http://www.johnconyers.com/hr676faqWhat is "single-payer"?
The term single-payer describes the kind of financing system that H.R. 676 uses. It means that one entity--in this case, established by the government--handles all billing and payment for health care services. Right now, there are thousands upon thousands of "payers"-- HMOs, PPOs, bill collection agencies, etc. The sheer volume of paperwork required by our current system means that administrative waste accounts for roughly 31% of the money spent on health care. The single-payer system would eliminate the wasteful paperwork and administrative costs, redirecting more of our health care dollars to providing care.
Medicare is perhaps the best known single-payer system. Essentially, H.R. 676 would improve Medicare and expand it, so that it covers all Americans, regardless of their income.
Who will be eligible for health care coverage under H.R. 676?
All Americans will be eligible for health care coverage. Every person who enrolls in the program and receive a United States National Health Insurance Card and individual ID number, and that is all anyone will need to receive care.
What health care services are covered?
The program established by H.R. 676 will cover all medically-necessary services without charging co-pays or deductibles. The services covered will include: primary care; inpatient, outpatient and emergency hospital care; prescription drugs; durable medical equipment; hearing, dental and vision care; chiropratic treatment; mental health services; and long-term care.
What about "catastrophic" care? Will I ever reach a limit for coverage?
No. There are no limits on coverage. Just as you will never pay a co-pay or a deductible under the universal national health care program, you will never reach a ceiling on your coverage.
Will I be able to choose my doctor?
Yes. Patients will have their choice of physicians, providers, hospitals and clinics. The financing will be public, but the providers will all remain private.
No co-pays or deductibles-- what's the catch? Will I actually pay less for health care?
There is no catch. Both families and employers will pay significantly less for health care.
Currently, the average family of four covered by an employer-provided health care plan spends roughly $4,225 on health care each year, including premiums, services, prescription drugs and supplies. This figure does not include the annual Medicare payroll tax, currently at 1.45%. Under the plan created by H.R. 676, a family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs. No deductibles, no co-pays, no worrying about catastrophic coverage.
Employers who provide health insurance currently pay, on average, 74% of employee health premiums. For a family of four, the average employer share is $8,510 per year. Under H.R. 676, the employer pays a 4.75% payroll tax, not a premium to health insurance companies. For an employee making the median family income of $56,200 annually, the employer would pay roughly $2,700.
Estimates taken from: Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and Educational Trust; Consumer Expenditure Survey, U.S. Department of Labor, Bureau of Labor Statistics; and Study by the Center for Economic Research and Policy.
How will the transition to the new system work?
The full conversion to a non-profit, single-payer universal health care program will not take place overnight once the bill is passed. The total transition time will be roughly a 15-year period. Important elements of the transition will include:
• Private health insurance companies will be prohibited from selling coverage that duplicates any benefits included in the universal national health care program. The private companies will, however, still be able to sell coverage for services that are not deemed medically necessary, such as many cosmetic surgery procedures.
• Private insurance company workers who are displaced as a result of the transition will be the first to be hired and retained by the new single-payer entity. Any of the displaced workers who are not rehired will receive two years of unemployment benefits.
How will the universal program be paid for?
First, switching to a single-payer system will lead to billions of dollars saved in reduced administrative costs. Those savings will be passed on through the system and allow coverage for all Americans. Additional savings in the overall cost of health care will come from annual reimbursement rate negotiations with physicians and negotiated prices for prescription drugs, medical supplies and equipment.
Second, a "Medicare For All Trust Fund" will be created to ensure a dedicated source of funding in addition to annual appropriations. Sources of funding will include:
• Maintain current federal and state funding for existing health care programs
• Closing corporate tax loopholes
• Repealing the Bush tax cuts for the highest income earners
• Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
• Establish a 5% health tax on the top 5% of income earners; a 10% tax on top 1% of wage earners
• One quarter of one percent stock transaction tax
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