Single-Payer Primer for the Press


Proposal of the Physicians’ Working Group for Single-Payer National Health Insurance
The Physicians’ Proposal for National Health Insurance establishes the vision and principles of a single-payer health system for the United States. The document was composed by a distinguished group of physician leaders, and secured the endorsement of 8,000 physicians by the time of its publication in the August 13, 2003 JAMA.

The text outlines the general structure of the single-payer plan: eligibility and coverage, physician and outpatient care payment, global budgeting of hospitals, the establishment of a national long-term care program, planned capital investment and single-payer financing.

Statement of Dr. Marcia Angell introducing the U.S. National Health Insurance Act
The U.S. National Health Insurance Act (also known as the Expanded and Improved Medicare for All Act), HR 676, was introduced on February 4, 2003. The following is the statement made at the introduction ceremony by Physicians’ Working Group member and former NEJM editor Dr. Marcia Angell.

Administrative Waste Consumes 31 Percent of Health Spending
PNHP Co-founders Drs. Steffie Woolhandler and David Himmelstein published this definitive study of the administrative costs of the U.S. health system in the August 21, 2003 edition of the New England Journal of Medicine. After analyzing the costs of insurers, employers, doctors, hospitals, nursing homes and home-care agencies in both the U.S. and Canada, they found that administration consumes 31.0 percent of U.S. health spending, double the proportion of Canada (16.7 percent). Average overhead among private U.S. insurers was 11.7 percent, compared with 1.3 percent for Canada’s single-payer system and 3.6 percent for Medicare. Streamlined to Canadian levels, enough administrative waste could be saved to provide compressive health insurance to all Americans.

How Much Would a Single-Payer System Cost?
The financial viability of a single-payer system has been analyzed time and again by researchers both from the U.S. government and independent consulting firms. Each time the conclusion is the same: single-payer saves enough on wasteful paperwork to provide high quality health coverage to all and contain future health spending. This paper catalogs the analyses of proposed single-payer systems at both the federal and state levels.

Illness And Injury As Contributors To Bankruptcy
In 2001, 1.458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited medical causes, which indicates that 1.9-2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs averaged $11,854 since the start of illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick.

The New Massachusetts Health Reform: Half a Step Forward and Three Steps Back
Massachusetts runs in regular cycles. Every eighty-six years our Red Sox win the World Series. Once a decade Harvard hires a senior woman scientist. And every twenty years our legislature passes a universal health care bill that the governor hopes to use as a springboard to the White House.