maybe somebody in LJ land can answer this...

[katster]

What's the difference between single-payer health care and universal health care?

I'm curious, because there's a few bills in the California legislature about the former, and I'm curious. And since I'm scared to death of losing coverage for my illnesses, I'm really hoping that we actually manage to pass it.

Comments

in my understanding

[i.livejournal.com]

single payer health care more or less means one giant insurance company and means everyone with health insurance essentially gets the same plan. it doesn't guarantee that everyone gets health insurance, though.

[anahata56.livejournal.com]

As far as losing your health insurance is concerned, there are any number of things that make me think this is becoming less and less likely. With the implementation of the HIPPA act (also known as the Kennedy-Kassebaum act, which went into full effect just the day before yesterday), the onus is on health insurance companies to guarantee the insurability of those previously "uninsurable". It guarantees that health insurance is portable (carrying your coverage from one job to another), makes pre-existing conditions less disruptive to future insurability, and all the way around makes it nearly impossible to refuse coverage to anyone on the basis of either lack of prior insurance or medical condition.

I don't know how I feel about the concept of what is described here as the proposed way of insuring people, because I have a tendency to believe that when you make coverage "universal", it ends up that a lot of people get worse coverage and/or treatment than if the insurance plan can be more catered to the needs of a specific insured. It also seems to me that it takes some choices out of the hands of the people who are paying for the insurance. I know that our company has been implementing a series of new plans over the last few years, just to offer more choices. One of the things that we think makes our company stand out is the concept that we can offer plans that are specific to the needs of those who are paying for the insurance, no matter what those needs are. One plan for all people seems to take a lot of that choice away.

One thing to bear in mind, however, is that the insurance industry is highly regulated by government, and there are any number of state mandates dictating how their people will be covered, so where you live has a good deal to do with your insurance coverage all the way around. It also has to do with the company for which you work, in that the employer has a huge impact on the coverage of their employees. Their decisions are often based entirely on premium, and they will choose or reject coverage based on cost. They determine your copays, your deductibles and a number of your rider coverages like chiropractic, substance abuse rehab and pharmacy, and employees can often put pressure on employers by expressing the desire to have certain coverages that the employer may have rejected just to save money.

Accessibility to affordable health care for everyone is becoming more and more a public concern, and the trend I am seeing is that the law is making more and more of an effort to mandate coverage to people previously considered "high risk". This can only serve to help you--but it is also important to know how some of these laws with impact you as an individual, because to pass legislation that guarantees universal coverage but at the expense of relevant coverage to those who really need it seems to simply lower the standard down the line.

OK, lemme see if I get this right...

[lirazel.livejournal.com]

"Single-payer"--companies who insure their workers (this is NOT everyone, by any means) pay into a pool administered by a single office, who do all the negotiating with the insurance companies, health-care providers, drug companies, etc. The plusses are:

- Companies know up front what their payment will be, instead of costs that shift from insurer to insurer.

- Record-keeping is (in theory) simplified for both companies and health-care providers. Right now, each doctor or doctor's group has to negotiate a fee and discount schedule with EACH insurer, submit separate payments, etc. This makes for a lot of administrative overhead. Of course, it probably will be replaced by some other form of administrative overhead, but...

- Record-keeping may become simpler for patients, too. In February, my husband had some skin and blood samples taken--we just paid the last bill, to the laboratory, for costs that his insurer didn't cover. We had three bills in total: for the doctor, for the surgery (anesthesia and all that), and for the lab, and we couldn't get them until Blue Cross paid, and... and...

- Drug costs and care costs tend to go down when the providers thereof have to deal with one behemoth who has a yes/no veto than when they get to deal with each other one by one. If you were Glaxo, say, and you were given a choice between doing business with the State of California at a great discount or not doing business at all, which would you choose?

Minuses: Single-payer is not universal. While coverage may be extended to more people, it still generally does not cover the part-time, the working poor, the student, the handicapped, etc. Some states combine Single-payer and Medicare, but it's still not universal.

Universal is just that. Everyone is covered by the state. Workers may pay additional taxes. Some costs may be passed on to the customer, but in general you get the same care if you're rich or poor. Caregivers tend to be employees of the government, or, if there are provisions for private enterprise you have to pay for it yourself AFTER you've paid in full for the universal care. But Patrick can tell you all about that.

Anyone with corrections, I am willing to learn...