Single-payer system models
for reform are perhaps the "gold standard." Physicians for a National Health Plan has reported
that under a national single-payer system, individuals could expect to pay 2% of
their income into the system and employers about 7% of payroll. These
amounts are significantly less than what is currently spent.
Single-payer systems ensure
all residents have access to health care and significantly reduce
administrative and billing costs through a single portal for the
administration of coverage and payments to providers for
services. Importantly, single-payer systems combine all money
currently being spent in a relatively uncoordinated way into a single pool -
individual, employer and government expenses. There
are single-payer movements in numerous states, including Illinois, New
Mexico, Pennsylvania, Washington, Connecticut and California, which has twice passed
a single-payer bill only to be vetoed by the Governor.
While the political hill single-payer must climb is steep, all health care
reforms should be judged against the standard set by single payer
proposals - comprehensive coverage, maximum out-of-pocket expenses, administrative efficiency and simplicity, and
costs limited to a percentage of income. Many reforms in states are moving
in that direction and advocates and legislators are increasingly demanding
that half-measures be replaced with comprehensive proposals that meet this
standard.
