Health Insurance HQ: An Update on the Health Care Landscape | Entertainment Community Fund

Health Insurance HQ: An Update on the Health Care Landscape

Welcome to Health Insurance HQ—coming to you from the experts at The Actors Fund's Artists Health Insurance Resource Center and special guests!

Dear Friends,

It seems that the 2020 presidential election is off to an early start. With the announcement that Sen. Bernie Sanders and other Democrats have thrown their hats in the ring comes renewed interest in their health care proposals. There’s a lot of chatting, particularly on social media, about “Medicare for All”, universal coverage, “socialized medicine”, and single payer systems. Unfortunately, people don’t always know what they’re talking about!

So, in the interest of making you the smartest person in the (chat) room, here’s a little primer on what these words actually mean.

Universal Coverage: this is the overarching goal of many Democrats in Congress (and some Republicans). Universal coverage means everyone has affordable health coverage, period. There are no uninsured people.

Single Payer:  a single payer system is just one way to achieve universal coverage. In a single payer system, everyone gets their health care paid for by one single payer, generally the government. There are different types of single payer systems. In Canada, for example, the government pays for the care, but the providers (doctors, nurses, etc) are not government employees. They are privately employed. In other systems, like in England, the government pays for the care and employs the providers. The doctors work for the government.

Many Americans (37% in 2015, according to the Census Bureau) are already enrolled in some form of single payer, government-funded health insurance and they don’t know it; for example, if you receive your healthcare through Medicare, Medicaid, the Child Health Insurance Program, VA, TRICARE, or the Indian Health Service, you are participating in government-funded and (at least partially) managed insurance. We have more government in our health care system than most people understand.  

Socialized medicine: This term was first used as a pejorative in opposition to President Harry S. Truman's 1947 health-care initiative, which would have provided a national public health care system. It was originally used to describe systems in which the government operates health care facilities and employs health care professionals, like in England (and, by the way, like the Veteran’s Administration in the US). It has since been broadened to apply to any publicly-funded system. Many people use the term “socialized medicine” when they mean single payer systems.

On a side note, you might hear people assert that “socialized medicine” is free. There is no such thing as free health care, anywhere. Everyone needs to get paid for the work they do. If there are no premiums, then the cost of insurance is generally coming out of the person’s paycheck or their taxes. This is, in fact, the system we use to pay for Medicare – if you are an employee, 1.45% of your income is deducted from every paycheck to pay for Medicare.

Medicare for All: These are single-payer bills that has been introduced both in the Senate by Bernie Sanders and in the House by Representative Ellison. These bills are based on the Canadian single-payer system; they are not Medicare as we know it. Instead, these bills are a total redesign of our current system; they would replace employer and union coverage, traditional Medicare, Medicaid, and other types of care for one plan, Medicare for All. This plan would add benefits that aren’t in our current Medicare system, such as dental coverage and long term care.

There are other ways to achieve universal coverage; for example, there are bills such as Medicare for America and Medicare at 50, which would keep other coverage types, such as employer and union insurance, in place but allow people to buy into our current Medicare system.

Already, a healthcare industry lobby group, Partnership for America’s Healthcare Future, has mobilized to fight all of these proposals. They don’t want the disruption, and they don’t want to be paid less.

Democrats in 2020 will likely distinguish themselves based on which type of proposal they support – revolution, in the form of Medicare for All, or reform, in the form of Medicare buy-in programs. Regardless of which way the country turns, one thing is certain – the issue of universal, government-supported coverage is no longer a fringe discussion, but part of the national political dialogue now. We look forward to keeping the conversation going by speaking up for the needs of our community, and we hope you will do the same.

Yours in good health,


Renata Marinaro

Do you work in performing arts and entertainment and have questions about health insurance? The Actors Fund provides assistance nationally. Contact our regional office closest to you to speak to a counselor.

New York City
917.281.5975

Los Angeles
855.491.3357

Don’t forget to use the resources section of our website. It contains tools to help you make decisions about your health insurance, including new online tutorials on how to choose providers and how to read an Explanation of Benefits. In addition, you’ll find an updated Stage Managers National Health Directory, our national online directory of health care providers recommended by industry professionals that can be used by theaters and touring companies. For these resources and more, visit actorsfund.org/HealthServices. You can also find out more about enrollment assistance and upcoming health insurance seminars near you!