by Michelle Graf

Created on: August 19, 2009   Last Updated: August 24, 2009

Single payer health systems are, to some degree or another, quickly becoming the norm in industrialized nations. For good reason, as the benefits tend to outweight the negatives, depending on how they are administered.

Costs - The big issue:

PRO- In single payer health systems where the single payer is government regulated and non-profit, costs are significantly less than in full private open systems. The universal government controlled health system in Canada, for example, costs Canadian taxpayers less than half what Americans pay, both out of pocket and through taxes, to fund the private and Medicare/Medicaid systems in place. Monopolies provide purchasing power, and when under a mandate to transfer those savings generated to the users/taxpayers, premiums and/or taxes are kept lower.

CON- The purchasing power that controls costs means somebody loses out - in this case, medical professionals, biotech manufacturers and pharmaceutical companies earn less as they do not have the same bargaining power to set rates as they do in an unregulated, multi-payer system. This will discourage people from entering the medical profession, and dampen medical innovation due to limited up-front research and development funds. Companies gamble on new drugs and treatments, investing their money, as the potential for profitting from a breakthrough justifies the risk of losing their investment. Less profit means less willingness to take a risk.

PRO - In single payer health systems, virtually all citizens are provided with at least basic coverage to meet their necessary medical expenses. While in the U.S., bankruptcies due to medical expenses are on the rise - in countries with some form of public health system, personal bankruptcies due to medical expenses are much less frequent. Bankrutpcy not only takes a toll on the individual, but also exacts a heavy cost from other consumers who will wind up paying for the bankrupt liabilities either through increased consumer costs or tax dollars. The more bankruptcies, the tighter credit markets become, the end result we are only seeing too clearly in the economic conditions now.

CON- The freedom of the individual to choose what type of coverage, or even whether to have it is taken away. In a taxpayer funded system, they will be obligated to pay for services they may not use or need. Individuals who do not take care of their health and indulge in risky, dangerous, or detrimental behaviours pass their ultimate care burden onto others who do take care of themselves, which is not fair and gives no incentive for people to be responsible and conscientious about their own health.

PRO- Individuals with chronic conditions will be able to obtain the ongoing treatment they require without fear of losing their coverage or financial ruin. If health care is affordable, people will be much more likely to participate in inexpensive, ongoing and early treatment of chronic conditions, thus reducing the need for much more expensive care when complications arise, needless suffering or even death.

CON- Individuals may overuse the system, running up costs for everyone.

PRO- Single payer health care systems have been absolutely proven to cost less overall and provide better results than for profit multi insurance systems.

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