The Case for Single-Payer
Table of Contents
Overviews2
Facts and Myths3
Health Economics and Financing4
The Case Against For-ProfitCare5
Quality and Malpractice6
The Failures of Other Reform Options7
International Health Systems8
Single-Payer Bibliography 9

Single-Payer Overviews

The Physicians Proposal for National Health Insurance
“Proposal of the Physicians’’ Working Group for Single-Payer National Health Insurance,” JAMA 290(6): Aug 30, 2003

Key Features of Single Payer
A useful handout detailing the main features of single payer.

Statement of Dr. Marcia Angell introducing the U.S. National Health Insurance Act
A great overview of the need for and logic of a single-payer system. Perfect as an introductory handout.

Liberal Benefits, Conservative Spending 
Another great introductory handout.

Public Citizen's Response to the Citizens' Health Care Working Groups Interim Recommendations
A great overview on the benefits of a single-payer system by Public Citizen.

Rep. Dennis Kucinich Tackles Health Care
Rep. Kucinich talks with Truthdig about the health care crisis in America.

Single Payer: Facts and Myths

Information on current status of the uninsured from the US Census Bureau

Single-Payer FAQ
A frequently-updated catalog of the most-asked questions about single payer.

Myths as Barriers to Health Care Reform
Refutation of many of the myths associated with single payer.

“Mythbusters” by the Canadian Health Services Research Foundation
A series of brief papers debunking the common misconceptions about the Canadian health system.

“Moral Hazard”: The Myth of the Need for Rationing
3 authors give compelling evidence that moral hazard is a poor basis on which to formulate health policy.

Health Economics and Financing

Paying More, Getting Less
How much is the sick U.S. health care system costing you?

Introduction: How Much Would a Single-Payer System Cost?
A review of government and independent studies of the cost of single-payer system.

Administrative Waste Consumes 31 Percent of Health Spending
Woolhandler, et al “Costs of Health Administration in the U.S. and Canada,” NEJM 349(8) Sept. 21, 2003

Administrative Costs in U.S. Hospitals are More Than Double Canada’s
Woolhandler, et al “Administrative Costs in U.S. Hosptials,” NEJM 329, Aug. 5, 1993

60 Percent of Health Spending is Already Publicly Financed, Enough to Cover Everyone
Woolhandler, et al. “Paying for National Health Insurance – And Not Getting It,” Health Affairs 21(4); July/Aug. 2002

A Proposal for Financing National Health Insurance
Rasell, Edith “An Equitable Way to Pay for Universal Coverage,” International Journal of Health Services. 29(1); 1999

"Liberal Benefits, Conservative Spending"
Grumbach, et al. JAMA, May 15, 1991, Vol. 265 No. 19

The Case Against For-Profit Care

Overview: The High Costs of For-Profit Care
Editorial by David Himmelstein, MD and Steffie Woolhandler, MD in the Canadian Medical Association Journal.

For-Profit Hospitals Cost More and Have Higher Death Rates
Devereaux, PJ “Payments at For-Profit and Non-Profit Hospitals,” Can. Med. Assoc. J., Jun 2004; 170
Devereaux, PJ “Mortality Rates of For-Profit and Non-Profit Hospitals,” Can. Med. Assoc. J, May 2002; 166

For-Profit Hospitals Cost More and Have Higher Administration Expenses
Himmelstein, et al “Costs of Care and Admin. At For-Profit and Other Hospitals in the U.S.” NEJM 336, 1997

For-Profit HMOs Provide Worse Quality Care
Himmelstein, et al “Quality of Care at Investor-Owned vs. Not-for-Profit HMOs” JAMA 282(2); July 14, 1999

For-Profit Medicare Plans Cost 11 Percent More Than Traditional Medicare
MedPac Report, Jun 9, 2006 

Quality and Malpractice

Introduction: Medical Malpractice, Health Care Quality and Health Care Reform 
A Forum Report by Gordon Schiff, MD.

How Single Payer Improves Health Care Quality
A brief by PNHP (makes a great handout!).

A Better Quality Alternative: Single-Payer National Health Insurance
Schiff, et al “A Better Quality Alternative” JAMA, 272(10); Sept. 12 1994

Comprehensive Quality Improvement Requires Comprehensive Reform 
Schiff, et al “You Can’t Leap a Chasm in Two Jumps,” Public Health Reports 116, Sept / Oct 2001

The Failures of Other Reform Options

Individual Mandates (The Massachusetts Plan)
Consumer Directed Health Care and Health Savings Accounts
Tax Credits for Private Insurance
Why HSAs Won't Cure What Ails U.S. Health Care
Critique of Sen. Wyden's (OR) "Healthy Americans Act"
Comparison between Schwarzenegger Health Plan and Single Payer for California State Single-Payer Bills

International Health Systems

Canada
The Canadian Health System: Lessons for the United States
US General Accounting Office Report, June 1991

A Survey of the Canadian Health System
Armstrong, et al “A Perfect System?” excerpted from Universal Health Care, New York Press, 1998

A Survey of Studies Comparing the U.S. and Canada 
PNHP Brief, May 2006.

The Future of Health Care in Canada
Report of the Romanow Commission.

International Comparisons
Comparison of international health systems

The U.S. spends more for less because of its fragmented financing system
Anderson, G. et al, "It’s the Prices, Stupid: Why the United States is so Different from Other Countries," Health Affairs 22(3), May/June 2004

U.S. Care Quality is No Better Than Other Countries
Hussey, P. et al "How Does the Quality of Care Compare in Five Countries?" Health Affairs 23(3) May/June 2004
Single-Payer Bibliography

A bibliography of single-payer studies and papers
From Physicians for a National Health Program, used with permission.