Core Elements of One-Payer Plans.

One Payer States recommends these key principles when creating and evaluating state and regional universal health plans:

• Eligibility: The health plan should cover everyone residing in the state or region regardless of age, employment, pre-existing condition, or other characteristics.

• Benefits: All medically necessary and appropriate care should be covered. There must be free choice of licensed health care providers. Care decisions must be based upon the clinical needs of each patient, not the financial goals of institutions.

• Financing: The system should be publicly-funded with broad-based and progressive taxes.

• Cost Constraints and Affordability: To control costs, a system should have sufficient size to negotiate prices and to establish budgets for institutions and defined populations.

• Transparency: Prices should be transparent for all health care goods and services.  The public should be able to view and comment on the budgets for institutions and populations as they are developed.

• Political and Financial Sustainability: One plan, for all people who live in the state or region, should be established for administrative simplicity, financial stability, and political sustainability for the program.

• Accountability: Those administering the plan should be held accountable to upholding the principles and maintaining policies to achieve the desired outcomes of high quality, equitable health care to all; fiscal responsibility with public money (or, tax-payer dollars); and sustainability of the system.

State-based or regional advocates can refer to documents developed by groups working in states where such systems are being developed, such as California, Colorado, Hawaii, Maine, Minnesota, New York, Oregon, Pennsylvania, and Rhode Island.