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A ‘pig in a poke’

Will someone in the Democrat party in New Hampshire please do a little research into what single payer government run health systems have done to, not for, the citizens of those countries that have such a scheme in place. Start with the National Health Service in the UK which is the oldest having been implemented in 1948 and read what Wikipedia has to say about the current state of that program and its failure to provide decent coverage to those who need it the most. Further, the NHS restricts patients access to cataract removal and people are losing their sight as they wait for surgery. In fact the Clinical Commissioning Groups (CCGs) now include cataract removal on their list of “procedures of limited clinical value.” Research has shown that patients may wait for 15 months before being scheduled for cataract removal. Some CCGs also consider hernia repair and hip and knee replacement as procedures of limited value. You can verify this by going to “theguardian.com” and typing in “NHS access to cataract removal.”

Now let’s take a look at the Canadian single payer health system which has been in place for the better part of forty years, and see what it means for Canadian citizens. A recent article in the Washington Examiner “Single payer means long waits for care” by Dr. Roger Stark examines the Canadian system which is a pure government run program with no private insurance available to its citizens. It describes the long waits between diagnosis and treatment with the average being 20.2 weeks and in some provinces it is even longer with New Brunswick being 45 weeks as the longest. While it is true that emergency issues are dealt with quickly in Canada, elective surgery such as hip and knee replacement have long wait times as does cataract removal. Dental care, vision care, prescription medications, psychotherapy, and physical therapy are items that are not covered and must be paid out of pocket. With a 2018 population of 37.06 million people across a huge area, it has less residents than the state of California at 39.56 million people. The total 2018 population of the United States is 327 million, almost 10 times that of Canada, so going to single payer here is a far more challenging situation due to size alone.

The experience of Vermont (Bernie Sanders home state) when it tried to implement a state run single payer health system is a classic example of the issues that government run health systems face. In 2011 the democrat controlled legislature directed then democrat Governor Peter Shumlin to appoint a commission to study the matter and report back in 2013. Keep in mind, the population of Vermont is 625 thousand people so it should be a perfect place to implement a single payer system. The commission determined the levels of coverage and estimated the cost for those coverage’s running computer models to see the impact on the state budget. Vermont’s total budget for 2014 was 5.1 billion and even with federal assistance, the single payer system (Green Mountain Care) would require another 2.6 billion in new taxes, a cost to the citizens and business that was too great to bear, so Governor Shumlin quietly killed the project. For those who are interested, the Washington Post took an in depth look at Vermont’s failure to enact a single payer system, published in its April 29th edition.

I continue to be amazed at the 2020 Democrat presidential candidates running on a “Medicare for all” promise without disclosing any plans on how it is to be implemented, how much it will cost and how it will be paid for. This is a “pig in a poke” in a manner of speaking, and should be viewed by the public with great skepticism until real plans are put on the table.

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