What is the definition of a dual-payer system?

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Single-payer and dual-payer refer to the reimbursement source in (for example) the health care system. In a single-payer system, one entity underwrites all the medical bills; in a dual-payer system, two entities share the burden of cost.

The terms have recently been used to distinguish a federal government-supported program, similar to to Medicare (single-payer), from one where the cost is shared by the federal and state governments, similar to Medicaid (dual-payer).

If someone is complaining about single-payer health care (generally refers to the federal government), they are most likely concerned about taxes, quality of care and access issues. If someone is complaining about dual-payer health care, they are most likely concerned about federal legislation imposing unfunded mandates on the states, or about the states' ability to carry their share of the expenses.
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