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In a research article published in the International Journal of Health Planning and Management, Hagenaars et al. identified the following OECD member nations as having single payer systems:
Government schemes with residence based entitlement (mostly national health service) – Australia, Canada, Denmark, Iceland, Ireland, Italy, Latvia, Portugal, Spain, Sweden, United Kingdom
Compulsory Social Health Insurance – Greece, Hungary, Korea, Luxembourg, Poland, Slovenia, Estonia

Source: Hagenaars, LL, Klazinga, NS, Mueller, M, Morgan, DJ, Jeurissen, PPT. How and why do countries differ in their governance and financing‐related administrative expenditure in health care? An analysis of OECD countries by health care system typology. Int J Health Plann Mgmt. 2018; 33: e263– e278. doi.org/10.1002/hpm.2458

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“In the United States, the traditional Medicare program is considered an example of an existing single-payer system for elderly and disabled people, but analysts disagree about whether the entire Medicare program is a single-payer system because private insurers play a significant role in delivering Medicare benefits outside the traditional Medicare program. Medicare beneficiaries can choose to receive benefits under Part A (Hospital Insurance) and Part B (Medical Insurance) in the traditional Medicare program or through one of the private insurers participating in the Medicare Advantage program. Those private insurers compete for enrollees with each other and with the traditional Medicare program, and they accept both the responsibility and the financial risk of providing Medicare benefits. The Medicare prescription drug program (Part D) is delivered exclusively by private insurers.

“Australia, Canada, Denmark, England, Sweden, and Taiwan are among the countries that are typically considered to have single-payer systems. Although some design features vary across those systems, they all achieve universal coverage by providing eligible people access to a specified set of health services regardless of their health status (see Table 1). Other countries, including Germany, the Netherlands, and Switzerland, have achieved universal coverage through highly regulated multipayer systems, in which more than one insurer provides health insurance coverage.”

Source: Congressional Budget Office, Key Design Components and Considerations for Establishing a Single-Payer Health Care System. May 2019.

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Selected Resources On Single Payer / “Medicare For All”
A. P. Galvani PhD, et al., The Lancet, 2020: Improving the prognosis of health care in the USA

Cai et al, PLOS Medicine, 2020: Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses

Congressional Budget Office, 2019: Key Design Components and Considerations for Establishing a Single-Payer Health Care System

Political Economy Research Institute, 2018: Economic Analysis of Medicare for All

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World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

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Page last updated April 3, 2025 by Doug McVay, Editor.