"Under a single-payer system... all medically necessary services (would be covered), including: doctor, hospital, preventive, long-term nursing-home and home-health care, mental health, reproductive health care, dental (but not orthodontia), vision, prescription drug, (some chiropracty, some treatments for macular degeneration), and medical supply costs...The government pays for care that is delivered in the private sector... This is similar to how Medicare works in (the United States)... Doctors are in private practice and are paid on a fee-for-service basis from government funds... (There would be no) premiums, co-pays, deductibles, and other out-of-pocket payments (implying there would be no lifetime limits. Supplemental insurance would be highly discouraged by policy and legislation.)"
- United States Medicare is not Single Payer. There are means-tested monthly premiums once on United States Medicare even if no longer working (in addition to a lifetime of means-tested premium prepayments while working). There are very high co-pays and deductibles for all but a few very inexpensive and/or somewhat questionable preventive services.
- United States Medicare does not cover long term nursing-home and home-health care, dental care, vision, or prescription drug costs if the drug is self administered.
- United States Medicare -- for the somewhat limited albeit important health services it does cover -- severely limits what it will pay providers for those services per service and limits per incident and lifetime how much it will pay on the beneficiary's behalf cumulatively. The simple way to say that is that United States Medicare lacks catastrophic coverage. And there is no annual limit on how much a beneficiary must pay out of pocket. Combined with the high co-pays and deductibles, this means that United States Medicare is absolutely the worst insurance design ever: no protection on either the high or the low side of financial loss.
- United States Medicare -- as with the MassCare and Berwick definition of Single Payer -- pays fee for service. Almost every current proposal for reform of both health care and health care insurance strongly argues against fee or service payment, as does current law -- the Patient Protection and Affordable Care Act of 2010 as amended.
- United States Medicare -- unlike Single Payer as defined by MassCare and Dr. Berwick -- is totally dependent on supplemental insurance. Over 110% of United States Medicare beneficiaries have supplemental insurance (adds up to more than 100% because many of us have two or three supplemental policies).