Why the United States Should Adopt a Single-Payer System of Health Care Finance

• Published in: Kennedy Institute of Ethics journal 1996-06, Vol.6 (2), p.145-160
• Main Author: DeGrazia, David
• Format: Article
• Language: English
• Subjects: Bioethics; Canada; Federal Government; Health administration; Health Care Rationing - economics; Health Care Reform - economics; Health Maintenance Organizations - economics; Health Services Accessibility; Internationality; National Health Insurance, United States - economics; National Health Programs; Preferred Provider Organizations - economics; Resource Allocation; Single-Payer System - economics; United States
• ISSN: 1054-6863; 1086-3249; 1086-3249
• DOI: 10.1353/ken.1996.0011

Although nothing could be less fashionable today than talk of comprehensive health care reform, the major problems of American health care have not gone away. Only a radical change in the way the U.S. finances health care--specifically, a single-payer system--will permit the achievement of universal coverage while keeping costs reasonably under control. Evidence from other countries, especially Canada, suggests the promise of this approach. In defending the single-payer approach, the author identifies several political and cultural factors that make it difficult for Americans to obtain a clear view of this option. Finally, the author argues that much discussion of rationing is vitiated by bracketing more systemic questions to which the issue of rationing is inextricably linked.