In the United States, we have a system called Medicare where Americans over 65 and with select medical needs receive heavily subsidized health insurance. There are differing Medicare plans, where wealthier folks can receive better coverage and drug subsidies. Medicare-for-all would expand this coverage to cover all Americans, regardless of age or health condition.
Single-payer care is defined as when one entity pays for health care. So if the United States adopted Medicare-for-all (under the Bernie Sanders plan), every American would have their health coverage paid for by the government through government-controlled health insurance. Instead of nationalizing the hospitals, the government would pay insurance companies directly to cover health care costs. Medicare-for-all would create a single-payer system in the United States.
Currently, our system is a broken employer-employee-government patchwork paying for different health insurance companies. The system is extremely complicated, but it has become so entrenched that it is very difficult to reform the system. A lot of different insurance companies, drug manufacturers, and health care employees benefit from the status quo. Our high costs come from our inefficiencies in every level of the health care system. It’s been so broken for so long, it will take a drastic change to fix it.