By Sally C. Pipes
Monday, August 24, 2020
Medicare for All may not be a part of Democratic
presidential nominee Joe Biden’s agenda. But the rest of the party is smitten
with the idea of a federal takeover of our health-insurance system.
Senator Kamala Harris (D., Calif.), Biden’s running mate,
co-sponsored Senator Bernie Sanders’s (D., Vt.) Medicare for All bills in 2017
and again in 2019. Last week’s Democratic National Convention, meanwhile,
featured speeches from many of single-payer’s most visible proponents, from
Sanders and Representative Alexandria Ocasio-Cortez (N.Y.) to Senator Elizabeth
Warren (Mass.) and progressive activist Ady Barkan, who runs the Be A Hero PAC
and suffers from ALS.
In fact, the moderates and progressives within the
Democratic Party largely agree that they want to work toward Medicare for All.
They just disagree on how to get there, and how fast.
A detour to Canada should disabuse them of their fondness
for single-payer. Our northern neighbors wait months for routine care and lack
access to the latest life-saving medications and technology. Importing this
system would lead to widespread misery.
I know firsthand. I was born in Canada and watched the
government-run health-care system there turn a blind eye to my mother’s
suffering. After experiencing stomach pain, she requested a colonoscopy but was
denied one because of her age; there were too many younger people ahead of her
on the waiting list. By the time she got one, her cancer had become
untreatable. She died shortly thereafter.
I’ve been educating Americans about the pitfalls of
single-payer for years. Earlier this month, I was called out by Wendell Potter,
a former insurance executive who took to the pages of the Washington Post
to apologize for using my work to “obscure important truths about the
differences between the U.S. and Canadian health-care systems.”
“Of the many regrets I have about what I once did for a
living, one of the biggest is slandering Canada’s health-care system,” Potter
wrote.
But Canada’s health-care system does not merit praise.
Long waits for care are a fact of life in Canada. Last
year, the median wait between referral from a general practitioner and receipt
of treatment from a specialist was nearly
21 weeks. In 2019, more
than 175,000 people in Canada’s four easternmost provinces were waiting for
a family doctor.
Fans of Canadian health care, including Potter, claim
that Canadians wait only for elective procedures, such as knee replacements.
But “elective” is in the eye of the beholder. Is a six-month wait for a knee
replacement — the median in Canada last year — reasonable, when it keeps
someone in pain and unable to work? One study puts the total cost of waiting
for joint-replacement surgery after taking into account lost wages and
additional tests and scans at almost $20,000. It’s no wonder that more than
323,000 Canadians left the country to seek care abroad in 2017.
Canadians also wait for access to novel drugs and medical
technologies, if they get access to them at all. Of the 290 new medicines
brought to market between 2011 and 2018, fewer than half were available in
Canada. U.S. patients had access to 89 percent of those new drugs.
In many cases, Canada’s Patented Medicines Prices Review
Board determines that, even at a discounted price, cutting-edge drugs are still
too expensive to be available to Canadian patients.
Last year, the median wait for an MRI was more than nine
weeks in Canada. It was nearly five
weeks for a CT scan. Perhaps those waits shouldn’t be surprising. As of
2017, Canada had fewer than 16 CT machines for every million people. The United
States had 2.6 times as many per capita. MRI machines are just as hard to come
by up north. There are fewer than 10 units per million Canadians — one-fourth
as many as in the United States.
Canada doesn’t appear interested in addressing these
discrepancies. A recent report from the Conference Board of Canada found that
27 percent of Canada’s stock of medical-imaging equipment is more than ten
years old. The rate at which new machines are being added is at a 20-year low.
But “Who cares about those numbers?” cry the fans of
Canadian health care. Canadians, they say, live longer than Americans while
spending far less.
It’s true that life expectancy in Canada is a little
under two years higher than in the United States. But that doesn’t tell us much
about the relative quality of the countries’ health-care systems, because so
many factors that have nothing to do with health care affect life expectancy.
For example, the U.S. murder rate is three times
Canada’s. Almost twice as many Americans, per capita, die in car crashes. And,
tragically, on a per-capita basis, many more Americans die via suicide and drug
overdose than do Canadians.
Those are all serious public-policy issues. But it’s
unlikely that Medicare for All would have much of an impact on them.
Canada may have universal coverage, but as recently
retired Canadian supreme-court chief justice Beverley McLachlin wrote in a 2005
ruling on a case that unsuccessfully challenged Canada’s ban on private insurance,
“access to a waiting list is not access to health care.” Those pushing for
Medicare for All are intent on ignoring that lesson — to the detriment of
American patients.
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