You know how Trump frequently says, "Most people don't know this...", but da da da? Well, I recently discovered something I suspect most people don't know. In a meeting with the HR Department at my company, I learned that my company is self insured for health insurance. We pay an insurance company to administer our plan, but the cost and risk is born solely by the company. Not the insurance company. The HR manager told me that actually most large companies self insure for healthcare, as it takes the profit motive out of health insurance.
This is exactly what a universal single payer system does. In fact, my HR manager said the difference between what most large corporations in USA do related to funding healthcare cost and what Amazon, JP Morgan and Berkshire Hathaway are launching is that the latter is even taking over the administration function and completely cutting them middle man out of healthcare for their companies.
Over forty-seven percent of Americans are currently covered by an employer based health care system, all of which are very similar to mini universal single payer plans. These employers pay on average 83% of the cost of health care for their employees. They in turn get to deduct the cost on their income tax returns, so the federal government, in essence kind of subsidizes these mini single payer health care plans.
The nonpartisan Congressional Budget Office estimates that in 2016, about 155 million people (or about 57 percent of the population under age 65) got health coverage through their job, or a family member’s job. That’s an awful lot of us.
Medicare, Medicaid and CHIP covers 39.7% of Americans for health insurance. These programs are covered, of course, almost completely by taxpayers, albeit inadequately funded. Another 9% of Americans are covered by the ACA, which is highly subsidized by taxpayers.
So when you combine self insured employer based plans that are subsidized by income tax deductions, Medicare, Medicaid and CHIP which are funded by taxpayers, and the ACA which is funded by taxpayers, 90% of Americans are currently covered by some form of government subsidized health insurance.
A universal single payer health care system would be way more efficient than the piecemeal single payer system we currently have. The only thing that prevents us from providing quality affordable health care for all Americans regardless of their level of income, is that republicans/conservatives promote that it would be socialism, which is bad, even though that is what we are currently doing, only in a grossly inefficient manner.
Although the 10% with no coverage at all is the most at-risk group, even the 40% who are covered by Medicare, Medicaid, CHIP and the ACA are somewhat at risk because those programs are inadequately funded. The 47% who are covered by their employers are the most stable, but the problem there is that if they are laid off or retire before they are eligible for Medicare, they put themselves at risk.
So WHY is universal single payer not the best way to provide health care coverage for Americans?