Over the last few days I have been told by others that I don’t understand the differences between Universal Health Care and Single Payer Health Care…. and frankly, I think it is others who really, REALLY do not get it… An American by birth, I worked for 16+ years in the US Healthcare Industry, and have lived for 10+ years under the Canadian Health Care system…
First, some definitions:
socialized medicine is the provision of medical and hospital care for all by means of public funds.
Universal health care, sometimes referred to as universal health coverage, universal coverage, or universal care, refers to a health care system which provides health care and financial protection to all citizens of a particular country.
Is there any real difference there?
Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of healthcare, a single-payer system would be setup such that one entity—a government run organization—would collect all healthcare fees, and pay out all healthcare costs.
Here in Canada we have a Single-payer system. It is not perfect, but it is better than I have ever had in my life...It is free at the point of use and has most services provided by private entities. Meaning the hospitals and clinics are not owned by the government, but the government assures the quality of care through federal standards. The government does not participate in day-to-day care or collect any information about an individual's health, which remains confidential between a person and his or her physician. Canada's provincially based Medicare systems are cost-effective partly because they are pretty simple to run. In each province each doctor handles the insurance claim against the provincial insurer. You, as the patient, never sees a bill from your doctor or hospital.
Private (or supplemental) health insurance is available, either through an employer, or out of pocket...and accounts for about 30% of health care financing. The Canada Health Act does not cover prescription drugs, home care or long-term care, prescription glasses or dental care, which means most Canadians pay out-of-pocket for these services or rely on private insurance. Provinces provide partial coverage for some of these items for vulnerable populations (children, those living in poverty and seniors). Limited coverage is provided for mental health care.
I wrote about this when my husband had a major stroke … Here is an example. He was in the hospital from September to just before Christmas. He had two operations on his brain….He had three doctors. A Surgeon, a Neurologist, and his GP. He was in the ICU (in a coma) for a few weeks, then in step down and finally released once our home was ready to meet his needs. His wheel chair was special and cost upwards of $5.000. The Province paid 75% of that. His employer's health insurance paid the other 25%. He had two years of out patient therapies… occupational, speech and physical.
He had in home health services for many years, three times per week an aide came and helped with showers and physical therapy. And gave ME a break to go out and run errands… There were a lot more services and treatments that I could list, but I think this brief account give you a good idea…
What did all of this cost? $0. It was already paid for through the taxes he had paid all of his working life. We did pay for the ambulance ride when he was first taken in to the hospital after his stroke…. $45.00. It is a private company, and provides services to the whole city. We did pay for his medications once he came home… he was on several pills and we had a co-pay through his employer’s insurance… I think the most expensive was about $15.00 out of our pocket. Some were covered entirely.
My husband passed on three years ago this coming February… the week before he died, I slipped on the ice and fell and broke my right hand. The week after he passed, I had surgery to that hand to place pins. I had the best hand surgeon in the city, weekly follow-ups with her. There was a molded brace made for my hand and physical therapy once the pins came out. The biggest difficulty I had was I couldn’t drive for 6 weeks… I have a standard shift and couldn’t use the stick shift…
The cost to me for all of this… $0.
I have been treated for cellulitis twice... once on an out-patient basis (IV antibiotics every evening in the ER for 5 days) and once in hospital for three days. The cost? $0
Single payer gives us the basic needed care. If you WANT some supplemental private insurance, to cover things not covered, such as glasses or medications, you CAN get it...either through your employer, or out of your own pocket...but here’s the thing...even if you DO NOT HAVE private insurance, you are NOT going to die or become crippled because you cannot afford to go to the doctor...or the hospital…Nor will you lose your house or go bankrupt trying to pay for astronomical medical bills.
So….it is really pretty simple… Universal Health Care = Socialized Medicine… and it covers EVERYONE EQUALLY…
Single Payer is simply how it is paid for… And it is pretty awesome….