Single-payer isn’t California’s only option for universal healthcare

A legislative committee in California is hearing proposals about how to achieve the goal of universal healthcare in the state, with advocates looking for inspiration in Canadian, British and German models.

The California State Assembly's Select Committee on Health Care Delivery Systems and Universal Coverage came about after legislation to create a single-payer healthcare system was shelved last year. Estimated to cost $400 billion a year, the plan would’ve offered expansive coverage of almost all medical expenses, with no copays, deductibles or premiums, while cutting out private insurance companies—but with “little incentive” for providers to control costs.

As Southern California Public Radio writes, single-payer isn’t the only approach other countries have used to achieve universal healthcare. The California panel will likely consider one of these three options for the state:

  • The Canadian system: 70 percent of care is covered by the government on a fee-for-service basis, but providers remain private, with many people purchasing additional private coverage for services like prescription drugs and dental care. 90 percent of those costs are covered by employers.
  • The United Kingdom’s National Health Service: Physicians and hospitals work for the government, care is “mostly free” at the point of service with higher taxes to cover the cost of the system. About 11 percent of the population purchases private coverage offering “more options and shorter wait times.”
  • The German system: insurance coverage is compulsory, with most buying from income tax-funded, nonprofit “sickness funds” that limit out-of-pocket costs to 1 to 2 percent of income. The cost is based on a person’s income, with an employer paying half, though lower-income Germans get government assistance. About 10 percent buy supplemental insurance from private plans.

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