Single payer universal health insurance pools health risks across all citizens and provides equitable access to care through a single benefits package and single payer of providers, typically a government. Countries with single payer systems like Canada, UK, Taiwan, and New Zealand achieve lower costs through reduced administrative expenses and ability to manage health spending. Taiwan's single payer system provides universal coverage through mandatory employer and individual premiums with subsidies for the poor, equal access to comprehensive benefits, and a single government payer that standardizes administrative procedures to reduce costs and improve care quality. While single payer could reduce costs in the US, political and technical challenges remain in implementing such a system.