Rep. Ellison’s Single-Payer Dream A Nightmare For Patients

Daniel Garza | President, Libre Initiative

Would Americans be better off if we had a health care system like Cuba’s? U.S. Rep. Keith Ellison thinks so. In a recent speech, the Minnesota Democrat – and Deputy Chairman of the Democratic Party — proclaimed that “countries like Cuba or Canada or Russia or a lot of places in this world spend half what we spend per capita and they got better health outcomes than we do.”

Rep. Ellison advocates switching to a single-payer system, meaning the government would run nationalized hospitals and doctor’s offices. Such a system would inevitably reduce choice and lower the quality of care received by Americans. Yet ideologues like Rep. Ellison are so married to the idea of single-payer that they pretend government-run health care systems in countries like Russia and Cuba are better than what we have in the United States.

His comments betray a stunning ignorance of the reality faced by the people of those countries.

In Cuba, you will indeed find excellent health care – assuming you are a foreign tourist or a member of the government elite. These lucky few will encounter the clean, state-of-the-art hospitals that so often impress visiting filmmakers and U.N. officials.

Such facilities are off-limits to ordinary Cubans, who have a very different experience of government-run health care. They face long waits to gain admittance to run-down hospitals that are short on basic medical supplies like antibiotics. Patients must bring their own bedsheets, food, toilet paper, and even light bulbs.

10 de Octubre in Havana is the sort of hospital where average citizens can expect to receive care. According to Cuban journalist Roberto de Jesús Guerra Pérez, “The floors are stained and surgeries and wards are not disinfected. Doors do not have locks and their frames are coming off. Some bathrooms have no toilets or sinks, and the water supply is erratic. Bat droppings, cockroaches, mosquitos [sic] and mice are all in evidence.”

It is probably little consolation that care is provided “free” by the government.

The situation is hardly better in Russia. In the words of retired KGB colonel Gennady Gudkov, “Russia state hospitals and clinics are in a tragic condition, especially in the provinces. There is outdated and often nonfunctioning equipment, a lack of medicines and hospital beds, and a shortage of medical specialists. The families of patients are often forced to bring them food.”

Many doctors refuse to allow family members to visit patients in intensive care units because they see them as a nuisance. Russians have become so distrustful of state health care that they spend millions each year on occult and faith-based medicine.

In the absence of competition produced by free markets, hospitals have little incentive to ensure that patients are seen promptly and receive high-quality treatment. Long waiting times and negligent care are hallmarks of socialized systems of medicine everywhere, even in affluent countries like Canada. A 2014 report by the Commonwealth Fund found that 29 percent of Canadian patients who needed to see a specialist waited two months or longer for their appointment.

Defenders of single-payer claim that it would dramatically lower the cost of health care – a claim that is directly at odds with the actual experience of states that have attempted to implement it.

Even deep blue states like Vermont and California have been forced to abandon their single-payer dreams in recent years due to the massive price tag attached to such proposals. Instituting single-payer in California alone was estimated to cost $400 billion per year – more than double the state’s entire budget.

The current health care system in the United States is far from perfect, and there are many reforms available that would expand choice, lower costs, improve quality, and spur medical innovation. However, inviting even more government control over the health care sector would do just the opposite, as we have seen in countries from Canada to Cuba.

But the facts are unlikely to deter single-payer ideologues like Rep. Ellison who would rather defend the health care systems of Cuba and Russia than admit the failings of government-run medicine worldwide.

Daniel Garza is president of the LIBRE Initiative.

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