Reply #48: Who pays for what

[Recursion]

Um, yes the cost of care is paid by the government. It's as much a premium as it is a tax, the insured seeks care wherever they want (you know, freedom of choice in choosing a provider of care), and the government pays the cost of that care.

If you're talking about Medicare rather than single payer in the abstract, the cost is paid by a dedicated payroll tax and supplemented by a trust fund containing past surpluses from that tax. People who have not had Medicare-deducted employment and want Medicare coverage do pay a premium, to the tune of $800 per month or so.

If you're talking about single payer in the abstract, then who and how that's paid for is up for grabs, and one of the biggest hurdles it faces is how exactly to pay for it. Nobody can seem to agree with each other on that, and also nobody knows how well the health care system could stand providing all its services at the rates it currently gets from Medicare. I'm personally dead-set against a single payer system that does not have a dedicated revenue stream (it would become a Federal Medicaid otherwise, with all the problems associated with that).

With delivery prices as high as they are, no matter how we choose to insure the population it's going to end up being tremendously expensive.