There appears (bloggers, Print & Mass Media, not to mention the general public) to be some confusion regarding the two terms, and what they are and what they do.
I believe it stems from the confusion over the reality that there are two systems in the healthcare industry.
The short answer:
Public Option is a Healthcare Insurance Plan. You get a medical card, with an ID number.
Single Payer is a Healthcare Bills Payment System. This is the organization that receives medical bills, and pays them.
The longer, probably more boring answer is below the fold.
I work in healthcare.
I am the person behind the Front Desk, when you go to the doctor's office. I check-in and check-out patients, take requests for medication refills, arrange specialty referrals, request interpreter and transportation services, schedule (and endlessly re-schedule) appointments with our two providers and for our IV infusion room, receive and send healthcare records requests, write letters (emotional support animals, INS waiver requests, housing waivers for medical necessity requests and clinic initiated correspondence), deal with Medicare & Medicaid when we stop getting payments (it's happened twice for more than two months in the 2.5 years I've worked at this clinic), and a lot of other tasks, too.
I know that many of our patients don't even know if they have Medicare or Medicaid, not to mention a Medicare Advantage plan. Healthcare insurance is just too damn complicated for most people.
But my short version is enough to explain to anyone the crucial difference.
One system pays doctors, one system is doctors.
The system that we need to change is the one that pays doctors.
That's all. We don't want or need to do anything to the other system.
Truthfully, in a Single Payer mode of healthcare bill payments system, the doctor system would quite possibly start costing less.
Currently, many doctors fees are inflated, to take into account the discount that Medicare, Medicaid and (increasingly) all private Insurers apply to medical billings. Our clinic currently receives, on average, about 38-42% of what we bill for.
Without the ability to help millions of our fellow citizens understand the difference between the two systems; and continuing to accept that allowing private scalawags (insurance companies) to withhold one third of all the money that passes through their coffers as part of the system is the road to ruination for all of us.
Without that one third, we will never be able to afford healthcare for all of our people. Never.
What must be impressed upon the masses, and engage them to contact their elected representatives, is the fact that those private insurance companies do no more than send checks to doctors. For that task, they keep one third of the funds they receive each year to pay doctors. That's an outrageous sum to be, basically, a bill payer service and nothing more.
My local credit union offers monthly to pay my bills for me from now on, for free. Just because I let them hold onto my money now and then. Totally free.
Now, extrapolate that thought, and ponder just how much money are we talking about? According the The Centers for Medicare and Medicaid or CMS in 2007 (the latest year for which statistics are available) the US spent an average of $7,421 per person or 16.2 percent of the nation's Gross Domestic Product. Total health expenditures reached $2.2 trillion.
That's about 1/6th of the entire amount of money spent on everything during that year.
And the Big Insurance Companies got the 1/3 of what they transacted.
Well - how much is that?
Hmmm... who would know that? Again, CMS is the source.
In 2007:
Medicare spent $431 billion.
Medicaid spent $329 billion.
The two total $760 Billion, leaving a mind-boggling sum of $1,440,000,000,000 or $1.44 Trillion dollars spent by private sector.
one third of that is $475,200,000,000 or $475 Billion dollars.
Now, I'm neither a mathematician, a financial analyst nor pretending that I've conducted a serious inquiry into this, but I'm using the governments own data, compilied and researched and analyzed to the gills.
I'm using simple mathematical calculations (addition, subtraction and simple division) on their own numbers.
But, doesn't that seem like a unfrickin believable amount of money - just to pay the doctor bills for us?
Remember, my credit union gives me this service for free, because I let them use my miserly hoard from time to time - what should the fucking insurance companies be giving us for using our $475 billion dollars?
Hey, on the other hand, if they've gotten all of that loot since the WWII era, haven't we given them enough?
Maybe it's time to close that gushing spout of cash, and re-direct it to where it should be going - to pay healthcare providers to provide healthcare to our citizens.