Popular Resistance -The Congressional Budget Office issued a report titled “Key Design Components and Considerations for
Establishing a Single-Payer Health Care System.” This report reviews a
range of considerations as regards the design and implementation of a
single- payer system as applied to the United States. The Medicare for
All bills currently before both the U.S. House of Representatives and
Senate, as introduced by Representative Pramila Jayapal and Senator
Bernie Sanders respectively, both advocate the adoption of a
single-payer system for the U.S.
The CBO report
properly examines both the positive potential as well as matters of
concern in establishing a single-payer system in the U.S. As the report
states, “A single-payer system would present both opportunities and
risks for the health care system.”
Overall, the CBO report, as with all such analyses, needs to address
two fundamental issues with respect to the establishment of a
single-payer system for the U.S. These are: 1) Is a single-payer system
capable of providing good-quality care to all U.S. residents; and 2) Is a
single-payer system capable of significantly reducing overall U.S.
health care costs while still delivering universal good-quality care?
The report does not provide explicit answers, yes or no, to these
questions. But it does present a framework for understanding how the
U.S. could, in fact, establish a successful single-payer system.
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