Single-payer system

Single-payer healthcare is a healthcare system financed by taxes that covers the costs of essential healthcare for all residents, with costs covered by a single public system (hence 'single-payer'). Alternatively, a multi-payer healthcare system is one in which private, qualified individuals or their employers pay for health insurance with various limits on healthcare coverage via multiple private or public sources.

Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). "Single-payer" describes the mechanism by which healthcare is paid for by a single public authority, not the type of delivery or for whom physicians work, which may be public, private, or a mix of both.

Single-payer healthcare systems pay for all covered healthcare-related services by a single government or government-related source. It is a strategy employed by governments to achieve several goals, including universal healthcare, decreased economic burden of health care, and improved health outcomes for the population. Universal health care worldwide was established as a goal of the World Health Organization in 2010 and adopted by the United Nations General Assembly in 2015 for the 2030 Agenda for Sustainable Development.

A single-payer health system establishes one health risk pool consisting of the entire population of a geographic or political region. It also establishes one set of rules for services offered, reimbursement rates, drug prices, and minimum standards for required services.

In wealthy nations, that kind of publicly managed insurance is typically extended to all citizens and legal residents. Examples include the United Kingdom's National Health Service, Australia's Medicare, Canada's Medicare, and Taiwan's National Health Insurance.

The standard usage of the term "single-payer healthcare" refers to health insurance, as opposed to healthcare delivery, operating as a public service and offered to citizens and legal residents towards providing nearly universal or universal healthcare. The fund can be managed by the government directly or as a publicly owned and regulated agency. Single-payer contrasts with other funding mechanisms like 'multi-payer' (multiple public and/or private sources), 'two-tiered' (defined either as a public source with the option to use qualifying private coverage as a substitute, or as a public source for catastrophic care backed by private insurance for common medical care), and 'insurance mandate' (citizens are required to buy private insurance which meets a national standard and which is generally subsidized). Some systems combine elements of these four funding mechanisms.

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