How a ‘single payer’ health care system works

SAN DIEGO (KUSI)-  Health care is going to be a hot topic during the 2020 presidential campaign. Voters are likely to hear a lot about “single payer” health care, but many people may not be sure what the phrase means.

We asked Dr. Ted Mazer, the past president of the California Medical Association to offer a basic explanation.

“A true single payer would be a government entity whether it’s a state or the federal government that would dictate all of the access and payment for health care, and I think a lot of people have some concerns abut that being a government type program,” Mazer said.

He said a lot of the details such as what would be covered and how much this would cost taxpayers have not been explored.

The phrase “single payer” has become a popular slogan on the campaign trail, and some prominent Democrats, such as Senator Bernie Sanders have called on Americans to embrace a single payer system.

Yet, according to one recent opinion poll, voters are not sold on the idea.

A poll of California voters conducted by Quinnipiac University asked respondents if they would support or oppose replacing the current private insurance system with one in which California residents would get their health insurance “from one state government plan.”

Even in a state where there are more registered Democrats, the results were mixed. 41% said they would support a single payer system, while 46% said they were opposed.

As Dr. Mazer noted, no one has come up with a blueprint to implement a single payer system.

If the federal government was in charge of the program, would it be the states’ responsibility to manage it?

If that was the case, health coverage and taxes would be different from state to state. Some politicians have used the term “Medicare for All,” and the term “single payer” almost interchangeably.

However, the Medicare program is different than a single payer system. Seniors on Medicare still have co-payments and deductibles and have to buy private insurance for the services and treatment that are not covered by Medicare.

Mazer said right now, without many details, calls for a single payer system remain only rhetoric.

“Without the details of how you pay for it, what is covered, what isn’t covered, can I go outside that system, can I buy supplemental coverage; all of those things have to be put on the table to start getting any handle on this whatsoever,” Maser said.