Single Payer in the US

¶ … controversial concepts is the proposed solution to the healthcare system in the U.S. is the movement towards a single payer system similar, to the systems found in virtually every other advanced nation in the world. The Affordable Care Act was argued to be significant step towards a single payer system, and although the system is technically far short of what could be considered a single payer healthcare system, even the mere expansion of healthcare access in the U.S. has been controversial, polarizing, and has had significant opposition.

Those in favor of single payer, have typically pointed to successes in other countries relative to cost efficiencies and health outcomes. In fact, the United States is the only country in the Organization for Economic Cooperation and Development (OECD) that relies heavily on out-of-pocket expenses (OOPs) and private health insurance to fund its healthcare system (Sumalinog, Abraham, & Yu, 2015).

This analysis will focus on one of the pioneering efforts to implement such a system in the United States and the potential for such a system to be implemented in the future. Implementation Matters McDonough (2015) investigated the Vermont single payer system attempt and the evidence indicated that public support for the system is not strong, with just forty percent support of the public in favor of this model. Furthermore, there have also been issues with the implementation of the system that include funding formulas.

Based on such evidence, the argument is made that push for single payer in Massachusetts maybe unfeasible to implement. Other research corroborates these findings and argue that as Vermont demonstrates, to design and adopt a single-payer reform that can withstand the legislative process is possible, but the odds of successfully implementing such a system in other states may be even lower than in Vermont (Fox & Blanchet, 2015) However, these arguments are founded on evidence from one specific attempt from a single U.S. state.

However, numerous examples of successful implementations are available from outside U.S. borders. For example, Canadian provinces have been able to administer a single payer for decades. Candia first implemented a single payer system in the 1960s, many Canadian provinces have a similar population demographics as Vermont. However, one of the fundamental differences is that Canadian hospitals are run by government agencies, usually regional health authorities, and only doctors are private, and they are still subject to standards outlined in the single payer system (Robinson, 2015).

What McDonough proposes is a slightly different in terms of how it perceives the debate. The argument is not based on the ethical qualities of a single payer, but rather about the implementation of it. There are several persuasive opinions that a single payer healthcare system is a simple matter of right and wrong --founded on the merits of policy makers to support the public health of society.

Furthermore, public spending on health care is theoretically different on the basis of desired outcomes, due to the fact that public health, considered as a public good, is categorically different from the pursuit of both health and profit (Musgrove, 1999). However, McDonough does not base the argument of ethics, and considers a single payer system on pragmatism and the feasibility of implementation on in the socio-economic dynamic.

From this perspective, it is necessary to consider additional factors, beyond whatever your personal opinion might be regarding the moral imperative of single payer system in contrast to the benefits of the profit motive as the driving force in a healthcare system. Solutions The challenges that Vermont faced in its attempts to implement a single payer healthcare can serve as a model for other American states who are contemplating a single payer system to address their citizens' health care needs.

While it may be tempting to use Canada or Europe for examples of successful implementations and outcomes, however these systems exist in an entirely different culture and socio-economic environment. In the United States, results have also been interpreted as support for private insurance and as an indication that Americans would never accept a single payer system (Chaufan, 2016). The U.S. has a greater appreciation for individualism than these countries, and the other countries that have successfully implemented them were able to build support at the national level.

In the U.S., the existing healthcare framework, is not readily compatible with a single payer system and thus a major transformation will be needed not only in support, but also in the healthcare infrastructure as well. For example, in Canada, less developed providences receive federal subsidies for their healthcare system, that effectively subsidize that regional systems with revenues from wealthier parts of the country, a system that will lack support in the United States.

Therefore, it will be required for state to fund the system internally, which is a major obstacle and the largest issues in Vermont's attempt to convert to a single.