Last week, she called for allowing more people to join Medicare — the government-run healthcare program for seniors — by allowing those “55 or 50 and up” to buy into it. Sanders can no doubt take credit for pulling her further left — his proposal to expand Medicare to cover all Americans has evinced widespread cheers from his partisans.
But the record of other single-payer systems at home and abroad should silence those cheers. Single-payer would devastate the quality of health care that patients receive in this country — and would rob them blind in the process.
Sanders has been agitating for single-payer in the United States for decades. The supposed price tag of his latest proposal for “Medicare-for-All?” A cool $14 trillion over 10 years, he’s claimed.
But according to two recent studies from the Urban Institute and the Tax Policy Center, the real cost would be about $33 trillion over a decade — more than double his original estimate. Even after accounting for the revenue that Sanders’s plethora of new taxes would take in, the government would still be short $16 trillion.
Such a program would amount to the biggest expansion of the federal government in history.
Nevertheless, Sanders’s focus on single-payer has lately attracted the attention of voters, doctors, and even state legislators.
A February survey by the Kaiser Family Foundation found that 63 percent of the public had a positive reaction to the term “Medicare for all.” Another Kaisersurvey concluded that more than half of Democrats want to expand Obamacare, the highest share ever recorded.
Meanwhile, thousands of doctors recently signed on to a plan similar to Sanders’s sponsored by the group Physicians for a National Health Program.
Some states could even green-light single-payer in the coming months. This November, Colorado voters will weigh a ballot question on whether to amend the state constitution to create a state-level single-payer system. Such an initiative would cost $38 billion a year — nearly matching Colorado’s entire state budget — and require billions in new taxes.
Coloradans should take note of another state that tried to implement a single-payer system and failed — Sanders’s home state of Vermont.
The Green Mountain State’s attempt at single-payer in 2014 was projected to cost $4.3 billion. That’s almost equivalent to that state’s entire $4.9 billion budget.
To fully fund the program, Vermont would have needed to come up with an extra $2 billion in revenue — and slap an 11.5 percent tax on businesses and 9 percent income tax on residents.
State officials abandoned the idea when it became clear that it would have collapsed the state’s economy. “I wanted to fix this at the state level. And I thought we could,” Gov. Peter Shumlin said in a statement at the time. He later called the implementation of single-payer “unwise and untenable.”
The recent history of single-payer systems sponsored by the federal government shouldn’t be much more encouraging to patients.
Take the Veterans Health Administration (VA), which continues to subject its beneficiaries to lengthy waits for care two years after President Obama promised “urgent” reforms. In March, the Government Accountability Office(GAO) tracked the experience of 180 newly-enrolled vets and found that 60 waited as many as 71 days to see a primary care doctor. Sixty more never even managed to get an appointment.
Worse, the GAO found that the VA was using administrative tricks to mask delays. The department started counting wait times when the VA itself contacted a veteran to set up an appointment — not when the veteran asked for an appointment. The days or weeks between this first interaction and when the VA finally called the veteran weren’t counted in the official wait time.
Patients haven’t fared much better under single-payer systems abroad.
Horror stories from Britain’s National Health Service emerge almost daily. Just this month, a government investigation found that hospitals are discharging elderly patients without ensuring that they’re fit to go home. Another report determined that hospitals are short 50,000 doctors and nurses because of cutbacks to meet spending caps.
This spring, thousands of junior doctors — including those who work in emergency rooms — went on strike in a fight over a new government contract. Patients had no choice but to wait for the walkout to end, as hospitals postponed more than 112,000 appointments and 12,700 operations in response.
Canada, my native land, has similar issues. Canadians must wait an average of 18.3 weeks — four-and-a-half months! — to see a specialist after getting a referral from a general practitioner. That wait time is 97 percent longer than it was in 1993. Almost 900,000 Canadians — or almost 3 percent of the population — are waiting for treatment.
Many Canadians are tired of waiting. In 2014, 52,000 Canadians came to the United States or went abroad for treatment because they deemed the lines for health care at home too long.
Single-payer is especially appealing during an election year, when candidates routinely promise voters everything short of the moon. But the promise of single-payer — high-quality, universally accessible, free — is nothing like the reality of such a system. Taxpayers pay dearly for the promise of such care.
This fall, voters must not allow themselves to fall prey to the siren song of single-payer.