Trust in public health has been shattered in the wake of COVID. Confidence in government health authorities has plummeted – 64% rate the FDA as “only fair or poor” and 58% rate the CDC the same.
Ironically, and in defiance of Americans demanding more health autonomy, Sen. Bernie Sanders has put forth a radical Medicare-for-All 2023 bill to impose the ultimate government control over health care – single-payer, socialized medicine. It not only controls the allocation of all medical care, but it explicitly outlaws private insurance competition with the government and creates a new “Office of Health Equity” that forces an extremist ideology on American taxpayers.
Sanders writes that his justification is “to end the international embarrassment of the US being the only major country that does not guarantee healthcare.”
Pretending that labeling people “insured” means “guaranteed care” is gaslighting Americans. In England’s NHS with its guarantees, a record-setting 7.4 million patients are on NHS waiting lists; over 371,000 patients are now waiting more than one full year, even after initial diagnosis and referral. In Canada’s single-payer system, the 2022 median wait from GP referral to first treatment, after already seeing a doctor, was about 7 months.
Even seriously ill patients referred for “urgent treatment” wait months after their doctors recommend treatment. In England’s NHS, more than 41% of cancer patients wait more than two months after GP referral for their first “urgent treatment” and 49% wait more than four months for their recommended brain surgery. Canadians with already diagnosed heart disease wait a median of 16.4 weeks for their first treatment; for neurosurgery after already seeing a doctor, they wait 58.9 weeks – more than one year.
All U.S. wait times are far shorter and have remained so – even comparing the lowest priority visits, including healthy check-ups, to seriously ill patients in single-payer countries. Current waits in the U.S. for all five surveyed specialties, regardless of insurance, average only 26 days. While Canadians wait 48 weeks to see an orthopedist after referral from their GP, Americans wait only 16.9 days; Canadian women wait 15.7 weeks for their OB-GYN appointment after referral for illness, while American women wait 31 days for their non-urgent check-up.
The pandemic lockdowns further highlighted the abject failure of single-payer systems. The UK’s Institute for Public Policy projected it will take seven years for missed cancer chemotherapy and twelve years for missed radiation therapy backlogs to clear. Many will die waiting. And despite the marketing that the NHS is a badge of national pride, satisfaction by the British fell to 29% and dissatisfaction rose to 51% – the worst since the first survey 50 years ago. Is it any wonder that we are finally seeing UK media call out the nation’s “reluctance to admit just how bad the reality is”?
The consequences of single-payer restrictions are clear – patients in those systems have suffered worse outcomes from all the most common serious diseases. For decades, the U.S. has had consistently superior survivals from cancer than single-payer systems, a fact Europeans begrudgingly admit (“Europeans are way, way more likely to die of cancer than Americans… Turns out the US is actually doing something right when it comes to health care”), as well as best treatment outcomes for diabetes, high blood pressure, stroke and heart disease. Should Americans ignore that over a 16-year period, more than 44,000 additional Canadian women died due to Canada’s wait times for treatment?
And it’s not only long waits for doctors that cause worse outcomes. Americans benefit from the broadest usage of screening tests for early cancer detection; widest access to safer, more accurate MRI and CT technology and critical care ICU beds; and fastest access to new, life-saving drugs. I doubt that cancer patients in single-payer systems were bragging about their “guarantees” when drug availability within two years of approval of the world’s 54 new cancer drugs lagged in the UK (38/54), Australia (15/54), France (23/54), and Canada (29/54), while U.S. patients had access to almost all (51/54).
As part of his gaslighting, Sanders won’t admit that countries with decades of single-payer experience now shift patients to the private sector to hide single-payer failures. According to the Nuffield Trust, NHS has increasingly paid for private care, ballooning by 70% to over £9.7 billion, because the NHS itself cannot deliver. Originally a negligible amount, the share of NHS money funneled to private doctors has increased to 45% of cataract surgeries and to 50% of hip and knee replacements. Sweden also relies on private care, privatizing pharmacies and a growing fraction of primary care facilities, while increasing spending on private-care contracts by 50% in the past 15 years. More and more individual Brits choose to pay for private care, on top of their NHS taxes; more than 690,000 Swedes now carry private health insurance, an increase of 42% since 2011. Governments of Finland, France, Ireland, Italy, the Netherlands, Norway, Portugal, Spain, Sweden, and Denmark with single-payer all shift taxpayer money to buy private care, sometimes even outside the country, to solve their scandalous failures. Did Sanders already forget that our own single-payer system, the VA, was forced to shunt patients to private care to address its failures?
Sanders must not care that abolishing private insurance will also abruptly end access to timely medical care for seniors currently on Medicare, because that access depends on payments from private insurance. Medicare pays hospitals and doctors below the cost of delivering health care – 60% of what private insurance pays for in-patient services, and 60-80% for physician services. The private insurance used by more than two-thirds of Americans pays 140% over the cost of care, allowing hospitals to stay in business. Even with private insurance intact, CMS has repeatedly issued dire warnings about losing access and quality of care for Medicare patients, calculating that most hospitals, skilled nursing facilities, and in-home care providers already lost money per Medicare patient. Given that 80% of seniors on Medicare also buy private insurance to replace or supplement traditional Medicare via employers, Medicare Advantage’s private options, or MediGap, I wonder what seniors will think of their Medicare once Sen. Sanders forces them to rely on it, forbidding them from supplementing it with private coverage?
Government-run health care has failed the world over. It’s time for individuals to stop politicians from disregarding facts while recklessly imposing their power, and instead demand control of the health care dollar and choices on how to spend it. And let’s be honest about yet another immorality hidden by Sen. Sanders: As with the harms from government lockdowns during COVID, it’s the poor and working class who will be stuck with single-payer health care, because only they will be unable to afford to circumvent that system.
