Americans Hate Waiting, So They'll Despise Single Payer
By Sally C. Pipes
What makes for an awful trip to the doctor? Waiting.
Earlier this year, doctor-rating website Zocdoc found that long waits or appointment delays were the primary motivators of negative marks from patients.
Given this aversion to waiting, it's shocking that Americans are coming around to government-run, single-payer health care. Waiting is endemic to single-payer. The healthcare systems of countries all over the world prove as much.
Under single-payer, those waits aren't just annoying -- they're deadly.
Support for single-payer is at record levels. Half of Americans want a single-payer system, according to a POLITICO/Morning Consult poll.
Lawmakers are responding. Sixteen Democratic U.S. senators are co-sponsoring Senator Bernie Sanders's, I-Vt., Medicare for All Act of 2017 to enroll all Americans in a significantly more generous version of Medicare.
If these politicians get their way, patients had better prepare to wait for the care they need.
Under the system envisioned by Sanders, patients would face no premiums, co-pays, or deductibles. So they'd have no incentive to moderate their consumption of care. Infinite demand for care, coupled with limited supply, is a recipe for outrageous spending.
The government does not have unlimited resources. It will have to cap demand for care, by rationing it outright, or hold down spending by setting artificially low reimbursement rates for providers.
Government officials will almost certainly opt for the latter. Why take the blame for rationing care when they can point to supposedly "greedy" doctors? After all, healthcare providers will respond to low reimbursement rates by limiting the amount of care that they're willing to provide.
From the patient's perspective, the effect is the same -- more waiting.
Consider Canada's single-payer system. Patients wait 20 weeks to receive treatment from a specialist after referral from a general practitioner. That's more than double the median wait time in 1993. Canadian patients who need orthopedic surgery have to sit tight for 38 weeks. Those needing brain surgery wait nearly a year.
Patients covered by the United Kingdom's government-run system, the National Health Service, also wait for absurd periods. Between January and March of this year, almost 1,600 patients waited over 12 hours to be admitted to an emergency room. In England alone, over 4 million patients are currently waiting for surgery.
In the United States, patients at the single-payer Veterans Health Administration fare no better. Between July and September of this year, nearly 200,000 veterans waited over a month for an appointment.
These wait times can have devastating consequences. My own mother is a victim of the Canadian single-payer system. Her doctors denied her a colonoscopy, arguing that younger people waiting for such a procedure should go first. In the end, she only got that colonoscopy after she started hemorrhaging. She was hospitalized for two weeks before dying from undiagnosed colon cancer.
She's not alone. From 1993 to 2009, diagnosis and treatment delays may have cost over 44,000 Canadian women their lives.
Here at home, veterans who waited more than 31 days for appointments were more likely to die in the following six months than folks who waited less.
Americans are not interested in waiting for health care. Once they realize that "Medicare-for-All" will worsen what they hate most about American health care -- waiting -- their dalliance with single-payer will end.
Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The Way Out of Obamacare (Encounter 2016). Follow her on Twitter @sallypipes.
