The Problem with Health Care Is Washington

Eschewing his usual bombastic rhetoric, Sen. Bernie Sanders took to the written word: "The day must come ... when we [federal government] guarantee health care for every man, woman, and child ... through a Medicare for All single payer system."  The appropriate response to Sanders's ill-conceived article is President Ronald Reagan's warning: "Government is not the solution to our problem; government is the problem." 

Volumes of medical evidence exist proving that government-controlled healthcare, viz., a single-payer system, fails to provide adequate medical care for the people it claims to serve.  

For more than fifty years, Washington has been increasing government control over healthcare using solutions such as Medicare, Medicaid, the Emergency Medical Transport and Labor Act (EMTALA), the Unfunded Mandate Reform Act (UMRA), the Health Insurance Portability and Accountability Act (HIPAA), and the Affordable Care Act (ACA).  Yet Medicare will be insolvent in less than five years.  Medicaid enrollees die waiting for care that never comes.  EMTALA created the unfunded mandate that forces rural hospitals to close.  The unfunded mandate persists despite UMRA.  HIPAA failed to make insurance portable or affordable and hampers communication between care providers.  The ACA reduced patients' access to medical care.

In 2022, the U.S. spent $4.3 trillion on healthcare, 18.3 percent of GDP.  The combined GDP of all nations on Earth is $88 trillion.  Sanders admits his plan would cost up to $40 trillion, a third to half of which produces no patient care!  It pays for BARRCOME (bureaucracy, administration, rules, regulations, compliance, oversight, mandates, and enforcement), not doctors, nurses, therapists, hospitals, and pharmacies. 

Sanders proudly calls Medicare for All what it is: single payer.  Outcomes data from Great Britain's National Health Service (NHS) and Canadian healthcare prove that single-payer systems fail to provide adequate patient care. 

Like the U.S., the NHS has a critical doctor shortage, made worse by an increasing "exodus" of senior physicians.  This is ominous for today's patients, and then who will train tomorrow's doctors?  In January 2018, the NHS had to cancel 50,000 scheduled surgeries.  Wait times for care in the U.S. can exceed four months, but in both the NHS and Canada, the wait can be even longer.  Death-by-queue — dying waiting in line for care — is a phrase coined for patients' experience in the NHS.  It is now happening here.  According to an internal V.A. audit, "47,000 veterans may have died" waiting for care.  Hundreds of Medicaid patients died in line for care. 

Wielding its regulatory authority, federal bureaucrats now make most medical as well as financial healthcare decisions.  Which drugs a doctor can prescribe; what surgery, by whom, and when; who will be your doctor; and how much providers are paid — these are all choices determined by federal rules, not physicians' judgment or patients' preference. 

The single-payer systems of Great Britain and Canada allow government to override a patient's wishes, contravening medical autonomy.  Sanders's single payer will take away Americans' medical freedom, giving Washington ultimate authority over Americans' life and death, reminiscent of Sarah Palin's "death panels."

When federal politicos practice medicine, they do so badly.  For proof, Americans need only recall Washington's COVID scam.

The federal government ginned up a flu-like respiratory virus, dangerous only to a small segment of the population, and pronounced it an existential threat to the entire nation.  Using this exaggerated health hazard as justification, through mandates and aggressive censorship, Washington politicians and bureaucrat-M.D.s like Anthony Fauci and Rochelle Walensky did grave harm to the U.S. 

Useless, unnecessary lockdowns stopped education of children and destroyed the livelihoods of millions.  To pay the millions who were prevented from working, Washington spent 2.3 trillion taxpayer dollars, money it didn't have.  Religious and other gatherings were prohibited in direct violation of the First Amendment.  Medical data contradicting the official narrative was suppressed.  Doctors were punished for using their own best judgment treating patients. 

President Biden first shamed, then mandated 330 million Americans to accept injections of an inadequately tested mRNA gene therapy made with poor quality control, falsely touting it as "safe, effective, and doctor-approved."  Such gene therapy had never been used for mass treatment.  There are no long-term or even moderate-term outcome data.  Reports of adverse health impacts of mRNA injections are finally now escaping the censors of Washington and the complicit media.  The public is learning how Washington's gross negligence, malpractice, and power-grab have injured millions of Americans.

As a "doctor" for sick "patient" Healthcare System, Bernie Sanders is urging a treatment — single payer — that has been proven not to work.  A competent physician would establish the cause of the patient's illness and only then recommend treatment. 

The U.S. healthcare system suffers from the following symptoms: "unsustainable" (Obama) national overspending; individual unaffordability of medical care; and inadequate access to care, causing death-by-queue. 

The root cause is Washington's control of healthcare. 

The federal regulatory apparatus empowers a third-party payment structure that disconnects patient from physician, or buyer from seller in economic terms.  The result is centrally controlled healthcare rather than free-market health care. 

Frightening examples abound of centrally controlled ("federal") healthcare: totalitarian regimes in the USSR, Venezuela, and North Korea, as well as democracies in Great Britain and Canada.  Their healthcare systems suffer from shortages, rising prices, poor quality, and lack of personal medical freedom

The U.S. should learn from others' mistakes and our own fifty-year disastrous foray into federal healthcare.  Single payer is precisely the wrong way to go.  Instead, we need to decouple Washington from healthcare.  Tear down massively expensive federal BARRCOME that diverts trillions from patient care to pay for bureaucracy and denies Americans their personal independence.  Taking control from bureaucrats and restoring it to patients will make health care affordable and readily accessible. 

Washington will never voluntarily get out of healthcare, as it is not in politicians' and bureaucrats' best interest.  We the People must elect people who will do what is our best interests: patient-controlled healthcare.  

Deane Waldman, M.D., MBA is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award-winning book Curing the Cancer in U.S. HealthcareStatesCare and Market-Based Medicine

Image: Pkd2016 via Wikimedia Commons, CC BY-SA 2.0 (cropped).

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