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I would like to understand better what is meant by "single payer". I think I know what it should mean, but then I see France as an example of single-payer syste

I would like to understand better what is meant by "single payer". I think I know what it should mean, but then I see France as an example of single-payer system. France has a complex system of insurance bodies (public entities, privates companies, some weird stuff in between)... If I understand correctly the biggest savings come from the mandatory nature of the coverage - everybody is covered at least partially by the State, + employees by their employers, + private offers for the others + universal coverage for immigrants and the most destitute. Risk is shared between the healthy and sick people, and prevention can be maximized.

coredog64 9y ago
When I see it in the NYTimes, I assume it means that the health care fairy pays for it. As you've noted, very few people are wonky enough to be able to discern any difference between the systems in the UK, France, Germany, and Switzerland. Instead, they're all lumped into "European single payer" regardless of the level of truth or correctness.
- pas 9y ago
  That's just bad faith. There are pretty well graspable differences. Germany has both private and public krankenkasse-s (sick people funds, so healthcare insurance providers). The UK has NHS, a big public insurance system. And so on. The economics are pretty well understood, so like climate change, it's not 100%, because it's big and complex as fuck, but a lot more certain, than a 50-50 coin flip. Of course people will have to still pay. The question is, what's the fair amount to ask from people. And it seems a progressive healthcare tax would be fair.
LensLarque 9y ago
In France when you work you have to pay a percentage of your salary for the national healthcare to cover you and your family. This national healthcare reimburse you about 60 to 80% of the bills depending on the type of treatment. The remainder is paid by a private healthcare that your employer is chosing and paying for you. The difference between the many private healthcare is usually the amount reimbursed for dental treatment and eyeglasses. If you have no work, there is an universal healthcare to cover you, but you cannot get fancy glasses or good tooth implant. The prices are regulated by deciding the amount reimbursed by the national healthcare for each medical act. The private healthcare reimbursement are based on these prices. Doctors are free to ask more money, but you are going to pay the delta. Savings are mainly achieved by having both sick and healthy people paying. Also, the fact that any medical treatment is basically free encourages you to see your doctor everytime you are beginning to be sick, preventing complications leading to a stay in hospital. Note also that many private healthcare are mutual insurance which are lowering the rates if there is a profit.

coredog64 9y ago

When I see it in the NYTimes, I assume it means that the health care fairy pays for it. As you've noted, very few people are wonky enough to be able to discern any difference between the systems in the UK, France, Germany, and Switzerland. Instead, they're all lumped into "European single payer" regardless of the level of truth or correctness.

pas 9y ago
That's just bad faith. There are pretty well graspable differences. Germany has both private and public krankenkasse-s (sick people funds, so healthcare insurance providers). The UK has NHS, a big public insurance system. And so on. The economics are pretty well understood, so like climate change, it's not 100%, because it's big and complex as fuck, but a lot more certain, than a 50-50 coin flip. Of course people will have to still pay. The question is, what's the fair amount to ask from people. And it seems a progressive healthcare tax would be fair.

LensLarque 9y ago

In France when you work you have to pay a percentage of your salary for the national healthcare to cover you and your family. This national healthcare reimburse you about 60 to 80% of the bills depending on the type of treatment. The remainder is paid by a private healthcare that your employer is chosing and paying for you. The difference between the many private healthcare is usually the amount reimbursed for dental treatment and eyeglasses. If you have no work, there is an universal healthcare to cover you, but you cannot get fancy glasses or good tooth implant. The prices are regulated by deciding the amount reimbursed by the national healthcare for each medical act. The private healthcare reimbursement are based on these prices. Doctors are free to ask more money, but you are going to pay the delta. Savings are mainly achieved by having both sick and healthy people paying. Also, the fact that any medical treatment is basically free encourages you to see your doctor everytime you are beginning to be sick, preventing complications leading to a stay in hospital. Note also that many private healthcare are mutual insurance which are lowering the rates if there is a profit.