How single-payer health care works, in 2 minutes


People have really strong opinions on single-payer
healthcare. It could be the silver bullet that fixes our healthcare system, or it could
be…. But most people don’t even know what single-payer means. So let’s start with what we have. You can think of the American healthcare system as a series of tubes. We do not have
single-payer healthcare. We have thousands and thousands of payer healthcare. And each
of them typically pay different amounts for the exact same medical service. And that’s
a lot of administrative work. For every three doctors in the United States, you have two
billing staff standing behind them just handling all that paperwork that comes in and out of
a doctors’ office. If you think of a single-payer system, it is just one tube of payments. All
money flows from the government to the doctors. And it’s actually pretty popular elsewhere.
Medicare here in the U.S. is like that — it pays all the healthcare bills for people over
65. But there’s also a catch. When the government is the one paying all the bills, they get
to decide what they will and will not pay for. If the system isn’t funded well enough, if
they haven’t raised enough taxes from their citizens, that could lead to longer wait times
and fewer doctors being available. Vermont right now is trying to set up the very first
single-payer system in the United States. By one estimate, Vermont could save 25 percent.
But it’s also expensive. The state government in Vermont needs to raise $2 billion. That
is a lot of maple syrup. But people really dislike the American healthcare system. It
gets pretty poor marks from Americans. And if you look at neighboring Massachusetts,
their healthcare experiment in 2006 did lead to Obamacare. So if this does work in Vermont,
who knows what could be next.

100 Replies to “How single-payer health care works, in 2 minutes”

  1. For those that would argue that single-payer is the ultimate solution and that under nearly any circumstance would any poor or lower class American be kept healthy and well I say this: In the UK with a single-payer healthcare in which the government ownes the market and everyone pays into everyone's healthcare through a moneypit you cannot buy your own insurance, let that sink it, there is a drug for people who are very old that helps make them not go blind, now imagine that you are 90 years old and you could buy the treatment, but since the government owns the market essencially, bureaucrats will decide when you need the treatment, not you! So you have the money to buy the treatment but since everything is being redistributed you can't get the healthcare until you've already gone blind in one eye! Yeah sucks doesn't it.

  2. STOP BEING SO PATHOLOGICALLY SCARED OF ORGANISED SOCIETY (a.k.a. the State)!!!

    Elsewhere in the world we pay realistic, progressive taxes, get good free schools, universities, hospitals, roads, public transport and nobody is enslaved of anything. The US has in fact been becoming steadily poorer since Reagan. Before that when "America was great" the US HAD HIGHER TAXES THAN EUROPE.

    (Don't believe me one word, check it up yourself!)

  3. this video was a complete waste and juvenile at best. Was this for 4th graders? Also, Vermont realized the cost and came to their senses. This country was built on competition, yet there is little among insurance companies. Compete across state lines and THEN let's do something more radical. Obamacare is a disaster right now as well. Roll back to 2008, allow insurance companies to compete across state lines and let's see where we are at in 3 years. IT can be no worse than where we are with Obamacare right now.

  4. Yes, it will take a lot of maple syrup to pay for Vermont's system.And no, medicare does not pay all of the medical bills for people over 65.They have to purchase insurance to fill in the gaps not covered by medicare.

  5. Here in the UK, consultants from Kaiser Permanente were used to improve the NHS.. Free market + gov health care is a wise choice so long as the health care market can remain profitable, also promoting innovation+incentive, and evolve into a better service. So, as long as a single payer system and a capitalist market can work together, the health care market will thrive.

  6. People from Canada that gets diagnosed with cancer is put in the back of the line. Most end up dying after they were diagnosed before they can even see a doctor. Politicians and the rich still get top priority health care. Like Martin Short said he loves Canadian health care. When his wife came down sick and because as rich as they are she was moved ahead of everyone . That is your single paid health care. The poor that lives in countries complain about single pay health care. Their family members has died because of being shoved to the back of the line because of their poverty level. So before spouting off lies why not take time and go seek the truth,

  7. I don't trust the US Gov't !!!!!!!!!!! I only trust the wealthy and the American businessman to fix things for us !!!!!

  8. #1 dont use a valley girl from cali to narrate your video, its really hard to take it seriously. #2 in no way, whatsoever, did she explain to me what single players is. #3 Canada is now moving towards an American style healthcare system as the current Canadian systems creator admits that it was a giant mistake.

  9. Doctors are already doing a free market solution to the healthcare dilemma as we speak. They're going to direct pay and tossing insurance companies aside. The problem is that insurance companies are outdated and do not provide any useful services any longer. Doctors can charge patients a lot less if they just go in and are charged like anything else.

    Single payer is not the answer, because it is a single healthcare policy that does not represent the values of all people under it, nor could it possibly do so. People who hate visiting doctors will be paying too much, healthy people will pay too much, and the elderly are always left out, receiving too few services and face discrimination.

  10. The biggest reason we don't already have it is health insurance is a huge industry with a powerful lobby. Single payer would basically eliminate that entire economic sector.

  11. What's with the valley girl voice-over? What Conservative is going to listen to that!? Canadian satisfaction of 38% is pretty low until viewer sees US is lower – would've included US from the beginning…

  12. Still keeping the narrative i guess huh, "IT WILL BE COSTLY" . Here is the truth if there is a time when gvt can't collect necessary cut for medicare from tax that means economy in Americans has gone down. Because here is something which all you A-hole refuse to mention. When you bring medicare for all / just medicare through single payer, you eliminate premium you pay for private insurance. Which(for your dumb down followers) is relative higher than what gvt would take from your income if you belong to middle or below in economic status.

    so at the end of day VOX gets it wrong even when they are on the right side(which is surprising and i hope they are on right side). Cunning as ever.

  13. I am originally from country which have Government run healthcare. It's Nepal. To get just a Doctor's appointment, we have to wait at least 3 to 4 months. And often doctor refers patient to go to private clinic for fast service. And I have friends in Canada experiencing a same problem.
    So to be short Government involving in healthcare never works. Let insurance be available through free market economy.

  14. 38% of Canadians are satisfied with their health care? What poll was that?In 2016 the Globe and Mail reported: "A majority of people surveyed in every region of the country said they would agree to tax hikes in exchange for more services being placed under the rubric of publicly funded care. That ranged from a high of 70 per cent in favour in British Columbia to a low of 53.6 per cent in favour on the Prairies."So the "major changes" that Canadians want is more taxes for more health services. So they have and want even more socialized medicine.

  15. How many of the people on this comment section understand that Single-Payer means that taxes will need to be tripled or quadrupled in order to pay for it? Think about this in your ivory-tower thought-process: Medicare not only gets 2.9% of every dollar EARNED in this country, but it also CHARGES the recipient a monthly premium of over $115. Now, if we go to single-payer, just how much will that Medicare portion of your FICA Tax be? And how much will that government premium be? Use your minds and recognize that "single-payer" does NOT mean free, it simply means that the government will be paying WITH YOUR TAX DOLLARS!

  16. The problem with the American healthcare system is that it is no longer a free-market. You can blame big government and lobbying for that. No competition is a bad thing, and it’s the same with the UKs NHS. Mediocre healthcare for £150 tax a month. You can not trust the government to provide good service at anything, because their money isn’t theirs, so they just spend at will! At least if you have private companies competition against each other, they’ll invest their own money to get the upper hand over the other.

  17. To be fair, the UK and Canadian systems are not directly comparable. In the UK almost all hospitals are publicly-run (even if the buildings if not exactly publicly-owned, but that's another story), while I don't think this is so in Canada.

  18. https://www.youtube.com/watch?v=VCU1JQzvoyM It didn't work with the VA, so why would it work with a MUCH LARGER population in the US? U should watch this video for the explanation.

  19. 38% satisfaction in Canada is fairly low, and 44% is just around half the country in Sweden. The U.S. healthcare system being unpopular doesn’t mean other systems are “pretty popular,” it makes them slightly less unpopular. Clearly no system is perfect, and there’s always going to be trade offs.

  20. Talk about how universal health care is about the government taking my money away from me for something that I won’t ever need. You kind of left that out

  21. Or we could just let Health Insurance Companies compete with eachother. Which would dramtically driving down prices to the point where it wouldn't be free but everyone could afford it.

  22. See the difference between Vermont and the rest of the country is; Vermont has a population of less than 2 million, America has a population of 321,000,000. Not only that, we’re Americans not dirty commies

  23. My main issue with universal healthcare is technological advancement in healthcare. I know that might sound bad, but hear me out. America is leading the world in cancer research (and many new medications are made in the US). Why is that? Is there something about having many different companies provide care to their customers that forces the to constantly improve (provided there are no monopolies)?

    How many people would you save in the long term using less efficient technologies longer than you have too? Does a system that makes faster advancements in healthcare save more people overall in the long run? Technological advancements raise the standard of healthcare for everyone as well. More efficient, affordable treatment = more lives saved, in my opinion.

    Would the pharmaceutical disappear completely in a more “socialist” model of healthcare? Or would it take on a different role? Would competition to make the highest quality medication, product, etc still exist? Or would the government healthcare system be the only ones making advancements?

    With my limited knowledge on the issue, I think progress would be stunted in the more “socialist” forms of healthcare, so maybe a hybrid system similar to France might be better.

  24. The escalating price of health insurance is a result of government.

    1.Governmental programs like medicaid and medicare caused extreme inflation in the health market. This is due to the government providing coverage to some people through the tax dollars of everyone. This may sound like a good idea on the surface but the adverse effect of this is that more people go to the hospital than otherwise would be able to, once more people flood hospitals than the demand on them goes up and the prices will follow to accommodate the increased inflow.

    2. Another aspect that effects prices is the state provided protection preventing health insurance companies from selling insurance across state lines. Insurance companies lobby their state representatives to prevent out of state insurers to come in and increase competition. This fundamentally disrupts the law of supply and demand, creating artificially higher prices for consumers.

    3. Due patents, another government program, medical companies are able to create medications and then patent them, effectively preventing anyone else from using this drug without first paying the company, aka a monopoly. This creates an environment where these companies can charge exorbitantly high prices for their drug, this is then covered by health insurers and the inflated price is passed onto customers.

    What people don't understand is that problems are much bigger and their roots go much deeper than most are willing to look into and because of this people come to quick fix conclusions. Of which, usually involves turning to the government. Universal healthcare does not address any of these aforementioned issues, it would only exacerbates them. This crony capitalist, quasi free market system only breadths corruption, where a few win and the majority of us lose.

  25. This was no explanation, it was an advertisement for Bernie and Jane. I receive medical care at the VA, the Doctors are there because they can't get a job anywhere else. The quality of care is like a veterinary slaughter house governed by politics, for every good medical staff member there is one who is lazy, incompetent and often prejudiced by race or religion. Better health care could be achieved by real controls over the Insurance Industries, Pharmaceutical Corporations, Hospital Corporations and all the other industries in health care.

    Hillary Clinton tried to start better health care in 1991, the Republicans and Bernie Sanders voted against the real start of the Affordable Care Act, since the beginning of the Democratic Medical Program how many times has the Republicans attacked to destroy a beginning of good Health Care policy that definitely needs upgrading?

  26. Today's snowflakes get awards just for participating, but not me. If I hear vocal fry I will like literally kill myself.

  27. Can you wonderful people here with Vox cover Bernie Sanders' single-payer bill? Fact Checker called him out for sourcing misleading information but no one is unbiasedly reviewing his healthcare bill. Much appreciated.

  28. This was deceptive. It says single payer will save 25% and then they say it's expensive. If it saves money, that means it is less expensive. So, if an expensive car costs $100,000. A 25% saving would reduce that price to $75,000, which is expensive, but is still $25,000 less. Why would we want to pay an extra 25%?

  29. Follow the money to find out who is responsible for ridiculous health care costs in the usa. Money is never spent and gone, it is simply transferred to another party. Most entities in the health care industry are taking advantage of their necessity with help from the government mandates. The only way to restore fair health care costs is to get the government completely out of the mix and return the system to the free market.

  30. So basically they have the right and I had the Responsibility. I don't believe that someone's mere existence should create a debt for someone else.

  31. I just don't understand why people are hating on the single payer healthcare system. This is NOT an issue of politics, people's lives are literally on the line here. Some say it's going to cost too much and would end up raising the unemployment rate for private workers, but it's just not true. We, the US, have the most expensive healthcare compared to all of the major countries, while also being the least efficient to provide people with health care. 26-28 million Americans are not insured with a healthcare across this country, and it's just unbelievable compared to our neighbor Canada.

  32. Guess what? Good news! The United States government is monetarily sovereign and thus can never run out of the currency it issues. The government “pays for” anything that Congress appropriates by crediting accounts digitally. That’s how trillions go to wars, and why they really are not concerned about billionaire tax cuts. It’s just keyboard strokes and digits.

    It’s not run like a household, state or local budget …. we cannot make currency! The feds can. Since Nixon.

  33. Canada is having trouble paying for their system so there will need to be changes to fund it. Best to make changes than to risk trouble.

  34. I do not read VOX because they it tends to be biased and ill informed, they make Fox News look GREAT because at least FOX makes an attempt to show the other side. This thing was worthless as well. I want to know how much a single payer system will cost me, I mean Obamacare was outrageously expensive and I declined to get it because of the price… BUT, no where do the proponents of SP tell you how much it will cost you…

  35. what about the quality adjusted life years?? we all know if you are in congress you get A+++ healthcare under this scenario while us common folk fall into the quality adjusted life years formula until its too much money to keep grandma around.

  36. Trust the government. Just look at the amazing customer service they provide at the Post Office, the DMV, the TSA, or the IRS. SandersCare is nationalized “I Just Needs T’ Checks Inside Ya Aaayssshole!!”
    https://youtu.be/mZCEq8jy5-M

  37. I know next to nothing about the system… but peripherally… it seems that under single payer the consumer base expands exponentially. Most people who don’t seek care likely don’t bcus they either can’t afford insurance or their premiums and deductibles are too high.

    Taxing the public seems to be the obvious answer. Break the rates into categories: richest folks pay the most into the system. Folks w/ larger families must also contribute more to balance out their kids or retired elders.

    Tax the hell out of corporations & wallstreet.

    And getting rid of all the greedy middle men – lobbyists, insurers, hospitals – will alleviate much of the burden.

  38. I believe the US health care system needs overhauled. My experience and others can testify that their is a fundamental lack of honesty in billing patients and insurance companies. For example, I was told by the hospital that my out-patient hernia operation would cost $3k if I paid up front (not counting doctor and anesthesia). I paid it. Three days after the operation, they sent me a bill for $10k. After I threatened legal action, they withdrew the charges. This happened twice, a different hospital the second time. That amount totaled over $40k for a simple, out-patient routine operation. The system is beyond broken, it's extortion at its finest. Mob territory. Criminal, felonious.

  39. Why can’t some Americans just accept that their healthcare system is very much broken and learn from other countries? Australia has an objectively better system, and the health spending is only 8% of our GDP, rather than the 16% of the US.

    It’s time to abandon the idea that privatisation is always better. It simply is not true.

  40. This is both a thinly-veiled vote for single-payer healthcare by Vox, and also a display of their ignorance. A small part of me hopes we move to a single -payer system just for one presidential term (Ocasio-Cortez?) so people can realize what a failure it (and she) would create. I also enjoyed the nod to Obamacare as if it has benefited us rather than set us back by injecting socialism into our healthcare system – lowering the average number of insurance providers by state from three to one, setting the world's largest insurers on a path to bankruptcy, fining citizens for NOT having care, ballooning costs, and enabling rampant Medicare fraud in the amount of tens of billions of dollars. It's not intellectually challenging to understand that fundamentally, when given something, human beings become dependent on continuing to be given it. Like every other animal in the animal kingdom, we take the path of least resistance and energy expenditure when working towards a goal. In a single payer system, where the government "controls" costs (like they control their finances?), healthcare abuse will continue and taxes will need to rise to cover it, and the quality of care will continue to be garbage. Unless we change. We need to convert healthcare to a truly free market industry LIKE EVERY OTHER INDUSTRY IN OUR ECONOMY that has given us cars, iPhones, and everything else under the sun that is kickass and that we and the rest of the world enjoy today. Wakey wakey, eggs and bake-y.

  41. being satisfied with the system u have is irrelevant and dumb, people are like free things that are less quality than better quality costly things….soo when u ask an american if they like to pay money for their healthcare ofc they'll say no… the real question should be is the healthcare the person is getting is rly working and is the quality on par with other countries

  42. Government health care is affordable, but are extremely long wait times, poor quality, and longer delay before surgery worth the price? Private run hospitals are better because more can open independently, meaning more competition and lower prices, quality will also be competed for so A BIG FAT NO FOR GOVERNMENT RUN HEALTHCARE

  43. 2-6hr wait times here in canada. Not enough docs and nurses. High taxes. Prescriptions very expensive. Months of wait times for allergy test, cat scan, etc. Personally experienced these issues. Welcome to one payer health program

  44. Ps when the rich people leave or are broke they’ll shut down their businesses and you’ll lose your jobs and you won’t have any healthcare. Doctors are in the 70% catagory you think they’ll stick around?

  45. Just Ask Google for knowing how universal healthcare works
    in the world… and know how many Universal healthcare nations (UHN) on this
    Earth right now – American people who are human deserve a better Universal
    healthcare system like those nations (UHN)

  46. In america you have an example of single payer and its called the VA (Veterans Affairs) and how is that working for you?

  47. Global News: Woman dies after 11-hour wait to see a doctor in New Brunswick emergency room.
    https://globalnews.ca/news/5082756/woman-dies-new-brunswick-emergency-room/

  48. thumb down for raspy voice kim kardashian Californian valley girl voice that is annoying to listen to

  49. There is no one who would not like to see medical insurance coverage available to everyone.
    The problem is though, when you have 1 entity (such as the government) in control of funding and managing/distributing any service for an entire society, you are setting up a scenario which can become both corrupt and defunct very quickly.
    This is exactly why we have laws against business monopolies. And having money taken from you via taxation, instead of being in a position where you get to Choose whether or not you will or will not buy a product from a certain company, makes it even more likely to become corrupt and dysfunctional at a faster rate. So I just don't know about this.
    People are in debt now for much of their lives to pay off federal student loans. If you add to that the eventual cost of increasing annual taxation which will eventually be necessary to cover national medical insurance for all, I think you are going to be creating a nation made up largely of citizens who are eternal indentured servants, as every year taxes will increase to pay for universal costs of government-mandated goods / services. I think we might be jumping from the frying pan into the fire financially as a collective society if we do this… but I could be wrong.

  50. Single payer is ultimately hateful because it denies everyone their basic human right to healthcare free of government taint. Some things are just too important to trust to something as poisonous and corrupt as the public sector.

  51. Have you noticed the potholes in the streets; the cracks and bridges that are failing; the crumbling infrastructure? The same people responsible for our infrastructure will be running YOUR healthcare. I have govt. healthcare; I am dropping it for private insurance. The services are reduced for lack of reimbursement and it leaves your health in a declining position. When the government can take care of their current responsibilities, then we can talk.

  52. Pretty clear explanation thanks and thanks for covering potential issues with this system as well.

    Trying to learn more about it, especially how much money this would cost to implement in the US

  53. The Medicare For all bill that Bernie is pushing for is even better than Canada’s and other countries it will expand more benifets

  54. Yeah and then you cut physician salaries in half and expect the best and brightest to still want to become physicians.

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