According to page 4 of this three year old industry link, 24 million Canadians have supplementary health insurance. That’s two-thirds. I tried to find something from Statistics Canada as a tie-breaker between your post and the industry source I found googling, and didn’t. However, this from Statistics Canada shows, on page 16, that Canadians, nine years ago, were paying about the same for supplemental insurance as for dental and prescriptions combined. So I’m going to say that the industry source is plausible and Canada is multi-payer with signficicant disparities.
Every country has health care disparaties between rich and poor. I’m for lowering them. I’m not for jumping to the conclusion that slapping the words “single payer” on a bill, and passing that, automatically does it.
I think the US is rich enough that we can have good competing payers that will satisfy even affluent consumers. My experience with non-profit Blue Cross plans says this is possible. My family’s experience with US Medicare – where roughly half the seniors have supplemental insurance and roughly half don’t, is otherwise.
Here’s a good link that compares systems of all types all over the world.
It’s very common to have private insurance as either a supplementary type, or to get you into a “higher-tier” facility, private room, quicker access to service and so forth.
I’m not going to say that multi-tier develops inevitably under single-payer. But it is very common in single-payer systems for a portion of the population to also have some type of private insurance which either supplements on co-pays (Japan for example has a very large market for this, US medicare supp also) or for “better cadillac healthcare service” (In England, 11% have this). Some portion of the population will always want more than what the basic single-payer provides, and is willing to spend to do so. I think it’s very fair to say that single-payer systems often end up with companion or supplemental private systems around them. I tried to make this point, backed up with cites, on other threads, and I’m not sure why something that’s so obviously true creates angst among some.
This is a good reference link, btw. The commonwealth fund has some good info.
Except that what is covered by supplemental health insurance is things that are not covered by the medicare system. So no concierge practices, no quicker access to treatment, which is what you seemed to be suggesting in your earlier posts. What is covered by medicare is single-payer, and supplemental health insurance doesn’t change that.
It’s not a strawman to talk about someone’s view of their own healthcare. But people are also fairly satisfied with their employer-provided coverage.
This article, even though critical of the system, notes that a 2016 Kaiser poll found that 83% of employees either think their employer-sponsored health insurance is good or excellent. That’s 5 out of 6:
AHIP pegs the number at 71% (not 5 out of 6, but still not bad):
I think if you want single-payer, you’re going to have to deal with the real (not strawman) view that people have of their insurance that they already have, and of the healthcare that they have. I have employer-based, and I use it, and like it. Don’t take away my doctors and my coverage…that’s a common view, and shrug it off at your peril.
This is misleading. The main reason so many Canadians have supplementary insurance is that it’s pretty much a standard employee benefit, and the main reason it’s pretty much standard is that it’s a cheap benefit, which in turn is because it doesn’t pay for much except common prescription drugs and dental. When I took early retirement nearly two decades ago, the thought of getting my own supplemental insurance never even entered my mind. Since then I’ve had a few doctors’ visits, a few prescriptions, and never spent more than a few tenners on the drugs and nothing on the medical care. But then a few years ago I had a major cardiac event, with hospitalization, surgery and ongoing drug treatment. None of it cost a cent except for $100 deductible for the drugs every year. Why the hell would I pay for supplemental insurance?
Medicare is so far removed from full-coverage unconditional and unlimited single-payer that there is no comparison.
If everyone had good employer provided coverage as you have and as I have we wouldn’t be having this discussion. But\ only 55.7% of Americans who have health insurance have this (8% have no insurance) and 16% direct purchase, which is often expensive or inadequate. So we might expect that those with direct paid insurance or no insurance are not going to be quite as satisfied. Not sure about Medicaid, but Medicare gets higher ratings.
I liked the insurance I already had. I like Medicare more. Satisfaction with one does not mean you won’t be satisfied with a new plan.
And the plan won’t take away your doctors. If we are dumb enough to get insurance companies too involved, maybe. If a doctor wants to quit, maybe. But the Medicare network is bigger than any single insurance company network. And it would be even bigger if it is the only game in town.
I think it’s because the Canadian single-payer system does not allow for a private system in addition, for various reasons. The Canadian system is the one most Americans are familiar with.
I think there was a typo in the following, which I’ve corrected in Red.
I agree with this completely. It sums up the big problem. Getting from the present system to a single-payer UHC is hugely difficul. Obamacare was touted as a first step in the right directiont — towards a goal that can only be achieved incrementally. (Obamacare with a public option would have been better — it might have had 59 votes but was vetoed by the Senator from Insurancicut.) But the mandate was essential to ACA, and it was maliciously repealed by the very party that first explained its necessity.
If the Democrats treated the country the way the Republicans do, they would destroy the health insurance companies as soon as the forces of sanity defeat the Dark Lords of Mordor.
Slavery was pretty darn good for those who owned the slaves. When will the U.S. grow up and understand that Democracy is not supposed to be a device for the 51% to exploit the 49%?
[sarcasm] Job Creators would suffer if employees were not motivated by fear to stay despite better prospects. Without the threat of insurance cancellation, employers would have to divert shareholder profits to compensating employees. Why do you hate Job Creators? Why do you hate America?
Amazingly, even with all the sabotage that Trump has tried on the ACA, the exchanges are still standing. All counties in America have at least one insurer willing to sell. And the numbers signing up are still respectable.
About 11.4 million expected to sign up. States that run their own exchanges are doing better at keeping their numbers up than states that are at the mercy of healthcare.gov. It looks to me like even without a functioning mandate, there’s still an ability to keep the exchanges going and for companies to make money. I think we need a real mandate at some point. But glad the Trump sabotage isn’t working so far.