February 5, 2016
It's a two-horse race for the Democratic nomination for president. This week, Sen. Bernie Sanders (Vt.) came within 0.2 percentage points of beating Hillary Clinton in the Iowa caucuses.
Sanders zealots are "feeling the Bern" in large part because of his healthcare plan. "I believe in a Medicare for all single payer program," he exclaimed at a near-victory rally Monday night.
New Hampshire's voters should chew on that line over the next few days, before their primary Feb. 9. Under single-payer, they'd "feel the Bern" in an entirely different way -- they'd be subjected to woefully inadequate healthcare and trillions of dollars in new taxes.
Consider Sanders's "Medicare for all" proposal, which would cost $14 trillion over ten years, increase taxes, and eliminate private insurance in favor of a fully government-run system. According to Sanders, Americans would no longer have to pay deductibles or co-pays, search for in-network doctors, or deal with insurance hassles.
If it sounds too good to be true, that's because it is. For evidence, look no further than Canada's single-payer system.
To keep a lid on health costs, Canadian officials ration care. Canada ranks last among 11 industrialized nations in the ability of a patient to get a same-day or next-day appointment with a doctor. It also has the worst emergency room wait times. More than one-quarter of patients wait four or more hours to be treated.
It gets worse. After being referred to a specialist by a primary car doctor, Canadian patients wait four and a half months for treatment, on average. Wait times for MRIs are more than eight weeks; for CT scans, patients wait almost four weeks.
As a native-born Canadian, I've witnessed this sort of rationing firsthand. My own mother died from colon cancer after doctors delayed her colonoscopy so younger people on the waiting list could go first.
These long wait times result in low-quality care. A study in the Lancet medical journal concluded that the United States had higher 5-year survival rates for breast and colon cancer than Canada.
When Canadians do need treatment, many come to the United States and pay for it out-of-pocket. According to the Fraser Institute, 52,000 Canadians sought care abroad in 2014.
There's also a domestic example of the failures of single-payer -- the U.S. Veterans Health Administration. The VA operates like Canada's system, with the government paying all doctors, nurses, and hospitals. Despite ever-increasing budgets, the VA has been plagued by chronic delays for treatment, some of them deadly.
Government-run healthcare is also riddled with waste and fraud. In 2005, for example, the VA set out to build a $328 million hospital outside Denver for 400,000 vets. By 2015, the cost had risen to $1.7 billion -- and still wasn't finished.
Medicare -- the single-payer system for the elderly -- wasted $60 billion in just one year on improper or fraudulent payments. That was almost 10 percent of its budget.
Sanders simply ignores these problems and claims that his plan for government-run care will somehow work better.
But his own numbers don't add up. Sanders's plan will supposedly cost taxpayers $1.4 trillion a year. But that's a relative "deal," since his reform package will reduce costs elsewhere in the healthcare system by $6 trillion over the next decade, mainly by slashing insurance administrative costs and forcing drug companies to lower their prices.
Even if Sanders could miraculously cut these costs in half, he'd still be $2.4 trillion short of his goal. That means he'd either have to reduce payments to hospitals and doctors, adopt Canadian-style delays, or raise taxes more than the trillion dollars a year in hikes he's already proposed.
The U.S. healthcare sector suffers from too much government -- not too little. The presidential candidates should instead embrace a free, open, and competitive healthcare market, one that empowers doctors and patients.
That would actually expand access to affordable, high-quality care -- unlike single-payer.
Sally Pipes is a policy adviser for the Leadership Project for America Foundation. This article originally appeared in The Hill.