As the debate over healthcare reform rages, more Americans are thinking we should adopt a single-payer healthcare system. Virtually all Democratic national and state elected officials, and Democratic candidates for the 2020 election, are either advocating for a complete government-run plan or an incremental movement toward a government-managed, single-payer system.
We don’t have to guess whether it would work well. The Canadian federal government passed the Canadian Health Care Act in 1984. It is a pure single-payer system. Every Canadian is covered by the plan and, in theory, has access to medical care. The provinces administer the plan with funding from federal taxpayers. The government determines what procedures are medically necessary based on data and statistics.
The Fraser Institute, a well-respected think tank in Vancouver, British Columbia, has tracked waiting times for patients to receive healthcare in Canada for the past 20 years. It surveys specialist physicians across 12 specialties throughout Canada. The institute recently released the waiting list data for 2018. Americans interested in single-payer healthcare will find it sobering.
The median time for specialty treatment after a patient was referred by a primary care doctor in 2018 was 20 weeks. Saskatchewan had the lowest wait at 15 weeks; the high was New Brunswick at 45 weeks, which is nearly a year.
On average, patients waited nine weeks to see a specialist, then waited an additional 11 weeks to receive treatment. Only 12 percent of delays in treatment were at the patient’s request.
There were also delays in diagnostic procedures. In 2018, Canadians waited four weeks to receive a CT scan or an ultrasound, and 10 weeks to receive an MRI.
There’s a reason behind these numbers: In Canada, the supply of healthcare is overwhelmed by the demand, leading to severe shortages. Consequently, medical care is rationed using long waiting lists and by limiting the number of certain medical procedures allowed. Unfortunately, costs and waiting times have not improved since 1984.
Long wait-times are more than an inconvenience for Canadians. Simple medical problems, if not treated early and quickly, can turn into chronic or life-threatening conditions. At the very least, waiting times prolong pain and suffering for patients. In Canada, healthcare costs have skyrocketed and now represent the largest expense for every province’s budget.
Almost 90 percent of Canadians live within driving distance of the United States. For those Canadians who can afford it and do not want to wait, quality healthcare is immediately available in the U.S. In reality, Canada has a two-tiered healthcare system, with the U.S. providing timely care for those willing and able to travel a short distance and pay more.
Canada has 40 years of experience with single-payer healthcare. Although most Canadians say they like their system, their culture is very different from that in the U.S. Wait times of 20 weeks for treatment would not be acceptable to the overwhelming majority of Americans.
In addition to long wait-times, a single-payer system discourages innovation. There is virtually no money in the system to encourage investment in new life-saving medicines and medical devices. Lack of innovation guarantees that no new treatments will be discovered, with no improvements in quality of life or life expectancy.
Under a single-payer system, healthcare spending must compete with all other government activities, such as defense, education, and transportation. This makes healthcare very political and subject to change with every new budget. It also forces each segment of the healthcare industry’s healthcare sectors, for example hospitals and doctors, to compete with the others for limited government money.
Sure, a single-payer system can “insure” everyone, but it in no way guarantees timely or adequate access to medical care. Americans should remember this point when considering “Medicare for all,” take the Canadian experience seriously, and call on elected officials to reform healthcare so that patients are in charge, not bureaucrats.
Dr. Roger Stark is the healthcare policy analyst for Washington Policy Center.
