The Physicians for a National Health Program National Health Plan
http://www.pnhp.org/ is the only plan Democrats should accept from the primary candidate we vote for.
http://www.pnhp.org/facts/single_payer_resources.phpSingle-Payer National Health Insurance
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 46 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, long-term care, mental health, 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 though 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
The Physicians Proposal for National Health Insurance
“Proposal of the Physicians’’ Working Group for Single-Payer National Health Insurance,” JAMA 290(6): Aug 30, 2003
http://www.pnhp.org/single_payer_resources/physicians_proposal_intro.phpKey Features of Single-Payer
A useful handout detailing the main features of single-payer.
http://www.pnhp.org/facts/key_features_of_singlepayer.phpStatement of Dr. Marcia Angell introducing the U.S. National Health Insurance Act
A great overview of the need for and logic of a single-payer system. Perfect as an introductory handout.
http://www.pnhp.org/facts/dr_marcia_angell.phpLiberal Benefits, Conservative Spending
Another great introductory handout.
http://www.pnhp.org/PDF_files/LiberalBenefitsConservativeSpending.pdfPublic Citizen's Response to the Citizens' Health Care Working Groups Interim Recommendations
A great overview on the benefits of a single-payer system by Public Citizen.
http://www.pnhp.org/single_payer_resources/public_citizens_response_to_chcwg_interim_recommendations.phpRep. Dennis Kucinich Tackles Health Care
Rep. Kucinich talks with Truthdig about the health care crisis in America.
http://www.pnhp.org/news/2006/november/rep_dennis_kucinich.phpSingle Payer: Facts and Myths
Single Payer FAQ
A frequently-updated catalog of the most-asked questions about single-payer.
http://www.pnhp.org/facts/singlepayer_faq.phpMyths as Barriers to Health Care Reform
A paper refuting many of the myths associated with single-payer.
http://www.pnhp.org/single_payer_resources/myths_as_barriers.php“Mythbusters” by the Canadian Health Services Research Foundation
A series of brief papers debunking the common misconceptions about the Canadian health system.
http://www.pnhp.org/single_payer_resources/mythbusters_by_the_canadian_health_services_research_foundation.php“Moral Hazard:” The Myth of the Need for Rationing
http://www.pnhp.org/single_payer_resources/moral_hazard_the_myth_of_the_need_for_rationing.phpRasell, 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
Health Economics and Financing
Introduction: How Much Would a Single-Payer System Cost? A review of government and independent studies of the cost of single-payer system.
http://www.pnhp.org/single_payer_resources/introduction_how_much_would_a_singlepayer_system_cost.php Administrative Waste Consumes 31 Percent of Health Spending - Woolhandler, et al “Costs of Health Administration in the U.S. and Canada,” NEJM 349(8) Sept. 21, 2003
http://www.pnhp.org/single_payer_resources/administrative_waste_consumes_31_percent_of_health_spending.phpAdministrative Costs in U.S. Hospitals are More Than Double Canada’s
Woolhandler, et al “Administrative Costs in U.S. Hosptials,” NEJM 329, Aug. 5, 1993
http://www.pnhp.org/single_payer_resources/administrative_costs_in_us_hospitals_are_more_than_double_canadas.php60 Percent of Health Spending is Already Publicly Financed, Enough to Cover Everyone =Woolhandler, et al. “Paying for National Health Insurance – And Not Getting It,” Health Affairs 21(4); July / Aug. 2002
http://www.pnhp.org/single_payer_resources/60_percent_of_health_spending_is_already_publicly_financed_enough_to_cover_everyone.phpA Proposal for Financing National Health Insurance
Rasell, Edith “An Equitable Way to Pay for Universal Coverage,” International Journal of Health Services. 29(1); 1999
http://www.pnhp.org/single_payer_resources/a_proposal_for_financing_national_health_insurance.php"Liberal Benefits, Conservative Spending"
Grumbach, et al. JAMA, May 15, 1991, Vol. 265 No. 19
http://www.pnhp.org/publications/liberal_benefits_conservative_spending.phpThe Case Against For-Profit Care
Overview: The High Costs of For-Profit Care
Editorial by David Himmelstein, MD and Steffie Woolhandler, MD in the Canadian Medical Association Journal -For-Profit Hospitals Cost More and Have Higher Death Rates
http://www.pnhp.org/PDF_files/ForProfitCare.pdfDevereaux, PJ “Payments at For-Profit and Non-Profit Hospitals,” Can. Med. Assoc. J., Jun 2004; 170
http://www.pnhp.org/single_payer_resources/forprofit_hospitals_cost_more_and_have_higher_death_rates.phpDevereaux, PJ “Mortality Rates of For-Profit and Non-Profit Hospitals,” Can. Med. Assoc. J, May 2002; 166
For-Profit Hospitals Cost More and Have Higher Administration Expenses
Himmelstein, et al “Costs of Care and Admin. At For-Profit and Other Hospitals in the U.S.” NEJM 336, 1997
http://www.pnhp.org/single_payer_resources/forprofit_hospitals_cost_more_and_have_higher_administration_expenses.phpFor-Profit HMOs Provide Worse Quality Care -
Himmelstein, et al “Quality of Care at Investor-Owned vs. Not-for-Profit HMOs” JAMA 282(2); July 14, 1999
http://www.pnhp.org/single_payer_resources/forprofit_hmos_provide_worse_quality_care.phpFor-Profit Medicare Plans Cost 11 Percent More Than Traditional Medicare
MedPac Report, Jun 9, 2006
http://www.pnhp.org/single_payer_resources/forprofit_medicare_plans_cost_11_percent_more_than_traditional_medicare.phpQuality and Malpractice
Introduction: Medical Malpractice, Health Care Quality and Health Care Reform (pdf)
A Forum Report by Gordon Schiff, MD
http://www.pnhp.org/reader/Section%205%20-%20Quality%20and%20Malpractice%20Issues/Gordy%20Malpractice%20Primer.pdfHow Single-Payer Improves Health Care Quality (pdf)
A brief by PNHP (makes a great handout!)
http://www.pnhp.org/facts/quality.pdfA Better Quality Alternative: Single-Payer National Health Insurance -Schiff, et al
http://www.pnhp.org/single_payer_resources/a_better_quality_alternative_singlepayer_national_health_insurance.php“A Better Quality Alternative” JAMA, 272(10); Sept. 12 1994
http://www.pnhp.org/single_payer_resources/a_better_quality_alternative_singlepayer_national_health_insurance.phpComprehensive Quality Improvement Requires Comprehensive Reform (pdf) -Schiff, et al “You Can’t Leap a Chasm in Two Jumps,” Public Health Reports 116, Sept / Oct 2001
http://www.pnhp.org/reader/Section%205%20-%20Quality%20and%20Malpractice%20Issues/IOM%20Chasm%20Paper.pdfThe Failures of Other Reform Options
Individual Mandates (The Massachusetts Plan)
http://www.pnhp.org/single_payer_resources/individual_mandates_the_massachusetts_plan.phpConsumer Directed Health Care and Health Savings Accounts
http://www.pnhp.org/single_payer_resources/consumer_directed_health_care_and_health_savings_accounts.phpTax Credits for Private Insurance
http://www.pnhp.org/single_payer_resources/tax_credits_for_private_insurance.phpWhy HSAs Won't Cure What Ails U.S. Health Care
http://www.cmwf.org/publications/publications_show.htm?doc_id=405167&#doc405167Critique of Sen. Wyden's (OR) "Healthy Americans Act"
http://www.pnhp.org/news/2006/december/lewin_group_analysis.phpComparison between Schwarzenegger Health Plan and Single Payer for California
http://www.pnhp.org/news/2007/january/comparison_between_s.phpState Single-Payer Bills
Arizona
http://www.pnhp.org/PDF_files/AZSinglePayerBill.pdfColorado
The Physicians for a National Health Program National Health Plan
http://www.pnhp.org / is the only plan Democrats should accept from the primary candidate we vote for.
http://www.pnhp.org/PDF_files/ColoradoSinglePayerBill.pdfInternational Health Systems
I. Canada
The Canadian Health System: Lessons for the United States
US General Accounting Office Report, June 1991
http://www.pnhp.org/single_payer_resources/the_canadian_health_system_lessons_for_the_united_states.phpA Survey of the Canadian Health System - Armstrong, et al “A Perfect System?” excerpted from Universal Health Care, New York Press, 1998
http://www.pnhp.org/single_payer_resources/a_survey_of_the_canadian_health_system.phpA Survey of Studies Comparing the U.S. and Canada (pdf)
PNHP Brief, May 2006
http://www.pnhp.org/single_payer_resources/CAN_Comparison_Sheet.pdfThe Future of Health Care in Canada (pdf)
Report of the Romanow Commission
http://www.pnhp.org/reader/Section%206%20-%20Canadian%20Health%20System/Message%20to%20Canadians.pdfII. International Comparisons
The U.S. spends more for less because of its fragmented financing system - Anderson, G. et al, "It’s the Prices, Stupid: Why the United States is so Different from Other Countries," Health Affairs 22(3), May/June 2004-
http://www.pnhp.org/single_payer_resources/the_us_spends_more_for_less_because_of_its_fragmented_financing_system.phpU.S. Care Quality is No Better Than Other Countries -Hussey, P. et al "How Does the Quality of Care Compare in Five Countries?" Health Affairs 23(3) May/June 2004
http://www.pnhp.org/single_payer_resources/us_care_quality_is_no_better_than_other_countries.phpSingle-Payer Bibliography
A bibliography of single-payer studies and papers
http://www.pnhp.org/reader/