What is Single Payer?

The problem

Every American, even people with health insurance, suffers under our country's expensive, fragmented and inequitable medical system.

It produces some of the worst health outcomes in the industrialized world—the U.S. has the highest rate of infant mortality, and the highest number of avoidable deaths—and devours an ever-increasing share of our economy with health spending accounting for an astounding 17.9 percent of the GDP.

Despite the improvements of the Affordable Care Act, more than 30 million Americans remain uninsured, without access to primary care that could prevent costly and life-threatening diseases. An additional 64 million Americans are underinsured, facing prohibitively expensive co-pays, premiums, and deductibles that limit access to care.

Even if you are one of the 175 million Americans who are fortunate enough to have insurance, illness and injury continue to push patients toward income instability and bankruptcy. Health care has become the country’s largest source of debt in collections with Americans borrowing a whopping $140 billion to pay for health care in 2018 alone!

The solution

The solution to our complex and fragmented healthcare system is simple. Members of Health Care For All NC believe that nothing less than a universal, single-payer national healthcare system is enough to minimize the current profit motive in healthcare, allowing for a system that reduces health disparities and systemic racism. Incremental changes cannot solve these problems; further reliance on market-based strategies will exacerbate them.

Single-payer national health insurance, also known as “Improved and Expanded Medicare for All,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.

The program would be funded by combining our current, considerable sources of public funding (such as Medicare and Medicaid) with modest new taxes based on ability to pay. Over $500 billion in administrative savings would be realized by replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer.

Single payer is a reform but it has radical implications. Not only would it ensure every American's right to health care, it would also place 1/5 of the American economy under public control, a huge sea change that has the potential to empower other human rights struggles.

There are currently two Medicare-for-All bills in Congress. You can learn more about them here.

Have more questions? Check out our list of frequently asked questions.