COMMENTARY: Sorry, but single-payer won’t fix American health care

Affordability is becoming the watchword for Republicans and Democrats alike this election year. Progressives in Senate races from Maine to Illinois to Minnesota are putting Medicare for All at the center of their agenda for making health care affordable. Polling shows that some two-thirds of Americans support the policy.

The prospect of “free” health care courtesy of federal taxpayers is understandably tempting. But it’s a temptation worth resisting.

Whatever problems America’s market-based health system suffers from at the moment, they are nothing compared to the deplorable conditions, rationed care, waiting lists, doctor shortages and human suffering that characterize government-run health care systems in other developed nations.

Look at the ongoing catastrophe in the United Kingdom’s National Health Service. The NHS’ hospitals are so under-resourced and overcrowded that it’s now routine for patients to be treated in hallways — a practice dubbed “corridor care.”

A study published in December in the British Journal of Medicine found that 8 in 10 NHS trusts are caring for emergency patients in corridors. According to a separate analysis, lengthy waits for beds at British emergency rooms are linked to more than 16,000 patients deaths a year.

The president of the Royal College of Emergency Medicine recently lamented this dismal situation: “If we had 16,000 patients a year dying in bus crashes or in aircraft crashes or anywhere else there would be such howls of outrage something would be done about it. And yet, we can’t understand why those awful statistics don’t provoke really determined action at the highest level across governments.”

Unfortunately, it will take more than forceful government action to fix what ails the British health system. When governments replace markets as the primary mechanisms for allocating health care resources, life-threatening inefficiencies, low-quality care, shortages and delays in treatment are inevitable.

The story is much the same in Canada, where I hail from. Our northern neighbor’s single-payer system has been wracked by such severe staffing shortages that hospitals are frequently forced to close their emergency rooms. By one estimate, Canadian emergency rooms have closed their doors for a total of 1.14 million hours since 2019, or about 47,500 days.

Canadians pay dearly for their government health insurance. According to the Vancouver-based Fraser Institute, a think tank, the average cost of public health coverage for a Canadian family of four was more than $19,000 last year. That amount is hidden in their tax burden.

These are the kinds of crises that await the United States should lawmakers outlaw private health insurance and grant the government a monopoly overpaying for health care — which is precisely what Medicare for All advocates seek to do.

That agenda is no longer hypothetical. Sen. Bernie Sanders, I-Vt., recently told a reporter that “the opportunity now is to prove aggressively that Medicare for All is right.”

Sanders introduced a Medicare for All bill last April; his compatriots Rep. Pramila Jayapal, D-Wash., and Rep. Debbie Dingell, D-Mich., did the same in the House. Jayapal has pledged to make the policy a central issue for Democrats this year.

Instead, lawmakers should be looking for ways to make our current system of private insurance function more efficiently and transparently. This means acting aggressively to eliminate the fraud and abuse that has proliferated in the insurance sector in recent years. But it also means paring back the regulations that have driven up premiums.

Indeed, the federal government deserves just as much blame for the current insurance affordability crisis as insurers do. Obamacare’s insurance rules — including its benefit mandates, pricing restrictions, and requirement that insurers sell to all comers regardless of health status or history — have helped send premiums into the stratosphere by making it considerably harder for insurers to control costs.

To be sure, soaring health insurance prices have hit Americans hard. But trading our system for one that routinely delays care, rations treatment and leaves patients dying in hallways would be a grave mistake. Other countries have tried single-payer — and their patients wait, suffer and even die as a result. Americans deserve reform, not imitation of failure.

Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in health care policy at the Pacific Research Institute. Follow her on X @sallypipes.