The following is reprinted from Physicians For A National Health Program:

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 45.7 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead,

underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Modest new taxes would replace premiums and out-of-pocket payments currently paid by individuals and business. Costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

The links below will lead you to more specific information on the details of single-payer:

Single-Payer Overviews

“Proposal of the Physicians’’ Working Group for Single-Payer National Health Insurance,” JAMA 290(6): Aug 30, 2003

Single Payer: Facts and Myths

Rasell, E “Cost Sharing in Health Insurance – A Reexamination,” New Eng J Med., 332(7) 1995

Roos, et al “Does Comprehensive Insurance Encourage Unnecessary Use?” Can. Med. Assoc. J 170(2) Jan. 20, 2004

Gladwell, M. “The Moral Hazard Myth,” New Yorker Aug. 29, 2005

Geyman, John; International Journal of Health Services, Volume 35, Number 1, Pages 63–90, 2005

Health Economics and Financing

Woolhandler, et al “Costs of Health Administration in the U.S. and Canada,” NEJM 349(8) Sept. 21, 2003

Woolhandler, et al “Administrative Costs in U.S. Hosptials,” NEJM 329, Aug. 5, 1993

Woolhandler, et al. “Paying for National Health Insurance – And Not Getting It,” Health Affairs 21(4); July / Aug. 2002

Rasell, Edith “An Equitable Way to Pay for Universal Coverage,” International Journal of Health Services. 29(1); 1999

"Liberal Benefits, Conservative Spending"
Grumbach, et al. JAMA, May 15, 1991, Vol. 265 No. 19

"Markets and Medical Care: The United States, 1993-2005"
Joseph White, Case Western Reserve University, The Milbank Quarterly, Volume 85, Number 3, 2007

"Single Payer—Fifty Players: Alternative Payers for Universal Health Insurance"
Thomas Bodenheimer, Health/PAC Bulletin, Fall 1992

Paying More, Getting Less: How much is the sick U.S. health care system costing you?
Joel A. Harrison, Dollars and Sense magazine, May/June 2008 issue

Canadian Health Insurance: Lessons for the United States
June 1991; General Accounting Office (ref no: T-HRD-91-35)

The Case Against For-Profit Care

Editorial by David Himmelstein, MD and Steffie Woolhandler, MD in the Canadian Medical Association Journal

Devereaux, PJ “Payments at For-Profit and Non-Profit Hospitals,” Can. Med. Assoc. J., Jun 2004; 170

Devereaux, PJ “Mortality Rates of For-Profit and Non-Profit Hospitals,” Can. Med. Assoc. J, May 2002; 166

Himmelstein, et al “Costs of Care and Admin. At For-Profit and Other Hospitals in the U.S.” NEJM 336, 1997

Himmelstein, et al “Quality of Care at Investor-Owned vs. Not-for-Profit HMOs” JAMA 282(2); July 14, 1999

Quality and Malpractice

Introduction: Medical Malpractice, Health Care Quality and Health Care Reform (pdf)
A Forum Report by Gordon Schiff, MD

How Single-Payer Improves Health Care Quality (pdf)
A brief by PNHP (makes a great handout!)

Schiff, et al “A Better Quality Alternative” JAMA, 272(10); Sept. 12 1994

Schiff, et al “You Can’t Leap a Chasm in Two Jumps,” Public Health Reports 116, Sept / Oct 2001

The Failures of Other Reform Options

Individual Mandates (The Massachusetts Plan)

Consumer Directed Health Care and Health Savings Accounts

Tax Credits for Private Insurance

Why HSAs Won't Cure What Ails U.S. Health Care

Critique of Sen. Wyden's (OR) "Healthy Americans Act"

State Single-Payer Bills

Issues for State Single-Payer Legislation
By Dr. Steffie Woolhandler

Key Features of Single-Payer
A useful handout to help recongnize state single-payer legislation

Health Spending By State Of Residence, 1991—2004
Health Affairs 26, no. 6 (2007): w651— w663

Arizona

California - SB810

Colorado

Illinois

Minnesota

International Health Systems

International Health Systems for Single Payer Advocates
By PNHP Executive Director Dr. Ida Hellander

International Resources on National Health Insurance
Compiled by Joel A. Harrison, Ph.D., MPH

Health Care Systems - Four Basic Models
An excerpt from T.R. Reid’s book on international health care, "We’re Number 37!"

Single-Payer Bibliography