Just last week, Senator Bernie Sanders put forth a “Medicare for All” bill with the intention of curbing health care spending. As many as half of all Americans support him in his efforts.
While estimated to cost a hefty $32 trillion, many consider it a bargain relative to expected private spending. What they fail to realize is that any possible “savings” of single-payer would come at the expense of longer wait-times, lower quality and less medical equipment and innovation, along with the potential for heightened social unrest.
I am a medical student and cancer researcher in the United States. My parents worked as physicians first in the Soviet Union and then in Canada. My aunt works as a physician in Ukraine to this day. They can attest to that fact that there is nothing “singular” about the suffering brought about by single-payer healthcare.
The Nordic Experiment
Bernie Sanders frequently points to the “success stories” of Nordic health systems, which spend less than us but frequently rank among the best in the world. While the Nordic nations spend less on health care, they spend substantially more on social safety net services, like unemployment coverage, education and foster care.
Taking all this into consideration, Nordic countries actually spend more than the United States per citizen. Keep in mind, all this spending falls on the government’s tab (i.e. the taxpayers), while in the United States, the majority of healthcare spending is still paid by the individual.
Such high spending is only possible with proportionally higher taxation. However, to stay globally competitive, these nations must maintain low corporate tax rates. The tax burden is therefore shifted to individuals, who pay taxes as high as 60 percent.
This social redistribution scheme, to which everyone eagerly pays in, is only possible because Scandinavian countries have small, homogenous populations, without any commitment to supporting historically impoverished minorities. In fact, quite to the contrary, the Nordic countries have some of the most nativist and anti-immigrant policies in Europe, going so far as to build a wall to protect against illegal immigrants and Middle-Eastern refugees.
American progressives can’t have it both ways: You either have a strong social safety net along with border protection and homogeneity, or neither.
Single Payer Doesn’t Work for a Large, Diverse Population
A single-payer system has never been attempted in any country as populous and diverse as the United States. Those European nations, like the UK, Germany or Canada, that did implement some ‘softer’ version of universal health care have seen unfortunate results.
In Canada, where state governments issue block-grants to private hospitals, mandated rationing has led to shortages of doctors and equipment. In the past years, wait times have hit record highs, which Canadians waiting over twenty weeks for life-saving surgeries.
The UK’s complete single-payer system faces similar challenges, so much so that this winter, triple as many patients as expected waited over four hours in the emergency room. In order to further cut costs, the UK has banned obese patients and smokers from receiving life-saving surgeries.
Meanwhile, Germany has a rampant two-tier system, with those able to afford private care receiving far better service than those on the public option.
The former Soviet Union, where my parents once practiced, took single-payer healthcare (and its consequences) to an extreme — all doctors would work at their state-mandated jobs for pennies for half the day, and then do private house-calls the other half.
At state hospitals, certain medical conditions (and their expensive treatments) that were well known in the West went deliberately untaught and unrecognized. Doctors looking to feed their families were forced to smuggle drugs in from Europe to give to private clientele who could afford them.
The situation in Ukraine today, where my aunt practices, has not much improved.
Her monthly salary of about $100 a month is only about a fifth of how much the medications for her family cost. Since the recent influx of migrants, Ukraine has taken after the Nordic example, putting up walls and discriminatory practices to avoid any further strain on an already broken system.
Applying “Medicare for All” in the United States
These are the hidden costs of single-payer healthcare. If the “Medicare for All” program were to cut costs through centrally planned rationing, it would exacerbate the expected 130 thousand physician shortage, as well as increase wait times, decrease quality and perhaps even stoke xenophobic tensions. It could also impede us from finding life-saving cures.
As a cancer researcher, I witness the $200 billion dollars pharmaceutical companies invest globally towards research and development. Most of this research is undertaken in the United States.
If Sanders’ “Medicare for All” tried to cut reimbursements to pharmaceutical companies, global research spending could decline as much as 40 percent. As governments inevitably deem the incremental benefits of research not worth the price tag, they crush the dreams of generations of scientists, doctors and patients.
Herein lies the worst danger of single-payer healthcare: It attempts to put a dollar value on the human life. Those like Senator Sanders who want to nickel-and-dime American healthcare are choosing cost over quality and, in turn, efficiency over humanity. The former Soviet Union also disregarded the value of human life, to the point that hundreds of millions perished.
The American public must, in fact, look to Europe, past and present, not as the “city upon a hill” which some progressive politicians paint it, but as a case study in what not to do.
Single-payer healthcare is deceptive in theory and in name. Although supporters like Bernie Sanders would have you believe that the rich would be the “single-payers,” in reality, all of us (and our posterity) would pay dearly.
Adam Barsouk is a medical student at Sidney Kimmel Medical College, researcher at the University of Pittsburgh Cancer Institute, health policy contributor and author of the upcoming book “Igniting Liberty.” Follow him on Twitter, Facebook and LinkedIn.
The views and opinions expressed in this commentary are those of the author and do not reflect the official position of The Daily Caller.