Bernie and the Single Payer Beast

Earlier this month, Sen. Bernie Sanders, I-Vt., reintroduced his landmark Medicare for All legislation alongside 14 of his fellow Democrats at a Senate Budget Committee hearing.

With a little persistence and a dash of political magic, Sanders hopes his fairy tale about government-run health care, which he championed for years while in the House and Senate, will finally come true. .

For the patients, it would be anything but a happy ending. Medicare for All would subject Americans to long waits for substandard care.

To see how, watch the inspiration for Senator Sanders’ single-payer vision: Canada. North of the border, health care is largely free at the point of service. This keeps the processing demand high.

But with a limited number of doctors – Canada has less than three per 1,000 people, one of the lowest ratios among developed countries – the country’s single-payer system is unable to meet the needs of the population.

Delayed care is the inevitable result of this mismatch. According to Vancouver’s Fraser Institute, a think tank, Canadians face a median wait of 25.6 weeks, or about six months, for specialist treatment following a referral from a GP last year.

No segment of the population escapes these expectations. Earlier this month, children waited until 4 p.m. for care at a pediatric emergency room in Alberta. Some seniors have been told they will have to wait up to two years for hip replacement surgery.

A woman was in so much pain after waiting a year for hip replacement surgery that she flew to Lithuania for surgery. A year after having surgery abroad, his Canadian doctor still hadn’t called to schedule him.

Stories like this are not uncommon. In Canada, the government has a monopoly on payment for “medically necessary” treatment; private insurance is prohibited for anything the government claims the right to cover. Thus, patients can either wait for public care or spend their own money to seek care abroad.

Many opt for the latter., a Canadian think tank, estimated that nearly a quarter of a million patients traveled abroad for treatment in 2017.

Some are not so lucky. More than 11,500 patients died while waiting in treatment queues between 2020 and 2021, according to

Routine cancer care is hard to come by. Only 54% of Canadian women aged 50 to 69 have been screened for breast cancer. That’s compared to 80% of American women in the same age group.

This lack of access translates into poor health outcomes. Canadian patients with breast cancer, stomach cancer, lung cancer and prostate cancer have lower survival rates than their American counterparts.

The human cost of these expectations is obvious. But there is also a significant financial cost. According to a new Fraser report, Canadians lost $4.1 billion in wages and productivity during the working day while waiting for care in 2021. With more than 1.4 million people waiting for treatment, the cost of waiting is approximately $3,000 per person.

And that’s a conservative estimate. When the researchers factored in nights and weekends, the cost of waiting jumped to nearly $12.4 billion, or about $8,700 per person.

Add that to the $15,000 the average Canadian family of four pays in taxes each year to fund the nation’s public health care system, and single-payer suddenly seems a lot less “free.”

Despite real-world evidence to the contrary, Senator Sanders says his $3 trillion-a-year plan for Medicare for All will “guarantee health care to every man, woman, and child in America in a cost-effective way.”

It’s wishful thinking, as Canada’s single-payer system proves.

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