Household Health Care Payments Under Rate Setting, Spending Growth Target, and Single-Payer Policies — Jodi L. Liu et al., 2024

This study models how healthcare payments shift under reform, finding single-payer financed by taxes reduces costs for lower-income households while increasing them for higher earners, making the system more progressive overall.

How the Study measures Household Payments

What the current system looks like

What happens under single-payer ⭐

The key transformation: progressivity

📊 What the data shows overall

⭐ Star Facts

• U.S. healthcare spending reached $4.5 trillion in 2022, showing massive system scale and cost pressure.
• Under the current system, households across all income levels spend about 24%–27% of their income on healthcare.
• Low-income households can face extreme burdens, with some spending over 50% of their income on healthcare.
• Under single-payer, lowest-income households see payments drop from about 27% → 15% of income.
• Middle-income households also pay less, dropping to about 17%–21% of income under single-payer.
• Highest-income households see payments rise from about 27% → 31% of income.
• About 90% of the population (below 1000% of poverty level) would pay less under single-payer.
• Under single-payer, premiums are eliminated entirely and replaced with taxes.
• Out-of-pocket costs drop significantly under single-payer, reducing financial risk.
• The system becomes more progressive, meaning higher earners pay a larger share of costs.
• Under single-payer, uninsurance drops to 0%, meaning full coverage.

🧠 Why these matter