Single-Payer Is Failing Overseas — We Shouldn’t Adopt It Here
Two weeks ago, Sens. Michael Bennet, D-Colo., and Tim Kaine, D-Va., introduced a bill that would effectively allow some Americans to buy into Medicare.
Other congressional Democrats favor an even more aggressive expansion of the program. Sen. Debbie Stabenow, D- Mich., recently proposed dropping the program’s eligibility age from 65 to 55. Last month, Sen. Bernie Sanders, I-Vt., unveiled a full-blown “Medicare-for-All” single-payer plan, which promptly attracted 16 co-sponsors.
These lawmakers need a reality check. The single-payer systems they idolize are imploding in Canada and the United Kingdom. Patients are dying, costs are skyrocketing and people are fleeing to seek care elsewhere.
It’d be madness to replicate these failing models in America.
The United Kingdom’s single-payer system, the National Health Service, is “straining at the seams” in the face of rising demand and dwindling resources, according to a new report from regulators at the Care Quality Commission.
To control costs, the NHS restricts construction of new health care facilities. That results in overcrowding. The number of available nursing-home beds has dropped by 4,000 over the past two years. Hospital occupancy rates have exceeded recommended levels since 2012.
The NHS also limits funding for staff. That results in chronically undermanned facilities and higher burnout rates. Staff vacancies at NHS facilities jumped by an alarming 16% in the last two years.
All that results in lengthy delays for patients. Wait times for patients seeking non-urgent treatment recently hit a nine-year high. Doctors have to push back surgeries 75% more often than they did just four years ago, according to the BBC.
These delays aren’t concentrated among just a few underperforming facilities. All but one of the nation’s 135 hospital networks, or “trusts,” failed to hit its “wait time targets” in 2016 and 2017. Consequently, many patients were forced to wait more than four hours for emergency department care or did not receive cancer treatment within 62 days.
This rationing leads to needless suffering. Terminally ill patients sometimes go without pain relievers and nursing support, according to a report from the King’s Fund, an English think tank. At least four patients recently went either partially or completely blind while awaiting treatment for macular degeneration, according to the Care Quality Commission report.
Britons know that their single-payer system isn’t working. In a recent interview, England’s chief hospital inspector openly admitted that the NHS is not “fit for the 21st century.”
The NHS is hardly an outlier. Canada’s single-payer system is also plagued by rationing. The median patient must wait 20 weeks after receiving a referral from a general practitioner until receiving treatment from a specialist. Canadians who need neurosurgery typically wait 47 weeks — nearly a full year — between referral and treatment.
Even simple procedures entail long delays. Patients wait almost four weeks for CT scans. Canada only has 15 CT scanners per million people. That’s 22nd out of 28 countries, according to a recent Fraser Institute report comparing the accessibility of various health care services in advanced nations.
The quality of treatment at Canada’s hospitals is tragically poor. Earlier this year, a patient in Halifax, Nova Scotia’s largest hospital spent six hours in a cold hallway with a broken IV in his vein before finally seeing a doctor. He died several hours later.
Conditions are so bad that several citizens are suing the government for the right to opt out of the single-payer system. Right now, it is illegal to buy private insurance plans that cover doctor visits, hospital stays or other services provided by the single-payer system.
A group of surgeons and their patients are challenging this prohibition. The case is currently before British Columbia’s Supreme Court. If the plaintiffs win, British Columbians could finally have an alternative to single-payer. The ruling could also set a precedent for the rest of the country.
The plaintiff in a similar 2005 lawsuit, Chaoulli v. Quebec, prevailed. But a 2014 suit in Alberta failed.
It’s no wonder that over 60,000 left the country in 2016 to seek non-urgent treatment elsewhere in the world.
Despite the obvious shortcomings of the British and Canadian systems, some progressives still view single-payer as the pinnacle of health care policy — a model so perfect it hardly needs defending. Sen. Sanders has said that it’s an “international embarrassment” that America hasn’t followed other developed nations in embracing socialized medicine.
What’s truly embarrassing is that members of Congress, not to mention leaders in several states, keep pushing for single-payer in the United States even though it’s failed everywhere else it has been tried.