what do they mean by "single payer" ?

Thank you for a great question. Single payer is shorthand for a kind of health care system which is financed by one agency, our government.

Our present system is a multi-payer system of health care financing, in which hundreds of different private, for-profit insurance companies market tens of thousands of health care plans to the public. I think I read that there are 17,000 plans in Illinois, alone. They compete with publicly financed plans for the elderly, disabled and poor: Medicare and Medicaid.

Medicare is an example of a single payer system that works. It serves all citizens over the age of 65. It is paid for through a 2.9% payroll tax split evenly between employers and workers and it costs members just $96 in monthly premiums.

My employer based family coverage costs me over $1,300 a month and our local Blue Cross Blue Shield announced a 12.7% hike in premiums for next year. Yikes.

We are talking only about how health care is paid for, not about how health care is delivered. Our system of health care delivery in the United States is private. We get to choose our doctors, hospitals, clinics, nursing homes and pharmacies. (Well, in so far as we can afford them, that is.) This would not change under a single payer system. We still would enjoy our choice of "providers".

Opponents of single payer claim that it is socialized medicine, but this is an attempt to mislead you. Medicine is socialized when the government not only pays for health care, but provides it.

The Veterans Health Administration is an example of a socialized system of medicine, in that benefits are only available at hospitals and clinics owned by the government and staffed by health care workers who are government employees.

Under a single payer system each of us would be enrolled in a single national health plan which would allow us to choose our public or private providers and permit us to pay based upon what we earn, through progressive taxation.

Changing the system of payment from employers to taxpayers is not just sleight-of-hand. By eliminating the insurance companies as middlemen, we would immediately save between $250 billion and $400 billion in administrative waste according to a number of studies. This is because Insurers blow up to 31% of your health care premiums on overhead. Medicare has come in under 2% for the past two years.

Administrative costs include shareholder dividends, executive salaries and benefits. The expense of designing and marketing scores of different insurance plans. Sales commissions paid to independent brokers. Underwriting to cherry pick the lowest risk, most profitable participants out of our national "risk pool". Bonuses to adjusters for successfully rescinding the policies of members who become sick. An obscenely inefficient claims review and provider reimbursement process. Clerical staff to approve or deny authorization for medical devices or procedures.

And most troubling of all: tens of millions of dollars for political contributions, hundreds of millions for federal lobbying and untold amounts on sophisticated media initiatives to manipulate public opinion.

Consider Sen. Max Baucus, who is spearheading health reform as Chairman of the Finance Committee. From 2003 - 2008 he accepted $1,650,000 from health insurers, pharmaceutical manufacturers and health professionals. The ranking Republican committee member Sen. Charles Grassley received $1,170,00 from the same healthcare sector. When it comes to a contest between private interests and the public good, can they buck their backers?

Remember those "Harry and Louise" ads during the Clinton administration that scared Americans away from single payer? The Health Insurance Association of America, a trade organization for health insurers, paid for them using your premiums.

Can you tell that I'm a single payer advocate? I'm also a primary care doctor, a small business owner, and a head of household. And I'm getting squeezed on the cost of health care.

There are two single payer bills before Congress. The National Health Care Act H.R. 676 introduced by Rep. John Conyers and co-sponsored by 75 Representatives and the American Health Security Act S. 703 introduced by Sen. Bernie Sanders.

These bills are in for the fight of their lives, because our representatives, many of whom receive generous support from the healthcare sector, cannot stand up to their powerful backers without a groundswell of support from us - the people who voted them into office.

Call our President, your Senators and Representatives now and let them know how you feel. They want to hear from you.