(This post was originally posted 2/25/19.)
(Author’s note: As we enter the last few weeks of the presidential campaign, there are several campaign issues which have been previously addressed in this blog. These include Medicare for All, single-payer healthcare, socialism, school choice and others. In the next few weeks I will be re-posting many of my previous posts on these issues as a review for voters. For this limited time I will be posting six days a week instead of the usual twice a week. These earlier posts will be intermingled with new posts on current topics.)
In Part I of this series, we talked about the Democratic claims for a new healthcare system called Medicare for All, introduced by Senator Bernie Sanders. All of the following claims have been made about this idea:
- Universal access to healthcare
- Elimination of insurance company approvals for treatment
- Increased taxes will be no more than current expenses for healthcare
- Lowered healthcare costs for patients and the government
- Improved healthcare quality for all Americans
- Americans will love this “free healthcare”
Part I began a discussion of the impact of Medicare for All on access to healthcare. Supporters of this bill believe it will increase access to healthcare because more people will have insurance coverage. Currently about 90% of Americans have some form of healthcare insurance coverage. Supporters of Medicare for All believe this bill will provide 100% coverage for all Americans.
However, as I discussed in Part I, having insurance coverage does not necessarily mean having increased access to healthcare. If you can’t get into a doctor’s office for treatment because your coverage doesn’t pay the doctor enough to cover his expenses, you still don’t have access to healthcare. This is often the case with those currently enrolled on Medicaid. Even though they have “coverage” by the expansion of Medicaid, their accessto healthcare has not improved.
Will Medicare for All increase access to healthcare?
To be sure, Medicare for All is a misnomer. It will not be Medicare expanded to cover everyone. It will mean the eliminationof private healthcare insurance, which currently provides healthcare coverage for about 200 million Americans, including those with Medicare supplement plans or Medicare Advantage plans.
Medicare for All is a clever but misleading catchphrase that polls better than describing it as single-payer healthcare– which is exactly what it is. A single-payer healthcare system means the government is the only payer – provider of healthcare. All doctors and hospitals must submit their bills to the government for approval and payment. The government controls the prices, the approvals, and the payments. Nothing gets done without government approval and no one gets paid more than the government allows.
Simply put, this is socialized medicine.Democrats don’t call it that because they know the word “socialized medicine” doesn’t poll well; just like the phrase “pro-abortion” doesn’t poll as well as “pro-choice.”
In every socialized medicine system in the world, including Canada, United Kingdom, Sweden, Denmark, etc., costs are controlled by reducing payments to providers (which reduces providers) and rationing care. This means long waits to see a doctor, government control of approvals, elimination of certain costly treatment options (especially for the elderly), and reduced medical innovation.
Elimination of insurance company approvals
Senator Kamala Harris recently announced her candidacy for president and declared her support for Medicare for All. When asked if her plan would eliminate private healthcare insurers, she agreed it would. She argued, who would miss them? “Who of us has not had that situation where you’ve got to wait for approval and the doctor says, “Well, I don’t know if your insurance company is going to cover this’? Let’s eliminate all of that, let’s move on.”
The naiveté of Senator Harris in this statement is appalling. Even the liberal Washington Post editorial board had to chastise her thinking when they responded, “Actually, no one can really eliminate “all of that” – not Ms. Harris and not possible 2020 candidate Senator Bernie Sanders. Even if the United States adopted Medicare for All or some other version of national health insurance, Americans would not get everything they want whenever they want it. No one, in any country, does.”
Every socialized healthcare system on the planet controls costs by rationing – by decreasing access to healthcare. The Washington Post editors agree. They write, “But what Medicare for All could not do – and what Ms. Harris and others who may tout the idea during the coming campaign cannot claim honestly, – is end healthcare rationing.”
How has this impacted access to healthcare in other socialized medicine countries?
Here is a sample of waiting time in two countries with similar socialized medicine.
- 2 million patients on the NHS waiting lists
- 362,600 patients waited longer than four monthsfor hospital treatment as of March last year
- 95,252 patients waited longer than six months
- 4,300 patients were on the waiting list more than a yearby July
- 19%of patients wait 2 months or longer to begin their first “urgent” cancer treatment
- 17% wait more than 4 months for brain surgery
- The median waiting time between seeing a general practitioner and a specialist was 10.2 weeks.
- 5 months between seeing a doctor and beginning treatment
- 3 months to see an ophthalmologist
- 4 months to see an orthopedist
- 10 months for orthopedic hip or knee replacement
- 5 months to see a neurosurgeon
- 8 months for neurosurgery
- 3 months for initialtreatment of heart disease
These excessive waiting times are not only for seeing doctors but also for obtaining diagnostic studies like CT Scans, MRI scans, and heart catheterizations, as well as to obtain the newest drugs for cancer and other serious diseases. Aside from transplants, the Organization for Economic Cooperation and Development (OECD), which compares other countries, states, “waiting lists are not a feature in the United States.”
Of course, these excessive waiting times lead to poorer healthcare outcomes. Single-payer systems have proved inferior to the U.S. in outcomes for almost all serious diseases, including cancer, diabetes, high blood pressure, stroke and heart disease.
While America is considering implementing a single-payer system like Medicare for All, those countries that currently have such a system are backing away from it with increased spending on private care.
- Sweden has increased its spending on private care for the elderly by 50% in the last decade, abolished its government’s monopoly over pharmacies, and made other reforms.
- The United Kingdom last year spent more than $1 Billion on private care according to the Financial Times.
- In Denmark patients can now choose a private hospital or a hospital outside the country if their wait time exceeds one month.
- Canada is also feeling the pressure on excessive waiting times and is increasing spending on private care for relief.
Scott W. Atlas, senior fellow at Stanford’s Hoover Institution recently wrote in The Wall Street Journal:“A single-payer “guarantee” is no promise of access to quality medical care. If brought to the U.S., the only reliable promises of single-payer would be worse health care for Americans and higher taxes. America’s poor and middle class would suffer the most from a turn to single-payer because only they would be unable to circumvent the system.”
(This series will be continued in the next post – Part III.)