Single payer healthcare has generated considerable attention and heated debate. Its appeal lies in its potential to address inequities in our current healthcare system and high costs. But many questions still exist regarding what constitutes such an arrangement; in this article we explore what “single payer” entails as well as some key features of proposals to create such an organization.

“Single payer” refers to various health systems where government funds from one single source cover all national healthcare services. One such system in the US is Medicare, while similar schemes also exist in Canada, the UK, Sweden and France. Note, however, that using this term doesn’t imply that government employs and runs healthcare providers or health systems in these countries. This distinction is key as those advocating a single payer system want to make sure it does not take control of healthcare delivery in any form whatsoever.

Though single-payer health systems have garnered much interest, implementing them in the US will be challenging due to several obstacles. Funding remains one of the primary impediments to successful implementation; national government would need to significantly raise taxes or borrow in order to finance such an arrangement, which may spark significant public opposition and make passing laws easier than before in Congress or state legislatures.

There is also the question of whether a single-payer system can deliver cost-effective health outcomes, something many experts argue cannot be achieved in the United States given that we spend more than other countries on healthcare while yet have lower life expectancies and perform worse on most measures of quality. Unfortunately, no matter how good a single payer system might appear on paper it remains impossible to know for certain how it will perform until it has been implemented and tested in real life environments.

At present, most single-payer plans that are gaining momentum in the United States tend to increase Medicare benefits or extend coverage to low-income individuals. TennCare, a managed care Medicaid plan in America that failed recently is an example of how difficult implementing and administering such a large expansion can be – balancing access, quality, and cost must all be carefully considered prior to implementation; learning lessons from previous efforts at single payer implementation will help future efforts remain sustainable and successful.