The Differences in Single Payer & Universal Health Care

Single-payer health care and universal health care are two terms that often go hand in hand, but actually describe two different parts of a health care system. Single payer health care is health care funded by a single source; universal health care is health care for all citizens of a country or group. Though the terms may overlap, there are some key differences.

Definitions

• A health care system is often both single payer and universal. Under such a system, all citizens would have health insurance (the "universal" part) and the funding for all citizens' health insurance would come from a single, usually public or quasi-public, source. This is how the health care systems in Great Britain and Canada work. Though the system is both single payer and universal, the terms mean different things: one refers to the source of funding for health care, while the other refers to the level of health care coverage.

Universal But Not Single Payer

• As the name suggests, single-payer health care funding usually comes from one source, such as the federal government. However, universal health care funding may come from several different sources. For example, a universal health care system's funding might combine government funds and private insurance companies' funds to make sure that all citizens are covered. Under a universal health care system, all citizens would have health insurance, but the health insurance would not necessarily be funded by the same single entity.

Single Payer But Not Universal

• Just as the source of funding may differ for health care delivery, the level of coverage may differ as well. A country may have a single payer system without universal health care. The best example of this in the United States is Medicare, the health insurance program for elderly citizens, and Medicaid, the corresponding program for low-income citizens. Both Medicare and Medicaid receive funding from a single source--the government--but are not universal health care, because recipients must meet a stringent age limit or income level to qualify.