Single - payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care. Single payer health care is a universal health care system where a "single" fund pays for health care costs (rather than private insurers). Under a single - payer system, all Americans would be covered for all medically necessary Financing single - payer national health insurance: Myths and facts. Financing single - payer national health insurance: Myths and facts. Myth: Employers fund the majority of health care in the U.S. Fact: Private business funds less. What is Single - Payer? If you'd like to learn the basics about what all this " single - payer " talk is all about, we've got the answers. A common myth among opponents of single - payer national health of the Affordable Care Act (ACA)—a misnomer given the following facts.