The Single Payer Reimbursement System

In the United States, access to health care is largely determined by who has financing to receive insurance (Shi & Singh, 2013, p. 197) Financing for health care comes from many different entities. For most Americans who have health insurance through their employment, the employers pay a part of the insurance premium and employees pay the rest (Shi & Singh, 2013, p.

In the United States we have private healthcare which each individual person has to pay

The concept of a national single-payer health care system in America is far from a new one. In his journal, Dr. Jonathan Oberlander (2016) listed some of the proposals that have been made in the United States over the years. The first on his list was a bill that was created in 1943 with plans to establish a payroll tax-funded health insurance for the whole country; despite the

1). Private health insurance is another way of paying for health care. The associated costs of health care are offset according to the policy the person has purchased. Private health insurance costs are paid by premiums, deductibles, and co-payments from the insured person. There is also the portion of people who are uninsured and are considered self-pay patients. These uninsured patients represent a large part of unpaid services. Although, not all uninsured patients leave bills to be absorbed by the health care system many do, and this increases the costs of health care to be absorbed in other areas.

The US health care system is a mixture of private and public sectors. About 80% of care is provided by the private sector. This includes hospitals, doctors, pharmacies, medical devices and medical research. The biggest price tag by far comes from the medical research aspect. This cost has to be passed down to the consumer of course. About 60% of Americans have health insurance which is provided by their employer. People who get their insurance through their employer don’t get charged more based on prior illness, age or gender. Insurance coverage can range in benefits and coverage, but pretty much cover preventative care, prescriptions, and medical care for illness. There is also a co-pay that needs to be payed this is usually

If the US were to adopt the single-payer system, as exists in Great Britain under the National Health Service (NHS), "a single-payer system would be setup such that one entity a government-run organization would collect all health care fees, and pay out all health care costs.... In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don't have it" (What is single payer, 2012, PNHP).

In the United States, there is a third party, aside from the patient who is the buyer, and the hospital who is the seller. The insurance company or government agency is considered the third party. The money flows through the third party. The reasons for having a third party is for patients to be prepared against large unseen costs of treatment, and so governments can assure their citizens access to health care. Healthcare is in part, market based, and is paid for privately by employers or an individual. Another way healthcare in the US is financed is by the government. For example, the US government funds supports Medicare, insurance for the elderly and disabled, and Medicaid, which covers low income Americans. In France everyone has health care. Health care in France is also financed by both private and government insurance, and people generally get insurance through their employer. The French national insurance program is mostly funded by payroll and income taxes (Shapiro 'Health care '). The funds are

Prior to The ACA, the United States was primarily composed of a private health care system. This meant that employers, families or individuals would buy health insurance through private insurance companies. There were also Medicare and Medicaid government insurance programs for qualifying individuals. (Bradey, 2016) Typically the Medicare program is reserved for those individuals who have reached retirement age and Medicaid is for the poor. There are exceptions to each of the programs that this paper will not explore.

The Affordable Care Act (ACA) also known as Obamacare is a healthcare reform law that is intended to reform the health care system by providing Americans with affordable quality health insurance by controlling the growth in healthcare spending. Some critics of the Affordable Care Act say the ACA has not provided universal coverage, and one way to fix this is to adopt a “single-payer system.” I agree with these critics on the counts of the Single Payer System being a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Doctors and patients regaining healthcare freedom, the accessibility of full coverage, and with financial benefits, the Single Payer System should be adopted by America today.

Besides the general purpose of providing healthcare to all, the idea of government healthcare is that there is a single-payer as opposed to multiple insurance companies as well as government payers. All citizens are considered insured and only charged based on each individual’s “ability to pay” (MacDonald, 2013). This insurance would be paid for by the single-payer, the government, though the taxation of its citizens. Examples of this type of system can be seen in countries such as Canada and Sweden, as well as our own Department of Veterans Affairs ' VA health system. The idea of a nation-wide single-payer system has remained fairly popular in the United States due to the popularity and acceptance of the government’s Medicare program. In MacDonald’s article, “Healthcare reform: Socialized medicine?”, he quotes Deborah Chollet, a senior fellow at Mathematica Policy Research in Washington, D.C.: "No matter where you move in the country, you keep your Medicare," she says. "It allows you to go to any doctor or hospital you choose, and it 's not wildly expensive given the relatively expensive population it serves." (2013) Opinions such as these are what is fueling the desire of U.S. citizens to evolve our multi-payer system into a universal single-payer system. This would eliminate competing private insurance plans and exclusion of patients from coverage due to their existing health status (Kemble, 2012). Overall, a single-payer system appears to be a more equal, streamline

In Canada or Great Britain, the government funds healthcare providers through taxes, and such a system is called social. The United States, on the other hand, being a profoundly capitalistic country, opted for another route and passed the burden of healthcare spending on private consumers as well as other

By switching to a single payer system it means that the government responibale for all Americans healthcare. Some people believe it is not the government resposiblilty. Nevertheless; it is a government resposbilitiy to grante healthcare access to every citizes. In places like Cannada where they use a single payer system costs actully decreses, manily because there is one payer system so hospitals find it hard to over charge patients. Eventhough government would be financing healthcare that does not neccesary means they have to deliever

One of the main reasons the single payer model has not been adopted by the U.S. is due to the political obstruction that stands in the way of change. For example, Representative John Conyers every year since 2002 has introduced an act for a single-payer system but neither his bill nor any others succeeded in getting more than 20 percent congressional co-sponsorship (http://www.huffingtonpost.com/entry/its-time-for-a-single-payer-healthcare-system_us_58d6470de4b0f633072b37f8). Such a low percentage demonstrates the stationary political climate associated with health care system reform in the U.S. Additionally, implementing a single payer system would monumentally increase government spending. Although, it has been found that, on a per capita basis the U.S. government health programs alone spend more than Canada, Australia, France and Britain each do on their entire health systems

(20) Medicare and Medicaid account for about forty-eight percent of total health care spending. Private insurance, which accounts for approximately thirty-three percent of health care spending, can be for-profit or nonprofit and is regulated by the state insurance commissioner.

Understanding the classification of healthcare services in terms of acute and long term care enable us to plan for services, to describe institutions, and to allocate funding and reimbursement. In the United States, healthcare services provided by health care providers (such as doctors and hospitals) are paid for by the following including, private insurance, Government insurance programs, people themselves (personal, out-of-pocket funds). Additionally, the government directly provides some health care in government hospitals and clinics staffed by government employees. Examples are the Veteran’s Health Administration and the Indian Health Service.