Key Features of Single-Payer

May 14, 2003

• Universal, Comprehensive Coverage
  Only such coverage ensures access, avoids a two-class system, and minimizes expense

• No out-of-pocket payments
  Co-payments and deductibles are barriers to access, administratively unwieldy, and unnecessary for cost containment

• A single insurance plan in each region, administered by a public or quasi-public agency
  A fragmentary payment system that entrusts private firms with administration ensures the waste of billions of dollars on useless paper pushing and profits. Private insurance duplicating public coverage fosters two-class care and drives up costs; such duplication should be prohibited

• Global operating budgets for hospitals, nursing homes, HMOs and other providers with separate allocation of capital funds
  Billing on a per-patient basis creates unnecessary administrative complexity and expense. Allowing diversion of operating funds for capital investments or profits undermines health planning and intensifies incentives for unnecessary care (under fee for service) or understatement (in HMOs)

• Free Choice of Providers
  Patients should be free to seek care from any licensed health care provider, without financial incentives or penalties

• Public Accountability, Not Corporate Dictates
  The public has an absolute right to democratically set overall health policies and priorities, but medical decisions must be made by patients and providers rather than dictated from afar. Market mechanisms principally empower employers and insurance bureaucrats pursuing narrow financial interests

• Ban on For-Profit Health Care Providers
  Profit seeking inevitably distorts care and diverts resources from patients to investors

• Protection of the rights of health care and insurance workers
  A single-payer national health program would eliminate the jobs of hundreds of thousands of people who currently perform billing, advertising, eligibility determination, and other superfluous tasks. These workers must be guaranteed retraining and placement in meaningful jobs.

from the American Journal of Public Health January 2003, Vol 93, No.1