HEALTH BENEFITS REPORT
A non-political overview of the
single-payer healthcare system
Now that the Affordable Care Act, which was
poorly named, has become institutionalized in
our nation, there has been a great deal of dis-
cussion on how we can enter into a single-pay-
er healthcare system. While this is a political hot
potato, I thought it might be a good chance to
define what a single-payer system is and how it
works.
According to the International Foundation of
Employee Benefit Plans, a single-payer system is
“an approach to healthcare financing with only
one source used to pay healthcare providers. The scope may be
national, statewide or community-based. The payer may be a
governmental unit or other entity such as an insurance compa-
ny. Healthcare providers are in private practice and are paid on
a fee-for-service basis. The government does not own or man-
age their medical practices or hospitals.”
In socialized medicine, which can also be considered a sin-
gle-payer system, doctors and hospitals work for and draw
payment from the government. Sounds great, but what are the
problems? Just as in private plans, somebody has to pay. In the
U.S., healthcare is currently 17.1 percent of the gross domestic
product. So that means that almost one out of every five dollars
16
NEW JERSEY COPS
■ FEBRUARY 2019
produced in this nation goes to healthcare. That revenue would
have come from taxes, and if you use Canada as an example, it
could be around 35 percent of your income, rich or poor.
Canada nationalized the healthcare system in 1967 and, in
that model, healthcare is the same for the poorest citizen and
the richest. Several years ago, the cost burden became too high,
and cutbacks made wait times grow from 9.3 weeks to 19.8
weeks from referral to specialist treatment (the Fraser Institute
National Waiting List Survey). Also in Canada, it is illegal to uti-
lize services or move people up on a list. The people who can
afford it end up coming to the U.S.
On the upside, Canada is known for its affordable prescrip-
tions. This is greatly due to the state-run system. If a company
comes in and says that it has a new drug that is four percent
more effective but three times the cost, the state-run system
won’t purchase it — or will only purchase it for the cost of the
previous drug, thus saving billions of dollars.
While no healthcare system is perfect, the single-payer sys-
tem remains a hot topic. It is important to know that it is not
a panacea. It won’t meet every single person’s expectations
and much more needs to be explored before we make a drastic
change to our healthcare choices.