Single Payer Healthcare System The Case of US

Single Payer Healthcare System: TheCase of US

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The role of America’s vibrant insurance industry can be easilyminimized if the government adopts a single payer system where allthe health costs for all citizens are incurred by the government. TheUS state governments have, however, made several unsuccessfulattempts to adopt the system. The states whose governments have madesuch attempts include California, Massachusetts, Hawaii,Pennsylvania, Illinois, Minnesota, Montana, New York and Oregon.Among the main reasons as to why the bill has received considerableresistance include the fact that it is associated with higher costsand low quality, the system leads to a considerable increase incometaxes, overuse and misuse of medical services, reduces morale ofmedical practitioners and centralization of healthcare services tomajor cities.

Tableof Contents

Single Payer Healthcare System: The Case of US 1

Abstract 2

Single Payer Healthcare System: The Case of US 4

Introduction 4

Initiative and Reasons for Resistance 4

Past and Present Initiatives 4

Reasons for Resistance to Single Payer System 5

Conclusion 6

References 8

Single Payer Healthcare System: TheCase of USIntroduction

The role of the insurance industry in the American healthcare systemcannot be underestimated. The industry receives several billions ofdollars in the form of premiums and other insurance charges frompessimistic American who intend to ameliorate the risk of lack ofsufficient funds for health care. If a single-payer healthcare systemwere to be introduced, this role would significantly be reduced. In asingle-payer healthcare system, the government (through a publicorganization or public-private organization) pays for all health carecosts. This eliminated the role of private insurers (Zimlichman etal., 2013). This is the case in most developed economies such asthe UK and Canada. In the US, there have been several attempts for auniversal single-payer healthcare system, but they have all failed.None has achieved a congressional co-sponsorship of more than 20%.

Initiative and Reasons for ResistancePast and Present Initiatives

In 1994, the state of California attempted to pass the single-payerbill. The first time that the bill successfully passed the CaliforniaState Legislature was in 2006 followed by 2008. Unfortunately,Governor Arnold Schwarzenegger vetoed it in both attempts. In 1986,Massachusetts had successfully passed a universal healthcare programthat failed later due to budget constraints. Both in 1992 and 2015,the state of New York has made unsuccessful attempts to pass asingle-payer health plan. The failure emanates from the bill’sinability to advance through the Senate. Oregon’s attempt in 2002to pass the single payer system bill was rejected by a significantmajority (Oberlander, 2016). In the state of Illinois, the bill hadpassed in 2007, but it was referred to the House rule committee andhas never been taken up again since then. Like the case inCalifornia, the state of Hawaii passed a single-payer healthcare billthat was vetoed by the Governor.

In 2011 in the state of Montana, Governor Brian Schweitzer announcedhis desire to seek a federal government waiver to enable him to setup a single-payer system, but it was not successful. The state ofPennsylvania has severally introduced the Family Business andHealthcare Security Act which is a form of the single-payer systemwith no success. In December 2014, Vermont experienced considerablesuccess in passing the single-payer bill. Unlike in other states, thegovernor successfully signed into it but it was abandoned in 2014with claims that the costs and taxes were too high to implement. InNovember 2016, the state of Colorado intends to vote for asingle-payer tax system to replace the current private healthinsurance premiums.

Reasons for Resistance to Single Payer System

One of the main reasons as to why bills regarding single payersystems to not get the basic support is the fact that a considerableportion of Americans believe that the bill may lead to higher costsand lower quality. Some are brainwashed to think so while others basetheir stance on facts and cases that have occurred in other developedeconomies that have adopted the system. Irrespective of the basis oftheir stances, it is a fact that the single payer system that isclosely associated with free healthcare services is not free(Ragupathy et al., 2012). It is the taxpayers who pay forthese costs. Some researchers and critics of the system point outthat the system would attract an increase in income taxes that equalto the amount paid to American insurance companies. The propositionthat American households would save greatly as a result of the billmight not, therefore, be a fact.

While this is so, the bill also receives considerable resistance as aresult of the belief that it would lead to overuse of medicalresources. When people do not directly pay for certain goods orservices, they are more likely to misuse them than make proper use ofthem. Misuse of healthcare services is one of the main drivers ofpoor healthcare services. Besides, people are likely to seek medicalattention even for minor, and unnecessary health issues are therebyaggravating the situation.

A crucial resistance factor is the fact that the system underminesthe morale of medical professionals. Overuse and misuse of healthservices and resources do not only lead to their deterioration butalso overworking of healthcare employees. This subsequently leads tolow employee morale hence reduced productivity. Motivation and moraleare essential elements in as far as employee performance, andproductivity is concerned. The absence leads to poor employeeperformance and high turnover as a result of resignation motivated byfrustrations. To hire qualified employees and retain them, thegovernment is compelled to increase their pay which increases the taxpayer’s burden.

In addition to the above factors, a single payer tax system compelsthe government to centralize health care services to major cities inan attempt to cut down on costs. This reduces their accessibility andefficiency. Like the case in the UK, rural health care ceases toexist or becomes less effective. Besides, the government gets animplicit right to control the citizen’s health. The government putslegislative measures that ensure citizens protect themselves(Zimlichman et al., 2013). “Bad” habits such as smokingare taxed heavily in an attempt to ensure that they reduce theirbehavior. The case is not any different consumers of unhealthy foodsand alcohol.


To wrap things up, the role of the insurance industry would reducesignificantly of the US government introduces the single-payersystem. Over the years, there have been several attempts byindividual state governments to implement the system, but none ofthem has ever succeeded. This is attributed to the fact that thesystem is associated with high-income taxes, high costs, and poorquality (Ragupathy et al., 2012). Other factors leading to itsresistance include overuse and misuse of medical resources, reducedmorale of medical professionals, its centralization nature and thegovernment’s excessive ability to control citizen’s health.


Oberlander, J. (2016). The Virtues and Vices of Single-Payer HealthCare. New England Journal of Medicine, 374(15),1401-1403.

Ragupathy, M. R., Aaltonen, K., Tordoff, J., Norris, P., &amp Reith,D. (2012). A 3-dimensional view of access to licensed and subsidizedmedicines under single-payer systems in the US, the UK, Australia andNew Zealand. Pharmacoeconomics, 30(11), 1051-1065.

Zimlichman, E., Henderson, D., Tamir, O., Franz, C., Song, P., Yamin,C. K., … &amp Bates, D. W. (2013). Health care–associatedinfections: a meta-analysis of costs and financial impact on the UShealth care system. JAMA internal medicine, 173(22),2039-2046.