Single-Payer Is Not the Devil’s Healthcare

by Robert A. Duke

What  does “single-payer healthcare really mean?

Some say it is the future of healthcare, or the solution to reforming the existing healthcare monstrosity America has conjured into existence.

I recently learned it was both and neither! Single-payer is not what I thought it was, and maybe not what you thought, either.

“Single-payer” is commonly used and understood as a universal payer for all and everything, but that’s not accurate. In fact, we already have single-payer healthcare, defined as many one-payer entities across many regions.

Presently, we have only one nationwide single-payer, and that is Medicare. Medicaid is a single-payer across states for an economic category of patients. In many rural areas with limited populations there are a variety of single-payers functioning where there are too few patients to support more than one payer. In some areas there are none.

Single-payer works and has been working for a long time. The concept of single-payer is not a threat to American healthcare, as we know it, and is not the ultimate solution to American healthcare reform. Nor is it some sort of socialist scheme to destroy our ability to choose our healthcare providers.

How Do I Know This?
Unable to find any MD, RN or other provider willing to talk to me at Bellingham’s Family Care Network (FCN), PeaceHealth or St. Joseph Hospital, I attended Portland’s 2017 Oregon State of Reform Health Policy Conference to hear what problems and solutions concern regional healthcare providers and politicians.

I learned that in urban areas healthcare providers must deal with up 30 payers for the patients they serve, which imposes a costly and complicated problem for medical practices.

Many doctors and other healthcare providers, and patients like me yearn for single-payer solutions to the complexities of healthcare administration. All the problems of widely adopting single-payer healthcare have not been solved, but it is a powerful and proven solution that deserves serious consideration rather than closed mind rejection.

Robert A. Duke is author of “Waking Up Dying: Caregiving When There Is No Tomorrow,” he lives in Bellingham. His email: