The Ugly Reality of Single-Payer

Late Sunday night, just hours before the fourth Democratic presidential debate, Vermont Sen. Bernie Sanders unveiled what’s probably the purest expression to date of his unreconstructed 1970s radicalism: a plan for “universal” single-payer health care in the United States.

Proudly titled “Medicare-for-All,” the Sanders scheme would eliminate the private insurance industry and establish a single, federally run insurance pool open to all.

Sanders promises a healthcare utopia – a future of “no more co-pays, no more deductibles and no more fighting with insurance companies.” During Sunday’s debate, the candidate claimed that his health care plan would “save the average middle-class family thousands of dollars a year.”

This is complete nonsense. Every other single-payer system around the world delivers subpar care at astronomical cost. Worse still, the multitrillion-dollar tax hikes – that’s “trillion,” with a “t” – that Sanders has proposed to finance his single-payer monstrosity would decimate the American economy.

Voters in need of a definitive reason to dismiss Vermont’s “democratic socialist” as a legitimate candidate now have one.

Sanders’s “Medicare-for-All” proposal would require $14 trillion in new public spending over the next decade and would expand the size of the federal government by over 50 percent. He plans to cover those costs by ratcheting up taxes on virtually everyone. He wants to hike income tax rates by 2.2 percentage points and levy a new 6.2 percent payroll tax on employers. He’d also dramatically crank up income tax rates for families making over $250,000 year. And he’d set the estate tax at 65 percent.

These new taxes would slow our economy to a halt. They’d rob businesses of capital to invest in expansion and job creation. The returns on entrepreneurship would dwindle. Corporations would direct investments to friendlier environs abroad.

Sanders ought to be intimately familiar with the eye-popping costs of single-payer. They just prevented leaders in his home state from implementing a single-payer scheme within their borders.

Four years ago, the Vermont legislature approved a plan to create a state-level single-payer system with basically all the features of Sanders’s “Medicare-for-All.” But last month, Gov. Peter Shumlin announced that he’d be killing the project, specifically because the requisite tax increases on individual earners and businesses “might hurt our economy.”

The Sanders “Medicare-for-All” plan is specific about how much lucre it’ll extract from the American public, but short on the details about how it would actually be administered. How will physicians’ compensation be determined? Who will they work for? For those that refuse to leave private employment, what will the punishment be? Who will own hospitals? The list of unanswered questions goes on and on.

Sanders and his ilk are pushing for single-payer in the United States in large part because they admire socialized health care systems in other countries like the United Kingdom and Canada. In their romanticized view, single-payer is more efficient, more egalitarian, more humane and less costly.

But the facts don’t fit that portrayal. Single-payer systems typically use price controls to control the cost of health care goods and services. Those price controls cause the purveyors of health care goods and services to limit the supply that they’ll deliver. Limited supply meets unlimited patient demand – after all, health care appears “free” – and shortages result.

There isn’t enough equipment. There aren’t enough doctors. And patients, while technically insured, have to endure long wait times before they actually receive care.

Take the United Kingdom. Over 3.4 million British patients are currently stuck on waiting lists for care, the biggest total in nearly a decade. That includes 6,100 that have been forced to wait for at least a year.

Those waiting lists have consequences. According to one major study, some 13,000 Brits died unnecessarily while in government hospitals between 2005 and 2012. Researchers unearthed systemic abuse and negligence. Sick patients were left to waste away in soiled beds without food or water

In Canada, over 40 percent of patients have been forced to wait two months or more to see a specialist. In rural provinces, the problem is even worse. A recent report found that 90 percent of spine surgery patients in Alberta have had to wait at least six months to get treated.

This is the ugly reality of single payer. And it’s what Sanders would bring to America if he becomes president.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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