What makes for an awful trip to the doctor? Waiting.
Earlier this year, doctor-rating website Zocdoc took a look at its database of doctor reviews and found that long waits or appointment delays were the primary motivators of negative marks from patients.
Given this aversion to waiting, it’s shocking that Americans are coming around to the idea of government-run, single-payer health care. Waiting is endemic to single-payer. The health care systems of countries all over the world prove as much.
Under single-payer, those waits aren’t just annoying—they’re deadly.
Support for single-payer is at record levels. Half of Americans want a single-payer system, according to a new POLITICO/Morning Consult poll. Sixty-seven percent of Democrats back the idea. That’s an increase of 13 percentage points from this spring.
Lawmakers are responding to public opinion. Sixteen Democratic U.S. senators are co-sponsoring Sen. Bernie Sanders’s, I-Vt., recently introduced Medicare for All Act of 2017 to enroll all Americans in a significantly more generous version of Medicare. Four co-sponsors are likely to seek the 2020 Democratic nomination for president: Kamala Harris, D-Calif., Elizabeth Warren, D-Mass., Cory Booker, D-N.J., and Kirsten Gillibrand, D-N.Y.
If these voters and politicians get their way, patients had better prepare to wait for the care they need.
Under the “Medicare-for-All” system envisioned by Sanders and company, patients would face no premiums, co-pays or deductibles. So they’d have no incentive to moderate their consumption of care. Infinite demand for care, coupled with the reality of limited supply, is a recipe for outrageous prices and spending.
The government does not have unlimited resources. It will have to either forcibly cap demand for care by rationing it outright, or hold down spending by setting artificially low reimbursement rates for health care providers.
Government officials will almost certainly opt for the latter. Why take the blame for rationing care when they can point to supposedly “greedy” doctors and hospitals? After all, health care providers will respond to low reimbursement rates by limiting the amount of care that they’re willing to provide.
From the patient’s perspective, the effect is the same — more waiting.
Consider Canada’s single-payer system. According to the most recent data, patients wait 20 weeks to receive treatment from a specialist after referral from a general practitioner. That’s more than double the median wait time of 9.3 weeks in 1993. Canadian patients who need orthopedic surgery have to sit tight for 38 weeks. Those needing brain surgery wait nearly a year.
In total, Canadians are waiting on roughly 1 million necessary procedures.
Patients covered by the United Kingdom’s government-run system, the National Health Service, also wait for absurd periods. Between January and March of this year, almost 1,600 patients waited over 12 hours to be admitted to an emergency room. In England alone, over 4 million patients are currently waiting for surgery. That’s the highest figure in 10 years.
Here in the United States, patients at the single-payer Veterans Health Administration fare no better. Between July and September of this year, nearly 200,000 veterans waited over a month for an appointment. Almost half a million waited more than a month before getting a follow-up.
These wait times can have devastating consequences. My own mother is a victim of the Canadian single-payer system’s excessive waits. Her doctors denied her a colonoscopy, arguing that younger people waiting for such a procedure should go first. In the end, she only got that colonoscopy after she started hemorrhaging. She was hospitalized for two weeks before dying from undiagnosed colon cancer.
Unfortunately, she’s not alone. From 1993 to 2009, diagnosis and treatment delays may have cost over 44,000 Canadian women their lives, according to a study from the Fraser Institute, a Canadian think tank.
Here at home, another analysis from the VA found that veterans who waited more than 31 days for appointments were more likely to die in the following six months than folks who waited less.
Americans have made clear that they’re not interested in waiting for health care. Once they realize that “Medicare-for-All” will worsen what they hate most about American health care — waiting — their dalliance with single-payer will end.