Acton Institute Powerblog

Americans Like Single-Payer Health Care — Until They Find Out What it Is

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single-payerA plurality of Americans support “Medicare for All”, legislation endorsed by Bernie Sanders and other Democrats that would establish a universal single-payer health care system in the U.S. At least they do until they find out what “single-payer” really means.

A recent AP poll found that 39 percent support and 33 oppose replacing the current private health insurance system in the U.S. with a single government-run and taxpayer-funded plan like Medicare for all Americans that would cover medical, dental, vision, and long-term care services. (Another 26 percent neither support nor oppose the change.)

But the same percentage (39 percent) opposed single-payer when it was found that it would cause their own taxes to increase or they’d need to give up other coverage, like health insurance provided by their employers. In both cases, about 4 out of 10 flipped to opposition when they discovered that caveat.

Even higher numbers opposed the plan if it would lead to longer wait-times for non-emergency medical services (47 percent) or if it took longer for new drugs and treatments to become available (51 percent).

“People say they believe in a principle, but when you describe the policy, it often loses support because they don’t like that there are side effects,” said Robert Blendon, a professor who tracks public opinion on health care at the Harvard T.H. Chan School of Public Health.

So what exactly would an American version of single-payer plan look like?

A single-payer system is one in which health-care providers are paid for their services by the government rather than by private insurers. Every year since 2003, Democrats in Congress have introduced H.R.676, the Expanded & Improved Medicare For All Act. The key provisions are that it would prohibit private health insurers from selling health insurance coverage that duplicates the benefits provided under the legislation and that it would raise taxes, including payroll taxes, to pay for the extended coverage.

Not surprisingly, the legislation is vague on how much taxes would be raised, saying only that the increase in payroll taxes would be “modest.” But according to the National Institute for Health Care Reform, a national single-payer system would require a payroll tax of 11.7 percent. That means a family earning $50,000 a year would have to pay $5,850 in taxes for health care.

And even that would not be enough to cover all the costs of health care. Even after all the new taxes proposed in Bernie Sanders plan (about $675 billion), the government would still fall $599 billion short of what the country actually spent on health care in 2013.

It’s hardly surprising, then, that when Americans discover the side effects of the single-payer system — higher taxes, fewer choices, longer wait times for treatment — they start to feel a bit queasy.

Joe Carter Joe Carter is a Senior Editor at the Acton Institute. Joe also serves as an editor at the The Gospel Coalition, a communications specialist for the Ethics and Religious Liberty Commission of the Southern Baptist Convention, and as an adjunct professor of journalism at Patrick Henry College. He is the editor of the NIV Lifehacks Bible and co-author of How to Argue like Jesus: Learning Persuasion from History's Greatest Communicator (Crossway).


  • Mark Goodbar

    Just a quick bit of math…. the suggested quote of increased taxes of $5850 a year for a family making $50,000 breaks down to $487.50 a month. That’s about a hundred dollars LESS than what my family has to pay under obamacare. It’s also cheaper than what a good insurance plan would have cost for my family before obamacare. And with obamacare, we still have a ridiculous premium to meet (about $6000) per person before benefits even kick in. Even before Obamacare we still had about a $1000 deductible.

    So by any measure now or in the past, this article is sounding to me like Single payer would actually be cheaper for the American citezen, and no deductibles, by the way. There are a number of things I would go to the doctor for if I didn’t have that deductible. So basically what you’re telling me is, if I were under a single payer system, I could walk right in to a doctor today and I don’t have to worry about it because my tax dollars have already paid for it? I gotta tell you, that sounds pretty good.

    HOWEVER, the question still remains about the level and quality of care received, and the length of time to wait for care, and those are some big ifs. I don’t know the answer to that question. I know if it was run like Bernie Sanders’ VA hospitals, then we’re all as good as dead. That fiasco was and is a disgrace to our vets.

    Secondly, what happens to the quality of our healthcare when the government decides they want to save some money by declining coverage for certain healthcare services? I used to work in a pharmacy and I would see this all the time. By all the time I mean almost daily. I don’t know how many times I heard, “But my medicare/medicaid USED to pay for that drug! Why did they change it?” We all know the reason… money.

    The government decides you don’t really need this particular medicine. Your doctor thinks otherwise and there may not be another drug comparable, but they’re still not going to pay for it. So the cost of single payer, by the numbers suggested in this article, sound really good. But do I trust my government to pay for the treatment that my doctor says I need? I’m not ready to say yes to that.

  • Jonathan Arthur

    Single payer is very good for The People and very bad, lethal really, to the health insurance industry. That is why we don’t have single payer – the insurance companies and 1% sycophants who equate corporate piracy with “individual liberty and sustained religious principles (sic)”. These are the expected and professional lies and unsupported claims one would expect from such odious, sociopathic and desperate industries as health insurance and pharmaceutical industry and all the little service industries built up to soak people being who are sick and needing care at their lowest point. What would Jesus do? Probably not be on the side of the piggy and insatiable goons at the insurance companies who value their commissions over human dignity or human life. Every study done (REPUTABLE study) shows the US spends way more for our dysfunctional system, even in the execrable Obamacare, which was a hoodoo, a ruse which, although better than no government intervention, offers way less care and more red tape and ridiculous health costs than in countries with single-payer systems. Like Christopher Hitchens always said, “What can be asserted without proof can be dismissed without proof.” Your assertions can be dismissed easily, but I’m sure you’ll ignore the evidence in favor of a faith-based approach to reality – meaning make whatever nonsense up for the weak-minded and hope enough of them believe you so as to to justify your conniving corporate and elitist bloviation. Power to The People!