The concept of “Medicare for all” is popular among the most liberal wing of the Democratic Party. I know that Bernie Sanders (and others) have good intentions when they propose such a radical overhaul of our healthcare system. The very people who are suggesting that a single payer system is the most efficient, cost-effective way to treat patients has never been a patient in a single payer healthcare system. The systems in place in Canada and Britain are not true socialized medicine because there is a second “underground” healthcare system in which the wealthy and privately-insured are treated separately. I have worked in private and government hospitals and clinics for nearly fifty years and think I can speak about healthcare with some authority. Americans have no idea as to what changes will occur under a single payer system. Conservatives and liberals alike oppose the idea of “monopolies” in the business world. This should come as no shock when I say that single payer (monopoly) in healthcare is equally bad. Single supplier of any product or service is poor business. We should be even more opposed to single payer healthcare because your life is in the balance in some situations. When there is no competition, prices generally go UP, not down as Bernie believes. What does tend to go down is QUALITY. When there is no competition, you needn’t be concerned about how good a job you do or whether the customer will return. With no competition the customer has no choice. No competition also stifles innovation and new drug development and medical devices will suffer as a result. This is not even discussing that wait times for appointments will be increased because EVERYONE will be dumped into the same system.
Before you embrace the idea of single payer, talk to someone who has waited months or years for an appointment with a specialist or a surgical procedure in Canada or Britain. Many of those patients travel to the U.S. to have those procedures performed despite higher costs. How can you put a price on your quality of life? Our system has some issues, such as internal policing of bad doctors and nurses. We also have a lack of transparency when it comes to cost. The same x-ray or procedure can vary by as much as 100% between two different medical hospitals or facilities. Every pharmacy, clinic and radiology center should be made to post the cost of drugs and tests. Hospitals and doctors should be graded on outcomes, not on how many costly drugs they can prescribe. Patients do not always know what is best and medical professionals must be the “adult in the room” and say no to patients when appropriate. The U.S. healthcare system needs some adjustments, but not the complete overhaul that Senators Warren, Sanders and others are calling for. Take my advice and reject this overly simple idea.