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How Would Single Payer Work For You?

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Single payer refers to a health care program that would be regulated and funded by the federal government. Insurance companies would be out of the health care business with the exception of a few services like cosmetic surgery that would not be covered by the government-run plan.

If House Resolution 676 were passed, you, as a resident of the United States or one of its territories, would sign up for coverage by stopping off at your doctor's office or a clinic, or HMO and filling out a short form

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You would then receive in the mail a United States National Health Insurance Card (USNHI) imprinted with a unique number. In the same way you use a credit card, you would present this card at the end of your visit to the doctor or any one else authorized to provide services. The doctor would submit a bill to a regional director via a written form or via computer.
What would you be entitled to?
Under this Act your card would entitle you to the following:
ª Primary care
ª Preventive care
ª Inpatient care such as a hospital stay
ª Outpatient care that is administered at a clinic or doctor's office
ª Emergency care
ª Prescription drugs
ª Durable medical equipment
ª Long-term care that you might need at home or in a nursing facility
ª Palliative care
ª Mental health services
ª Dental services (not cosmetic dentistry)
ª Substance abuse treatment services
ª Chiropractic services
ª Basic vision care and vision correction
ª Hearing services, including hearing aids
ª Podiatric care
You would be entitled to these services whether you are employed, unemployed or self-employed, homeless or housed, young or old, chronically ill or mentally ill, moving from job to job or from town to town or from state to state.

Payment for monthly premiums would be a thing of the past. There would be no deductibles, co-payments, co-insurance, or other cost-sharing with respect to these benefits.

You would CHOOSE YOUR OWN DOCTOR. This same choice applies to hospitals.

Who would provide these services?
Private physicians, private clinics and private health care providers could continue to operate as private entities but could not be investor-owned. No institution could participate unless it was a public or not-for-profit institution. If owners of for-profit providers wanted to achieve non-profit status, they would be compensated for any reasonable financial losses they incurred in the conversion process.

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Physicians, dentists, etc., would be compensated in one of three ways: through a fee established for the particular service that they provided, through their salary as an employee in an institution such as a hospital, or through a salaried position within a group practice or HMO.

Using current fees as the basis, fees would be negotiated with physicians and other clinicians after consultation with a National Board of Universal Quality and Access and with regional and state directors. Other safeguards for medical standards would also be put in place.

How would these benefits be paid for?
The tax money that is now expended for Medicare, Medicaid, and the Children's Health Insurance Program would be folded into a USNHC Trust Fund. An increase in personal income taxes for those earning in the top 5% bracket would go into the fund along with a progressive but modest excise tax on payroll and self-employment income (currently at a flat rate of 2.9%) as well as a small tax on stock and bond transfers.

How would these funds be allocated?
Under this Act, an operating budget and a capital expenditures budget would be set up along with the fee schedules for providers and a health professional education budget including continued funding for resident physician training programs (medical schools). The USNHC Director would allocate these funds to regional offices.

Hospitals and some HMOs would receive global or lump sum allocations - money given ahead of time to take care of their expenses since they would not operate on a billing system.
Would savings be realized in changing from the present system?
Big savings would come from reducing paperwork. More would come from the government's bulk buying of medications from pharmaceuticals. Improved access to doctors rather than relying on emergency room treatment would be another saver. The biggest savings would go to consumers by taking profit-making by insurance companies out of health care.

Cities and towns would no longer have the burden of health care costs. The same would go for businesses. More people would start their own businesses if health care were guaranteed for them and their families. This would be good for the economy because small businesses generate the most jobs.

Those workers laid off by insurance companies would be given priority in the hiring for the new jobs generated by this change-over.

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Because of the huge campaign contributions that the president and many members of Congress have received, they refuse to consider this single payer bill. Call, email or visit them during August when they are in their districts and tell them that you want the same kind of health care that they have!


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Author of Discovering America: A Political Journey and of a free booklet on Patriarchy; a feminist and political activist.

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