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How To Spot A Fake Single-Payer Plan

Above: Supporters of single-payer health care march in Sacramento, Calif., in April. (Rich Pedroncelli / AP)

Note: Get involved in our campaign to put in place a national improved Medicare for all. Visit Health Over Profit for Everyone and sign-up. Join our national conference calls and help build the movement to win national improved Medicare for all. KZ

Polls show that a majority of Americans (and their doctors) support a Medicare-for-all health system. But instead of pushing for real single payer, many lawmakers and think tanks have proposed watered-down, incremental approaches to health reform. They have confusing names like “Medicare X” or “Medicare Extra for All” that sound almost like the real thing. These plans are promoted as “politically feasible” and “less disruptive” than comprehensive single-payer bills like H.R. 676.

Fellow health care advocates often ask me if these plans are worth supporting, since they claim to potentially bring more coverage to more people. I tell them that the differences between “fake” and real single payer are too important to ignore.

The fatal flaw that these fake plans share is a continued (in some cases, expanded) role for private health insurance. No matter how well intentioned, adding another layer to our labyrinthine health financing system creates more complexity and waste, which drives up health care costs for everyone. Our research shows that only single payer can achieve the efficiency and cost savings necessary to provide high-quality, universal coverage.

How can you spot a fake single-payer plan?

Use this checklist to determine if the latest proposal passes the test. (Click here to download and print copies of the checklist):

▢ UNIVERSAL COVERAGE: The plan includes everyone living in the U.S. from day one, and every provider and hospital is “in-network.”

▢ MEDICALLY NECESSARY CARE: The plan covers all medically necessary care, including inpatient and outpatient services, prescription drugs, mental health, reproductive health, dental, vision, and long-term care.

▢ NO COST SHARING: The plan covers 100% of health care costs and does not require premiums, copays, or deductibles from patients.

▢ ADMINISTRATIVE EFFICIENCY: The plan maximizes efficiencies with large-scale cost control measures such as global budgeting for hospitals, negotiated fee schedules with physicians, and bulk purchasing of drugs.

▢ NON-PROFIT: The plan does not include a role for private health insurance.

Help spread the word about the difference between real and fake single-payer plans:

Join us at these upcoming single-payer events:

  • Wednesday, June 13, at 9:00 p.m. ET: Dr. Adam Gaffney leads a webinar on PNHP’s recent pharmaceutical reform proposal, “Healing an ailing pharmaceutical system: A prescription for reform for the U.S. and Canada.” To participate, register here by Friday, June 8 (priority will be given to members who are interested in presenting grand rounds).
  • Saturday, June 23, at 10 a.m. ET: Poor People’s Campaign Mass Rally in Washington, D.C. (National Mall, 7th Street Stage). To join the White Coat Contingent of health care providers, please contact Perri Morgan at
  • November 9-10: Please save the date for PNHP’s Leadership Training and Annual Meeting in San Diego.
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