In the U.S. context, “single payer” usually refers to “single-payer national health insurance,” a nonprofit system in which everyone is covered under a single public or quasi-public plan that pays for care, but the delivery of care remains largely in private hands.

Under a single-payer system, every resident of the U.S. would be covered from birth to death for all medically necessary care, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would no longer face financial barriers to care such as premiums, copays and deductibles, all of which would be abolished. Coverage would be portable – e.g. no longer tied to employment or to an insurer’s network of providers – and truly universal.

Patients would have free choice of doctor and hospital. The restrictive networks associated with today’s private insurance companies would be eliminated.

Doctors would regain autonomy over patient care, no longer micromanaged by private insurers or burdened by costly paperwork.

The single-payer system’s overarching aim is to provide comprehensive health coverage to everyone in the country, and to do so equitably, efficiently and at lower cost to individuals and the nation.

Key features of a single-payer program are concisely enumerated here. For a recent, detailed description of such plan, see the Physicians’ Proposal for Single-Payer Health Reform published in the American Journal of Public Health.