# With single payer health plans, whither insurance companies? **URL:** \ **Category:** Great Debates\ **Created:** [May 7, 2017, 9:02pm UTC](https://boards.straightdope.com/t/with-single-payer-health-plans-whither-insurance-companies/786088 "2017-05-07T21:02:04Z")\ **Posts on this page:** 1\ **Showing post:** 73
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [July 19, 2017, 5:27pm UTC](https://boards.straightdope.com/t/with-single-payer-health-plans-whither-insurance-companies/786088/73 "2017-07-19T17:27:08Z")
> [@Tee](#): > > [QUOTE=Northern Piper] > > My comment is that as long as you keep using the language of insurance, you are not really thinking of single-payer as a government service, which is the mental paradigm shift that you need to make. Did you not see your countryman up there talking about “uniform negotiated fee schedules” and such? It’s easy to get tripped up here by Canadians, and I mean no snark either. [/QUOTE] The uniform fee schedule doesn’t mean that it’s an insurance system. It means that it’s a set fee-for-service, paid by the provincial medicare commission to the doctor. Here’s why it’s not insurance, compared to the US model, which is insurance. **US:**** Tee **goes to a doctor or a hospital. They provide** Tee **with medical services.** Tee **owes them that money.** Tee **is covered by insurance.** Tee **’s insurance company pays the medical bills on** Tee **’s behalf, to the extent those bills are covered by** Tee **’s insurance policy. Things that aren’t covered,** Tee**has to pay himself (e.g. - one of the doctors who had involvement in**Tee**’s care isn’t in his insurance company’s approved network). As you say: > [@](#): > > My health care is an arrangement composed of private parties: me, the provider, and my insurance carrier. If I didn’t have insurance, the arrangement would be that I pay whatever the providers want me to pay, or avoid treatment. **Canada** : **Piper** goes to a doctor or a hospital. They provide **Piper** with medical services. **Piper** does not owe them any money. **Piper** is a resident of the province and covered by medicare. The provincial medicare commission owes the doctor or hospital for **Piper** ’s care. The provincial medicare commission has a set fee schedule for all medical charges and procedures. The provincial medicare commission pays the doctor and hospital in full for the the medical charges and procedures. **Piper** is not on the hook for any of the charges. It’s not an insurance system in Canada. I pay no premiums, I’m not liable personally for the cost of the care, and I have no contractual relationship with the provincial medicare commission. The provincial medicare commission is liable directly to the doctor and hospital and pays directly, not on behalf of me. It’s a government service, paid out of general tax revenue, not an insurance system. --- _[View the full topic](https://boards.straightdope.com/t/with-single-payer-health-plans-whither-insurance-companies/786088)._