackets, but the middle class and businesses would ultimately benefit because they would not pay premiums or have to provide packages for employees.