Defining Terms: Universal Health Coverage and Single-Payer System

August 8, 2019

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Pader Moua, MPH
Policy Analyst

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During last week’s Democratic presidential debates, we heard candidates using the terms “universal health coverage” and “single-payer system” when discussing reform options for the current healthcare system. Let’s explore what these two terms mean.

Generally, “universal health coverage” means healthcare coverage that is available to all persons in an eligible population, e.g., a country or a state.

“Single-payer system” refers to how healthcare is financed. A single-payer system is a means ― though not the only means ― to achieving universal health coverage. Although there are variations in definition and design, a single-payer system is generally described as having one payer that covers the healthcare costs of the eligible population. A single payer is typically a governmental entity, but the term is not necessarily restricted to governmental entities.

Different approaches to achieving universal health coverage are being considered not only at the federal level but also at the state level. ACHI will send staff to this month’s National Academy for State Health Policy conference, where there will be a focused discussion on state innovations in increasing healthcare access and lowering costs.

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