Democratic front-runner Bernie Sanders is fond of saying that he wants to make sure that “healthcare is a right of all people, not just a privilege.” But were the Vermont senator to get his way, then quality healthcare, currently enjoyed by the vast majority of U.S. citizens, would only remain available to the privileged few.
The U.S. healthcare system, to be sure, has its problems, many of which were exacerbated by Obamacare. But to hear Sanders speak about the system, it’s as if the United States is living in the dark ages.
In reality, 91.5% of U.S. citizens have some form of health insurance coverage. And despite Sanders’s tirades against private insurance, 79% of U.S. citizens rate the quality of care that they receive as good or excellent.
Of course, there are many inefficiencies with the U.S. healthcare system. My preference would be to improve the system by unleashing the free market to improve choices and competition and bring down costs. While I don’t expect Democrats to come around to my views anytime soon, even those calling for more government intervention could focus on targeted ways to improve coverage for the minority of the population who are uninsured.
Instead, Sanders has argued that the only acceptable approach is to blow up the current system that 8 of 10 people rate highly. He would kick everybody off their current plans, moving the entire country to a single government-run plan within four years.
Sanders promises that the new plan will offer much more generous benefits without premiums, deductibles, or copayments. And importantly, the approach he’s outlined is more extensive than the government-run systems of other countries, which typically offer more limited benefits or ask beneficiaries to kick in some money toward their care. Furthermore, never before in history has a healthcare system as large as the U.S. transitioned so rapidly from a mixed public-private system to one that’s totally financed by the government. Moreover, Sanders has presented no realistic path to implementing this vision without causing major disruption.
Containing costs in such a system would require more than going after drug companies (a favorite target of Sanders) because spending on prescriptions only accounts for 9% of healthcare spending. It will instead require significant cuts to the money currently being paid to doctors and hospitals, which together account for a majority of the healthcare spending in the U.S.
Sanders likes to praise other healthcare systems for providing coverage to more people at a lower cost than the U.S. But U.S. doctors, on average, earn about twice what their counterparts do in the United Kingdom or Germany; two and a half times what French doctors earn; and nearly five times as much as doctors in Spain, according to a survey by Medscape.
Slashing salaries for doctors and cutting payments to hospitals is going to reduce the supply of both, while at the same time, Sanders would significantly increase demand by offering supposedly free and generous coverage to the entire population. There may be some people who currently have limited access, who would prefer a system with long waits over the current system. But for the overwhelming majority of U.S. citizens who generally like the coverage they receive, the socialist system Sanders envisions would be a major downgrade. It’s no surprise that in Nevada, Sanders has been locking horns with the state’s Culinary Union, because his plan would annihilate the very good health coverage that they’ve negotiated over the years, often in lieu of salary increases.
But you know who would be largely insulated from these major changes? The very wealthy. While the Sanders healthcare plan contains details on what standards medical providers would have to be able to meet to be included in the new government plan, in its current iteration, there is nothing forcing doctors to participate. Many of them would prefer, then, to avoid the mess entirely and cater to rich clients who can pay them directly.
In practice, that means that people who are rich enough would be able to afford to pay for concierge medicine, effectively giving them VIP access to care, which can range from a few thousand dollars a year to $25,000. Heck, a billionaire could outright pay to keep a private physician on call.
So in the system that Sanders envisions, those in the middle class or upper-middle class, who currently enjoy solid coverage, are going to be significantly worse off. But the privileged few would be able to navigate the system, buying their way out of the long queues for treatment and reduced quality.
