Question

Describe some of the key features of the multi-payer and single payer health systems in the United Kingdom and Canada. What are the similarities and differences between them? How are they different than the multipayer US system?

Describe some methods or approaches that might be taken to control rising costs and improve the quality of care?

Answer 1

A Multipayer system, by contrast, allows multiple entities (e.g., insurance companies) to collect and pay for those services.When looking to our global counterparts, the single-payer system in some rich economies (Germany, the Netherlands, and Switzerland) allows people to enroll in multiple insurance plans that are run by both private companies and non-profit organizations. Other countries, such as the United Kingdom, have government both run hospitals and employ physicians. Each system is the result of numerous iterations and a long evolution.Multiple payer refers to a health system that is financed through more than a single entity, one of which may include government. ... Whether a health care system is single or multiple payer does not in and of itself define the system in terms of coverage.Highly regulated, universal,multi-payer health insurance systems are illustrated by countrieslike Germany and France, which have universal health insurance via non-profit “sickness funds” or “social insurance funds”.Multi-payer systems may be better able to collect revenues in countries with a weak taxation system, and can limit the amount of government control over revenue collection. Health insurers pool revenues to protect indivi- duals from the financial risks associated with the use of medical services.Multiple payer refers to a health system that is financed through more than a single entity, one of which may include government. Private health insurance companies participate in multiple-payer systems, with financing through individual premiums paid directly by beneficiaries, employers, and, in some cases, government.Whether a health care system is single or multiple payer does not in and of itself define the system in terms of coverage. Universal coverage means simply that all people within a particular jurisdiction have health insurance, be it single or multiple payer. Universal coverage requires governmental mandate; however, the form of that mandate may be through either single or multiple payer or a hybrid model.Health care in the United States is currently a unique hybrid, multiple-payer system, but with elements of single payer (i.e., Medicare, although beneficiaries also contribute through premiums), publicly subsidized private payers (e.g., employer-sponsored health insurance), socialized medicine (e.g., Department of Veterans Affairs, in which government is both the payer and the employer), and self-pay (i.e., out of pocket).Political Accommodations in Multipayer Health Care Systems: Implications for the United States,” Tuohy provides additional perspectives on definitions while examining the history and current state of multiple-payer systems.

Single-payer healthcare is a type of universal healthcare in which the costs of essential healthcare for all residents are covered by a single public system (hence 'single-payer').

Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). "Single-payer" describes the mechanism by which healthcare is paid for by a single public authority, not a private authority, nor a mix of both.Several nations worldwide have single-payer health insurance programs. These programs generally provide some form of universal healthcare, which is implemented in a variety of ways. In some cases doctors are employed and hospitals are run by the government, such as in the UK or Spain.Alternatively, the government may purchase healthcare services from outside organizations, such as the approach taken in Canada.

Healthcare in Canada is delivered through a publicly funded healthcare system, which is mostly free at the point of use and has most services provided by private entities.The system was established by the provisions of the Canada Health Act of 1984.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 their physician.Canada's provincially based Medicare systems are cost-effective partly because of their administrative simplicity. In each province, every doctor handles the insurance claim against the provincial insurer. There is no need for the person who accesses healthcare to be involved in billing and reclaim. Private insurance represents a minimal part of the overall system.In general, costs are paid through funding from income taxes. A health card is issued by the Provincial Ministry of Health to each individual who enrolls for the program and everyone receives the same level of care.There is no need for a variety of plans because virtually all essential basic care is covered, including maternity and infertility problems. Depending on the province, dental and vision care may not be covered but are often insured by employers through private companies. In some provinces, private supplemental plans are available for those who desire private rooms if they are hospitalized.Cosmetic surgery and some forms of elective surgery are not considered essential care and are generally not covered. These can be paid out-of-pocket or through private insurers. Health coverage is not affected by loss or change of jobs, and there are no lifetime limits or exclusions for pre-existing conditions.Pharmaceutical medications are covered by public funds or through employment-based private insurance.Drug prices are negotiated with suppliers by the federal government to control costs. Family physicians (often known as general practitioners or GPs in Canada) are chosen by individuals. If a patient wishes to see a specialist or is counseled to see a specialist, a referral can be made by a GP.Canadians do wait for some treatments and diagnostic services. Survey data shows that the median wait time to see a special physician is a little over four weeks with 89.5% waiting less than three months. The median wait time for diagnostic services such as MRI and CAT scans is two weeks, with 86.4% waiting less than three months.The median wait time for surgery is four weeks, with 82.2% waiting less than three months.While physician income initially boomed after the implementation of a single-payer program, a reduction in physician salaries followed, which many feared would be a long-term result of government-run healthcare. However, by the beginning of the 21st century, medical professionals were again among Canada's top earners.

2) Single-payer system promotes equity, while multipayer system may be superior in efficiency enhancement.

Multipayer
system carries higher running costs, while a single-payer system may be exploited under a hostile government. No differences in quality of care were identified between the two types.
3) single-payer system of healthcare is where a single entity is responsible for collecting the funds that pay for healthcare on behalf of an entire population. A multi-payer system, by contrast, allows multiple entities (e.g., insurance companies) to collect and pay for those services.Single payer refers to a health system that is financed by a single entity; in its common usage, that single entity is government.Multiple payer refers to a health system that is financed through more than a single entity, one of which may include government.

3) U.S. healthcare could save more than $600 billion in administrative costs by adopting a single-payer system like neighboring Canada, a new study suggests.
The U.S.’s current multi-payer system cost the country $812 billion in administrative costs in 2017—four times more than Canada, which has a single-payer system—mostly due to the increasing overhead of private insurers, according to a study in the Annals of Internal Medicine.The study concluded that cutting U.S. administrative costs to Canadian levels by adopting single-payer health financing would have saved more than $600 billion.The study could provide ammunition to proponents who are advocating for a change to a single-payer system, such as so-called "Medicare For All," which is being touted by some Democratic presidential candidates, including senators Elizabeth Warren of Massachusetts and Bernie Sanders of Vermont.The idea is controversial, and some candidates have now backed away from Medicare for All and are advocating for a public option plan that keeps the current system of private insurers and makes Medicare available to those who want it.But one of the study researchers said that option won’t cut costs the way a single-payer system would.“The U.S. can afford a Medicare-for-All program that would cover everyone and eliminate copayments and deductibles, but only if we transfer the $600 billion now wasted on excess administration to clinical care,” said study author Steffie Woolhandler, M.D., a practicing primary care doctor, a professor at City University of New York at Hunter College and a lecturer at Harvard Medical School, in an email to FierceHealthcare.

1. Save Money on Medicines.
2. Use Your Benefits.
3. Plan Ahead for Urgent and Emergency Care.
4. Ask About Outpatient Facilities.
5. Choose In-Network Health Care Providers.
6. Take Care of Your Health.
7. Choose a Health Plan That is Right for You.
8. Use a Health Care Savings Account (HSA) or Flexible Spending Account (FSA)
five steps primary careproviders can take right now to improve quality healthcare for their patients:
1. Collect Data and Analyze Patient Outcomes.
2. Set Goals and Commit to Ongoing Evaluation.
3. Improve Access to Care.
4. Focus on Patient Engagement.
5. Connect and Collaborate With Other Organizations.