So, to summarize:
- Since care is 'free', patients have no incentive to moderate their use of medical services or shop around to secure the best prices
- The only way to keep costs down is to ration care, creating long waiting lists and delays
- Canadians face a media wait of 5 months for specialist treatment after referral
- Patients awaiting care suffer lost wages, which are not factored in to cost estimates
- Why would we want this system in the US? The benefits are clear for those who cannot pay, but it would be unwise to destroy the system to benefit only those who cannot pay.
SALLY C. PIPES
8/14/2018
Senator Bernie Sanders and his army of supporters of government-run health care evidently believe that American workers could use a pay cut.
That's the natural consequence of single-payer health care, as a recent analysis of Canada's healthcare system illustrates.
Last year, Canadian patients forewent $1.9 billion in wages while waiting for medical treatment, according to a report from the Fraser Institute, a Canadian think-tank. Canadian patients face some of the longest waits for care in the industrialized world due to their government-run system's strict rationing.
If progressives successfully install single-payer here in the United States, Americans will pay for the privilege of waiting in line.
In Canada, the government covers the cost of most healthcare services. Patients don't pay directly when they visit doctors or emergency rooms -- though they do indirectly, in the form of high taxes.
But because the cost of their care is hidden, they have no reason to moderate their consumption of medical services or shop around for treatments and providers that provide the best value.
To control spending, the government requires hospitals and clinics to adhere to strict budgets. Doctors and hospital administrators have to ration care to stay under budget. So patients face grueling treatment delays.
Last year, Canadians faced a median wait of more than 21 weeks to receive treatment from specialists after obtaining referrals from their general practitioners. That's double the median wait time of 25 years ago.
Patients in some parts of the country had it far worse. The typical patient from New Brunswick had to confront a median wait of nearly 42 weeks — about ten months. Nationwide, for the first time, more than 1 million Canadians are waiting for treatment.
A recent analysis of health systems in 11 wealthy nations found that Canadians faced the longest wait times — and not just for specialist care. Delays for family care and emergency room treatment were also the longest among peer nations.
These treatment delays can injure or even kill patients. Long wait times were a factor in 44,000 Canadian women's deaths from 1993 to 2009.
Patients waiting for surgeries and other procedures often can't work. They may be in pain or have limited mobility.
Even if they can work, they're generally far less productive and are forced to stay home sick more frequently. According to the Fraser Institute's new analysis, on average, every patient waiting for care lost $1,800 in foregone wages.
And that figure is actually a conservative, charitable estimate of the negative impact of single-payer's waits. It only factors in hours lost during an average workday; it doesn't place any value on the non-work hours that patients spend suffering in pain.
When all hours of the week are accounted for — excluding time for sleep — Canadian patients actually lost a combined $5.8 billion, or almost $5,600 per person, playing the waiting game.
Even that higher estimate doesn't account for the financial burden on friends and family who take time off to care for waiting patients. Nor does it factor in the expenses incurred by roughly 60,000 Canadians who travel to another country — often the United States — to seek non-emergency medical care each year.
Single-Payer: Health Care Fool's Gold
Americans have long opposed Canadian-style health care. But public attitudes are changing. Just over half of Americans support single-payer health care, according to a Washington Post-Kaiser Family Foundation poll from earlier this year.
Democrats are trying to capitalize on that swing in public opinion. They've introduced no less than a half-dozen plans that would ratchet up government control of the U.S. healthcare system to varying degrees — with the eventual goal of fully socialized medicine.
Senator Bernie Sanders's "Medicare for All" plan is the most radical. He's modeled his scheme on the Canadian system. During a trip to the country last fall, he asked rhetorically, "How is it that here in Canada, they provide quality health care to all people . . . and they do it for half the cost?"
But as the evidence from Canada shows, "free" single-payer health care is actually quite expensive. Americans needn't learn that lesson the hard way.
Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is "The False Promise of Single-Payer Health Care" (Encounter). Follow her on Twitter @sallypipes.
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