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Single payer healthcare: Pluses, minuses, and what it means for you

June 27, 2016

About the Author

photo of Andrea S. Christopher, MD

Andrea S. Christopher, MD, Contributor

Andrea S. Christopher, MD, MPH is an internist at the Cambridge Health Alliance and fellow in general internal medicine at Harvard Medical School in Boston. She received her MD from the University of Washington School of … See Full Bio
View all posts by Andrea S. Christopher, MD


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No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.


August 20, 2016

Insurers add only one advantage, cost containment. That is, they say no. They look for the cheap way out. But do they improve outcomes? And is their cost containment exceeded by the amount of money they take out of the system. We pay much more for healthcare and have less favorable outcomes than our other developed nation cohorts.
We should do the smartest thing, without any need to make profitable insurance companies.
Who could still sell the same products they offer to Medicare members.

August 18, 2016

We have the best health care in the world for a reason. Have you seen our crusted out mail trucks and Amtrak trains? They look third world. Congress has raided SS and the highway improvement fund. The government, money and management are just a bad combo all the way around.

Diane J. Peterson
July 8, 2016

I recommend purging “system” from any speech pertaining to health care in the U.S. Accurately naming what we have in health care is vital to understanding and ameliorating our problem. Thus, correctly labeling the American health care chaos as chaos–for that is surely what we have, not a health care system–will assist Americans in coping with our problem. For many years, our culture did not have a label for a widespread problem happening in the privacy of homes, but now that we have labeled the problem accurately as “domestic abuse” or as “wife battering,” we have improved coping mechanisms for addressing that problem. Similarly, if we begin talking about our American health care chaos, and refrain from incorrectly speaking or writing about it as something as logical as a system, we will be doing ourselves a favor by using a term which more precisely reminds us of the problem plaguing us. Our health care chaos does not deserve the dignity of being thought of or talked about as a respectable system. Characterizing the chaos by naming it as chaos get us closer to a solution.

August 19, 2016

Typical of democrats, so called “progressives”, and liberals – you seek to enact political change by labeling. Your full-on government medical administration will be incredibly chaotic and costly, but your first manipulative step is to label what you consider the opposition as chaos.

July 1, 2016

I believe that a single-payer system, Medicare for all, is the best choice. A big reason for my choice is that there would be less confusion, Simplicity in acquiring and implementing health insurance has to be a blessing to many. I am 73. I was lucky to always have very good private health insurance, and now of course Medicare. For some people it has not been as effortless. This is a thoughtful and balanced article.

June 28, 2016

This article is spot on. There is a false belief in this country that single payer would add more bureaucracy when the reality is the opposite. Health insurance companies do not add any value to our health care system, they are just a middleman whose main purpose is not to provide care but to make profits by actually denying it. That is, in part, what causes the insane level of bureaucracy that the current system has. Single payer does not mean a government take over of health care, is just a more common sense way to fund the system. Only in a few countries like Canada or the Uk the government controls the system and owns the hospitals, but in most European single payer countries, the delivery remains both private and public, just like in the US and they have a choice of hospitals and doctors in the same way we do here. With a single payer you would create a wider pool of patients with pure community rating and prices would actually go down as the government would have a better ability to negotiate prices with the providers than individual health insurance companies. That explains why the US expends twice as much per ca pita in health care than most western countries and yet has no universal coverage. The only reason we do not have a single payer yet in the US is because of the influence of big money in politics. We need a government that represents our interests, not those of the wealthy corporations.

June 28, 2016

Inequalities in health care is really a terrible thing. I encountered this in my life and I really recommend it to anyone. I hope that something will change in this regard.

Kathy Forte
June 27, 2016

So Harvard thinks that a giant, anonymous federal bureaucracy would give all of us improved health care. It’s sort of like “if you like your doctor, you can keep your doctor.” Obamacare made our medical system worse, not better. Let’s restore health care to the place closest to the patient and doctor, back to the states and let the power of the people as expressed in a local, free market, where people are accountable for their decisions. Health care is out of control because there are too many government bureaucrats and anonymous insurance functionaries taking money out of the system.

July 10, 2016

Your comment has been cloned from other right-wing responses throughout the years. I’m afraid you are a bot. Nonetheless, I’ll call out your stupidity.

What system could be closer to patient-doctor than single payer? Do you prefer a system where insurance is determined by an employer, the deals that employer has with health insurance companies, the deal those companies have with certain doctors, and the deal those doctors have with drug companies? Is that your idea?

To discuss “free market” and “people accountable for their decisions” in a healthcare discussion shows you don’t understand economics. I make choices when buying a phone or a car; if I’m having a heart attack I don’t give a damn about the free market.

Please go spew your right-wing nonsense somewhere else.

Steve Ambrose
June 27, 2016

It is important to understand that just because 58% favor a single health payer plan for U.S. healthcare, doesn’t mean you are polling people who understand U.S. healthcare. Just ask the people that voted for Brexit, and may well come to regret it.

If the U.S. STARTED OUT with single payer for all, it would have been easier and perhaps more fair. However, I also wonder just how much medical advance we would have made without the growth of publicly owned companies in this system. Those shareholder dollars paid or great advances. The flip side is that it was shareholder money, and that means driving profit, instead of better patient-based outcomes, such as satisfaction and customer service.

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