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Universal Health Coverage - Single Or Multi Payer System

Jan 24, 2008
You've heard the terms single payer universal coverage system or multi payer system tossed around by politicians, legislators and healthcare administrators when discussing healthcare reform. But, what do they mean? Are there similarities between the two models? What are the differences? Should we adopt this system for the United States?

Single-payer systems are usually financed relying on existing taxation systems; they effectively distribute risks throughout one large risk pool; and they offer governments a high degree of control over the total expenditure on health. Multi-payer systems sacrifice this control for a greater ability to meet the diverse needs and preferences of beneficiaries.

Canada is an example of a country that has a single payer universal coverage system. They provide socialized health insurance to all Canadian citizens and the single payer into their system is the Canadian government. The United States has a multi payer system that is a mix of both private and public funds. According to the Department of Health and Human Services, in 2006, private insurance paid for 36% of personal health expenditures, private out-of-pocket payments were 15%, while federal, state, and local governments paid 44%.

There are other countries that provide universal coverage to their citizens but use the multi payer model. Germany, the Netherlands, Japan, France, and Switzerland also rely on private health insurance to keep their multi-payer systems innovative and solvent. In Germany, 10% of the population has private health insurance; in the Netherlands, 31%; in Japan, over 50%; in France, 86% have complementary private health insurance; and in Switzerland, by mandate 100% have private primary health insurance.

According to the World Health Report in 2006, the U.S. spends more on health care per capita than any other nation in the world. Current estimates put U.S. health care spending at approximately 15% of Gross Domestic Product (GDP), the world's highest. We also have some of the lowest statistics in the industrialized world in terms of life expectancy and infant mortality. The CIA World Factbook ranked the United States 41st in the world for lowest infant mortality rate and 45th for highest total life expectancy.

Many people would agree that Americans are in need of serious health care reform. This is one of the platforms that all presidential candidates run on and one of the major factors that voters use to determine their ultimate voting decision. Americans want and are in need of change from the current system and there are examples from other industrialized countries to choose from and model after.

The United States has options in terms of selecting and implementing a new health care plan for its citizens. Universal coverage whether it is a single or multi payer system would be a viable choice.
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