October 19, 2015
This month, Bernie Sanders took his vision for the future of American health care to a national television audience in the first Democratic presidential debate.
“We should look to countries like Denmark, like Sweden and Norway and learn from what they have accomplished,” Sanders said. He wants the United States to copy Denmark’s single-payer health care system.
This idea electrifies his supporters. Under a Sanders presidency, he promises, there’d be no more spiraling insurance premiums or high drug prices.
But a closer look demonstrates that single-payer — in Denmark or anywhere else — devastates a nation’s health care system. Sanders’ plan would do nothing but guarantee exploding costs, long wait times, and low-quality care.
Consider Medicare, the federal health care program for seniors. Last year, Medicare wasted $60 billion — about 10 percent of its budget — on improper or fraudulent payments. That money went to nonexistent healthcare providers with phony addresses and doctors with suspended licenses. And the government was none the wiser.
Because of Medicare's massive size and inability to adequately monitor its spending, the Government Accountability Office first labeled the program “high risk” in 1990 — meaning especially susceptible to fraud and abuse.
Unsurprisingly, the program is headed toward bankruptcy. Medicare’s latest annual report revealed that its main Part A trust fund — for Hospital Insurance — will be exhausted in 15 years. The feds will then have to sharply cut benefits, raise the payroll taxes used to fund it — or raid the rest of the federal budget to cover seniors’ care.
Seniors themselves are increasingly rejecting traditional Medicare in favor of a privately administered alternative called Medicare Advantage. This program lets seniors choose private insurance plans that contract with Medicare to provide benefits.
These Medicare Advantage plans often provide better benefits than traditional Medicare. For example, seniors don’t have to purchase supplementary “Medigap” insurance policies — policies that enrollees need to plug gaps in coverage under standard Medicare plans.
Enrollment in Medicare Advantage plans has nearly tripled since 2004. As a result, one in three seniors on Medicare has enrolled in a private Advantage plan compared with just 1 in 10 a decade ago.
That doesn’t say much for the program Sanders wants to impose on everyone. Nor does his plan’s $15 trillion price tag.
Other countries that have adopted single-payer systems haven’t fared any better than Medicare.
Take Canada. As someone who was born there, I can tell you firsthand that Canada’s single-payer health system is the last thing the United States needs.
Canadians looking for treatment must wait for care, even if they’re in desperate need. Alberta Health Services, for example, reports that 90 percent of patients who need back surgery have to wait up to almost nine months. Hundreds have fled to clinics in the United States to get treatments that their government health programs have been denying them.
The Fraser Institute, a Canadian think tank, calculates that residents of our northern neighbor have to wait an average of two months to get an MRI — and almost a year if they need orthopedic surgery. One in three is waiting to see a primary care doctor.
Part of the problem is a lack of capacity. For example, the province of Ontario has fewer hospital beds per capita — just 1.4 per 1,000 people — than other industrialized nations. The average in eight similarly developed nations is 3.4 beds per 1,000 people. And while Ontario officials brag that this is a sign of how efficiently they run their health care system, medical professionals say that this shortage has caused the hospital equivalent of gridlock.
“This means the hospital’s beds are full. Surgeries have to be cancelled and there are no beds in which patients can recover,” noted the Ontario Health Coalition, which is trying to ward off still more spending cuts as the province deals with a $10.9 billion budget gap.
Fraser estimates that Canada’s health care system costs patients nearly $1 billion a year in lost productivity.
Innovation has suffered as well. Companies have little incentive to develop new technologies for the Canadian market, as they know that the government will immediately slap price controls on their services. Between 2001 and 2013, for example, research and development within the country’s pharmaceutical industry dropped 29 percent.
Denmark’s single-payer system, which Sanders wants to copy, has also failed to help patients. The Commonwealth Fund recently evaluated the quality of health care in 13 major industrial nations. While the United States had one of the lowest rates of death from cancer, Denmark had the highest.
Normally, policy proposals by a self-proclaimed “Democratic Socialist” wouldn’t merit much attention. But Sanders has been drawing big crowds — and posting big poll numbers — with an agenda that includes single-payer health care. If Sanders wins the presidency, patients will lose.
This article originally appeared at Forbes.com.