Perhaps the cold — or the proximity to Canada — got to New Hampshire’s voters on February 9.
Both Republicans and Democrats in the Granite State handed presidential primary victories to candidates who have — at one time or another — supported government-run, Canadian-style single-payer health care.
Sen. Bernie Sanders, I-Vt., who crushed Hillary Clinton in New Hampshire but lost in Nevada, has come out with a detailed plan to outlaw private insurance in the United States and create “Medicare for all.”
Donald Trump, meanwhile, who handily beat his GOP competitors in both New Hampshire and now South Carolina, once argued for single-payer in the United States. He claimed that it works wonders in other countries, including Canada.
So goes New Hampshire, so goes the nation? Let’s hope not. Single-payer would ruin America’s healthcare system, deliver subpar care to patients, kill jobs, and bankrupt the country.
Trump has been extremely vague — and often contradictory — about what he’d do to reform our nation’s healthcare system. He has promised that he’d repeal Obamacare and replace it with “something terrific.” Let’s hope that Trump’s replacement would be different from what Sen. Sanders is pushing, in spite of the Donald’s past praise for single-payer.
In his 2000 book The America We Deserve, Trump wrote, “We need, as a nation, to reexamine the single-payer plan, as many individual states are doing.” When asked about that line during the first Republican presidential debate, Trump said that he’s no longer in favor of single-payer in the United States. But he did say, “It works in Canada. It works incredibly well in Scotland.”
But Trump has, when pressed for details on what he would put in Obamacare’s place, recently sounded an awful lot like a single-payer advocate. “Everybody’s going to be taken care of much better than they’re taken care of now,” he told“60 Minutes.” And “the government’s gonna pay for it.”
He reiterated these thoughts during last week’s town hall debate for GOP candidates. While talking with CNN’s Anderson Cooper, Trump said: “We’re gonna take care of [patients] through maybe concepts of Medicare.” He then went on to praise Obamacare’s individual mandate — the deeply unpopular part of the law that fines people for not having health insurance.
While Trump has since walked back these comments, they are nevertheless troubling.
Sanders has been upfront about his plans for a government takeover of the U.S. healthcare system. He wants to get rid of private insurers entirely and have the government administer healthcare plans. Uncle Sam would pick up the costs — primary care, specialty treatments, long-term care, vision, dental, the works.
Sanders figures the bill for his plan will come to $1.4 trillion a year. He justifies that expenditure by claiming that it would trim $600 billion from what we’d spend if things continued as they are.
So even though he has to raise taxes on businesses, the rich, and the middle class to pay for “Medicare for all,” Sanders says everyone — except the rich, of course — will save money, because they’ll no longer have to pay premiums or out-of-pocket costs. By Sanders’s math, a family of four making $50,000 a year would pay $466 in taxes — but save more than $6,000 in premiums and deductibles.
That math is, shall we say, fuzzy.
Emory University professor Kenneth Thorpe reviewed Sanders’s plan and found that it would cost almost twice what Sanders says. Thorpe concluded that the Sanders proposal would require a massive new 14.3 percent payroll tax and a 5.7 percent boost in income tax rates.
Tax rates that high would end up killing 11.6 million jobs, according to an analysis by the Manhattan Institute’s Yevgeniy Feyman.
It’s easy to see how Sanders low-balled his cost estimates. He says, for example, that he can save vast amounts of money by doing away with private insurance overhead. But last year, overhead costs amounted to $222 billion, according to the Centers for Medicare and Medicaid Services. By 2024, these costs will still only be about half what Sanders claims he can save each year.
Where will the rest come from? Steep, unsustainable cuts in government payments to doctors, hospitals, and drug companies, along with good-old-fashioned rationing of care.
Consider the Canadian single-payer system, which is way less generous with taxpayer money than Sanders proposes.
About 30 percent of health spending in Canada comes from private sources. This spending goes toward services that the Canada Health Act does not cover, like Lasik surgery or cosmetic surgery. Yet Canadians must still withstand lengthy delays for routine and specialized care. Today, the average patient must wait more than 18 weeks from seeing a primary-care physician to receiving specialty care.
Canadian patients also have less access to advanced medical tests, like MRIs, than do their American peers. When many Canadians need care, they often fly south to the United States — and pay out of their own pockets for it.
It’s not surprising that Sanders, a lifelong socialist, would turn a blind eye to the pitfalls of Canada’s healthcare system.
But it is surprising that Trump, who claims to be a successful businessman and a conservative, would think that such a plan could ever work. Other GOP candidates have broadly outlined Obamacare replacement plans that would dial back government’s involvement in health care, not inject it still further.
If Trump wants to win the GOP nomination, he would be wise to join the rest of the GOP party and embrace a mark-based replacement plan for Obamacare. Republican primary voters would then have a plan that supports their views. Let’s hope Trump realizes this in the weeks to come.