Assignment:
The November 2019 issue of the American Journal of Public Health (AJPH) had a special section on Financing Health Care in light of the current political discourse. The articles (6 are required readings and 2 are optional) provide different perspectives on the single- and multiple-payer systems proposed by or advocated for by the different political parties and presidential candidates.
These articles, along with your other readings this week, collectively form the basis of your individual Assignment. Feel free to consult with additional resources to support your position. Your 600 to 800 word essay should include:
Introduction
Arguments for a single-payer system
Arguments against a single-payer system
Your well-supported opinion on what the next approach is for health care reform in the United States.
References (this week's textbook and article readings are sufficient, but feel free to add more)
Below are few definitions to guide your readings. These definitions are extracted from the Editorial to the special section in the AJPH November issue (p. 1482):
Single payer refers to a health system that is financed by a single entity; in its common usage, that single entity is government. Government is the payer for services, and such payments are financed by taxes, but there is no implication that government employs the providers or actually owns or operates the health system. There still may be intermediaries between the government as payer and the provider... In its "purest" form, in a single- payer system, health care services are paid for only by the government; in the case of Medicare, bene?ciaries also contribute to payments through premiums.
Multiple payer refers to a health system that is ?nanced through more than a single entity, one of which may include government. Private health insurance companies participate in multiple-payer systems, with ?nancing through individual premiums paid directly by bene?ciaries, employers, and, in some cases, government.
Whether a health care system is single or multiple payer does not in and of itself de?ne the system in terms of coverage. Universal coverage means simply that all people within a particular jurisdiction have health insurance, be it single or multiple payer. Universal coverage requires governmental mandate; however, the form of that mandate may be through either single or multiple payer or a hybrid model.
Health care in the United States is currently a unique hybrid, multiple-payer system, but with elements of single payer (i.e., Medicare, although bene?ciaries also contribute through premiums), publicly subsidized private payers (e.g., employer-sponsored health insurance), socialized medicine (e.g., Department of Veterans Affairs, in which government is both the payer and the employer), and self-pay (i.e., out of pocket).
Readings:
Health Policy and Law
By Sara E. Wilensky