singlepayer

Single-payer refers to a health care financing system in which a single public or quasi-public entity collects funds and pays for health care services for all residents. It is distinguished from a multi-payer system, where many private or public insurers operate. In many designs, providers may be private, public, or mixed; coverage remains universal.

In a typical single-payer system, the government or a government-controlled agency pools risk and pays providers for medically necessary services, while physicians and hospitals may be private or publicly run. Coverage is universal and standardized, with most essential services funded through taxation or mandatory contributions. Private supplemental insurance may exist for non-covered services or faster access.

Examples and variations: Canada-administered by provincial programs with a national framework; Taiwan's National Health Insurance is a single-payer system financed by payroll taxes and government subsidies; the United Kingdom operates the National Health Service, a government payer that finances services largely delivered by publicly owned providers, with private options alongside.

Debate: Supporters cite universal access, lower administrative costs, simplified billing, and bargaining power to control prices. Critics point to higher taxes, potential waiting times, risk of rationing, and concerns about innovation and choice. Implementations differ based on how much private delivery remains, how providers are compensated, and whether coverage is universal and comprehensive.