Minnesota Single-Payer Impact Study Released

From Health Care for All – Minnesota

A report from Growth and Justice on the Lewin Group’s study of a single-payer health care system in Minnesota was recently released.

Lewin Group’s Findings:
– A total savings of $35.7 million to state and local governments;
– An average savings of $1,214 per worker, for employers offering health insurance coverage prior to the ACA;
– An average additional cost of $1,963 per worker, for employers not offering health insurance coverage prior to the ACA;
– An average savings of $1,362 for families, including wage effects;
– A reduction of 42,800 Minnesota jobs for those with insurance related job functions; and
– A ten year total statewide savings of $189.5 billion, from 2014 to 2023

Executive Summary from Beyond the Affordable Care Act: An Economic Analysis of a Unified System of Health Care for Minnesota

Minnesota has long been cited as a leader in health care, boasting relatively low rates of uninsured, innovative
programs for low-income people and those with high-risk conditions, a history of cooperation and collaboration to improve outcomes and share best practices, internationally recognized medical research and education, leadership in the med-tech industry and a healthier than average population. Despite being a standout in high value care, these reforms, including innovations in health care delivery, have failed to diminish racial disparities in health or guarantee affordable access to quality care for all Minnesotans. Our health care costs are rising at an unsustainable rate. Minnesotans are losing ground.

According to the latest data, more than 10% of Minnesotans are uninsured and an increasing number of employers are dropping employee coverage. Premium increases are far outstripping pay increases and patients are expected to pay a growing share of health care expenses out-of-pocket. Should the federal Affordable Care Act (ACA) survive the court challenge and be fully implemented, it will expand access to insurance, but access will not be universal and a high cost-sharing burden will continue to be placed on patients in order to reduce health spending.

Minnesota should consider reforms that go beyond the critical first steps of the

Affordable Care Act and aim to:
– attain universal coverage;
– assure affordability of health care;
– reduce health care inflation; and
– create a more equitable system, reducing racial and economic disparities.

One option for meeting those goals is the so-called single-payer system, a concept supported by Gov. Mark Dayton in his 2010 campaign. Growth & Justice set out to investigate whether, by moving toward a unified system and thereby reducing fragmentation, administrative complexity, and fraud, and by countering the pricing power of our consolidated insurance and provider markets, Minnesota can establish stable, affordable access to health care for every Minnesotan without increasing total health care spending.

The Lewin Group was contracted to conduct an economic impact study of a unified and universal health care system for Minnesota. Lewin modeled a comprehensive plan covering medical, mental health and dental benefits, eliminating deductibles and coinsurance, while using only minimal copays on specialists, hospitalizations, procedures, and diagnostic tests, with coverage for all Minnesota residents. The modeling used a baseline year of 2014 in order to compare to the economic impact of the ACA.

A unified system, as modeled in this report, entails
– a single system of coverage and pooled risk: everyone is in it.
– a uniform, comprehensive benefit set for everyone.
– a single network of all licensed health care providers, and an end to choice-limiting networks.
– a uniform and streamlined enrollment process.
– uniform pricing, payment rules, and payment methods, with monopoly (one-buyer) purchasing power.
– naturally appreciating financing based on wages or income.

Download Beyond the Affordable Care Act: An Economic Analysis of a Unified System of Health Care for Minnesota (.pdf).


  1. ILONA ANDERSON on April 13, 2012 at 11:53 am

    I commend Minnesota Governor for looking out for people in his state. I wish my Governor in Washington State would do the same. When I asked her about Single Payer Healthcare she referred to Obamacare. And changed the subject. More states need to follow Vermont and pass Single Payer Healthcare in their own state.

  2. emily schacht on April 13, 2012 at 12:03 pm

    health care should not be run by a profit making organization Quality of care not the bottom line should be the purpose and result of policy/regs

  3. Harold Hill on April 13, 2012 at 12:40 pm

    Dear Sir/ Madam:
    Does this study show how many jobs will be created if a single payer system is adopted in Minnesota? Does the figure of 42,000 jobs lost reflect net jobs lost?

    Harold Hill

    • Willie on April 13, 2012 at 2:50 pm

      Who cares if vampires lose their jobs?

      • Nickic on April 14, 2012 at 11:45 pm

        The jobs that would be lost are the jobs of all the insurance agents who make generally over 100 to 200K signing on as many companies to insurances as possible. They aren’t looking out for those they insure, they are looking out for the companies and CEO’s to be happy with their sell and when the yearly bump of 22% or more comes in, it’s just more profit for these people whom have very little education, a few nurse dropouts but are getting their money the same way the Wall Street CEO’s did, it’s all dirty money and it’s all wrong! These people are the vampires! Blood sucking kid killing no good low down scum

  4. Michael Mooney on April 13, 2012 at 1:24 pm

    Single payer is the only way to go, as proven in the rest of the civilized world. We don’t have to look for or do more of the analysis that Lewin did. And the USA could do it better than any other country since we have more money and resources.

  5. Holly Fuchs on April 13, 2012 at 2:16 pm

    I was glad to see this study showed jobs would be lost because that was one question I had about single-payer–how single payer would save money without losing jobs? It doesn’t. So I was understanding thes iutation correctly. It saves money because jobs are lost. So there are downsides to single payer.

    Now what about the quality of care available that someone mentioned? Is that unchanged under single payer or not? In particular, I wonder if it has the same difficulty I have had in contacting Medicare to get information. For example, they work shorter hours than 8 to 5, they don’t know the information requested or will only give it to a doctor (e.g. is procedure # thus and so approved by Medicare or not?). It is very frustrating not to know if a procedure that might be done in the future could be covered by insurance or not.

    Finally, what happens to the stock holders of the formerly for profit health insurance companies? Do they lose the value of their stock?

    • Alan Glick on April 13, 2012 at 2:37 pm

      yes, jobs will be lost precisely because they are not adding value to the ACTUAL delivery of healthcare. Programs could be setup to retrain these workers or provide tax credits to those who hire these workers I imagine, but it is not our duty and not good economics over the long term to provide jobs that do not create sustainable value. Each person, family and business is subsidizing an industry that does inefficiently (and often ineffectively) takes care of its customers. Why should we do that with health insurance workers and not other industries that evolve over time. Printers, travel agents, milk truck drivers, etc. all had to learn new trades.

    • John Barker on April 16, 2012 at 12:50 pm

      Conservatives often state that health care is about one seventh of the economy and cite job loss as a reason why we should not go for single payer. We would put all those people out of work. Crocodile tears to be sure as conservatives aren’t generally much concerned with ordinary workers losing jobs.

      What does the fact that one seventh of the economy involves health care tell us? It says that private for profit health care is one big bloated health care bureacracy badly in need of a diet. Conservatives rail against the government bureacracy they say single payer would creat but hypocritically nerver mention what their opposition to single payer has already created. The ordinary workers in insurance companies aren’t vampires its just that their jobs should never have existed in the first place. They should never have been one seventh of the economy. They would have obtained real jobs if conservatives had not prevailed and single payer had been enacted in the 1940’s. For profit health care profiteers at the top are the vampires.

      Single payer is inevitable. For profit health care sows the seeds of its own demise and it can’t come too soon.

  6. Maggie on April 13, 2012 at 2:30 pm

    We desperately need a change in our healthcare for the sake of all the uninsured people in the country and for those paying exorbitant prices for insurance plans. Medicare has standard prices for services and providers which keeps prices much lower for everyone.

    • jOY sWANSON on April 13, 2012 at 6:49 pm

      The only problem with our current Medical Delivery System is, that no matter how many insurance policies you’re required to have, e.g. over 65ers that have Medicare also need Supplemental Ins., and there doesn’t seem to be any restrictions on how much co-pay you also have to pay besides all your insurance premiums. It make one wonder what we have insurances for anyway. If we can’t control how much doctors charge us, separately, even if we have more than one insurance policy, I think we need to revamp the whole Medical System to make it more fair and equitable. There is no reason why someone making under $10,000 a year has to pay the same co-pays as someone making over $40,000 a year. It’s an unfair reverse tax system on the middle class on down to low income to retirees no matter how yo look at it. It’s the cost of “whatever the traffic will bear” that is hurting us the most in every purchasing situation including health care. We need total reform of honesty, integrity and fairness in medical costs no matter what kind of insurance we will eventually have.

  7. Bob Babcock on April 13, 2012 at 5:37 pm

    I am insurance licensed and have worked in many areas of financial services for decades.
    It’s important to understand that while jobs will be lost, the individual and family savings constitute a net increase in available spendable dollars. Most often, this gets circulated in the economy and creates more jobs with an associated increase in tax revenue.
    There are too many families right now who are unable to afford the insurance they need to cover the impact of death and disability, along with proper savings for retirement, etc.
    Job losses in health INSURANCE don’t worry me because it’ll be fairly easy for those folks to slide over into the clerical jobs created in other, less vulturely, insurance jobs.

    • Nickic on April 14, 2012 at 11:51 pm

      Spoken by a true caring person who knows what is happening is wrong and uless things change. Status Qua isn’t working and remember unless the plan is to keep the poor and sick away from the rich and healthy, each person who doesn’t get care and you sit next to , eat after at a returant or the pollition we see attacking our kids, will eventually touch the rich insured who thinks they are fine.

  8. Ted Whittemore on April 14, 2012 at 10:10 am

    Single-payer is the only sane approach. Just last night a retired physician opined to me that its coming is inevitable–and thankfully so. State-sponsorship may be the route it will have to take (but Vermont and Minnesota are so cold!).

  9. No Difference on April 14, 2012 at 6:55 pm


    • No Difference on April 14, 2012 at 6:56 pm

      ERISA? What about ERISA anyway?

      Hmmmmm. I wonder what might happen if Single Payer advocates google on “ERISA” and how it might impact efforts to implement an American Single Payer system?

  10. Geoff Thomas on April 23, 2012 at 8:49 am

    And let’s be very very clear- Lewin’s work will have been slanted to every advantage in the modeling that favors the arguments against single payer: why? because they are fully owned by Unitted HeatlhCare

  11. Lois Hamilton on April 26, 2012 at 3:53 pm

    The state of California has passed Universal Single-Payer Health Care bills now three times. Governor Arnold Schwarzenegger vetoed the bills twice and this last go around, SB810 made it through the Assembly and the Health Care Committee, but failed in the Senate due to all Republicans voting against it and 4 Democrats not voting. These Dems were immediately contacted by residents all over California, who condemned their behavior. In 2012, if we can elect just 2 more Progressive Democrats to the Senate, we may finally get this important bill passed. It looks like Governor Brown would sign it into law! The 2012 election is therefore a extremely important one for Californians.

    • James Dean on July 27, 2012 at 5:15 pm

      Lois, you do realize that California tried a Universal system in the late 90’s and it failed miserably just like every other state that has tried it has. It blew the top off their budget and crumbled after four years. Do you know why this happens? Because just like this article, analysis confirms Universal Healthcare plans are farm more exspensive than proponents are willing to admit. Don’t be fooled.

  12. James Dean on July 27, 2012 at 5:08 pm

    Anyone who believes these statistics are basically undereducated retards. Yes, the state government may save some money but who do you think picks up the slack??? Yes, YOU. With everyone in a risk pool, including people with pre existing health conditions, coupled with the fact low income residents cannot afford healthcare premiums = middle income and high income families will have extremely high monthly health premiums (26% to 42% higher than what they pay now). Not to mention their state income taxes will be raised at the same time. It has already been proven that universal healthcare leads to worse delivery of healthcare due to long lines at the clinics and hospitals. In Canada if you’re a female diagnosed with breast cancer it takes 6 months before you can see a doctor. In England, with same Universal single payer system, if you have breast cancer it takes one year before you are treated. Guess what firm Mark Dayton paid millions of dollars in federal grant money to design our exchange? The same firm that created the universal health system in Canada and England. Funny thing is, citizens from Canada and England, that have enough money, actually come to the USA to get better care faster. The minnesota department of commerce did a study through MIT stating health premiums for residents of MN will increase 26% to 42% and can expect to pay about 9% of their annual income towards health premiums whether they want it or not. Not to mention the largest health insurance companies in MN operate as a non profit organization. BCBS of MN, the largest carrier up here, operates at a 1% profit level and has the highest claim payout percentage of any carrier in the USA. That is why MN has the least amount of uninsured in the country. Don’t let these left wing democrats fool you. Single payer is very expensive and leads to the government telling you when you can and cannot receive care.