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SINGLE PAYER HEALTHCARE SYSTEM IN THE UNITED STATES
Single Payer Healthcare System in the United States
Student Name
English Composition
October 17, 2017
1
SINGLE PAYER HEALTHCARE SYSTEM IN THE UNITED STATES
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Single Payer Healthcare System in the United States
Single payer is a concept that the government of the United States has battled with for
several years. While some scholars state that the idea is instrumental in improving healthcare,
others argue that the concept restricts the quality of care received by the citizens of the United
States. The history of single payer system in the United States dates back to periods after the
Second World War when the then president Harry Truman proposed a healthcare system that
could address health issues of all citizens. Thereafter, the concept was introduced in the form of
Medicaid and Medicare in 1965. Both the Medicaid and Medicare systems were indeed single
payer in relation to the nature in which they provided their services. However, the limitation
witnessed in services delivered by Medicaid and Medicare is a factor that initiated the continued
proposition of single payer system. Canada, United Kingdom, and Taiwan are some of the
countries that use single payer system. The proposal intends to have individuals insured by a
public funded entity.
Obamacare
Overview and Single Payer System
During his first term in office, president Obama worked on a proposal that focused on
increasing the number of people covered by healthcare insurance. In March 2010, the president
signed the Affordable Care Act (ACA) into law with the intention of reducing the cost of
healthcare incurred by several individuals in the United States. The act has a number of
provisions all of which focus on minimizing the suffering of the poor and underprivileged. Some
of the major cornerstones of the law include equal insurance charges for men and women as well
as prohibiting denial of cover to people suffering from pre-existing medical conditions. The act
also compels businesses that have more than 50 permanent employees to provide insurance cover
SINGLE PAYER HEALTHCARE SYSTEM IN THE UNITED STATES
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to their employees and champions for prolonged cover until a person attains 26 years (Béland,
Rocco, & Waddan, 2016). In as much as the act is very momentous to the poor individuals, it has
experienced various dissenting views arguments from employers and the republicans.
Consequently, single payer system is one of the proposals tabled before the United States
congress. While some members in the congress accept the proposal, others who include president
Obama are skeptical about it. Instead, president Obama and Hillary Clinton propose a mix of
public and private payer systems. Some of the controversies surrounding the single payer system
include its impact in the health sector. Jiwani, Himmelstein, Woolhandler, and Kahn (2014)
explain that those supporting single payer system claim that the system will reduce the suffering
of doctors who often grapple with several payer systems and arbitrary process involving the
multiple insurance entities. The dissenting views however argue that the system minimizes the
quality of care received by patients. Due to its limitation on the freedom of physicians, the
number of people enrolling in the profession may eventually reduce a factor that will lower the
quality of care accorded to patients.
Democrat and Republican Views on Single Payer System
Democrats and republicans demonstrate different views on the concept of single payer
system. Apparently, majority of the republicans dissent the proposal but champion for a version
that is similar to that provided in countries like the United Kingdom. Placed between two
options, Obamacare and the single payer system, the republicans are opting for a single payer
version which is unique from the one advanced by Sanders. In his opinion, Bernie Sanders
presented a single payer plan that would free the citizens of the United States from any medical
costs (Béland, Rocco, & Waddan, 2016). However, the proposal did not have a plan on how the
funds to finance the medication cover would come from since current taxes are not sustainable.
SINGLE PAYER HEALTHCARE SYSTEM IN THE UNITED STATES
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Just like majority of his republican counterparts, the current president of the United States
Donald Trump appears to be supporting a single payer system of healthcare. Notably, some
scholars have argued that Trump’s alignment with the single payer system is due to his intention
to remove Obamacare.
Limitations of Single Payer System and Opposition to the System
The single payer healthcare system is popular in many nations, which attests to its quality
and value. Although there has been a debate on its limitation in providing healthcare services to
the citizens, the reduced costs associated with it is its major advantage. Opponents of the system
cite its limitation in providing quality healthcare because of its limited funding sources.
However, its success in a number of world power nations such as Canada and the United
Kingdom suggests that it is a viable option. On the other hand, the multi-payer healthcare
systems have a superior stability because of their reliance on a number of sources for its funding.
One of the most significant demonstrations of the multi-payer system is Obamacare. Having
been started with the major purpose of widening the health cover over a larger population, the
system is lauded to be successful. The health insurance system has reached segments of the
population that were previously unreached. In fact, no significant problem is said about the
system apart from political rhetoric that seeks to discredit the Obama administration.
Apparently, the proponents of the single payer system in America have failed to give its
significant gains apart from trying to portray it as oppressive to some quarters of the population.
However, the debate for and against the single payer healthcare system is healthy and provides
an avenue for scrutiny and evaluation of the two systems. Clearly, both systems have been
applied and have worked in the context of their application. Nevertheless, the arguments should
be made in line with real facts and a concern for the citizen rather than as political tools. The
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arguments against Obamacare exemplify the extent to which political alienations can stand in the
way of true service to humanity.
Single Payer System in Canada and the United Kingdom
Canada and the United Kingdom have single payer systems of healthcare insurance. To
ensure that its citizens enjoy services that match modern standards, the Canadian government
follows the procedures of its healthcare sector using its federal health provisions. The taxes
collected from the population play a great role in facilitating treatment, making medical services
in the country low and almost free. As feared by many dissenting scholars in the United States,
Canadian physicians enjoyed a boom after the payer materialized before suffering from reduced
earnings. Reduced physician earnings threatened their provision of high quality health services
but the situation changed gradually (Jiwani, Himmelstein, Woolhandler, & Kahn, 2014). By the
early 21st century, physician earnings in the country had topped the list of highly paid employees
in the country.
Moreover, in Canada the application of single payer system is so simplified that the
patients do not need to be involved in the payments of medical services that they receive. Due to
the efficient nature of the system, doctors work together with insurance companies to ensure that
the medical costs are fully paid. It is imperative to assert that the effectiveness of the system in
Canada is an outcome of the payer set up that is under provincially management. As such, the
respective provinces handle their insurance issues independently under the guidelines of the
federal provisions of heath. Béland et al. (2016) argue that one of the factors that make the single
payer system in Canada an example to be emulated by other countries is its extensive cover.
Although the cover may not extend to dental care and vision, individuals can still acquire cover
on the areas from their employers.
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To cater for the needs of those who desire private healthcare services, the Canadian
government gives the citizens the liberty to subscribe to a wide range of supplemental plans.
Fundamentally, the payer system in the country does not include the British Columbia region.
Jiwani et al. (2014) explain that in the British Columbia region, people have to pay a monthly
premium, which is fixed and only applicable to those who are working and earning a relatively
high income. Irrespective of the fixed premiums imposed on resident living in British Columbia,
the waiver on underprivileged individuals is a factor that amplifies the quality of care received
by individuals in all parts of the Canada.
The United Kingdom
In the United Kingdom, the system follows a devolved format where each of the states
undertakes their system independently. In as much as each of the states practices payer systems
independently, the entity, which receives private and public funds, is the National Health
Services (NHS) (Jiwani, 2014). The difference that is evident from the single payer system
applied in Canada and the one used in the United Kingdom is its hybrid nature. Besides using a
public payer system to fund medical services offered to permanent citizens, the United Kingdom
also employs the services of private insurance companies.
Notably, while Scotland, Wales, England, and Ireland provide services independently to
their citizens, they also have smaller private insurers who provide cover to those members of the
public who wish to enjoy private coverage. To qualify for private insurance cover, an individual
needs to pay monthly premiums either through salary deductions by the employer or personal
payments. Béland et al. (2016) claim that the National Health Service of Scotland, England and
Wales, as well as Health and Social Care in Northern Ireland (HSCNI) are individually owned
payer systems of the United Kingdom. Remarkably, devolution of payer systems of healthcare to
SINGLE PAYER HEALTHCARE SYSTEM IN THE UNITED STATES
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the various states and its amplification into a hybrid is a factor that has made the cost of
acquiring medical services in the United Kingdom decrease significantly.
Conclusion
While the single payer system may bring benefits, the success of the multi-payer system
under the Obamacare provides no valid reason for its abolition. The establishment of the system
as it is proposed should be based on a sober comparison of its merits and demerits and in
comparison, with the present system. Eventually, the benefits to the citizens should be paramount
in any proposal including in the implementation of the single payer healthcare system.
SINGLE PAYER HEALTHCARE SYSTEM IN THE UNITED STATES
References
Béland, D., Rocco, P., & Waddan, A. (2016). Obamacare Wars: Federalism, State Politics, and
the Affordable Care Act. University Press of Kansas.
Jiwani, A., Himmelstein, D., Woolhandler, S., & Kahn, J. (2014). Billing and insurance-related
administrative costs in United States’ health care: synthesis of micro-costing evidence.
BMC health services research, 14(1), 556.
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