Progressives are dreaming once again of a government takeover of the healthcare system. Locked out of power in Washington, they’re taking their fight for single-payer to blue states.
This week, four New Yorkers took to the pages of the journal Health Affairs to make their case for how the Empire State can deliver universal coverage on its own.
Absent from their analysis — and from any pitch for single-payer, for that matter — is the immense human cost of government-provisioned health insurance. Waiting lists, doctor shortages, and restrictions on access to care are the norm.
Just ask patients in Canada and the United Kingdom.
In England, 100,000 patients last year waited longer than the government’s two-month target for urgent cancer treatment.
The story is similar in Canada. According to the Fraser Institute, a Vancouver-based think tank, the median wait for treatment from a specialist following referral by a general practitioner was more than 28 weeks last year. That’s more than seven months. Canadians face median waits of more than 8 weeks for a CT scan and more than 18 weeks for an MRI.
These delays are not accidents. They’re the predictable result of government-run systems that operate under fixed budgets and strict price controls. When government sets prices below market-clearing levels and caps overall spending, supply contracts. And rationing follows.
Consider the market for prescription drugs in each country. Canada and Britain impose aggressive price controls on new medicines. So patients there gain access much later than Americans do. Just 59% of the medicines launched globally between 2012 and 2021 were available in the United Kingdom as of October 2022. In Canada, 45% were available.
Contrast that with the United States, where patients had access to 85% of those novel medicines.
Research published this month by the Fraser Institute found that Canadians waited an average of 91 weeks longer than Americans for their government to approve new medicines between 2019 and 2025.
Higher drug prices in the United States may seem unfair. But they ensure earlier access to new therapies.
THE RIGHT’S STEVE BANNON PROBLEM
States tempted by single-payer should take a clear-eyed look at the tradeoffs. Governments may be able to guarantee coverage. But they cannot — and do not — guarantee access to care, as Canadians and Britons know all too well.
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.
