How Single-Payer Stacks Up: Evaluating Different Models of Universal Health Coverage on Cost, Access and Quality,

Authors

Ashley Fox, University at Albany, State University of New YorkFollow
Roland Poirier, University at Albany, State University of New York

Author ORCID Identifier

Ashley Fox: https://orcid.org/0000-0003-4106-7853

Document Type

Article

Publication Date

2018

DOI

https://doi.org/10.1177/0020731418779377

Abstract

Described as “universal prepayment,” the national health insurance (or single-payer) model of universal health coverage is increasingly promoted by international actors as a means of raising revenue for health care and improving social risk protection in low- and middle-income countries. Likewise, in the United States, the recent failed efforts to repeal and replace the Affordable Care Act have renewed debate about where to go next with health reform and arguably opened the door for a singlepayer, Medicare-for-All plan, an alternative once considered politically infeasible. Policy debates about single-payer or national health insurance in the United States and abroad have relied heavily on Canada’s system as an ideal-typical single-payer system but have not systematically examined health system performance indicators across different universal coverage models. Using available cross-national data, we categorize countries with universal coverage into those best exemplifying national health insurance (single-payer), national health service, and social health insurance models and compare them to the United States in terms of cost, access, and quality. Through this comparison, we find that many critiques of single-payer are based on misconceptions or are factually incorrect, but also that single-payer is not the only option for achieving universal coverage in the United States and internationally.

Comments

Publisher Acknowledgement:

This is the Author's Accepted Manuscript. The version of record can be found here: Fox, A.M., Poirier, R.* (2018). “How Single-Payer Stacks Up: Evaluating Different Models of Universal Health Coverage on Cost, Access and Quality,” International Journal of Health Services, 48(3): 568-585. https://doi.org/10.1177/0020731418779377

Recommended Citation

Fox, Ashley and Poirier, Roland, "How Single-Payer Stacks Up: Evaluating Different Models of Universal Health Coverage on Cost, Access and Quality," (2018). Public Administration and Policy Faculty Scholarship. 9.
https://scholarsarchive.library.albany.edu/rockefeller_pad_scholar/9