Mainstream Democrats are clamoring for Canadian-style single-payer health care — a demand once relegated to the far-left fringe of the party.
Sixteen Senate Democrats, including several with aspirations for the party’s presidential nomination in 2020, have signed onto Sen. Bernie Sanders’s “Medicare for All” plan. Fealty to single-payer is already proving a litmus test for Democrats running for public office in blue states like California.
The increasing idolization of our northern neighbor’s health system is ironic, as Canada’s single-payer system — which I grew up under — just experienced its worst year ever.
Canadian patients waited a record 21.2 weeks to receive treatment from a specialist after being referred by their general practitioner in 2017, according to the latest survey of wait times by the Fraser Institute, a Vancouver-based think tank. That’s a week longer than last year — and more than double the corresponding figure from 1993, when Fraser began keeping track.
Patients with complex medical needs languished even longer. Those in need of neurosurgery, for instance, faced a median wait of nearly 33 weeks. For orthopedic surgery, wait times exceeded 41 weeks.
Rural Canadians faced similar delays. The median wait time for specialist treatment in New Brunswick was almost 42 weeks. In Nova Scotia, it was nearly 38 weeks. And on Prince Edward Island, over 32 weeks.
While months-long delays are routine in the Canadian system, years-long waits are not unprecedented. One Ontario patient was recently asked to wait four-and-a-half years to see a neurologist.
All told, Canadians are currently waiting on more than 1 million medical procedures. That means that roughly 3 percent of Canadians are biding their time until it’s their turn to be treated, according to Fraser’s calculations.
Canadians don’t just wait to see doctors — they also have to stand in line for diagnostic tests. Patients can expect to wait roughly a month for CT scans and ultrasounds. People who need an MRI stand by for nearly 11 weeks.
These wait times pose a serious cost to patients’ health. As the Fraser report notes, treatment delays can turn “potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities.”
That’s what happened to Walid Khalfallah, a boy whose scoliosis was so bad that he was promised an “expedited” surgery. Despite his dire need for treatment, Khalfallah was forced to wait more than three years for his surgery date. His condition deteriorated throughout his grueling wait, according to a profile in the Vancouver Sun. He is now a paraplegic.
Such tragic stories debunk the notion that Canada provides its citizens “universal” health care. At best, single-payer offers patients universal access to a wait list.
Nor is it true that Canadians enjoy “free” health care. Treatment delays cost Canadian patients an estimated $1.7 billion a year in lost time and wages. Canadians also pay steep taxes to both the federal and provincial governments to fund their health system. The average family of four has to shell out more than $12,000 a year in taxes to cover its share of the cost.
That sum is insufficient to buy the level of care Canadians actually want — especially given that they face no deductibles, co-pays, or other measures that could cause them to moderate their demand for care.
Canada’s provincial governments, each of which run the single-payer system within their borders, don’t directly ration the supply of care. They force providers to do it for them by making the practice of medicine miserable.
Doctors do not work directly for the government. But their only “client” is the provincial government that pays them. And Medicare’s payment rates are so low that entering the medical field or investing in healthcare infrastructure seems to many like it won’t ever pay off.
Orthopedic surgeons in Canada make less than half the salary of their American counterparts. In the 1990s, many Canadian doctors moved to America after provinces cut their pay.
Those already in the field don’t work as many hours as they might if pay were better. Recent graduates, especially specialists, have trouble finding work because the government doesn’t have enough money to pay them.
Others who might have considered careers in medicine look elsewhere, unenthusiastic about investing tens of thousands of dollars and years of their life for which they may never be adequately remunerated.
Rather than pay doctors more, or make medical education more affordable, Canada finds it cheaper to import international medical graduates who are willing to accept what the single-payer system will give them.
American proponents of Canadian health care refuse to acknowledge the shortages and treatment delays endemic to single-payer. On a recent trip to Canada, for instance, Sen. Bernie Sanders rhetorically inquired, “How is it that here in Canada, they provide quality health care to all people . . . and they do it for half the cost?”
A system that forces patients to wait months — sometimes years — for treatment should be nobody’s idea of “quality health care.”
Unfortunately, Sen. Sanders’s single-payer fever has proved contagious. Potential presidential candidates including Sens. Kirsten Gillibrand, D-N.Y., Kamala Harris, D-Calif., Cory Booker, D-N.J., and Elizabeth Warren, D-Mass., have all embraced Canadian-style health care. Meanwhile, lawmakers in California, New York, and other states are toying with installing single-payer systems within their borders, if the federal government doesn’t act.
With President Trump in the Oval Office, aspiring Democratic commanders-in-chief won’t be able to implement single-payer until 2021 at the earliest. But they probably won’t mind the delay. After all, they seem to have no problem with long waits.