The Development of a Single-Payer Healthcare System: Part 1The title "Developing Single Payer Healthcare" on a blue background

By Glendora Claybrooks, Chair of Washington County Democrats Black American Caucus, PhD Candidate, GCPM, MHA

The development of a comprehensive Single-Payer Universal Healthcare Delivery System is a necessary and urgent task. It will constitute a health and healthcare service model that works for all citizens to eliminate continual racial and ethnic discrimination in Oregon and across the nation. To effect this method, we must contemplate a broad framework that is sustainable, strong, and serviceable. The current national healthcare delivery system structures operate using challenging principles guided by how we finance, organize, practice, distribute, and deliver healthcare services. These principled foundations are admirable and necessary; nevertheless, I see them as being unequal, inequitable, grossly mismanaged, exclusionary, profit-driven, and life-threatening. As a result, this approach has not been socioeconomically, equitably, or equally beneficial for all healthcare consumers. Therefore, it is ineffective, inefficient, and unsustainable.

Strong qualitative and quantitative evidence exist that show a disproportionate impact to minorities.  These are rooted in the historical and contemporary, institutional, and environmental structures of our social, cultural, political, and economic policies and practices we have today.

Other crucial elements impacting minority behaviors, attitudes, health, and well-being are low quality of care services and health providers’ implicit racial bias (unconscious stereotypical thinking). These social elements and their structural features add to the ongoing significant and negative influences on Black, Hispanic, Asian, and Native Americans’ poor health status and health outcomes. These factors also contribute to other social determinants of health circumstances, including rural residence, concentration in low-income (and often racially segregated) areas, urban residence, and other manifestations of socio-economic inequalities, health inequities, and health differences.

These significant issues, among other discriminatory factors, stem from inadequate health insurance due to either underemployment or unemployment and inferior healthcare plans. These associated components magnify insufficient access to healthcare and quality of care services that result in financial distress, unequal treatments, poor health outcomes, increased health disparities, and reduced preventative care services. These situations add to the importance, necessity, and urgency of creating a robust healthcare system that is conducive to all society and its citizens.

Therefore, the primary purpose of developing a Single-Payer Universal Healthcare Delivery System is to identify appropriate strategies to eradicate long-term racial-ethnic health inequalities, health disparities, and health inequities.

In so doing, it will rid us of other racial and ethnic discrimination, such as classism, ageism, and gender inequality associated with socio-economic, social determinants of health inequities, and cultural issues. The primary benefit is that it will address the unmet health and healthcare needs of the poor and racial-ethnic populations in Oregon and throughout the United States.

Meeting both health and healthcare needs that reflect sufficient access to health services and the quality of care services received will include:

  • timely scheduling
  • emotional support
  • diagnostic testing
  • preventative services
  • appropriate medication, and
  • adequate nutrition

It must address provisions for equal and equitable access to social determinants of health impacts by ensuring adequate, affordable, and impartial housing and educational services. Other factors it will provide for that affect access to care and self-maintenance practices are employment, reliable non-emergency medical transportation services, and facility locations.

A Single-Payer Universal Healthcare Delivery System possesses the most significant potential and power to reduce administrative healthcare costs, and simultaneously achieve the highest standard of quality of care services. This unique system’s approach will ease the burden and concerns of increased healthcare costs, and poor quality of care, as it meets Oregon’s triple aim of attaining better health, better quality, and lower cost.

This approach is most reflective when we consider the anticipated healthcare costs involved with the public health crises of the Coronavirus (COVID-19) pandemic and the long-standing Black minority disproportionate health impacts and outcomes. Since the enactment of the 2010 Affordable Care Act—Patient Protection Clause—and its 2013 implementation and expansion of healthcare coverage nationwide, Blacks are still experiencing unresolved health inequities and inequalities. These acknowledged observations can be seen in the ongoing poor health outcomes:  death rates, poor quality of care, and limited access to healthcare services and treatments, and other issues. The emotional and economic health of our state and country, especially the Black community, is at unprecedented high risk.

Considering these critical circumstances, we can no longer ignore these historical and current issues and health impacts in silence while individuals are prematurely and disproportionately dying from preventable conditions, which is no fault of their own. The unprecedented COVID-19 virus has revealed astounding and significant mortality rates among various racial and ethnic minorities compared to the White population. In Chicago, 42% of the Black community has succumbed to COVID-19, a rate that is 3.4 times higher than their White counterparts (1). This occurrence is despite Blacks constituting only 14% of the total population of Illinois (1). These and other differentiated racial outcomes make it imperative to change the way our current healthcare model practices, finances, delivers and distributes healthcare services in the United States (U.S.).

Continue to Part 2: Understanding Today and the Future >