Support for single-payer health care has reached an all-time high, according to Gallup. Seven in 10 Democratic voters — and one in three Republicans — favor a government takeover of the health sector.
They should be careful what they wish for. Single-payer systems have failed everywhere they’ve been implemented, from the United Kingdom to Canada. Americans who fall for single-payer’s promise of “universal health coverage” at lower cost will instead find themselves facing long waits for subpar care.
Support for single-payer is rising in part because voters don’t understand how such a system would work. Forty-seven percent of Americans believe they’d be able to keep their current health plans if the United States adopted single-payer. They wouldn’t. Just look at the single-payer proposals advocated by leading congressional Democrats.
Earlier this month, Democratic National Committee deputy chair Rep. Keith Ellison, D-Minn., became the lead sponsor of a “Medicare-for-All” bill which has already attracted support from more than 60 percent of House Democrats. Meanwhile, Sen. Bernie Sanders, I-Vt., has convinced 16 Democrats to co-sponsor his single-payer bill.
Both bills would effectively outlaw private insurance. The roughly 160 million Americans insured through an employer plan — as well as the 20 million who buy plans in the individual market — would lose their current coverage.
Instead, the federal government would enroll all legal U.S. residents in a one-size-fits-all health plan. The House and Senate bills call for this plan
to provide free care at the point of service. That means patients would face no co-pays or co-insurance when they visit the doctor’s office or pick up a prescription at the pharmacy.
As I argue in my new book, The False Promise of Single-Payer Health Care, such “free” care would come at the cost of patients’ well-being.
When governments make care “free,” they remove any incentive for patients to moderate their use of treatments and procedures. Patients would feel no pressure to choose a cheaper generic drug over a brand-name medicine. They’d see no reason to decline an optional knee replacement.
Since the government would be unable to limit demand for care, it would only have one way to control costs — and that’s to limit the supply of care. Single-payer systems do so by providing cut-rate payments to doctors and hospitals. That discourages people from entering the medical profession, building new clinics and health facilities, and generally logging enough hours to provide all the care that patients would like to demand.
Chronic doctor shortages and overcrowded facilities inevitably lead to long wait times.
Just look at Canada’s single-payer system, which I grew up under. Doctors routinely delay treatment for serious medical conditions. Last year, the median wait time for specialist care following referral from a general practitioner was a record-high 21.2 weeks, according to the Vancouver-based Fraser Institute — up from 9.3 weeks in 1993.
Access to care is so restricted that more than 60,000 Canadians left the country to obtain treatment elsewhere in 2016.
The United Kingdom’s single-payer system — the National Health Service — is no better at providing timely, quality care. This winter, the NHS was forced to cancel 55,000 surgeries to free up hospital beds for flu patients.
Despite the cancellations, the NHS still faced a critical shortage of beds, doctors, and nurses. As many as 100,000 patients were forced to wait in
the backs of ambulances for 30 minutes or more before even entering a hospital.
Earlier this month, a woman who broke her back in a fall languished in pain for two hours while waiting for an ambulance. She waited another five-and-a-half hours to be seen by doctors.
This rationing isn’t accidental. It’s the central feature of all single-payer systems. Two British health agencies recently announced plans to deny routine surgeries to overweight patients and smokers in order to conserve resources.
Somehow, Sen. Sanders, Rep. Ellison, and their allies in states including Washington, Rhode Island, New Hampshire, California, and Massachusetts advancing similar plans always forget to mention that guarantees of “free universal care” apparently don’t apply to those who are overweight.
Proponents of single-payer rarely even acknowledge the model’s tradeoffs and shortcomings. In a trip to Canada last fall, Sen. Sanders praised our northern neighbors’ healthcare system, claiming that there is no question whether “the quality of care is as good or better than the United States.”
But as Canadians and Britons can attest, that’s not true. Single-payer systems ration care by design. Americans mustn’t fall for single-payer’s false promise of free, universal care.