We should heed the example of the U.K. and Canada, where single-payer is a disaster.
We should heed the example of the U.K. and Canada, where single-payer is a disaster.
B ernie Sanders, the Vermont socialist who is the new chairman of the Senate Health, Education, and Labor Committee, has one great goal left at age 81. He will be spending most of his time trying to convince Congress to enact a single-payer system and eliminate private health insurance.
But Medicare for All would harm and perhaps kill many Americans. Just look at the pain and suffering that England’s version of single-payer, the National Health Service, is inflicting on patients.
The NHS reports that as of November 2022, 2.9 million of the 7.2 million patients referred for treatment waited more than 18 weeks to start treatment. Over 450,000 patients waited more than a year.
The NHS acknowledges that these results do not meet its standards, but it admits that its goal is to ensure that 92 percent of patients wait “no more than 18 weeks.”
NHS emergency rooms also are a disaster. Another NHS report shows that in December 2022, 35 percent of patients were not seen, i.e., had not begun to receive care, within four hours.
The Times of London summed up the grim consequences: “There were 1,600 more deaths than usual during Christmas week. . . . Covid accounts only for a minority of recent extra deaths, focusing attention on ‘compelling’ evidence that the crisis in the NHS is killing hundreds of people a week. . . . Figures from the Office for National Statistics yesterday showed the third consecutive week of more than 1,000 excess deaths.” That means the number of deaths is above the normal average level.
All over the world, single-payer health-care systems are experiencing similar problems. But instead of moving further in the direction that Bernie Sanders wants to go, they are incorporating more private sector solutions.
Take Canada, our next-door neighbor. According to the Fraser Institute, the median wait time in Canada last year between referral and treatment was 27.4 weeks, the longest on record, compared with just 9.3 weeks in 1993.
The province of Ontario (which has 40 percent of Canada’s population) has a backlog of 206,000 surgeries. Ontario’s Conservative premier, Doug Ford, has announced he will allow more patients to visit private clinics for cataract and joint-replacement surgeries as well as MRIs and CT scans.
But even former officials from Canada’s Liberal Party are urging fresh thinking. Bill Morneau, former finance minister under Canada’s left-wing prime minister, Justin Trudeau, says Canada must change a system that costs some 13 percent of the nation’s gross domestic product and yet delivers shoddy results.
In the U.S., the largest government-run health-care program is at the Department of Veterans Affairs. It handles more than 7 million patients a year. It, too, has been forced to move away from its own single-payer model.
In 2018, Congress passed, and President Trump signed into law, a bill allowing veterans much more access to private-sector care when in-house treatment was unavailable in a timely manner. Naturally, Bernie Sanders was one of only five senators to vote against the bill.
In 2021, the Biden administration appointed Denis McDonough, who served as chief of staff in President Barack Obama’s White House, as its secretary of Veterans Affairs. He had the authority to change the rules and scale back the private-sector reforms.
Instead, the outsourcing of VA patients to private providers has grown and now consumes more than a third of veteran health care. McDonough reported to Congress last year that the VA and its outside contractors are engaged in a “healthy competition to be the best, most accessible highest quality option” for patients. He “is proposing no immediate changes” to the new system.
The problem of runaway costs in government-financed medical care is, of course, facing a day of reckoning. Actuaries report that the Medicare hospital fund will be broke only five years from now, in 2028. But the solution is certainly not to expand Medicare’s mission, as Bernie Sanders will be pushing for. That would not only bankrupt the system more quickly; it would lead to worse outcomes.
The Senate should kill Medicare for All before it kills us.
John Fund is National Review’s national-affairs reporter. David Simon is a lawyer in Chicago and a fellow at the Committee to Unleash Prosperity.