America Marches Blindly Toward Single-Payer

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.
America Marches Blindly Toward Single-Payer
A sign supporting Medicare is seen on Capitol Hill in Washington, D.C., on July 30, 2015, as registered nurses and other community leaders celebrate the 50th anniversary of Medicare and Medicaid. Medicare spending on breakthrough medications for hepatitis C will nearly double in 2015, passing $9 billion, according to new government figures. That’s raising insurance costs for all beneficiaries, whether or not they have the liver-wasting viral disease. (AP Photo/Jacquelyn Martin)
Sally C. Pipes
5/18/2016
Updated:
5/19/2016

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 health care 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.

Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) speaks at the University of Chicago on Sept. 28, 2015. After seven years of the political drama known as "Obamacare," you might think voters would be tired of big ideas for revamping health care. If so, the presidential candidates seem to have missed the memo. On the left, part of the appeal of Sanders is his years-long advocacy of "single payer," a tax-supported, Medicare-like plan for all. The idea is in the political DNA of liberals, and Sanders as president would lead a movement to make it happen, his campaign says. (AP Photo/Paul Beaty)
Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) speaks at the University of Chicago on Sept. 28, 2015. After seven years of the political drama known as "Obamacare," you might think voters would be tired of big ideas for revamping health care. If so, the presidential candidates seem to have missed the memo. On the left, part of the appeal of Sanders is his years-long advocacy of "single payer," a tax-supported, Medicare-like plan for all. The idea is in the political DNA of liberals, and Sanders as president would lead a movement to make it happen, his campaign says. (AP Photo/Paul Beaty)

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 (NHS) 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. Among her books are “The Cure for Obamacare“ and ”The Way Out of Obamacare.”

Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is "False Premise, False Promise: The Disastrous Reality of Medicare for All," (Encounter 2020). Follow her on Twitter @sallypipes
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