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 health care system.
This is part of a national 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 that these plans are inspired by, these bills would provide unlimited, free health care at the point of care. This may sound attractive. But single-payer health care saddles patients with endless waits for substandard care and makes them pay dearly for the privilege.
Fortunately, it’s much easier to talk about implementing a single-payer system than to actually do it.
Last month, California Governor Gavin Newsom signed a bill requiring state lawmakers to develop a plan for a single-payer system by November 2025. The new law banks on a federal government waiver of spending federal funds intended for Medicare, Medicaid, and so on on a new state-run health plan. It is not certain that the federal government will grant this exemption.
The overall cost of California’s single-payer system could reach $500 billion per year. This represents more than double the annual state budget.
Across the country, New York lawmakers revived the New York Health Act, another single-payer proposal, for the umpteenth time last July. The RAND Corporation predicted in 2018 that the Empire State would need $139 billion in 2022 to finance this project. That’s 156% more than the state was supposed to collect in taxes.
New York State governors have historically been reluctant about single-payer. Democratic Governor Kathy Hochul is considered unsupportive. His predecessor, Gov. Andrew Cuomo, was criticized from his left flank for insisting that only the federal government should institute a single-payer plan.
Both Oregon and Washington have created commissions to determine how to achieve a single-payer system within their borders.
While American progressives work to put bureaucrats in charge of the health care system, patients in countries that have already done so are suffering under the single-payer system.
British Prime Minister Rishi Sunak promised in January that “waiting lists would go down” for care provided by the National Health Service. At the time, 7.2 million people were on the waiting list. Today, there are 7.75 million, the longest waiting list in history. That number could reach 8 million by summer, according to a recent report.
Waiting times in the NHS have been exacerbated by the launch of a series of strikes by healthcare providers over the past year for higher pay. The strikes have put pressure on remaining providers to care for patients, including a GP 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 she cared for 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. This represents an increase of 34% compared to the previous year. The Canadian government announced this year that it would send $200 billion to its provinces over the next decade to bail out their overburdened health systems.
Like supporters of Medicare for All in the United States, some Canadian lawmakers don’t seem to realize the root of the problem. Members of the Progressive New Democratic Party are pushing for a national single-payer program to cover prescription drugs. This would strain the healthcare system and subject Canadian patients to the same type of denial of prescription coverage that UK patients routinely face.
Fortunately, not all Canadian leaders have fallen into the single-payer illusion. Ontario passed legislation in May expanding private delivery of care, after the province’s premier, Doug Ford, called for measures to ease pressure on the health-care system. Such reforms will come as a relief to Canadian patients, who spent an estimated $690 million leaving the country for health care in 2017.
State lawmakers who aspire to single-payer should take a look at the disasters unfolding in Canada and Britain. What they see should dissuade them from the idea that socialized medicine is worth importing.
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