Republicans left Washington this month having failed to repeal and replace Obamacare. Many Democrats and their ideological allies are using the congressional recess to crow about the GOP’s defeat — and dream about replacing Obamacare with a bonafide single-payer system.
Sen. Bernie Sanders, I-Vt., has promised to introduce a single-payer bill next month. “I have no illusions that . . . suddenly we’re going to see a Medicare-for-all, single-payer passed,” he said last week. “Why is the United States the only major country on earth not to guarantee health care to all people?”
Several folks within the senator’s sizeable political following have hinted that support for single-payer will be a “litmus test” that will determine whether they will get behind Democratic candidates — or primary them.
Such triumphalism is unwarranted — and could be Democrats’ undoing. Government-run, single-payer healthcare systems the world over deliver poor-quality care at extremely high cost, both in dollars and lives.
Take the “Medicare-for-All” plan Sanders introduced last year when running for president. The plan would have enrolled all Americans in Medicare — and even provided extra benefits like vision, hearing, and mental health care. Sanders claimed that the plan would save Americans $6 trillion over the next decade.
But that figure is fantasy. Sanders’s savings estimate rested on the premise that the plan would cost $1.4 trillion yearly.
But a comprehensive analysis by Emory University professor Kenneth E. Thorpe revealed that it would actually cost $2.5 trillion — nearly double what the Sanders campaign claimed. Another study by the Urban Institute found that the plan would increase spending by $32 trillion over the next decade.
Medicare is already in dire financial straits. It can barely afford to pay for the treatment of those currently enrolled in the program. Medicare Part A, which covers medical services in hospitals, will be bankrupt in 12 years. Over the next decade, Medicare spending in total will nearly double, to $1.1 trillion.
Several states recently backed away from implementing their own single-payer systems after getting a look at the price tag.
Last November, Colorado voters rejected Amendment 69, a ballot initiative that would have created a single-payer system in the state, by an 80-20 margin. An independent analysis revealed that the plan would have run a deficit of $253 million in its first year — and $7.8 billion by 2028.
Bernie Sanders’s own state of Vermont experienced similar sticker shock. The plan under consideration in the Green Mountain State would have cost $4.3 billion — nearly 90% of the entire state budget.
To cover that tab, payroll taxes would have surged 11.5%; income taxes would have increased 9%. Consequently, in 2014, Democratic Governor Peter Shumlin shelved the plan, deeming it “unwise and untenable.”
Just this summer, California pressed pause on a proposed single-payer plan. The bill creating the system would have about doubled the state budget. Its chief sponsors offered no details on where that money would come from.
Assembly Speaker Anthony Rendon, a Democrat, pointed out as much — and said that he would reconsider the bill if its proponents could come up with a funding scheme. They have responded by launching an initiative to recall him from office.
Other nations have found ways to provide single-payer more affordably. And that is by rationing care.
The median Canadian, for example, waits nearly five months to get treatment from a specialist after receiving a referral from his general practitioner. That is more than twice the wait of 25 years ago.
The United Kingdom’s single-payer system offers more of the same. At the end of June, 4 million people were waiting for care. That is the highest figure in a decade.
Is this really the path the United States wants to go down? According to a June Pew survey, only 33% of Americans think single-payer health insurance is a good idea. But that number is up 12 percentage points since 2014.
It should come back down, once Americans realize that single-payer means paying a lot more for a lot less health care.