America Marches Blindly Toward Single-Payer
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By Sally C. Pipes
Hillary Clinton just dipped her toe a little bit further into the waters of single-payer health care, prodded by her competitor for the Democratic presidential nomination, Bernie Sanders.
She recently called for allowing more people to join Medicare -- the government-run healthcare program for seniors -- by allowing those "55 or 50 and up" to buy into it. Sanders can no doubt take credit for pulling her further left -- his proposal to expand Medicare to all Americans has evinced cheers from his partisans.
But the record of other single-payer systems should silence those cheers. Single-payer would destroy health care quality and rob patients blind in the process.
Sanders has been agitating for single-payer for decades. The supposed price tag of his latest proposal for "Medicare-for-All?" About $14 trillion over 10 years, he's claimed.
But according to studies from the Urban Institute and the Tax Policy Center, the real cost would be about $33 trillion. Even after accounting for the revenue that Sanders's plethora of new taxes would take in, the government would still need $16 trillion.
Nevertheless, Sanders's focus on single-payer has attracted attention. A recent survey found that 63 percent of people had a positive reaction to the term "Medicare for all." Meanwhile, thousands of doctors recently signed on to a plan similar to Sanders's.
Some states could even green-light single-payer in the coming months. This November, Colorado voters will decide whether to create a state-level single-payer system. The initiative would cost $38 billion annually and require billions in new taxes.
Coloradans should take note of another state that tried to implement a single-payer system and failed -- Sanders's home state of Vermont.
The state's attempt at single-payer in 2014 was projected to cost $4.3 billion -- almost equivalent to the state's entire $4.9 billion budget. To fund the program, Vermont would have needed an extra $2 billion in revenue -- plus new taxes on businesses and residents. Officials abandoned the idea because it would have collapsed the state's economy.
The recent history of single-payer systems sponsored by the federal government isn't much more encouraging.
Take the Veterans Health Administration, which continues to subject beneficiaries to lengthy waits for care. In March, the Government Accountability Office tracked the experience of 180 newly-enrolled vets and found that 60 waited as many as 71 days to see a primary care doctor. Sixty more never even managed to get an appointment.
Patients haven't fared much better under single-payer systems abroad.
Horror stories from Britain's National Health Service emerge almost daily. Recently, a government investigation found that hospitals are discharging elderly patients without ensuring that they're fit to go home.
This spring, thousands of junior doctors went on strike. Patients had no choice but to wait for the walkout to end, as hospitals postponed more than 112,000 appointments and 12,700 operations in response.
Canada, my native land, has similar issues. Canadians must wait an average of 18.3 weeks to see a specialist after getting a referral. That wait time is 97 percent longer than it was in 1993. Almost 900,000 Canadians are waiting for treatment.
The promise of single-payer -- high-quality, universally accessible, free -- is nothing like the reality of such a system. Taxpayers pay dearly for the promise of such care.
This fall, voters must not allow themselves to fall prey to the siren song of single-payer.
Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The Way Out of Obamacare (Encounter 2016).