Doctors Who Support Single-Payer Should Seek a Second Opinion
Sen. Bernie Sanders isn’t alone in his adoration for universal healthcare. According to one recent survey, 56 percent of U.S. doctors are at least somewhat supportive of government-run healthcare.
Their support is somewhat understandable. Every insurer has different administrative requirements, covers different therapies at different levels, and reimburses on a different timeline. Medicare and Medicaid complicate matters further. Dealing with only one insurer — the government — may sound appealing.
But one look at the United Kingdom’s government-run National Health Service should cure American doctors of any fondness for socialized medicine. The NHS, founded in 1948 and poised to celebrate its 70th birthday this year, is currently in a state of crisis. Patients must endure long waits only to receive subpar care. British doctors, meanwhile, must put up with low pay, high stress, long hours, and low morale.
American doctors haven’t always been keen on government-run health care. As recently as 2008, a strong majority of U.S. physicians opposed the idea.
The NHS’s state today shows that U.S. docs were right a decade ago. The starting salary for the average junior doctor in the United Kingdom is a meager £22,636 — just under $32,000. That’s nearly 17 percent below the nation’s average income.
To put that in perspective, a British subway operator makes roughly double the income of a junior doctor each year.
Such low pay is often accompanied by demanding work schedules. Junior physicians can be subject to 100-hour workweeks.
And while British doctors’ salaries increase as their careers progress, their pay still lags far behind that of American physicians. The average salary for a general practitioner in the United Kingdom is £90,000— around $124,500.
In the United States, the average pay for a primary care doctor is $217,000.
Given the relatively low pay for British doctors, it should be no surprise that there’s a significant shortage of staff throughout the NHS. As recently as last month, 71 percent of hospital doctors reported staff shortages in their departments. That’s a 6 percent increase in staff shortages, compared to May 2017.
Unsurprisingly, these shortages make it difficult for doctors to provide quality, timely care. Just last month, 68 emergency-room physicians warned the British government that it is now common to treat patients in hospital corridors — and that “some [are] dying prematurely” as a result.
NHS doctors are all too familiar with rationing of this kind. Last year, the British Medical Journal reported a surge in rationing for various treatments, including cataract surgery, hip replacements, and arthritis medication. One physician slammed NHS policies as “unfairly and unnecessarily prolonging the time patients will spend in pain.”
These high-stress environments — coupled with inadequate compensation — help explain why many NHS doctors are looking to leave the profession. An April 2017 poll found that 40 percent of general practitioners planned to quit the NHS, in part due to “perilously” low morale.
Dismal working conditions can take a toll on a doctor’s well-being. In another survey from last year, nearly two-thirds of young doctors reported that their physical or mental health had been compromised by the stresses of working in the NHS.
These conditions explain in part why NHS has struggled to attract doctors. Last year, NHS England launched an expensive and highly publicized initiative to recruit 600 general practitioners from abroad by April 2018. New reports show that they will add just 100 new general practitioners by that time — 500 short of their goal.
Sadly, such inefficiencies aren’t unique to the NHS — they are the hallmark of all single-payer systems. The government-run health system in my native Canada, for instance, is so overburdened that the typical patient waits 21.2 weeks for treatment from a specialist after receiving a referral from his general practitioner. In 1993, the median wait was less than half that figure — 9.3 weeks.
In individual provinces, waits can be even longer. The median wait time in New Brunswick is almost 42 weeks for treatment from a specialist after referral from a general practitioner. In Nova Scotia, it’s nearly 38 weeks; in Prince Edward Island, 32 weeks.
The reason for these failures isn’t difficult to grasp — government bureaucracies are incapable of effectively managing entire sectors of our
economy, where thousands of people make millions of decisions each day. Absent price signals, competition, and other market forces, shortages, rationing, and treatment delays are inevitable.
If America were to follow the United Kingdom’s example by implementing “Medicare for All,” we’d soon have our own version of the NHS crisis.
The U.S. health system is far from perfect. But unless doctors are eager for the government to make them underpaid, overworked, and incapable of providing high-quality care, they must eschew the single-payer model.