Single-payer, or government-sponsored healthcare, admittedly has some appeal. Imagine free doctors’ care for whatever ails you! So what, taxes will go up? It sounds like a good idea. That is until taxes do go up and the economic realities of a smaller paycheck set in. And it’s not as if there won’t be rules. Remember, it’s the same government that takes an average of 117.9 days to process a veteran’s disability claim. And consider wait times for Veterans Affairs (VA) medical facility visits. Since April 1, 2018, wait times for various treatment can be found online. I looked it up today for facilities in New York City:
Primary Care: Manhattan 12 days, Queens 22 days, Bronx 20 days
Cardiology: Manhattan 13 days, Queens is taking no new appointments, Bronx 15 days
Mental Health: Manhattan 16 days, Queens 6 days, Bronx 10 days
Orthopedics: Manhattan 17 days, Brooklyn (not offered in Queens) 30 days, Bronx 33 days
For those single-payer advocates, waiting times translate into rationing, since budget restraints will prevent hiring enough doctors to provide timely care. With government budget oversight, like the VA, you may have that shoulder ache for 33 days before a doctor can see you. But yes, you can always go to the emergency room – we all love those visits, don’t we?
And then this from the Louisiana Times-Picayune: Connie Raborn, a U.S. government-covered TRICARE oncology patient had to wait patiently for her high-cost specialty medications. Ms. Raborn had a double mastectomy and the misfortune of developing a growing cancerous tumor in her shoulder. The expensive medication was denied by TRICARE and her oncologist was quoted in the article: “It’s a frequent problem in oncology. The more expensive the medication the more likely there will be a delay.” While the government has an appeal process which can take up to 90 days, this appeal only took 30 days; but the article states that neither the doctor nor the patient were notified of the successful appeal.
The article blames the pharmacy benefit manager, Express Scripts, for the delay – but I think this problem will be magnified in a single-payer system. Keeping up with the resources needed to assess medical necessity for highly specialized drugs will be difficult.
There is no doubt the devil we have (high cost and insurance carrier bureaucracy) is pretty bad. But consider the devil we are going to get (rationing and government bureaucracy). There will be a whole new set of nightmares.