Question

1. In the recent election, the cost of healthcare was the number one issue for voters. One of the options which is being discussed is a single-payer health insurance (Universal healthcare, "Medicare for all").

1a. What is a single-payer health insurance plan, and how would it work?

1b. What are the pros and cons of a single-payer health insurance plan?

1c. If a single-payer health insurance plan was instituted by the government, what effect would that have on employers and employees?

2. What is telemedicine, and why are many employers offering this service? How can it benefit both employers and employees.

3. Due to rising medical costs, many employers have turned to wellness programs. Evaluate the pros and cons of these programs. Also discuss any possible limitations or regulations of which employers must be aware when offering wellness incentives.

Answer 1

1a) Most basically, it's a health care system in which all the payments come from a single source. In practical terms, in means that a government (usually national, but not always) pays for all the health care costs for its citizens. That means that health care is paid for out of public money (primarily provided by taxes), instead of from the patients, or their insurers, or any other combination of sources. Effectively, it means medical care becomes a public service, like schools or policing.

1b) There are a number of advantages to such a system. It means that coverage is universal within that group of citizens. Individuals won't be turned away or denied treatment based on their ability to pay. They won't be driven to bankruptcy by hospital bills. Even the poorest will have access to preventative care and long-term treatments, which helps to prevent much worse health problems down the road. It's far, far simpler for doctors and hospitals to deal with. The American system, in which clinics and hospitals have to send and follow up on multiple bills to multiple sources, is a complete mess. It's slow and it's costly. Such a system also prevents the overhead involved with private insurance companies (marketing, profits, corporate costs, etc, etc). There are also less obvious benefits. For example, healthcare in America is usually connected to your job, which makes losing a job, or quitting, much more risky. Disconnecting the two would give people more flexibility in changing jobs or trying to start their own companies.

The disadvantage is that it means the government is on the hook for all healthcare expenditures. This means that taxes are higher. Poor people will general benefit from that, because the savings in healthcare costs far outweigh any change in taxes, but the wealthy will end up paying more to subsidize the poor. At the same time, it gives the government vast control over the healthcare system. The government will have to make the decisions about a) how much it's appropriate to pay for medical care and b) what procedures and medicines are and are not practical to pay for. Because of these points, people who a) are opposed to taxation in principle and b) have a deep mistrust of the government tend to be opposed to single-payer healthcare.

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