The Congressional Budget Office (CBO), best known for putting a price tag on various legislative proposals, has released a new report that describes the primary features of a single-payer system as well as some design considerations Congress would have to take into account when creating one – but it does not delve into the question of its cost.
Key Design Components and Considerations for Establishing a Single-Payer Health Care System states, somewhat obviously, that changing the current system to a new single-payer system would result in shifting expenditures from private to public sources. That would “significantly increase government spending and require substantial additional government resources. The amount of those additional resources would depend on the system’s design and on the choice of whether or not to increase budget deficits.”
Administrative costs would probably be lower, but demand for services would be higher, the report concludes, adding, “Whether the supply of providers would be adequate to meet the greater demand would depend on various components of the system, such as provider payment rates."
The report notes that about 70% of U.S. hospitals are privately owned. A single-payer system “could retain current ownership structures, or the government could play a larger role in owning hospitals and employing providers,” the CBO wrote, noting that the government would then “have more control over the healthcare delivery system, but it would also take on more responsibilities.”
The CBO clearly does not provide any concrete answers about a proposal that represents one of the most comprehensive changes to the U.S. economy. But its 30-page report does paint a broad picture of the topic.