We always hear that Europe is a single payer system that must be avoided. This is a total myth that prevents rational debate over the future of the U.S. system.
In fact, of 27 European health systems, about half are single-payer, and more than a dozen are multipayer systems with both private health insurance and private doctors and hospitals. What is common across Europe is a single collector model, not a single payer. This is where the money is collected through payroll taxes or employee-employer split contributions and put into a single fund. The payer part varies tremendously, but private insurers administer many systems.
Its basically the same as Medicare with the same pros and cons. The advantage is that the administrative cost of collecting the money is substantially lowerthere is no employer-based premium. The bad part is that the government that collects the money will then micromanage its distribution across multiple payers. We see this proven every time a state tries to set up coverage of the uninsured.
The closest thing we have to the European systems is the Medicare fee-for-service program and the Medicare Advantage program. Its not working in Europe either. There is no single payer system in Europe that is a good model for the U.S.
William BoylesPublisherGlobal Health Markets Washington
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