Frequently Asked Questions
Having single payer health care in Pennsylvania would be a huge benefit to you individually and a massive advantage for us as a state. It would also be a major change – and we understand that change can be scary. So, to help calm any fears you might have, here are answers to some of the most frequent questions we encounter. And if you have one that you didn’t see here, please, let us know, and we’ll do our best to respond to it.
Q: What Is single payer?
A: Simply put, single payer is health insurance – or the payment of health care – that you would have through the non-profit state of Pennsylvania rather than through a private, profit-first insurance company. The state would be the “single payer” of your health care and would cover all Pennsylvania residents. The premiums would be a flat rate of 3% of income for individuals or families and 10% of payroll for businesses.
Think of it as buying health care at wholesale prices instead of retail prices, like you would a particular brand of cereal at a wholesale outlet instead of a grocery store. It’s the exact same product, but because it’s being purchased in major bulk by the millions of Pennsylvania taxpayers (instead of the mere thousands of customers of a particular health insurance company), you wind up getting a lot more of it at a much lower cost.
Q: What are the advantages of the Pennsylvania Health Care Plan (PHCP) for individuals and families?
A: While the PHCP requires all residents to pay 3% of gross income into the plan, if you are an individual or family who spends more than 3% of your income on health care (including premiums, deductibles, co-pays, prescriptions and out-of-pocket expenses for medical, dental and vision) – which 80% of Pennsylvanians do – you will save money. You and your children would be automatically covered, as would every tax filer regardless of income, employment, age, health or marital status.
Q: Will single payer result in rationing of care?
A: No. Contrary to popular belief, it’s our current profit-first insurance system that is the one that results in rationing. It has led to thousands of rejected medical claims as well as financial ruin in the way of home foreclosures and bankruptcy due to medical bills for significant numbers of families. Huge deductibles have also caused people even with insurance to forego using it. And, even with the ACA being fully implemented, lack of insurance still results in deaths here in Pennsylvania.
By contrast, the PA Plan expands comprehensive care. And more nurses, doctors and other medical providers will be made available to all Pennsylvania residents.
Q: Can I choose my own doctor, hospital, or other health care provider, and what other benefits would I get?
A: First off, yes, PA single payer guarantees you the freedom to choose which doctors, dentists, hospitals and other medical care providers you want. Secondly, the other benefits to single payer are that it includes dental, vision, prescription drugs, mental health services, hospital and doctor services, and more. It also does away with premiums, deductibles and co-pays. And last but not least, the PA Plan finally eliminates the need to purchase health care.
Q: Is this socialized medicine?
A: No, no, a thousand times no. Socialized medicine is when the doctors are government employees and the hospitals are government owned. The Veterans Administration (VA) is a good example of that. On the other hand, in the proposed PA single payer, doctors will continue to be in private enterprise, as will hospitals and other private medical care providers. With the PA Plan, you will still get to choose your own doctors and hospitals, and competition among medical providers will increase as you, not an insurance company, decide where to get care. You and your doctor will still decide what treatments and courses of action to take.
Q: How is this different from the Affordable Care Act (Obamacare)?
A: A single payer system is the only system that insures everyone, making it truly “universal.” Unfortunately, the ACA is not single payer. While it may be a first step, it’s only a first step. That’s because it’s simply an extension of the current private insurance system. Yes, the ACA expands coverage, but it still leaves too many Pennsylvanians uninsured and fails to cut the unsustainable costs of health care.
Now for the good news. The ACA allows states the option to innovate with their own health care plan so long as the proposed plan is more economical and efficient than the ACA. Our single payer plan, the PHCP, does just that.
Q: Is the PA Plan job-based?
A: Absolutely not. The PA Plan frees you from job-based insurance – or what has become known as “job lock”. Coverage would be in no way tied to employers anymore since they would no longer be administering health insurance.
Q: How does single payer affect doctors and hospitals?
A: The PA Plan addresses the need for doctors and hospitals to absorb the cost of care for the uninsured because everyone (and that includes you) is insured. It would also eliminate any and all billing issues.
Q: If I’m already on Medicare, how does single payer affect me and what I pay?
A: You would still pay the Part B coverage of Medicare along with the 3% of annual income. However, you would no longer need to purchase a Medigap Plan or Advantage Plan because the PHCP will completely cover Parts C and D. Additionally, single payer would eliminate all co-pays, deductibles and out-of-pocket expenses for you. All of which will put more money back into your pocket and keep more money in your savings.
Q: What are the advantages of single payer for businesses?
A: While the PHCP requires all businesses to pay 10% of payroll into the system, if you are a PA business spending more than that 10% on health benefits – which most are – you will save money. But that’s not the only savings you will experience. Additional benefits come from a lower cost for vehicle insurance, workers compensation, liability insurance and COBRA obligations. A new metric in tort reform would be created, as well. In short, the playing field will be leveled.
And further savings will come about by removing such issues as:
- Retiree health care costs, or “legacy costs”
- Contentious collective bargaining over health care
- Double-digit percentage increases in insurance costs
Finally, single payer promotes true free and open market principles, but where it should be – at the provider level (doctors, hospitals, etc.), not at the insurance company level.
Q: What about job losses and gains?
A: Net job creation under this plan in all sectors of the PA economy is estimated to be between 120,000 to 200,000 jobs. While private health care companies will no longer be needed in Pennsylvania, their employees – medical, administrative and clerical – will be eligible for re-training and placement, some with the new public payer system and some in other careers. They will receive up to two years of salary, capped at $60,000 per year, as well as a $20,000 retraining and educational allowance.
Simply put, the PA Plan would be the most business-friendly model out there, and would make our state much more vibrant for companies and industries already here and more attractive for those outside of our state borders.
Q: What are the advantages of single payer for government entities such as school districts and municipalities?
A: Many school districts and municipalities would see their contributions drop from their current 20% or more of payroll to only 10% with single payer. Many public employers would save 25% to 50% of current costs, in some cases changing municipal deficits into surpluses, which, in turn, could translate into relief for taxpayers.