Single payer health care is a system where one entity (typically the government) pays for everyone's health care. Instead of hundreds of insurance companies, thousands of different plans, each with their own rules, paperwork, and profit goals, there is one streamlined system that covers everyone.

In the single payer system being proposed for Oregon, it's the billing process that will be changed. The delivery of health care will remain just how it is today: providers, hospitals, etc. will remain private. You can choose your own doctor and hospital, and you'll have more choice since there will be no restricted provider networks to navigate. Your health insurance coverage can't be dropped or denied, and isn't tied to your job.

This is one of the most common myths. Wait times vary enormously from country to country. Some countries, like Canada, struggle with long wait times in some provinces (but not all!). Opponents often point to Canada's example but ignore the fact that many nations with universal health care actually have shorter wait times than the U.S.

Measurements of wait times in the U.S. are also misleading since they don't include the waits for people who delay getting care due to cost, and the people who don't have health insurance who have to wait for their symptoms to become an emergency. The truth is, the U.S. already has significant wait times, especially for people who are uninsured, underinsured, and who can't afford the out-of-pocket costs of care.

Universal health care doesn't inevitably cause wait times; poor planning and underfunding do. A well-designed system (like those in Taiwan, South Korea, Japan, Germany, Australia, etc.) can deliver timely care for everyone.

Every country that has adopted universal health care spends less per person than the United States does, and covers everyone. The U.S. currently spends far more on health care than any other nation, yet millions of people remain uninsured or underinsured. How does a single payer system save money?

• By minimizing waste and inefficiency; cutting the enormous administrative costs of dealing with hundreds of insurance companies, eliminating billing complexity and fighting to get care approved.
• Giving the system more bargaining power to negotiate fair prices for medications and services.
• Standardizing how much providers are paid.
• Using tools like "global budgets", which allow hospitals to stabilize their funding while also containing costs.

Notably, the United Kingdom launched its National Health Service in 1948, right after World War II, when the country was nearly bankrupt, and has maintained it ever since.

Our current system is the most expensive, inefficient, and wasteful. The question isn't whether we can afford universal health care. It's whether we can afford not to have it.

States have a long history of leading the way on innovative social policies, providing successful test cases that led to later adoption by the federal government. Social security, workers' compensation, unemployment insurance, and minimum wage laws all started as state-level experiments before becoming national policy. Health care reform can follow the same path.

As an example, Canada's universal health care started in a single province (Canada's version of a state). In 1947, Saskatchewan introduced the first government-funded universal hospital insurance program in North America. At the time, Saskatchewan had a population of roughly 800,000 people (far smaller than Oregon's 4.2 million today). Canada's other provinces gradually followed Saskatchewan's lead, and by 1966 the federal government had adopted universal health care for the entire country.

Oregon doesn't need to wait for Washington D.C. to act. We have the size, the resources, and the policy infrastructure to lead. Oregon can be the first domino to inspire the rest of the country, just as Saskatchewan did.

For most people, your overall cost will go down, the new health care tax can be thought of as cheaper, more comprehensive premium. Right now, you likely pay monthly premiums, deductibles, co-pays, and co-insurance. Under a single payer system, your health care tax replaces ALL of those costs. You pay once, and that's it. No surprise bills. No need to hit your deductible before coverage kicks in. No worrying about whether a doctor is "in network." Estimates by the Universal Health Plan Governance Board show that the majority of households will pay less overall than they do today.

Actually, government-run health programs in the U.S. are among the most efficient around. Medicare's administrative overhead is around 2%, compared to 12-20% for private insurers. That gap represents hundreds of billions of dollars that currently go to marketing, executive salaries, and shareholder profits instead of your care. A single payer system eliminates that waste. Under our fragmented multi-payer system, doctors and hospitals spend enormous amounts of time and money navigating different insurance rules, prior authorizations, and billing codes. Simplifying the system saves money for everyone.

Right now, if you have private health insurance, a corporation is already making those decisions, and their goal is to maximize their profits, not your health. Insurance companies routinely deny treatments your doctor recommends, require prior authorizations for basic care, and force doctors to prescribe cheaper treatments before approving the medication or care they want to prescribe (a practice called "step therapy").

Under a single payer system, your doctor decides your care, not a claims adjuster. Research shows that public health insurance programs have far less day-to-day interference in medical decisions than private insurers do.

Good news: you'll actually have more choice, not less! Today, your choices are limited by which doctors are "in network" for your specific insurance plan. Many people are locked into a "narrow network" of providers, or they pay significantly more to see an out-of-network specialist. Under a universal health care system, every licensed doctor and hospital can participate. There are no networks. You can see any doctor you want, anywhere in the state.

Quality of care is expected to improve. When everyone is covered, people stop avoiding the doctor because of cost. This means conditions get caught earlier and treated more effectively. Doctors can focus on medicine instead of paperwork and insurance battles. And the system can invest in preventive care, which keeps people healthier and reduces expensive emergency care down the road. Countries with universal health care consistently rank above the U.S. on major health outcomes, including life expectancy, infant mortality, and management of chronic disease.

Many doctors are more likely to stay (or even come to Oregon!) under a universal system. Physician burnout is at crisis levels right now, and much of it stems from the administrative burden of dealing with insurance companies: prior authorizations and having their treatment decisions denied. Doctors went into medicine to help patients, not to fight with insurance adjusters. A simpler, single payer system frees them to do what they were trained to do.

In reality, moving is a major life decision that very few people make based solely on health care. People have jobs, families, children in school, homes, and deep community ties that keep them where they are. Research on states with more generous health programs has not shown a significant influx of out-of-state residents seeking care. Similar fears were raised when certain states established a minimum wage, social security, and other benefits, but significant migration in-flows did not occur. And even if some people did move to Oregon for better coverage, they would also be paying into the system through taxes and contributing to the economy, which helps cover the costs.

They're close, but not quite. There's an important difference between "universal coverage" and "universal health care." Universal coverage means that most or all people have some form of insurance, but people in these states may still have high deductibles, narrow networks, coverage gaps, and significant out-of-pocket costs. These costs can cause people to delay or forego care, even though they technically have health insurance. True universal health care means everyone is covered with minimal financial barriers to access. Massachusetts has near universal coverage, but 2 out of 5 residents still report issues with affordability. What HCAO is working toward is a genuine universal health care system, one where coverage is designed so that people truly have access to the care they need.

Oregon has been a longtime, recognized leader in health policy reform: our state has achieved international recognition for our innovative approaches to the Oregon Health Plan; Oregon is a model program for expanding access to Medicaid through its creation of the Oregon Bridge Plan, etc.

In 2022, Oregonians also passed Ballot Measure 111, which recognized "health care as a fundamental right" in our state constitution. That means the legislature is required to fulfill that promise. Universal health care has been shown in every wealthy nation to be the most effective, efficient way to do so.

Many countries (and smaller regions within countries) have successfully made this transition. Oregon has the policy expertise, the health infrastructure, and the public will to do it right.