The false promise of Canada’s single-payer system
Government-run, single-payer health care is back in vogue. It’s the Left’s admitted fallback as Obamacare fails. And the Senate just held a hearing on single-payer systems in other countries — with no shortage of witnesses touting their supposed benefits.
While Obamacare continues to disappoint, some states are pushing for a single-payer replacement. Vermont is working to create such a system within its borders. Hawaii’s governor has singled out single-payer as the only potential replacement for his state’s failing exchange. And legislators in California, New York, Pennsylvania, Minnesota, and Colorado have offered up proposals that would institute single-payer within their borders.
Single-payer’s cheerleaders cite Canada as proof of the system’s superiority. Their Canadian fetish is foolish. Our northern neighbor’s healthcare system is plagued by rationing, long waits, poor-quality care, scarcities of vital medical technologies, and unsustainable costs. That’s exactly what’s in store for America if we follow Canada’s lead.
As a native of Canada, I’ve seen this reality firsthand.
To keep a lid on healthcare costs, Canadian officials ration care. As a result, the average Canadian has to wait four-and-a-half months between getting a referral from his primary care physician to a specialist for elective medical treatment — and actually receiving it.
Bostonians face the longest wait times for an appointment in America, according to Merritt Hawkins, a consultancy. That’s no surprise, given that Massachusetts essentially enacted Obamacare in 2006, four years before it went national.
Even so, the average wait in Boston is 45.4 days — about three months less than in Canada.
“Elective treatment” in Canada doesn’t mean Botox or a tummy tuck. We’re talking about life-or-death procedures like neurosurgery, orthopaedic surgery, or cardiovascular surgery.
And these wait times are only growing. The average 18-week delay plaguing Canadians today is 91 percent longer than in 1993.
There’s also a severe shortage of essential medical equipment. Canada ranks 14th among 22 OECD countries in MRI machines per million people, with an average wait time to use one at just over eight weeks. The United States, by contrast, ranks second.
Canada ranks a dismal 16th of 23 OECD countries in CT scanners per million people, with an average wait time of over 3.6 weeks. The United States ranks fifth.
Every Canadian is technically “guaranteed” access to healthcare. But long waits and the scarcity of medical technologies leave many untreated.
When people aren’t treated in a timely fashion, their conditions worsen, and they often end up requiring significantly more expensive and extensive treatments.
The Center for Spatial Economics, a Canadian research organization, estimates that wait times for just four key procedures — MRI scans and surgeries for joint replacement, cataracts, and coronary artery bypass grafts — cost Canadian patients $14.8 billion every year in excess medical costs and lost productivity.
Once Canadian patients finally receive treatment, it’s far from “free.” Their government levies heavy taxes to pay for the system. According to Nadeem Esmail, a scholar at the Fraser Institute, a Canadian think tank, “Some 68 per cent of personal income taxes paid in aggregate are required to cover the cost of Canada’s taxpayer-funded health care program.”
Patients may only have to pay a nominal fee when services are rendered. But the typical Canadian family pays about $11,300 in taxes every year to finance the public insurance system.
Vermont is experiencing this high-tax reality firsthand, as it prepares its single-payer system. One Democratic state representative has admitted that the system will “cost more” than the initial estimate of between $1.6 billion and $2.2 billion annually. Avalere Health, a consultancy, estimates that Vermont will have to essentially double its tax revenue to pay for the system.
Because of the low quality of care and long waits in their home country, an enormous number of Canadians travel to the United States to receive medical attention. In 2012, over 42,000 crossed the border to do just that.
Many of these line-jumpers are part of Canada’s political elite. The national healthcare system may be good enough for their constituents, but it’s apparently not good enough for them.
Former Member of Parliament Belinda Stronach spent her career vigorously opposing privatization of the national health system. But when she was diagnosed with breast cancer in 2007, she flew to Los Angeles for surgery.
In 2010, the premier of Newfoundland flew to Florida for heart valve surgery. When questioned about the decision, he said, “This was my heart, my choice and my health.”
Millions of ordinary Canadians would surely love to have that option.
Canadians know their system isn’t all it’s cracked up to be. Anne Doig, former head of the Canadian Medical Association, has called the system “sick” and “imploding.” Dr. Brian Day, an orthopedic surgeon in Vancouver who runs the private Cambie Clinic has quipped that Canada is a country where a dog can get a hip replacement in less than a week — but his owner would have to wait two years.
Canada’s single-payer system isn’t one America should long for — it’s one we should strenuously avoid.
[Sally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is “The Cure for Obamacare” (Encounter 2013).]