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http://www.dailykos.com/stories/2016/1/18/1471257/-My-Life-Under-Single-Payer-Healthcare
My Life Under Single-Payer Healthcare
Jan 18, 2016 3:39am EST by sbklaw2005
Bernie Sanders released his plan for single-payer health care in America. As an ex-pat/dual citizen living under a single-payer health care system myself, I thought it would be a good idea to share with the community what life is like under single-payer health care from my perspective as a man with a family, a tax-paying teacher, and a football player (dont laugh).
As you know from my previous posts, I live in Israel. (Side note: this post has nothing to do with the ongoing regional conflict, just the medical system here, which is available to all citizens). We came here 21 months ago when my wife received a post-doctoral fellowship. I gave up my career as a lawyer (and my big house in suburban Atlanta, and my SUV) to move across the world to aid my wifes career.
Heres basically the system in Israel:
- Healthcare is predominantly paid for through the government.
Everyone receives a certain, basic basket of services based on their age (children get free basic dental care, people over 90 years old get free home health aids, etc.).
- Everyone pays into the system, or has someone pay for them, based on income.
- The basic payment structure is similar to what Sen. Sanders proposes for the US. Workers pay between 3% and 9% of their salary (progressively based on income) and employers pay a similar matching percentage. We do not have to negotiate for health insurance when applying for a job.
- There are four quasi-private health care providers.
- They open clinics and have affiliate doctors and hospitals throughout the country. A doctor can work for a companys clinic, or work privately and decide whether or not to accept the customers of each of the four companies.
All four companies provide the same basic standard of care for similar prices.
- What about competition? Each company wants as many subscribers as possible. So they have to get the best doctors to provide the best care, the best equipment and offices, and availability in the most communities.
- The four companies have options for supplemental insurance above and beyond the basic basket. This includes, dental, long term care, discounted hospital stays, discounts on private (non-plan) doctors, alternative medicine, and fertility services.
- There is private insurance available, also above and beyond the basic basket.
But how does this work in real life?
What We Pay
REST AT LINK; GO READ IT
JDPriestly
(57,936 posts)This description and the comments pretty much represent my experience, but back when I was using single payer I did not use any private insurance and still had excellent, speedy care. I loved it. I think it would work well in the US.
We would probably have single payer but multiple non-profit (and possibly some limited for-profit) companies giving care. Doctors would be able to accept patients as they wish. In the countries I lived in the doctors did not seem to have a problem with dealing with the single-payer system.
Germany has had single-payer (which does not mean single provider but rather pooling of the payments from patients for insurance so that everyone is insured) since the late 19th century.
The system is not all that new or revolutionary. Our country is just backward about it.
I would suggest that people 50 and over be included in Medicare first. They could opt in or out, but their insurance would be paid as is Medicare from increased taxes on all working people and all capital gains and other sources of income. Also, insurance companies should be non-profit for the basic care. The government states what is in the basic care plan and that is what everyone is entitled to as a basic right. People can pay for more if they wish. That would be my proposal.