As usual at a Universal Health Care Commission (UHCC) meeting, supporters of a universal, taxpayer-financed system of health care in Washington state showed up to give public comment. And as usual, they urged commissioners to “hurry up.” They expressed disappointment that we don’t have such a system, despite the work of the UHCC, with one commenter saying of changing our extremely complicated and layered health care system, “Please. It’s not that hard.”
With friends like these ….
The commission’s website says Washington state “seeks to establish a universal system of health care for all residents,” and it explains how Senate Bill 5399 created the UHCC in 2021 to aid in this effort. So why is it so hard?
First, no one has been able to figure out a reasonable way to pay for the system. Other states have abandoned the effort because of this. Vermont ditched its plan for a taxpayer-financed system of health care after finding the cost would be “enormous” or provide residents skimpier health coverage than most insured Vermonters already had. Officials determined an 11.5% state payroll tax and 9.5% income tax would be necessary to pay for the new health care system.
More importantly, other countries show that the pattern of a universal, taxpayer-financed system is wait-listing and rationing that would be unacceptable to Washingtonians. Great Britain and Canada have taxpayer-funded, universal programs that are often thought of as successful. Studies, however, show dire problems with access to care in these countries. So does speaking with citizens of those countries.
The Fraser Institute in Canada writes that in 2024, physicians across Canada reported a median wait time of 30 weeks between a referral from a general practitioner and receipt of treatment. That’s up from 27.7 in 2023. It’s 222% longer than the 9.3-week wait Canadian patients could expect in 1993. The system is not working.
In Great Britain, a Wall Street Journal article reported that people who suffer heart attacks or strokes wait more than 1½ hours on average for an ambulance. The Royal College of Emergency Medicine estimated 300 to 500 people suffer premature deaths each week because of a lack of access to timely care. It added that more than one in 10 people are stuck on waiting lists for non-emergency hospital treatment for things like hip replacements.
Read more about why the system that state lawmakers created a commission to bring us is misguided in this legislative memo. I analyzed a now-passed proposal, SJM 8004, that asks the federal government to enact government-run health care or help Washington state implement its own system of taxpayer-financed care.
Federal buy-in needed
Among the other reasons why this switch is so hard — and inadvisable — is the fact that federal waivers involving government-provided health care will not be easy to get.
To step outside traditional Medicaid and use funding streams to build a new, universal system requires major agreement from the federal government. Based on current policy trends and the Trump administration's actions, approval of waivers for a state-run universal health care system is highly unlikely.
As usual, I found myself swimming against the current in the December meeting's public comment time. (Comments are accepted at each meeting and are typically limited to a minute or two.) I offered the following this time around, hopeful that UHCC members will eventually advise lawmakers that their work is not only extremely hard, but a taxpayer-advised system will not benefit Washington state’s patients, health care providers or taxpayers. We need to be careful what we wish and plan for.
—————
“I’m Elizabeth New from the Washington Policy Center, a think tank interested in a free-market health care system — a system we do not have.
Our third-party-payer system is hurting us, and this commission is working to create an even stronger third-party-payer system in Washington state. Trading one bad system for another one is not the answer.
I urge you to recognize the shortcomings that will come with the system you seek. The pattern of universal, taxpayer-financed health care is wait-listing and rationing. The kind of health care in universal, taxpayer-financed systems would not be acceptable to Washingtonians.
We need patient-centered health care where the decisions made are closer to doctors and patients, not insurers or lawmakers.
Health care is expensive. Cost increases are not unique to those receiving insurance through the exchange. They are increasing for employers and workers as well. Various state polices and regulations are also causing a cost-shifting that is unsustainable for providers and commercial payers.
More competition, not less, and more payers, not fewer, are key for bringing cost containment and affordable, quality health care for all.
Thank you.”
—————
* If interested in future UHCC meetings, see the meeting schedule on their website at https://www.hca.wa.gov/about-hca/who-we-are/universal-health-care-commission#news-announcements.
