Medicare vs. Single-Payer Healthcare: What's the Difference?

The Medicare program established in 1965 is a form of single-payer health insurance, with the U.S. government as the payer — or purchaser — of medical services. It is not uncommon for advocates of a national single-payer health-care system to describe it as "Medicare for all."

Differences between Medicare and single-payer programs are more about labeling and degrees of coverage than anything else.

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One U.S. organization, Physicians for a National Health Program, defines single-payer health care as "a system in which a single public or quasi-public agency organizes health-care financing, but the delivery of care remains largely in private hands."

This essentially describes Medicare, which covers Americans ages 65 and older as well as some people younger than 65 with disabilities or end-stage renal disease. Through taxpayer-funded Medicare, the U.S. government pays for doctor's visits, hospital stays, prescriptions and other services deemed medically necessary.

Medicare officials also negotiate and ultimately set the prices — or reimbursements — they will pay to drug manufacturers, hospitals and health-care providers serving Medicare patients.

The ability for a single payer to set prices would help keep health care costs lower, Ezra Klein wrote for The Washington Post. Private insurance companies typically pay what Medicare pays plus an addition percentage.

But even Medicare is not a pure single-payer system, in which all medical costs are covered. It's a hybrid: Medicare patients share some costs through co-pays and deductibles, and many buy supplemental private insurance to fill in the coverage gaps.

Canada is considered one example of a country with more comprehensive, national single-payer health care that is nationally funded and less reliant on patient deductibles or co-pays.

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The Affordable Care Act, also known as Obamacare, is not a single-payer system, although some have speculated that with its mix of public subsidies and private insurance, it might be positioned as a bridge to an eventual single-payer system — the "Medicare for all" that single-payer proponents envision.

A true single-payer system would eliminate private insurance, according to Obamacare Facts.

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