Bills
| 3.23.22

Medicare for All: Should the U.S. Adopt a Single Payer Healthcare System? (H.R. 676)

Do you support or oppose this bill?

What is H.R. 676?

(Updated December 4, 2021)

This bill — the Expanded and Improved Medicare for All Act — would provide individuals residing in the U.S. with healthcare for all “medically necessary care” by increasing or imposing a variety of taxes. Medically necessary care would include primary care, prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care. Patients would choose between participating physicians and institutions for receiving care, and the Dept. of Health and Human Services (HHS) would be required to create a confidential electronic patient record system.

The program would be funded in the following ways, although specifics about increased or new tax rates aren’t included in the bill:

  • Existing sources of government revenues for healthcare, such as Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP);

  • Increasing personal income taxes on the top five percent of income earners (about $210,000 annually for a household);

  • Imposing a “modest and progressive” excise tax on payroll and self-employment income;

  • Imposing a “modest tax” on unearned income (like interest from a savings account, stock dividends, bond interest or alimony);

  • Imposing a “small tax” on stock and bond transactions.

Only public or nonprofit institutions would be allowed to participate. Health insurers would be prohibited from selling insurance that duplicates the benefits provided under this bill, but could sell benefits that aren’t medically necessary such as cosmetic surgery.

The Indian Health Service would be integrated into the new Medicare program after five years, while Congress would evaluate the continued independence of the Dept. of Veterans Affairs health programs.

The program would also provide employment transition benefits and prioritize the retraining and job placement of individuals whose jobs are eliminated due to reduced clerical and administrative work under this bill.

Argument in favor

A single payer healthcare system is the best way to ensure that all Americans have access to the healthcare they need without having to worry about paying for health insurance. It would be more efficient than the status quo at controlling costs and produce better outcomes while bringing the U.S. in line with other developed nations with single-payer systems.

Argument opposed

A single payer healthcare system would concentrate too much power in the federal government, creating inefficiencies in the healthcare market. It would reduce physicians’ pay and consequently the quality of care they provide, and lead to long wait lists for patients to see their doctor — all while imposing a massive tax increase on middle class Americans.

Impact

All Americans; physicians and others involved in the healthcare industry; the financial sector; and the federal government.

Cost of H.R. 676

A CBO cost estimate is unavailable.

Additional Info

In-Depth: Sponsoring Rep. John Conyers (D-MI) introduced this bill to establish a privately-delivered, publicly-financed universal healthcare system by expanding Medicare and funding the increased services through a variety of new or increased taxes:

“The data is clear that simply expanding Medicare to all Americans to create a single-payer system would be far more efficient. According to the Organization for Economic Cooperation and Development (OECD), the U.S. spends more than 17% of its gross domestic product (GDP) on healthcare, while countries with single-payer systems like France, Germany, Canada, the UK, and Australia spend 9-11% of GDP. In addition to paying a fraction of what we do for healthcare, those countries enjoy better outcomes and higher satisfaction than in the United States. Single-payer isn’t just the moral thing to do or a good government issue, it’s what Americans want. Many leading health care practitioners and experts share my belief and that of most Americans that establishing a non-profit universal health care system would be the best way to effectively contain health care costs and provide quality care for all Americans.”

Opponents of a single-payer healthcare system argue that it would create new problems that don’t exist to the same extent under our current multipayer system. For example, Canadians and British citizens whose government adopted single-payer systems face long wait times for care, sometimes more than six months for operations like hip or knee replacements, or cataract surgery. They also argue that such systems underpay physicians because government planners arbitrarily determine their compensation, rather than letting those healthcare providers compete. This in turn can lead to shortages of certain services as physicians retire or opt for different careers, or reduce the quality of care patients receive.


This legislation has the support of 108 cosponsors in the House, all of whom are Democrats. That total represents more than half of all House Democrats.



Media:

Summary by Eric Revell

(Photo Credit: Michael Fleshman via Flickr / Creative Commons)