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Knowledge Base

Is Single Payer Right For America?

What is single-payer health care?

A single payer health care system is where the government pays for all health care expenses, financed by tax revenue. Single payer refers to paying for health care, not necessarily the provision of care. Hospitals and other points of delivery can be privately owned and operated in single payer systems.

Do examples of single-payer health care exist in the United States?

Medicaid, healthcare provided through Veterans Affairs (often called the “VA”), and Medicare Parts A and B are examples of existing single payer health care systems already in the United States. State and federal governments handle all payments, financed through payroll and income taxes, for recipients of those programs.

How much would single-payer cost in the United States?

Several state and national efforts to pass single payer health care have received official estimates of their cost from researchers, think tanks, and non-partisan budget offices that suggest single payer would be more expensive than our current mixed-care system.

Vermont passed legislation in 2011 to implement single payer health care in its state. Initial estimates put the total cost at $2 billion; the state’s budget for everything at the time was $2.7 billion. It abandoned plans to implement single payer in 2014 when it determined that it could not raise enough revenue in order to fund the program.

For more on Vermont’s efforts for single payer, see here, here, and here.

Estimates of moving New York to a single payer system range from an additional $91 to $226 billion on an existing state budget of $82 million. Those estimates come from Gerald Friedman (PDF) and Avik Roy (PDF).

The most recent estimate of single payer in California totals $400 billion in costs, more than double the current $180 billion spent on general and special funds in the state.

Estimates of a national single payer also appear to be much higher than supporters claim. Even including drastic tax increases, studies from the Urban Institute, the Tax Policy Center, and the Committee for a Responsible Federal Budget all find that national single payer would add trillions of dollars to the federal deficit.