"Universal healthcare now!" must be the Democratic motto in 2018

[muon2]

Is universal health care the same thing as single payer? I support the former, but resist the latter, unless there is no other way to do it, that will not cost a lot more money (other than money which funds drug research).

They do not need to be the same, and universal health care can be operated with a multi-payer system. In Germany there are over 100 funds that insure most of the population, paid for by a combination of employer, employee and government contributions. The premium is fixed for individuals in these funds independent of risk. There is also an opt-out provision for qualified individuals to pay a tax and buy insurance independently of the regulated funds, but those individuals can be charged based on risk.

[muon2]

Is universal health care the same thing as single payer? I support the former, but resist the latter, unless there is no other way to do it, that will not cost a lot more money (other than money which funds drug research).

They do not need to be the same, and universal health care can be operated with a multi-payer system. In Germany there are over 100 funds that insure most of the population, paid for by a combination of employer, employee and government contributions. The premium is fixed for individuals in these funds independent of risk. There is also an opt-out provision for qualified individuals to pay a tax and buy insurance independently of the regulated funds, but those individuals can be charged based on risk.

Thank you. Do you think the German model has merit to consider for the US?

Health Insurance is compulsory for people living in Germany. Any1 under 50,000 Euros is forcibly provided with a public Health Insurance plan with a federally decided set of benefits. The above 50,000 Euros is around 11% odd of the population. So 90% are in a forced Single Payer within this system & the rest have to get Private Insurance. Employees pay a tax on salary if they are under 50K, similar to a pay-roll tax as under a  US government! There is around 15.5% tax (Employer + Employee) on people to finance the public insurance.

Germany has a LONG history of health insurance & conservative governments are staunch supporters of such welfare programs & are not much dissimilar to the US Democrats of today. It is also too much instability & chaos to transition into a different system when something is working for years! Multi-payer in US will also cause big tax hikes & have some of the same problems to sell to people as Single payer (Tax increases). In addition, it creates another massive problem - Government deciding an income level for people to get public healthcare which will be a massive debate (difficult to sell to people) & forced intrusion. And it will be easier to dismantle by conservative governments held by the GOP who can play around with the income level & decrease it so much to make it render non-universal. Or you can have a Multi-payer where everyone gets some insurance & the rest is through purchase of secondary plans. Now that will be even more vulnerable & will result in plans which are trash & cover little requiring everyone to purchase private Insurance. The situation in Germany is very complex & transitioning across income & plans isn't perfect. For example, let's say your income falls from 70K to 30K, you may find it difficult to immediately get a public plan. It can cause chaos if implemented not correctly in US & damn well conservatives won't support it fully.

Single-Payer is the most simplistic, universal & by far the cheapest solution & every other universal plan would require tax increase too (ACA subsidies also required some tax increase on wealthy people). USA already has a multi-payer system of sorts, a modified Single payer called Medicare & private insurance. The only difference is this multi-payer system is not universal ! Not only does Medicare not generate huge profits to increase costs, but the administrative costs of Medicare is around 2% vs 17% of Private Insurance! This is a bit of an easy choice really !

My understanding of Germany is that the public insurance system is not single-payer but it is mandatory. It is a complex system where the price and benefits are set by the government, but individuals are members of independent non-profit funds. The 2017 cost is 14.6% of income + up to 1.1% supplemental depending on the fund. There is a cost cap at a monthly income of 4350 Euros.

I personally thought that the Healthy Americans Act of 2007 and 2009 would have been a better solution than the ACA (and it was bipartisan Wyden-Bennett et al.) It has some elements similar to the German system.