Bernie (and Hillary): Heed These Warnings About Single Payer

Bernie Sanders's campaign website states: "The only long-term solution to America's health care crisis is a single-payer national health care program." This would be amusing if it weren't so frightening.

British single payer collapsing
British experts and officials just reported that their National Health Service, the classic single payer approach, is "buckling under huge financial and operational pressures." It may and probably will collapse. They are beginning to "question the viability of free universal healthcare."

Sanders observes what is happening to the paradigm of a single payer healthcare system, and says he wants that for us!

Does Sanders advocate U.S. bankruptcy?
Even before Obamacare, the U.S. was spending twice as much on healthcare as anyone else in the world. That was why President Obama said he needed to reform our system: he said he would bend down our "unsustainable healthcare spending curve." Forget for a moment that Obamacare bent that spending curve upward, by $2.6 trillion. Consider this.

Sanders says his health plan will only cost $15 trillion--that is more than five times what Obamacare cost. Frankly, more reliable estimates put the price tag for Sanders' single payer plan at $32 trillion. That is slightly less than twice the GDP of our entire country ($18 trillion).

If spending on healthcare were "unsustainable" before Obamacare, how much more unsustainable will it be under single payer? Are Bernie Sanders (and Hillary Clinton for that matter) competing to see who can put the U.S. into bankruptcy court the fastest?

Single payer doesn't save money
Before people start shouting about all the money we would save with single payer, consider one fact and answer one question. Fact: The NHS is so costly that the Brits cannot afford to keep it going. Question: Can you name a single government program that is dollar-efficient? If so, show us the proof.

Single payer advocates see all the money that goes to insurance companies and they think, "Well, under single payer, we won't have to spend that. That money will go to care." Wrong. All the administration, eligibility, verification, follow-up, compliance, and regulatory review will still take place, and that is the major cost. While you might save the profit that insurance companies now take, the inefficiency of government-run programs will consume that saving and then some.

And when single payer does save money...
Bernie also seems to believe single payer systems work to the benefit of patients. He probably did not notice that British doctors went out on strike twice in the past five months. What were they striking for? More pay and better working conditions. Better working conditions means safer care and more timely care. But the government won't do that.

Remember, single payer doctors do not work for their patients. They work for the government. Is that what American patients want? Is that something American physicians will accept?

Single payer pushes grandma off the cliff
Finally, remember the campaign to smear Republican attempts to create Medicare or Medicaid block grants by saying, "they would push grandma in her wheelchair off a cliff?" Ask anyone who knows about single payer systems how they cut costs?

Single payer systems ration care, typically by age. In Great Britain, they save money by not authorizing dialysis for patients in kidney failure over the age of 55 years. The NHS claims the process is "not cost effective," and so, the patient in renal failure, who could be saved ... well, he dies. Single payer systems DO push grandma off the cliff, even before she needs a wheelchair.

People like Bernie Sanders and groups like Physicians for a National Health Plan believe fervently that single payer is the answer. They believe with almost religious fervor. They may believe in the single payer solution with all their hearts, but that don't make it so. Reality has a way of trumping (forgive the pun) fantasy.

"Dr. Deane" Waldman MD MBA is the author of NIE Award winnner The Cancer in the American Healthcare System; and Amazon Bestsellers Our Allies Have Become Our Enemies, and Washington's BARRC Is Its Bite. Dr. Deane is host of; Professor Emeritus of Pediatrics, Pathology and Decision Science; and Adjunct Scholar (Healthcare) for the Rio Grande Foundation, a public policy think tank. Dr. Deane serves as "Consumer Advocate" Director on the Board of the New Mexico Health Insurance Exchange. Opinions expressed here are solely his own and do not necessarily reflect those of the Board.