For progressives, the answer to every healthcare problem is invariably the same: more government.
First came Obamacare. Now, some on the Left are trying to take the next step toward socialized medicine — “free” primary care for all. A new report from the Searchlight Institute, authored by several architects of the Affordable Care Act, urges Democratic policymakers to guarantee primary care with no out-of-pocket costs at the point of service.
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It sounds compassionate. But making something “free” does not magically create more of it.
The Association of American Medical Colleges projects that the United States could face a shortage of more than 40,000 primary care doctors by 2036. Even today, many patients wait weeks, sometimes months, for appointments.
Creating a new federal entitlement to no-cost primary care would dramatically increase demand for doctor visits without expanding the supply of physicians.
That imbalance has predictable consequences: longer waits, overburdened doctors, and reduced access to care.
Countries with government-run health systems offer a preview. Canada and the United Kingdom both promise “free” healthcare at the point of service. But patients ultimately pay in other ways: through high taxes, restricted access to care, and reduced access to the latest treatments and diagnostic technology.
Britain’s National Health Service is funded through some of the highest tax burdens in the developed world. Yet the system is under strain. More than 6 million patients in England are currently waiting for some form of care through the NHS.
Canada’s system faces similar problems. The median wait between referral from a general practitioner and specialist treatment now exceeds 28 weeks, according to the Fraser Institute. Despite Canada’s guarantee of universal coverage, nearly 6 million Canadians do not have a family doctor out of a total population of 41.5 million.
Canadians pay dearly for the privilege of waiting. The average Canadian family of four pays more than $19,000 a year in taxes to cover the cost of their public health insurance.
Those systems ration care because they have to. When governments suppress prices and eliminate cost-sharing, demand for services rises sharply. But the supply of physicians, clinics, and hospital capacity does not suddenly expand to match it.
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Guaranteeing “free” primary care for everyone without dramatically increasing the number of doctors available to provide it would leave Americans competing for a scarce resource — and waiting longer to receive it.
That is not a cure for America’s healthcare challenges. It is a recipe for making them worse.
Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy—and How to Keep It (Encounter 2025). Follow her on X @sallypipes.