Ray Carter | June 11, 2020
Experts warns ‘Medicare for all’ fails patients
U.S. Sen. Bernie Sanders of Vermont has become the nation’s most high-profile supporter of “Medicare for all,” a proposal that would eliminate private insurance and place all citizens on government health programs.
Yet Sanders’ own personal experience undermines his case, according to Sally Pipes, the president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute, a California-based think tank.
During a recent speech to an Oklahoma audience, conducted online due to COVID-19 restrictions, Pipes noted that Sanders had emergency angioplasty to repair a blocked artery last fall.
“He went to a private hospital and he had first-rate treatment and he had his care immediately,” Pipes said. “If this issue had happened in Canada under a single-payer system, he should have noted that no one receives care within 24 hours and nearly two-thirds have to wait more than three days, while the average angioplasty wait is three to 11 weeks—almost four months.”
A longtime health care expert, Pipes most recently authored, False Premise, False Promise: The Disastrous Reality of Medicare for All. She said most Americans would recoil if subjected to the experiences of Canadians and citizens in the United Kingdom, which has a government-run National Health Service.
While some on the political left have argued the COVID-19 pandemic highlights the necessity of having a “Medicare for all” system, Pipes noted that countries with “Medicare for all”-style systems have fared worse than the United States.
She said the United Kingdom and Italy both have government-run health care systems that guarantee coverage to all. But those two countries also had both “huge numbers” of COVID-19 cases “and very high death rates.”
“On a per-capita basis, deaths in Italy and the U.K. with their government systems were two times as high as they are in the United States,” Pipes said.
When the SARS (Severe Acute Respiratory Syndrome) virus was spreading in 2002-2003, a similar pattern was also apparent, Pipes said.
“Canada had 375 cases—44 people died from it,” Pipes said. “The U.S., with 10 times the population, had 27 cases and nobody died.”
In 2019, the average wait between seeing a primary care doctor and being treated by a specialist in Canada was 20.9 weeks.
“Americans would not want to be told that you’re going to have to wait over five months from seeing a primary care doctor to getting treatment by a specialist,” Pipes said. “The average wait in Canada for an MRI today is 11 weeks. For neurosurgery, it’s 33 weeks. Can you imagine that if you thought that you had a brain tumor you would have to wait on average 11 weeks to get your MRI and then 33 weeks to get your surgery?”
Pipes’ own mother faced that dilemma in Canada—with ultimately fatal results.
“My own mother died from colon cancer as a senior because when she thought she had colon cancer and had symptoms, she was told she could not get a colonoscopy because there were too many younger people in Vancouver on the waiting list for a colonoscopy,” Pipes said. “Finally, six months later when she had lost a lot of weight and was hemorrhaging, she went to the hospital in an ambulance and she did get her colonoscopy, but she died two weeks later from metastasized colon cancer. This is what happens when government is totally in charge of your health care.”
One reason for those poor health-care quality statistics is that single-payer health care is incredibly expensive, yet not a financially attractive profession to the best and brightest.
“American primary care doctors earned about $218,000 a year on average in 2016,” Pipes said, “whereas their counterparts in Canada, which has a single-payer system, $146,000, and NHS doctors, $134,000. So under a government-run plan, government sets what doctors are going to be paid.”
She said the United Kingdom has over 100,000 vacancies in its health system for doctors, nurses, and other health professionals, due in part to the low pay.
She warned Oklahomans that expansion of the state’s Medicaid program—seen by some proponents as a stepping stone to single-payer, government-run health care—suffers from the same problem.
“A lot of doctors won’t take Medicaid patients because docs are paid for treating Medicaid patients even less than they’re paid for treating Medicare patients,” Pipes said. “It’s about 38 to 42 percent below. And so you may have Medicaid coverage, but if you can’t find a doctor, you end up turning up at an emergency room for care.”
While polling has shown growing public support for “Medicare for all,” Pipes said it appears that support is driven by the fact that “a lot of people just don’t understand what ‘Medicare for all’ means.”
When people are asked if they support a single-payer system if it means all private insurance coverage is eliminated, support plummets, she noted. The same thing occurs when people are asked if they are willing to support tax increases to pay for “Medicare for all.”
Researchers on both the political right and left have estimated that “Medicare for all” will cost trillions. The cost is estimated to be $32 trillion to $38 trillion over 10 years—and that assumes savings in administrative costs and drug payments. Otherwise, the total cost of the plan is up to $60 trillion over 10 years, Pipes said.
While the average American family pays $11,000 for health coverage, the average Canadian family pays $13,311 in “hidden taxes for a health care system that makes them wait, care is rationed, and there is a doctor shortage,” Pipes said
Supporters of “Medicare for all” have acknowledged that one way the program will achieve savings is by cutting payments to doctors by 40 percent compared to what they typically receive now. Pipes noted low reimbursements in Medicare already make it difficult for beneficiaries to find doctors who will treat them and said “Medicare for all” will only supersize that problem.
“When government is in charge of your health care,” Pipes said, “there are going to be long waits and care will be rationed.”
Director, Center for Independent Journalism
Ray Carter is the director of OCPA’s Center for Independent Journalism. He has two decades of experience in journalism and communications. He previously served as senior Capitol reporter for The Journal Record, media director for the Oklahoma House of Representatives, and chief editorial writer at The Oklahoman. As a reporter for The Journal Record, Carter received 12 Carl Rogan Awards in four years—including awards for investigative reporting, general news reporting, feature writing, spot news reporting, business reporting, and sports reporting. While at The Oklahoman, he was the recipient of several awards, including first place in the editorial writing category of the Associated Press/Oklahoma News Executives Carl Rogan Memorial News Excellence Competition for an editorial on the history of racism in the Oklahoma legislature.