America’s doctors are lobbying for better pay. The American Medical Association and other doctor groups are currently urging Congress to roll back a 3.37 percent cut to Medicare reimbursement rates that took effect at the beginning of the year. 

This quarrel over pay should disabuse U.S. doctors of any sympathy for a complete government takeover of the nation’s health insurance system in the form of Medicare for All. Single-payer health care would result in much bigger pay cuts for doctors — and much worse care for patients. 

Their peers across the Atlantic can fill them in.

Junior doctors working in the National Health Service in England and Wales engaged in a series of strike actions in January — including a six-day walkout, the longest in NHS history — to argue for better pay.

The recent reduction in reimbursement rates for Medicare, the federal health insurance program for older adults, is just the latest in a series of pay cuts for U.S. doctors. When adjusted for inflation, Medicare paid doctors 26 percent less in 2023 than it did in 2001.

Meanwhile, the costs associated with operating a physician practice — staff, rent, and administrative expenses, among others — have increased. In response, some doctors are limiting how many Medicare patients they’ll see. Others, particularly young physicians, are abandoning private practice in favor of employment with hospitals.

Nearly one in ten doctors reported in a Medscape survey last year that they wouldn’t take new Medicare patients. Just 65 percent of doctors said they would continue treating current Medicare and Medicaid patients and taking new ones — the lowest percentage since Medscape began surveying them back in 2011.

Expanding Medicare further — as progressives like independent Vermont Sen. Bernie Sanders have long called for — would push the U.S. healthcare system toward the government-dominated model that’s been in place in Britain for three-quarters of a century. U.S. doctors won’t like that model.

The typical U.S. doctor makes $316,000, while the average physician in Britain makes $138,000, according to the 2021 Medscape Physician Compensation Report. Junior doctors — similar to residents and fellows in the United States — make even less. Their salaries can total as little as around $34,000 annually, or about $16.50 per hour, according to the British Medical Association. 

It’s these junior doctors who just wrapped up a six-day strike, which was the longest in the history of England’s National Health Service and the tenth walkout since March of last year. They’re asking for a 35 percent pay raise to counteract the inflation-adjusted pay cuts they’ve experienced since 2008.

Since March, the junior doctors’ strikes have led to nearly 1.2 million canceled or rescheduled appointments. 

The NHS pays doctors a pittance in an effort to control costs. But these low wages mean people aren’t exactly clamoring to enter the profession. Junior doctors have said many of their colleagues are leaving the NHS for better pay in other countries. Some are opting to spend more time treating private-pay patients outside the NHS. 

As a result, the supply of care is increasingly limited. But demand for care is effectively unlimited, considering Britons receive “free” health care at the point of service. That’s a recipe for long waits. 

In November, there were 7.6 million people on NHS waiting lists for care. In December, more than 666,000 people waited more than four hours to receive care in the emergency room. The same month, people who had strokes, heart attacks, and other urgent medical emergencies had to wait 45 minutes, on average, for an ambulance to arrive. 

Thousands of patients die each year due to overcrowding and long wait times in emergency rooms.

The long waits and canceled appointments plaguing the NHS are leading more Britons to turn to private care. Demand for private medicine is growing so significantly that healthcare systems like Cleveland Clinic are expanding their footprints in the United Kingdom. 

The royal family tends not to use the public system. Kate Middleton, the Princess of Wales, recently opted to have abdominal surgery in a private hospital.

Britons are finding out the hard way that government-run health systems are bad for doctors and patients alike. Americans — and especially the doctors frustrated with Medicare’s parsimony — should take note. 

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on X, formerly Twitter, @sallypipes.