Alice Marshall
Jul 7, 2015 · 2 min read

Bringing a single payer system to DC, what it will take

Under Obama’s Affordable Care Act, states, including the District of Columbia, can establish their own single payer systems. We have Bernie Sanders to thank for this provision.

So how can we bring a single payer system to DC? How can we win the benefits of total healthcare security for residents of DC?

First we must explain what a single payer system is, that is is like Medicare, except that it would be administered by the city and would cover everyone from cradle to grave.

We must be specific, voters will never support this except that we can explain how it would work. Would we have a health tax, such as they have in Canada? And how much would people pay? So we would need people with expertise with such systems. Fortunately this city has this expertise in abundance. However, presently these experts are concentrating on the national movement. We need to persuade some of them to give some of their time to a local effort.

We need experts in the DC budget, who can explain how much the city presently pay to insure DC employes, and contracting fees for Medicaid providers, and how this would be far cheaper for the city to self insure for all residents rather than pay for-profit third party providers who charge a great deal and provide poor service in return.

We need to enlist the help of accountants, who can demonstrate what most businesses presently pay for insurance and how a single payer system would drastically lower their costs, in addition to creating a level playing field where start ups could easily compete on the benefits side of compensation with the largest employers.

We need economists who can explain the multiplier effects of what would happen if we did not have to dump so much of our disposable income on healthcare.

We need web designers to create a decent website.

We will need fundraisers to raise the money to pay for web development, IT equipment, and staff. Initially the costs will be low, but we will have to raise something in the neighborhood of $200,000 in order to sustain the sort of campaign necessary to persuade the mayor and city council to pass this.

If you are interested in helping with this, contact me at

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Alice Marshall

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Author of “The precinct captain’s guide to political victory, buy it on Amazon Kindle.