Can anyone explain to me the difference between a single payer system and a public option?

[FourScore]

I would be so appreciative.

Thank you.

[MineralMan]

1. Let's see...

Single Payer - This is a system where there is only one insurer or system available. Generally government operated, but not necessarily.

Public Option - In this system, you may opt for a government-run health insurance or healthcare system or choose to purchase private insurance or go commando.

[ejpoeta]

2. a single payer system would be like medicare for all where everyone is in one system

and the private insurance companies are relegated to the extras. a public option would compete with the private companies. like if they let us buy into medicare and the private companies were then forced to compete with medicare for enrollees.

[Shagbark Hickory]

17. I sure wish people would stop comparing single payer to medicare!

They're not that analogous.

[ejpoeta]

21. medicare is something people understand. also, we pay into it through our lives

and collect later. don't know how it is not analagous considering that it is a system we pay into the government and the government manages.... this is what a single payer system would be.

[Shagbark Hickory]

23. Oh my gosh, NO!!! It shouldn't be anything like medicare!

First of all, when people like you refer to medicare, you're referring to PART B.
Part B only pays 80%, the recipient pays the rest or they get medicare supplemental insurance (you've seen the commercials that AARP puts out). 20% of a medical procedure can still bankrupt someone very very quickly.

There's also a lot of waste. It's not well run. That's what people think of when they think of medicare.

So if you're going to compare it, at least compare it to medicAID.

If you want to use language that the average joe can understand, call it "free healthcare". They don't get medicare. All they know from watching fox news is that medicare is wasteful. (and it is)

[ejpoeta]

24. medicare has a 3% overhead. what are you talking about. and most people would

gladly take an 80/20 split considering they now have a large deductible before they even get to the 80/20 split. i don't know anyone using it who would give it up and most people know someone using it. it's not 'free healthcare'.... we pay for it.

[Shagbark Hickory]

26. People wait in lines for hours for things that are free.

I'm just saying, it's how you package it.

The thugs are great at packaging and marketing.

As for the Co-pay, that's only for people that qualify for Part B!
Like I said before, 20% can be a devastating amount if someone gets stuck paying it, especially someone on a fixed income.

What's wasteful? We can discuss this all day, but when a doctor pops his head in the doorway and says "how are ya" and then charges $400 for that, it's wasteful. A $24 box of kleenex is wasteful. $6300 Scooters for basically anyone who asks for one, is fucking wasteful.


As for it being free, well for a lot of people it is free healthcare. A lot of people will receive benefits but not pay for it through tax dollars.
If you check out of the hospital or clinic and you don't render any payment, that's free and should be called free unless premiums are paid by all recipients.

[Bonobo]

3. Yes, I will try.

The "public OPTION" was supposed to simply offer a government managed health plan. It was a plan to compromise with the other side--to allow private insurance to continue while offering an option.

It is not incompatible with the idea of single payer, but as I see it, "single payer" implies that it would be more inclusive... a system that included everyone and therefore would eventually force out private insurers perhaps.

[FourScore]

4. That is what I thought. I know I am going to get beat up for saying this, but I think a PO

sounds better. I do not want ANY kind of government monopoly -- not even with healthcare. I DO, however, want the option to buy into a medicare type of plan or go with something else if I choose.

[TransitJohn]

10. Municipal drinking water is a government monopoly.

So you want that run by for-profit companies?

[FourScore]

14. I AM NOT ADVOCATING FOR-PROFIT INSURANCE!!!

Quite fankly, I'm offended (not easy to do with me) because I feel very passionately about HC reform.

I am just not convinced that a SP system is the best way to go. I lean more toward a PO plan.

I can post more later. I have someplace to be now.

[TransitJohn]

16. That's all well and good but I didn't say that you were. (and why are you shouting at me?)

You said that you didn't want any government monopoly of anything, especially healthcare, I brought up an example of a government monopoly that works perfectly fine. How about fire and police protection? Complete government monopoly.

[FourScore]

20. "So you want that run by for-profit companies?"

Sorry for shouting. That sentence made me think you did say it. I really have to run. I will post later because I want this discussion. I want to hear more, and understand better, and all that jazz, but i really have got to go.

Thanks, TransitJohn.

[Gormy Cuss]

12. What is your fear of a "government monopoly" if you want a Medicare -like option?

Is it the fear that you can't buy better coverage? Nothing about a single payer plan inherently precludes the individual from buying additional insurance in the private market. In some countries supplemental private insurances are fairly common among upper income households.

[FourScore]

15. That's what I needed to hear!

Now I like the sound of it better.

I probably have more questions, but I gotta go! Got an appt.

[EOTE]

18. You should know that a PO would almost definitely lead to single payer.

Because the profit motive would be removed from a PO, for-profit insurance companies would have a very hard time keeping up. Most likely, after a few years, they'd stop being profitable and would have to give up the ghost. I'd be very happy with a public option, knowing that in a few years it would bring about single payer. And the public would bring it about via their choices in coverage.

[Scuba]

5. MineralMan's answer is correct. If I may expand....

Were a "public option" system implemented, I believe it would result in a long, painful journey toward "single-payer" and make our country's health situation even more perilous in the short run.

For-profit insurance companies would accelerate the pace of accepting only healthy (read: most profitable) patients. Higher risk patients would be forced to the single-payer solution. This option would have to be heavily subsidized to avoid being unaffordably expensive (it has all the sick patients!!!). The right would use this to claim "gov't healthcare is a failure".

This situation is what we have now, only worse, it would be gov't sanctioned and enforced.

Only when we have single-payer will our nation's healthcare costs be spread over the entire population, making it affordable for everyone.

[FourScore]

6. The Germans have a PO system and it works quite well.

I'm just not sure I (one of the most liberal people I know) am ready for a full-out government control of healthcare. It sounds very bloated. I just worry that if I am not so sure about it, then red America will NEVER be sold on it.

The Germans have a PO and it does seem to work well.

ON EDIT: I certainly do not claim to be an expert on this though.

[blondeatlast]

7. To be honest, I'm kind of torn. I have a chronic condition, require lots of care (although I'm

probably healthier day-to-day than most people (insulin dependent diabetes since age 7, several decades ago), and I'm torn between diluting the risk pool as much as possible (single payer), but in the meantime, I'm worried that in the short term i'd be a "second class" patient.

Still, despite what we are told, Medicare works pretty well (except it's a struggle for docs).

I don't claim to have the solution; I just want to keep my treatment going. Without some kind os subsidy, I would slowly, well, you figure it out. :(

[FourScore]

8. My dear blondeatlast,

I am so sorry to hear of your condition. It is exactly because of people like you that I want universal care. So, as long as that goal is met - whether through PO or SP -- I would be happy. Please take care of yourself.
FourScore

[Bluenorthwest]

9. Key bit of information about other nations that mandate purchase

of health insurance from a spectrum of choices. In all of those nations, it is illegal to profit from providing the mandated services. Here, the profit is the most important thing, job one. There, it is illegal, against the law, not permitted. We will soon be the only nation on Earth ever to mandate the purchase of any form of private for profit product.
And you know, this is important stuff, so 'sounds bloated' is not nearly enough, when there are actual figures and facts you could look at. Do single payer nations spend more or less than we do? Less. Do they get more services or less? More. So 'sounds bloated'? In what respect, Charlie?

[Armstead]

22. Bingo....Nail on head

[Bluenorthwest]

11. Over 87% of Germans opt for the public insurance

the rest take private insurance. This shows that the option of public insurance is preferred by those with a choice, does it not?

[FourScore]

13. Oh absolutely! I used it too during the many years that I lived there.

But I have a chronic condition, and I can tell you that there was open waste and abuse even within the PO system. I imagine it to be even worse with SP. That is what I worry about. I don't have time to clarify my thoughts/fears right now because I am running late for an appt, but I will try to think about what I want to say while I am out, and articulate it later. I think about this a lot. I DO want universal care, I am just not convinced yet that a SP system is the best way to go. I will confess -- SP is better than what we have now, that is for sure!!!

[Recursion]

27. I am 100% opposed to a public option without a dedicated revenue source

For exactly that reason.

[Shagbark Hickory]

19. The difference is "Public Option" was a make believe fantasy bullshit term used by politicians

that exists nowhere else on earth. It was an unproven concept used to lure support and interest for and in the legislation. It wasn't clearly detailed on how it would work thus nobody can really answer your question except to say that it's not the same as single-payer canada.

[Lydia Leftcoast]

25. Well, it sort of exists in Japan

You either get insurance through your employer (and different industry and professional groups have insurance systems) or you take the public option. The premiums and benefits are close enough that it all depends on your job situation more than anything.

The premiums are based on income, and there are copays, but no deductibles. Furthermore, if you have certain catastrophic or chronic conditions, there are no copays. Even for non-catastrophic or non-covered conditions, you can receive a subsidy from the government if your copays exceed a certain amount per year.

[Shagbark Hickory]

29. Did you ever once, hear "public option" explained and outlined as to how it would work?

By an actual politician?

Of course not. We don't know if it would be anything like japan. It's just what our imaginations are thinking up.

[Recursion]

28. My attempt at a short(ish) answer

A single payer system would mean the government is the one and only insurer for medical costs. You would either pay in premiums at a fixed level (presumably in the form of a payroll levy) or it would come out of the general fund (but require much higher taxes). It would set all standards of care and negotiate the prices for therapies with providers. If it shakes out like in most countries, you're either fully-locked-in or fully-locked-out as a provider and a patient: you must only use the single payer system, or you can't use it at all. (eg, in Canada it's a crime for a doctor to provide a covered procedure to a covered individual and bill privately, even if the patient wants that.)

A public option would be largely like the current system except that if you're in a position of choosing insurance (a position that most people with full-time jobs with benefits are never actually in) you would have the "option" (get it?) of choosing a plan run by the government. And frankly it's an awful idea, because insurance companies could dump all their sick people onto it -- that's why insurance companies liked it. Hospitals and doctors hated it, and killed it in the Senate bill.