The United States National Health Insurance Act (H.R.676) was introduced by Representative John Conyers, Jr. of Michigan, and is co-sponsored by over 83 additional members of Congress as of April, with nine representing California (Xavier Becerra, Howard L. Berman, Sam Farr, Bob Filner, Michael M. Honda, Barbara Lee, George Miller, Grace F. Napolitano; and Lucille Roybal-Allard.
The following information provided about the single-payer system is from Conyers’ Web site.
Single-payer describes the kind of financing system that H.R. 676 uses. It means that one entity, in this case, established by the government, handles all billing and payment for healthcare services. Right now, there are thousands upon thousands of “payers” — HMOs, PPOs, bill collection agenciesÖ The sheer volume of paperwork required by our current system means that administrative waste accounts for roughly 31 percent of the money spent on healthcare. The single-payer system would eliminate the wasteful paperwork and administrative costs, redirecting more of our healthcare dollars to providing care.
Medicare is perhaps the best-known single-payer system. Essentially, H.R. 676 would improve Medicare and expand it, so that it covers all Americans, regardless of their income.
All Americans will be eligible for healthcare coverage. Every person who enrolls in the program and receives a U.S. National Health Insurance Card and individual ID number would receive healthcare.
The program will cover all medically necessary services without charging co-pays or deductibles and there is no limit on the coverage. Covered services would include: primary care; inpatient; outpatient and emergency hospital care; prescription drugs; durable medical equipment; hearing, dental and vision care; chiropractic treatment; mental health services; and long-term care.
Patients will have their choice of physicians, providers, hospitals and clinics. The financing will be public, but the providers will all remain private.
Both families and employers will pay significantly less for healthcare. Currently, the average family of four covered by an employer-provided healthcare plan spends roughly $4,225 on healthcare each year, including premiums, services, prescription drugs and supplies. This figure doesn’t include the annual Medicare payroll tax, currently at 1.45 percent. Under the plan created by H.R. 676, a family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all healthcare costs.
Employers who provide health insurance currently pay, on average, 74 percent of employee health premiums. For a family of four, the average employer share is $8,510 per year. Under H.R.676, the employer pays a 4.75 percent payroll tax, not a premium to health insurance companies. For an employee making the median family income of $56,200 annually, the employer would pay roughly $2,700.
The full conversion to a non-profit, single-payer universal healthcare system will not take place overnight once the bill is passed. The total transition time will be roughly a 15-year phase-out period of the present system for reimbursement of the healthcare entities by the use of federal securities or Treasury bonds. Important transition elements include: private health insurance companies will be prohibited from selling coverage that duplicates any benefits included in the universal national healthcare program. The private companies will still be able to sell coverage for services that are not deemed medically necessary, such as many cosmetic surgery procedures. Private insurance company workers who are displaced as a result of the transition will be the first to be hired and retained by the new single-payer entity. Any of the displaced workers who are not rehired will receive two years of unemployment benefits.
Switching to a single-payer system will lead to billions of dollars saved in reduced administrative costs. Those savings will be passed on through the system and allow coverage for all Americans. Additional savings in the overall cost of healthcare will come from annual reimbursement rate negotiations with physicians and negotiated prices for prescription drugs, medical supplies and equipment.
Second, a “Medicare For All Trust Fund” will be created to ensure a dedicated source of funding in addition to annual appropriations. Sources of funding will include: maintain current federal and state funding for existing healthcare programs; closing corporate tax loopholes; repealing the Bush tax cuts for the highest income earners; establish employer/employee payroll tax of 4.75 percent (includes present 1.45 percent Medicare tax); establish a five percent health tax on the top five percent of income earners; a ten percent tax on the top one percent of wage earners; and one quarter of one percent stock transaction tax.