Elizabeth Warren’s version of Medicare for All has already been criticized for the dodgy plan to finance it, relying on tax hikes on wealthy Americans and corporations. She has claimed that the middle class would pay nothing extra to have all of their health care needs provided by the federal government.
Now the Washington Free Beacon is reporting that under Warren’s health care scheme. patients would trade money for Canada-style wait times for treatment.
“Warren, a Democratic presidential frontrunner, relies on aggressive cost-cutting measures, including tightly restricted reimbursements and global budgeting. Health care policy expert Christopher Pope said her approach would effectively amount to a rationing scheme. This, in turn, would likely curtail Americans’ access to care, replacing a ‘fee for service’ system with long wait times and mandatory caps on spending.”
A “global budget” would involve the government dispensing a fixed amount of money to doctors, hospitals, and other health care providers per year based on an estimate of what health care ought to cost, according to federal bureaucrats. If the actual costs of providing health care to patients exceed the amount of what the government says it is, then the doctors and hospitals have to eat the difference.
In Canada, whose government-run health care system uses global budgeting, health care providers make up the difference by making patients wait for services, an average of five months for specialists.
The Fraser Institute, a Canadian think tank that monitors that country’s government-run health care system, suggests that wait times for health care services are increasing over time. The system has had a malign effect on the general health of Canadians.
“Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences. Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish. In certain instances, they can also result in poorer medical outcomes—transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities. In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.”
Imagine getting a diagnosis of cancer under the system that Elizabeth Warren is proposing. The natural desire for a patient is to get treatment going right away, the better to try to get into remission and not allow the disease to get worse. A five-week wait for getting cancer treatment would seem to an eternity for someone who may be under, what is in effect, a sentence of death the longer that treatment is deferred.
Global budgeting also does not provide incentives for innovation and coordination across medical disciplines. As a result, it promotes a fragmented and inefficient health care system, increasing costs as well as rationing and wait times.
Warren’s proposal is likely not politically viable. According to the Free Beacon, Pope stated, “it’s going to mean that people aren’t going to be able to access care, especially high-quality care to the extent that they have been able to.”
Remember, the majority of Americans have private insurance and are, by and large, satisfied with the services it provides. Warren and other politicians like Bernie Sanders propose to do away that form of health care and replace it with a one size fits all government-run health insurance scheme as a way to extend health care to the people who, for whatever reason, do not have health insurance and are required to pay huge amounts of money out of pocket – or not if they defer treatment.
Several European countries, including France, the Netherlands, and Norway have eliminated global budgeting in their health care systems. These countries have shifted to a system called activity-based funding, in which hospitals and doctors receive compensation for the real-world cost of treating patients. Some Canadian provinces have started to experiment with this form of funding health care.
The inevitable conclusion that many analysts have arrived at is that Warren and her advisors have not thought through some of the real-world consequences of Medicare for All scheme. They are relying on the selling point that her plan provides “free” health care for all. The approach may not be viable either from a policy or a political standpoint.