The Potential Impacts of Single-Payer Health Care

from RAND Research Topic: Health and Health Care at on January 31, 2019 at 10:15PM

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What Are the Potential Impacts of Single-Payer Health Care?

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Controlling costs while improving health care access dominates policy debates in Congress. Some policymakers are increasingly discussing “Medicare-for-All” proposals and multiple single-payer proposals have recently emerged. What do policymakers need to know when thinking about single-payer proposals and their likely effects on cost and access?

In this briefing, Jodi Liu discusses:

  • key characteristics of single-payer health care proposals and their potential impact
  • common misconceptions and areas of uncertainty
  • plan details and implementation decisions that would affect impacts, including the cost of care, changes in total spending, and provider payment.

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  • A single-payer health care plan could expand coverage to all New York residents, but it would require significant new tax revenue. Overall health care costs would decrease slightly over time if administrative costs are reduced and state officials slow the growth of payments to providers.

  • Traditional Medicare is popular and therefore can lend a good brand name to coverage expansion proposals, but its limits can be significant for some patients. Those proposing and evaluating “Medicare for All” proposals should consider whether and how these limits are addressed.

  • Medicare for All is a talking point for both major U.S. political parties. Would it be free? Would people have to switch doctors? Would waits be long? Misconceptions abound about single-payer proposals and their likely effects. Here are the facts.

  • Policy discussions of single-payer health system proposals need to account for the substantial variation in how they would change the financing, pooling, purchasing and delivery of health care.