- - Thursday, February 28, 2019

Hours after taking office in January, California’s new governor, Gavin Newsom, asked federal officials for permission to create a statewide single-payer health care system.

Other states are contemplating similar moves. Gov. Jay Inslee of Washington recently announced his plan for a state-sponsored public health insurance option. Colorado Gov. Jared Polis and his counterparts in the state legislature are looking to create a public option, too.

This trend should concern patients, especially those in red states who may believe that what happens in the likes of true-blue California has little impact on them.

In my native Canada, socialized medicine started as a radical reform initiative in one province before spreading nationwide. Half a century later, Canada’s version of Medicare for All forces patients to endure lengthy waits for subpar care.

The United States now risks repeating those mistakes.



Canada’s socialized medicine story starts in 1947, when Saskatchewan premier Tommy Douglas, the leader of the socialist Co-operative Commonwealth Federation who was later named the “Greatest Canadian” by the Canadian Broadcasting Corp. in 2004, established free hospital care for all citizens of the province. By 1962, the program had grown to include doctor care, making it the first universal, single-payer system in North America.

The province’s doctors were not fans. They saw socialized medicine as a threat to high-quality care. So on July 1, 1962 — the day the program went into effect — most of Saskatchewan’s doctors went on strike.

Their efforts were ultimately fruitless. Soon, progressive members of Canada’s parliament were backing a national version of Saskatchewan’s reforms. At the same time, public support for single-payer across the country began to swell.

That led to the 1966 passage of the National Medical Care Insurance Act, which created a single-payer system across Canada. In just four years, government-run health care had gone from an experiment in one province to a national policy.

In 1984, the Canadian government passed the Canada Health Act, which sets the conditions under which the federal government sends money to provincial governments to administer their own health care systems. Those conditions include making care free at the point of service and covering a comprehensive suite of medically necessary benefits, including hospital and doctor care but not prescription drugs.

In retrospect, Canada’s doctors were right about socialized medicine leading to poor-quality care. According to the latest research from the Fraser Institute, a Canadian think tank, Canadian patients waited a median of nearly 20 weeks for treatment from a specialist after receiving a referral from a general practitioner in 2018. The median wait for orthopedic surgery last year was 39 weeks after referral from a general practitioner.

A recent Commonwealth Fund analysis of 11 health care systems in developed countries ranked Canada last on measures of timeliness. The same report found only 43 percent of patients were able to see a doctor or nurse on the same or next day the last time they required medical attention. Half of Canadians were forced to wait two hours or more for emergency-room care, compared to just one-quarter of Americans.

When medical care is administered by a government bureaucracy that outlaws private coverage and is financed by limited public funds, rationing and inefficiency are inevitable.

Yet, the leaders of several U.S. states are vying to be modern-day Tommy Douglases — and foist socialized medicine upon their constituents. The idea is in play beyond California, Washington and Colorado. Earlier this month, New York Assemblyman Richard Gottfried introduced a bill that would establish single-payer in the Empire State. Just last month, New York Mayor Bill de Blasio announced his own plan for universal government coverage in the nation’s largest city.

Medicare for All will likely be the official position of the Democratic nominee for president in 2020. And according to the latest Kaiser Family Foundation poll, 56 percent of Americans support single-payer.

In other words, the same confluence of forces that led to the Canadian government’s takeover of the country’s health care system are now playing out in the United States. Consequently, the single-payer reforms that blue states and progressive enclaves are contemplating could go national faster than most would expect.

For the sake of American patients, our leaders would do well to take note of the Canadian health care system’s long waits, rationed care, higher taxes and doctor shortages — and not import our northern neighbor’s failed policies here.

Sally C. Pipes is president, CEO and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is “The False Promise of Single-Payer Health Care (Encounter).

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