Single-payer would drastically change health care in America. Heres how it works.
As Republican efforts to repeal and replace the Affordable Care Act continue in the background, some Democrats are starting to eye a new health policy goal: implementing a single-payer system. Sen. Bernie Sanders (I-Vt.) introduced a single-payer bill in mid-September with 16 Democratic co-sponsors — 16 more than he got when he introduced the bill two years earlier. But how is the health-care system funded now, and how would “single-payer” change that?
There are three major components to every health-care system, single-payer or not: a patient, a payer (typically an insurance company or the government) and a provider. Here’s how money moves between them:
How multi-payer systems work
Virtually all health-care systems follow this general pattern, but who the payers are can vary widely. In the U.S. private insurance market, patients typically purchase coverage from one insurance company among many competing insurers. Because different people end up with different insurers, there are multiple payers throughout the U.S. health-care system.
How single-payer systems work
In a purely single-payer system, there is, as the name would indicate, just one payer — typically the government. This is analogous to how the United States administers some portions of Medicaid: The government provides coverage, and no private insurers are involved.
There are good graphics at the link but weren't displaying correctly here.
= new reply since forum marked as read
Germany's health-insurance-system has two competing components:
Government single-payer and private health-insurance. You MUST have a health-insurance. Any.
Germany has the "Allgemeine Ortskrankenkassen", AOK. ("General Local Health-Insurance"
https://de.wikipedia.org/wiki/Allgemeine_Ortskrankenkasse
* They were originally founded by the german government and are nowadays a network of health-insurance companies, one per state. (But you can just switch from one to the other without problem if you move to a different state, because they all sell the same insurance-plans and use the same administrative structure.)
* Though independent companies, they are tightly regulated by the government.
* The AOKs must give health-insurance to anyone who wants to sign up. No discrimination against preexisting conditions allowed.
* As they insure the bulk of the population, and because they sell plans that are basically just essential healthcare, and because of tight government-regulation, they are fairly cheap.
* If you cannot afford to pay for your health-insurance, because you're too poor or unemployed, then the government pays for a bare-bones AOK healthcare-plan.
On the other side are private insurers. (What the US has now.)
* They are allowed to check for preexisting conditions.
* They sell you big, comprehensive, expensive healthcare-plans that will get you the best healthcare possible in all situations.
