Bernie And The Single-Payer Beast

Earlier this month, Senator Bernie Sanders, I-Vt., reintroduced his signature Medicare for All legislation alongside 14 of his Democratic colleagues at a Senate Budget Committee hearing.

With a little perseverance and a touch of political magic, Sanders is hoping his government-run healthcare fairytale, which he has championed for years during his time in the House and Senate, will finally become reality.

For patients, that’d be anything but a happy ending. Medicare for All would subject Americans to long waits for subpar care.

To see how, look to the inspiration for Sen. Sanders’s single-payer vision—Canada. North of the border, health care is largely free at the point of service. That keeps demand for treatment high.

But with a limited supply of physicians—Canada has fewer than three per 1,000 people, one of the lowest ratios among developed countries—the country’s single-payer system is unable to meet people’s needs.

Delayed care is the inevitable result of this mismatch. Canadians face a median wait of 25.6 weeks—roughly six months—for treatment from a specialist following referral by a general practitioner last year, according to the Vancouver-based Fraser Institute, a think tank.

No segment of the population escapes these waits. Earlier this month, children were waiting up to 16 hours to receive care at a pediatric emergency room in Alberta. Some seniors have been told that they’ll need to wait up to two years for a hip replacement.

One woman was in so much pain after waiting a year for a hip replacement that she flew to Lithuania to get the procedure done. A year after she got the surgery abroad, her Canadian doctor still hadn’t called to schedule it.

Stories like this are not uncommon. In Canada, the government has a monopoly on paying for “medically necessary” treatment; private insurance is banned for anything the government asserts the right to cover. So patients can either wait for publicly-provisioned care—or spend their own money to seek treatment abroad.

Many opt for the latter. Secondstreet.org, a Canadian think tank, estimated that nearly a quarter of a million patients went abroad for treatment in 2017.

Some aren’t so lucky. More than 11,500 patients died waiting in treatment queues between 2020 and 2021, according to Secondstreet.org.

Routine cancer care is hard to come by. Just 54% of Canadian women between the ages of 50 and 69 have been screened for breast cancer. That’s compared to 80% of U.S. women in the same age group.

This lack of access translates into poor health outcomes. Canadian breast cancer, stomach cancer, lung cancer, and prostate cancer patients have lower survival rates compared to their American counterparts.

The human cost of these waits is clear. But there’s also a significant financial cost. According to a new Fraser report, Canadians lost $4.1 billion in wages and productivity during the workday as they waited for care in 2021. With more than 1.4 million people in treatment queues, the cost of waiting is about $3,000 per person.

And that’s a conservative estimate. When researchers factored in nights and weekends, the cost of waiting ballooned to nearly $12.4 billion—about $8,700 per person.

Add that to the $15,000 the average Canadian family of four pays in taxes each year to fund the country’s public healthcare system, and single-payer suddenly looks a lot less “free.”

Despite real-world evidence to the contrary, Sen. Sanders claims that his $3 trillion-a-year plan for Medicare for All will guarantee “health care to every man, woman, and child in America in a cost effective way.”

That’s wishful thinking—as Canada’s single-payer system proves.