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Breaking down the Single-Payer healthcare system

Written by 
Leila Abbas, APN
Reviewed by 
Mary Beth Kacyn, LCSW

Article at a glance

  • Health has been a hot debate topic for years in the United States. Some Americans view health insurance as a human right. Others believe access to health care should be handled by private insurance companies. 

  • There have been calls for health reform in America’s health care system. One such option could be a national health program known as Medicare For All. Medicare For All is a single-payer health plan that would provide universal coverage for all citizens in the U.S.

  • A single-payer health system and universal healthcare are terms that are often viewed synonymously, however, there are many nuanced differences.

Health insurance coverage has been a hot topic of debate in the United States for years. While some Americans want healthcare to be provided by private insurers, other Americans view healthcare as a human right and want healthcare reform and federal government involvement. For some Americans, this means implementing a single-payer healthcare system known as Medicare For All. 

This article will explain everything there is to know about single-payer healthcare systems.

The State Of Healthcare In The U.S.

The United States does not have universal coverage for healthcare. Universal coverage means that every citizen in a given country has healthcare coverage. As it stands, the United States has a healthcare system that could be described as a hybrid.” This hybrid healthcare system includes:

  • Multi-payer system

  • A single-payer system (Medicare, with beneficiary contributions to premiums)

  • Publicly subsidized private payers (employer-sponsored)

  • Socialized medicine (Veteran Affairs)

  • Self-pay (An individual paying out of pocket) 

What Is The Affordable Care Act?

The Affordable Care Act (ACA) was enacted in March 2010. According to the Department of Health and Human Services, the ACA had three main goals: 


  • Make health care more affordable and available to more people

  • Expand the Medicaid program 

  • Support innovative medical care to lower healthcare costs


The ACA was one of the first attempts at health reform in the U.S.

What is a Single-Payer System?

A single-payer system is known as a type of health care system that provides universal coverage or universal health care for the citizens of a country. Specifically speaking, a single-payer system is when a single public or quasi-public agency finances healthcare for a nation. In most cases, the public agency funding health services is the government. An example of a single-payer system is the Canadian health system or the United States Medicare system.

That being said, the healthcare services are facilitated privately by various practices and healthcare providers, giving patients the freedom to choose who they receive healthcare from and where. 

A single-payer healthcare system makes all medically necessary services available to patients, e.g., annual doctor visits, long-term care, mental health care, reproductive health care, dental care, vision services, prescription medications, preventive care, etc.

Medicare for All

In many ways, single-payer healthcare systems are similar to the U.S. national health insurance program known as Medicare. 

Medicare For All would follow a similar structure to Medicare.


Note: To learn more about Medicare for All,” the single-payer health system being pushed for in the U.S., visit this source.

Comparing Single-Payer Health Care to Other Healthcare Systems

In order to fully understand single-payer health insurance, it’s important to compare single-payer health care to other types of health insurance coverage.

Difference Between Single-Payer Healthcare & Multiple-Payer Healthcare

A sole entity fully finances single-payer health care systems. Meanwhile, multiple-payer healthcare systems are funded by more than one entity. In most cases, the single entity funding healthcare in single-payer systems is the government. However, in multiple-payer systems, the government is but one of the few agencies providing healthcare for its nation. Frequently in multiple-payer systems, various private health insurance companies offer patients individual premiums for their healthcare coverage. 

Single-Payer Healthcare: Pros & Cons

Medicare for All is a hot topic of debate in recent years, pinning single-payer healthcare systems as a key point of discussion. While the arguments are expansive, some of the most common points on both sides are listed below.

Arguments for Single-Payer Healthcare Systems

Three of the most common arguments in favor of single-payer systems are:

  1. Single-payer healthcare systems are a step in the direction of equality and equity as they provide healthcare coverage for all citizens. Having coverage for all permits every resident direct access to care and treatment options and could improve health outcomes.

  2. If single-payer healthcare systems were introduced in the United States, health insurance costs would be reduced in comparison to what they are now.

  3. Single-payer healthcare systems lessen the administrative burden placed on health care providers because they only have to forward their patients’ health care costs to one entity vice a multitude of private health insurers.

Note: To learn more about arguments in favor of single-payer healthcare systems, visit this source.

Arguments Against Single-Payer Healthcare Systems

Two of the most common arguments against single-payer systems are:

  1. In order to transition into a single-payer healthcare system, taxes would need to be increased to cover the cost of universal health coverage.

  2. While single-payer systems do increase access to care, obtaining physical care would be difficult. This means to say, increasing access to healthcare without increasing the number of providers in the field leads to longer wait times and limited appointment availability for patients.

Note: To learn more about arguments against single-payer healthcare systems, visit this source.

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