We are a long way from having a national health insurance program in the United States. Practically every other "civilized" or "Western" country in the world has a form of national health insurance. Leaving us in the mud. Currently, 10 states still have not expanded Medicare. All of them are "red states" save purple Wisconsin. And thanks to Trump, millions across the country no longer are even enrolled in the Affordable Care Act (the ACA, or "Obamacare" if you will) because the subsidies have been cut.
Private insurance companies have sunk their capitalistic tentacles deeply into our disorganized healthcare system, and getting them out will be tricky. It's doable, if we have enough civic-minded, and not profit-minded, elected officials. Until the US does something resembling Medicare for All, we cannot claim we are the greatest country in the world. Far from it. Trump seems to be trying his best to make the US one of those "shithole" countries he condemns.
Below is some decent info I came across on Medicare for All. Will we ever get there? Not under Republicans, you can be sure of that.
Medicare for All
Single-payer systems
How it would work
Takeaway
Medicare for All is a proposal for a single-payer healthcare system in the United States. Single-payer systems refer to health insurance programs that are governed by one organization.
Single-payer healthcare systems can be found worldwide. They vary in how they are funded, who is eligible, what benefits they offer, and more.
Medicare for All is a proposal to create a single-payer healthcare system in the United States.
This article examines how single-payer systems work and how Medicare for All stacks up as a proposed health insurance option in the United States.
What is Medicare for All?
If passed, Medicare for All will be a tax-funded, single-payer health insurance program that would provide healthcare coverage to every person in America.
The Medicare for All proposal would be an expansion of Medicare, the health insurance program that covers Americans age 65 and older. Medicare is currently broken into different parts:
There is also Medicare supplement insurance, also known as Medigap. Each part of Medicare provides different forms of healthcare coverage.
Together, Medicare Part A and Part B are what’s known as Original Medicare. Part A covers inpatient care, while Part B covers outpatient services.
Medicare Part C, or Medicare Advantage, covers everything under Medicare Parts A and B, as well as extras, such as:
Some Medicare Advantage plans also cover fitness and meal delivery services.
- Medicare Part D is prescription drug coverage, which helps cover the cost of your medications.
- Medigap is supplemental Medicare insurance that helps cover some of the costs associated with your Medicare plan, like copays and deductibles.
Expanding Medicare to Medicare for All would involve:
- providing coverage for all individuals, regardless of age or health status
- offering Original Medicare coverage, including inpatient and outpatient medical insurance
- adding additional coverage, such as reproductive, maternity, and pediatric care
- lowering prescription drug prices and offering more choices for prescription drugs
- deductibles
- premiums
- coinsurance
- copays
What is a single-payer system?
Medicare for All is only one type of single-payer system. A variety of single-payer healthcare systems are currently in use around the world in countries such as Canada, Mexico, Great Britain, Australia, Sweden, and others.
The overall idea behind a single-payer healthcare system is that one group is responsible for collecting and distributing funds to provide healthcare services to the entire population.
However, there is no single definition of a single-payer system, and there are different ways that a healthcare system like this can be organized.
In a 2017 study Trusted Source, 25 different proposals for a single-payer healthcare system were analyzed. The researchers found that the common healthcare functions included:
- revenue and contributions
- eligible population
- provider payment
- covered benefits
- eligible providers
Further, there were differing options about how each of these functions would be handled under a single-payer system.
For example:
- Collection of funds, or revenue, could come from federal funds, taxes, or premiums.
- Pooling of funds, or eligible population, could be based on an individual’s residency.
- Allocation of funds, or provider payment, could be population-based, fee-for-service, or global budget.
Generally, when it comes to covered benefits, all single-payer healthcare systems aim to provide coverage for essential health benefits. These benefits include:
- inpatient and outpatient medical services
- preventive and wellness services
- mental health services
- prenatal, maternity, newborn, and pediatric services
- rehabilitation and substance misuse services
Some proposals, like Medicare for All, call for an expansion of these programs. Other proposals call for the programs we have to be discontinued in favor of a replacement option in which everyone can enroll.
Medicare for All as a single-payer system
Here’s how Medicare for All would function as a single-payer healthcare system:
- Revenue and contributions. Medicare for All would be funded through income tax increases, premiums, and contributions.
- Eligible population. All residents of the United States, regardless of age or health status, would be eligible for health coverage under Medicare for All.
- Provider payment. Services administered by Medicare for All providers would be paid for on a fee-for-service basis using a fee schedule.
- Covered benefits. Medicare for All would cover comprehensive health benefits, including any services medically necessary to diagnose, treat, or manage a condition.
- Eligible providers. All providers under Medicare for All must follow national minimum standards and the rules and regulations set by the Act.
The takeaway
While there are multiple single-payer proposals on the table for healthcare in the United States, Medicare for All is the most widely known and supported.
As a single-payer program, Medicare for All would provide comprehensive healthcare benefits to all people in the U.S. at no up-front cost.
It would be primarily tax-funded, use a fee schedule for provider payments, and cover all essential health benefits.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
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