State Legislatures Can’t Shake Their Single-Payer Dreams. That’s A Problem.

Michigan is the latest state to flirt with a government takeover of the health insurance system.

Earlier this year, Democratic Rep. Carrie Rheingans, who represents Ann Arbor, and several of her colleagues introduced House Bill 4893, which would create a state-run single-payer healthcare system.

It’s part of a nationwide trend. Lawmakers in 21 states introduced 66 different single-payer bills between 2010 and 2019, according to a study published in the University of Pennsylvania Law Review.

Like the national Medicare for All legislation from which these plans draw their inspiration, these bills would provide unlimited health care for no charge at the point of service. That may sound appealing. But single-payer health care saddles patients with interminable waits for subpar care—and charges them dearly for the privilege.

Thankfully, it’s a lot easier to talk about implementing single-payer than to actually do so.

Last month, California Governor Gavin Newsom signed a bill that requires state lawmakers to devise a plan for a single-payer system by November 2025. The new law is banking on a waiver from the federal government to spend federal funds earmarked for Medicare, Medicaid, and the like on a new state-run health plan. It’s no sure thing that the feds will grant that waiver.

The overall cost of single-payer in California could reach $500 billion a year. That’s more than twice the state’s annual budget.

Across the country, New York lawmakers revived the New York Health Act, another single-payer proposal, for the umpteenth time this past July. The RAND Corporation projected in 2018 that the Empire State would need $139 billion in 2022 to pay for it. That’s 156% more than the state was projected to take in taxes.

New York’s governors have historically been cool to single-payer. Democratic Gov. Kathy Hochul is considered unsupportive. Her predecessor, Gov. Andrew Cuomo, caught flak from his left flank for insisting that only the federal government should institute a single-payer plan.

Oregon and Washington have both chartered commissions to try to figure out how to install single-payer within their borders.

As American progressives work to put bureaucrats in charge of the healthcare system, patients in countries that have already done so are suffering under single-payer.

British Prime Minister Rishi Sunak pledged in January that “waiting lists will fall” for care delivered by the National Health Service. At the time, there were 7.2 million people on the wait list. Today, there are 7.75 million, the longest wait list in recorded history. That number could rise to 8 million by the summer, according to a recent report.

The NHS’s wait times have been exacerbated as healthcare providers have launched a battery of strikes over the last year for higher wages. The strikes have put pressure on providers who remained on the job to take care of patients, including one general practitioner who told the Financial Times that she frequently works 10-hour days to treat a backlog of 10,000 patients—a significant increase from the 1,600 patients in her care when she began her career in the 1980s.

In my native Canada, more than 1.3 million patients waited in emergency rooms without ever being seen by a doctor between April 2022 and March 2023, CTV News reported last month. That’s a 34% increase over the figure the previous year. The Canadian government this year announced it would send $200 billion to its provinces in the coming decade to bail out their overburdened healthcare systems.

Like Medicare for All supporters in the states, some Canadian lawmakers don’t seem to realize the root of the problem. Members of the progressive New Democratic Party are pushing for the country’s single-payer program to cover prescription drugs. Doing so would further strain the healthcare system and subject Canadian patients to the same kind of prescription coverage denials that British patients routinely face.

Fortunately, not all Canadian leaders have fallen prey to the single-payer delusion. Ontario in May passed a law expanding private delivery of care, after the province’s premier, Doug Ford called for measures to relieve the strain on the healthcare system. Reforms like that will be a relief to Canadian patients, who spent around $690 million leaving the country for health care in 2017.

State legislators pining for single-payer ought to take a look at the disasters unfolding in Canada and Britain. What they see should disabuse them of the notion that socialized medicine is something worth importing.

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