In one recent poll, a majority of doctors expressed at least some level of support for a government takeover of the U.S. health care system. In March, Bob Doherty, an executive with the American College of Physicians, wrote that “more and more ACP members are advocating that the College come out strongly in favor of single-payer health care, and not just in so-called liberal-leaning ‘blue’ states.”
But doctors should be careful what they wish for. A single-payer system would leave them overworked, underpaid and unable to meet their patients’ needs.
In the United Kingdom’s single-payer system, the National Health Service, physicians are all too familiar with the occupational hazards of government-run health care.
Doctors are paid a fraction of what their American counterparts earn. Starting pay for junior physicians is just £22,636 a year, or $31,757. That’s 20 percent less than the country’s average annual income. British subway drivers earn more than double what junior doctors do.
Experienced physicians aren’t paid much better. The average general practitioner in the NHS earns roughly £90,000, or about $127,000. Here in the United States, that same doctor could expect to make $217,000 — 70 percent more.
Some British doctors supplement their income by seeing the roughly 10 percent of patients who carry private medical insurance.
NHS doctors are paid less yet work every bit as hard as their U.S. peers. British junior doctors often log 100-hour weeks. In a recent survey of young U.K. physicians, 62 percent said they had gone through at least one shift in the previous month without eating a meal.
They work so hard in part because the NHS doesn’t have enough money to appropriately outfit its facilities. One in 11 staff positions is currently vacant. At one point in January, 133 out of 137 of England’s NHS hospital trusts had an unsafe number of patients in their care.
Hospitals are overcrowded. This past winter, an estimated 120 patients a day were treated in hallways because of a lack of open beds. Thousands more were forced to wait hours in the backs of ambulances before being allowed into a hospital.
And things are unlikely to improve. The NHS’ deficit is expected to reach £930 million, or $1.3 billion, by the end of this year.
In the face of such brutal working conditions, many NHS doctors are bailing out of the system altogether. According to a 2017 survey, 40 percent of the system’s general practitioners intend to quit.
Those who aren’t heading for the exits are putting their own well-being at risk. Nearly two-thirds of young NHS doctors admit that their jobs have done damage to their mental or physical health.
It’s no mystery why the National Health Service is so frail. An entire nation’s health care sector is simply too dynamic and complicated to be managed successfully by the government. And when limited public resources are mismanaged, rationing, overcrowding, staff shortages and pay cuts ensue.
Doctors be warned: Single-payer fever is contagious and dangerous. A government takeover of the American health care system would pay doctors less, work them harder and effectively prevent them from delivering high-quality care.