Single Payer Healthcare

Single payer healthcare is definitely not a new topic, but it is one that has made a comeback in recent years. You might have heard it mentioned in the press or read about it in passing. What is it exactly and how will it affect different stakeholders in the public?

What is Single Payer Healthcare Coverage?

Single payer healthcare is exactly how it sounds – a single payer, such as a government, providing healthcare coverage for everyone. This topic has been discussed since the 1900’s. According to an article on the history of American National Health Movements, published in the online journal of the American Medical Association, the first move towards a national healthcare coverage came in 1965 when Medicare and Medicaid were first introduced. However, these two systems do not cover the entire population, only certain demographics such as the elderly or low-income individuals. The US government website gives more detail about who is covered under Medicare and Medicaid currently.

In the 1990’s was when the term “single payer” started being used. However, it was never put into effect. This is different from the United States’ current, multi-payer system where individuals who cannot be covered by government plans, purchase insurance from private organizations.

Recently the idea has been brought forth again.

Currently there are two legislative proposals to congress for single-payer healthcare or the “Medicare for All Act of 2019”. The Act details the proposed plan from how the transition will made to what the actual plan entails. You can view the specifics of the Act here.

Potential Effects of the Proposed Medicare for All Act

On Patients

From a patient’s perspective, the security of being covered for healthcare costs regardless of their socioeconomic status can be considered a benefit of the proposed system. According to the 2019 Census report on health insurance coverage, in the US, 26.1 million people did not have health insurance at any point in the year. Meanwhile, private coverage was the most common type amongst those who were covered. If it was a single payer system, the burden of not being covered or paying for private coverage may be decreased, positively affecting a large number of the public.

On Physicians

Another perspective to consider is a potential change in physician income. A study by Dr. Jacalyn Duffin from Queen’s University in Canada looked at the change in physician earnings when Canada transitioned to a single payer healthcare system. Findings show that physicians experienced an initial decrease of high earnings, followed by a period of re-adjustment, and overall Canadian physicians maintain a top-earning profession. However, there are also many factors to consider such as differences between Canada and America in terms of population, funding, how the transition is managed, etc.

On Administrative Activities

There may also be decreased administrative costs with a single insurance payer rather than a multi-payer system as everything could be organized into a common system. For billers, this might make your job more difficult having to potentially learn a new system, or perhaps a centralized system could make your job easier. There may also be considerations as to how to act if this Act is instated and the country is transitioning to a single payer system. For example, the proposed plan states that those who are covered by health insurance currently will not experience disruptions in their care during transition. If this is the case, how does billing change during this time as well as afterwards? These details remain to be figured out.

Opinions Against

Opinions against this system for the US say that a system that is used in another country, such as Canada, may not be manageable in a country with a population that is almost 9 times as large. According to this article, which looks at the differences between the American, Canadian, and German healthcare systems, opponents also argue that in a single payer system, the budget is allocated by the government and determining how to allocate those funds maybe result in decreases in efficiency and deliverance of healthcare services for patients. There may be longer wait times for patients as well. There are also the costs that go into the transition. Whether it’s time or money, it is a large change that would affect many parties involved.

Final Thoughts

A recent poll found that around half of Americans support this Medicare for All plan. This is a topic with many different pros and cons depending on the perspective in which you approach it. There are also changes to the current world of healthcare, such as with the COVID-19 pandemic and different effects on different individuals. We have listed a few ideas to consider in this article, but there is definitely a long history and many perspectives to be discussed and considered.

As experts in this industry, we stay on top of all current changes in the healthcare industry that could affect medical billing and collections. If there are any administrative changes, our experienced team knows how to respond and continue to bill efficiently and effectively for our clients. Call us or book a free consultation today to learn more about how we can help your medical practice with your medical billing needs.