Tag Archives: Elizabeth Warren

Canada’s single payer health care: pay up front, take a number and wait until you die

Price of healthcare per Canadian household (Source: Fraser Institute)
Price of healthcare per Canadian household (Source: Fraser Institute)

I post a lot of research from Canada’s Fraser Institute, but they are not the only think tank that publishes research on the efficiency and costs of single payer health care in Canada. This time, I found a report from the Heritage Foundation, where they go over quality of care, taxes, out of pocket costs, coverage, rationing, waiting lists, staff shortages, substandard equipment, and outdated drugs.

Here’s the report from the Heritage Foundation. I’ll focus on the differences.

Canadians pay slightly less in out of pocket costs:

The OECD calculates that Canadians spend 1.6 percent of GDP on out-of-pocket health spending, compared to 1.9 percent in the U.S.

[…]While these numbers are very close, they are actually getting closer. Since 1970, U.S. out-of-pocket spending as a percentage of total medical spending has been falling steadily, from 33 percent in 1970 to about 10 percent in 2017.19

Meanwhile, Canadian out-of-pocket spending has been falling much slower, so that by 2016 it totaled 15 percent of total medical spending—a higher proportion than in the U.S.20

 As a result, Statistics Canada warned in early 2020 that the percentage of Canadians experiencing large out-of-pocket burdens is growing, writing that “[b]etween 1998 and 2009…the percentage of households spending more than 10% of their total after-tax income on health care rose by 56%.”

Canadians pay more in federal and state taxes:

Federal taxation excluding social security contributions, then, comes to 28 percent of GDP in Canada, compared to just 19 percent in the U.S.—meaning 51 percent more.

[…]This excess taxation is largely a result of health spending, which has bloated provincial budgets to nearly three times the taxes of U.S. states.

Provincial taxes have grown to nearly the same level as federal taxation. Meanwhile, provincial health costs have risen to fully 37 percent of provincial budgets in 2016—up from 33 percent in 1993 – —and range as high as 42 percent.

Canada’s Fraser Institute has estimated this excess tax burden from public health costs at roughly $9,000 for a household of two adults with or without children or $750 per month in additional taxes.

When I wanted an MRI I was scheduled the same week
When I wanted an MRI I was scheduled the same week

Canadians wait far longer for treatment than Americans:

Medical waiting times have become a national crisis in Canada, and continue to worsen. The average wait time for medically necessary treatment between referral from a general practitioner and a consultation with a specialist was 8.7 weeks in 2018, 136 percent longer than in 1993. Patients then have to wait again between seeing the specialist and the actual treatment, another 11 weeks on average, 97 percent longer than in 1993.

From referral to treatment, then, it takes an average of 19.8 weeks (see Chart 2) to be treated, in addition to the original wait to see the family doctor in the first place—this for “medically necessary” treatment, not cosmetic surgery.

In contrast, nearly 77 percent of Americans are treated within four weeks of referral, and only 6 percent of Americans report waiting more than two months to see a specialist.

As for appointments, a 2017 survey of American physicians in the 15 largest U.S. cities found that it took just 24 days on average to schedule a new-patient physician appointment, including 11 days for an orthopedic surgeon and 21 days for a cardiologist.

As a result of these long waits, by one recent estimate, at any given moment, over one million Canadians—3 percent of the entire population—are waiting for a medical treatment.

These lists can average six months, and often much longer in rural areas, which tend to suffer from doctor shortages so severe that many do not even have a family doctor. Overall, 15 percent of Canadians did not have a regular health care provider in 2017.

The shortages ripple through the system; one doctor in Ontario called in a referral to the local hospital, only to be told there was a four-and-a-half year wait to see a neurologist.

In Canada, people die or become inoperable on waiting lists:

A Montreal man was finally called for his long-delayed urgent surgery two months after he had died. One 16-year-old boy in British Columbia waited three years for an “urgent” surgery, during which time his condition deteriorated so much that he became a paraplegic.

Canadians have to travel abroad to countries with functioning health care systems in order to be treated:

These cases are, unfortunately, not isolated; a survey of specialists found that average wait times exceed what is deemed clinically “reasonable” for fully 72 percent of conditions in Canada. The situation continues to worsen every year: In 1994, the average gap between clinically reasonable delay and actual delay was only four days, and by 2018 had grown to 23 days.

[…]With one million waiting, many Canadians turn in desperation to U.S. health care—the very system some U.S. policymakers propose to transform. In 2017 alone, Canadians made 217,500 trips to other countries for health care, of which 52,500 were to the U.S., paying out of pocket to skip the waiting.

Outdated equipment, outdated drugs, staff shortages:

 While the average employer-sponsored private insurance plan in Canada covers between 10,000 and 12,000 drugs, most public plans in Canada only cover 4,000. Canada has 35 percent fewer acute care beds than the U.S., and only one-fourth as many magnetic resonance imaging (MRI) units per capita—indeed, it has fewer MRI units per capita than Turkey, Chile, or Latvia.

[…]Some common treatments are simply unavailable to Canadians. For new pharmaceuticals, for example, Canada’s policy of forcing down prices so that American consumers essentially pay for Canada’s research and development has led to years-long delays for Canadian patients.

[…]Cutting corners on facilities and using outdated drugs show up in Canadian mortality rates. Thirty-day in-hospital mortality rates in Canada are 20 percent higher than in the U.S. for heart attacks, and nearly three times the U.S. level for strokes. Cancer age-standardized mortality is 10 percent higher in Canada than in the U.S.—despite far healthier lifestyles.

[…]When it comes to personnel, Canada underspends on medical staff and doctors, ranking 29th out of 33 among high-income countries for doctors per 1,000 population, accounting for a large part of those wait times. Canada has half as many specialist physicians per capita as the U.S.

[…]With such shortages and waiting lists, Canadian emergency rooms are packed. So packed that Canadians sometimes just give up and go home. Of Canadian ER visitors who are seen, 29 percent report wait times of over four hours, three times the U.S. level.

[…]Canadian seniors are 65 percent more likely to have visited the emergency room (ER) four or more times in the past year than American seniors.

Ultimately, nearly 5 percent of Canadian ER visitors end up leaving without ever being treated, giving up on a medical system that is perennially “free” but out of stock at the moment. In one study at two ERs in Alberta, 14 of the 498 walkaways were subsequently hospitalized, and one died within the week.

And keep in mind how things work in a single payer system. You pay up front through your taxes. The harder you work, the more you pay into the system. When you want treatment, you just get in line behind people who never paid one dime into the system – like all those low-skill refugees that Canada imports from Middle Eastern countries to build up the socialist voting bloc.

Canada’s single payer health care: pay up front, take a number and wait until you die

Price of healthcare per Canadian household (Source: Fraser Institute)
Price of healthcare per Canadian household (Source: Fraser Institute)

I post a lot of research from Canada’s Fraser Institute, but they are not the only think tank that publishes research on the efficiency and costs of single payer health care in Canada. This time, I found a report from the Heritage Foundation, where they go over quality of care, taxes, out of pocket costs, coverage, rationing, waiting lists, staff shortages, substandard equipment, and outdated drugs.

Here’s the report from the Heritage Foundation. I’ll focus on the differences.

Canadians pay slightly less in out of pocket costs:

The OECD calculates that Canadians spend 1.6 percent of GDP on out-of-pocket health spending, compared to 1.9 percent in the U.S.

[…]While these numbers are very close, they are actually getting closer. Since 1970, U.S. out-of-pocket spending as a percentage of total medical spending has been falling steadily, from 33 percent in 1970 to about 10 percent in 2017.19

Meanwhile, Canadian out-of-pocket spending has been falling much slower, so that by 2016 it totaled 15 percent of total medical spending—a higher proportion than in the U.S.20

 As a result, Statistics Canada warned in early 2020 that the percentage of Canadians experiencing large out-of-pocket burdens is growing, writing that “[b]etween 1998 and 2009…the percentage of households spending more than 10% of their total after-tax income on health care rose by 56%.”

Canadians pay more in federal and state taxes:

Federal taxation excluding social security contributions, then, comes to 28 percent of GDP in Canada, compared to just 19 percent in the U.S.—meaning 51 percent more.

[…]This excess taxation is largely a result of health spending, which has bloated provincial budgets to nearly three times the taxes of U.S. states.

Provincial taxes have grown to nearly the same level as federal taxation. Meanwhile, provincial health costs have risen to fully 37 percent of provincial budgets in 2016—up from 33 percent in 1993 – —and range as high as 42 percent.

Canada’s Fraser Institute has estimated this excess tax burden from public health costs at roughly $9,000 for a household of two adults with or without children or $750 per month in additional taxes.

When I wanted an MRI I was scheduled the same week
When I wanted an MRI I was scheduled the same week

Canadians wait far longer for treatment than Americans:

Medical waiting times have become a national crisis in Canada, and continue to worsen. The average wait time for medically necessary treatment between referral from a general practitioner and a consultation with a specialist was 8.7 weeks in 2018, 136 percent longer than in 1993. Patients then have to wait again between seeing the specialist and the actual treatment, another 11 weeks on average, 97 percent longer than in 1993.

From referral to treatment, then, it takes an average of 19.8 weeks (see Chart 2) to be treated, in addition to the original wait to see the family doctor in the first place—this for “medically necessary” treatment, not cosmetic surgery.

In contrast, nearly 77 percent of Americans are treated within four weeks of referral, and only 6 percent of Americans report waiting more than two months to see a specialist.

As for appointments, a 2017 survey of American physicians in the 15 largest U.S. cities found that it took just 24 days on average to schedule a new-patient physician appointment, including 11 days for an orthopedic surgeon and 21 days for a cardiologist.

As a result of these long waits, by one recent estimate, at any given moment, over one million Canadians—3 percent of the entire population—are waiting for a medical treatment.

These lists can average six months, and often much longer in rural areas, which tend to suffer from doctor shortages so severe that many do not even have a family doctor. Overall, 15 percent of Canadians did not have a regular health care provider in 2017.

The shortages ripple through the system; one doctor in Ontario called in a referral to the local hospital, only to be told there was a four-and-a-half year wait to see a neurologist.

In Canada, people die or become inoperable on waiting lists:

A Montreal man was finally called for his long-delayed urgent surgery two months after he had died. One 16-year-old boy in British Columbia waited three years for an “urgent” surgery, during which time his condition deteriorated so much that he became a paraplegic.

Canadians have to travel abroad to countries with functioning health care systems in order to be treated:

These cases are, unfortunately, not isolated; a survey of specialists found that average wait times exceed what is deemed clinically “reasonable” for fully 72 percent of conditions in Canada. The situation continues to worsen every year: In 1994, the average gap between clinically reasonable delay and actual delay was only four days, and by 2018 had grown to 23 days.

[…]With one million waiting, many Canadians turn in desperation to U.S. health care—the very system some U.S. policymakers propose to transform. In 2017 alone, Canadians made 217,500 trips to other countries for health care, of which 52,500 were to the U.S., paying out of pocket to skip the waiting.

Outdated equipment, outdated drugs, staff shortages:

 While the average employer-sponsored private insurance plan in Canada covers between 10,000 and 12,000 drugs, most public plans in Canada only cover 4,000. Canada has 35 percent fewer acute care beds than the U.S., and only one-fourth as many magnetic resonance imaging (MRI) units per capita—indeed, it has fewer MRI units per capita than Turkey, Chile, or Latvia.

[…]Some common treatments are simply unavailable to Canadians. For new pharmaceuticals, for example, Canada’s policy of forcing down prices so that American consumers essentially pay for Canada’s research and development has led to years-long delays for Canadian patients.

[…]Cutting corners on facilities and using outdated drugs show up in Canadian mortality rates. Thirty-day in-hospital mortality rates in Canada are 20 percent higher than in the U.S. for heart attacks, and nearly three times the U.S. level for strokes. Cancer age-standardized mortality is 10 percent higher in Canada than in the U.S.—despite far healthier lifestyles.

[…]When it comes to personnel, Canada underspends on medical staff and doctors, ranking 29th out of 33 among high-income countries for doctors per 1,000 population, accounting for a large part of those wait times. Canada has half as many specialist physicians per capita as the U.S.

[…]With such shortages and waiting lists, Canadian emergency rooms are packed. So packed that Canadians sometimes just give up and go home. Of Canadian ER visitors who are seen, 29 percent report wait times of over four hours, three times the U.S. level.

[…]Canadian seniors are 65 percent more likely to have visited the emergency room (ER) four or more times in the past year than American seniors.

Ultimately, nearly 5 percent of Canadian ER visitors end up leaving without ever being treated, giving up on a medical system that is perennially “free” but out of stock at the moment. In one study at two ERs in Alberta, 14 of the 498 walkaways were subsequently hospitalized, and one died within the week.

And keep in mind how things work in a single payer system. You pay up front through your taxes. The harder you work, the more you pay into the system. When you want treatment, you just get in line behind people who never paid one dime into the system – like all those low-skill refugees that Canada imports from Middle Eastern countries to build up the socialist voting bloc.

If Elizabeth Warren wins in 2020, expect her to end Christian private schools

Elizabeth Warren will says Christian schools are her enemy
Elizabeth Warren will says Christian schools are her enemy

It’s hard to see into the minds of the Democrat party candidates to know what they believe about God. But I think that support for infanticide and opposition to Christian churches, schools and other organizations is a pretty good sign of what they really believe. Elizabeth Warren for example is pretty clearly not a Christian, and has an obvious contempt for the Bible.

Here’s the story from Western Journal:

On Sunday Sen. Elizabeth Warren shared a HuffPost article on Twitter bashing private Christian schools for having “anti-LGBTQ+ policies.”

The article focused attention on a U.S. Supreme Court case attacking Montana private religious schools and attempting to take away tax credits to individuals who contributed to private schools because the money supports policies that “discriminate against LGBTQ staff and employees.”

Such policies include having bathrooms designated for people according to their biological gender and hiring faculty and staff who abide by Christian marriage values.

“States should focus on funding public schools, not private ones — especially ones that maintain anti-LGBTQ+ policies. We must ensure every kid–especially LGBTQ+ kids–can get a high-quality public education,” Warren tweeted.

The article explains that these Christians schools respect what the Bible teaches in various areas. Some schools expect teaches to be Christians. Others affirm a Biblical view of sexuality – sex allowed only within a heterosexual marriage. Some of them just don’t want men in women’s bathrooms. But none of this is OK with Elizabeth Warren, because she thinks that the hurt feelings of LGBT people are more important than the Constitutional rights of Christians.

Why might Warren be taking this position? Well, Democrats have traditionally enjoyed massive support from public schools. And public schools see private schools as threats to their monopoly. When private schools offer children a better education, public schools prefer to shut them down rather than work harder.

Take a look at these donations by the American Federation of Teachers:

Political contributions by the American Federation of Teachers union
Political contributions by the American Federation of Teachers union

The article notes:

Public school groups have been vocal about their feelings towards the case, claiming that it “could have a devastating effect on education and play a major role in disintegrating the U.S. doctrine of the separation of church and state.”

Randi Weingarten, president of the American Federation of Teachers, said that this case could turn the American understanding of “separation of church and state” upside down, and that “it will basically change over 200 years of practice in the United States,” The Daily Wire reported.

Those in favor of public funding for private schools argue that school choice and voucher programs give lower income students the same opportunities as students from more well-to-do families.

Democrats like to talk about how they don’t take money from “big corporations”. But if you take a look at that graph above, you’ll see that some people have bought themselves a whole lot of influence with the Democrat party. Do these unionized public school teachers and administrators have YOUR interests at heart?

All six Democrat senators running for president in 2020 vote against bill to ban infanticide

Wil Trump remember how Democrats voted during his re-election campaign?
Wil Trump remember how Democrats voted during his re-election campaign?

Republicans introduced a bill in the Senate to require that doctors must provide medical care to babies BORN ALIVE during an abortion. There were 50 Republicans present for the vote. All 50 supported the bill. But 44 out 47 Democrats present voted for infanticide, including 6 who are running for President in 2020.

Here’s how McConnell introduced the bill: (H/T Pulpit & Pen)

But first, in a few hours the Senate will vote on advancing a straight-forward piece of legislation to protect newborn babies.

This legislation is simple. It would simply require that medical professionals give the standard care and treatment to newborn babies who have survived an attempted abortion as any other newborn baby would receive in any other circumstances.

It isnt about new restrictions on abortion. It isn’t about changing options available to women. It’s just about recognizing that a newborn baby is a newborn baby, period.

This Bill would make clear that in the United States of American, in the year 2019, the medical professionals on-hand when a baby is born alive need to maintain their basic ethical and professional responsibilities to that newborn.

It would make sure our laws reflect the fact that the human rights of newborn boys and girls are innate. They don’t come and go based on whatever the circumstances. If that medical professional comes face-to-face with a baby who’s been born alive, they are looking at a human being with human rights, period.

So how did it go? Well, all the Republicans in the Senate voted for it. And none of them voted against it. The bill failed, though. It failed because 44 Democrat senators voted against it, and it needs 60 votes to pass.

What I think is interesting from a strategic point of view is that 6 of the 44 senators who voted against it are running for President.

Here are the 6, maybe 7, Democrat senators running for President:

  • Cory Booker
  • Kirsten Gillibrand
  • Kamala Harris
  • Amy Klobuchar
  • Elizabeth Warren
  • Bernie Sanders
  • Sherrod Brown (maybe)

If one of those candidates ends up being the Democrat nominee, Trump will be able to use their vote on this infanticide bill in debates and in election ads.

And it’s not just these Democrat Presidential candidates – infanticide is now the mainstream view of most Democrat politicians.

Life News reports that more states are introducing legislation to remove all restrictions on abortion:

New York, Vermont, New Mexico and now Rhode Island politicians are pushing radical pro-abortion legislation that could legalize the killing of unborn babies for basically any reason up to birth in their states.

Earlier this week, Rhode Island lawmakers introduced legislation to keep abortion legal and unrestricted if the U.S. Supreme Court overturns Roe v. Wade, the AP reports.

It was just New York, Virginia, Rhode Island, New Mexico and Vermont at the end of January.

But in February, Illinois can be added to the list:

“The Democratic supermajority’s proposals now pending in the Illinois General Assembly are the most pro-abortion legislative measures of their type in the country,” said Peter Breen, Vice President and Senior Counsel for the Thomas More Society, and former Illinois House Minority Floor Leader. “The barbaric procedures promoted by this legislation are nothing short of infanticide. These bills go well beyond the recent New York law and would turn Illinois into a third-trimester abortion destination and an underage abortion haven.”

Will Democrat voters get on board with infanticide? I think some of their liberal special interest groups will. But think about how independents supported Trump’s opposition to infanticide in his State of the Union speech. I think that the Democrats are being forced to move their party too far to the left to win another election. All it takes is for pro-lifers to introduce legislation, have them vote on it, and then make the appropriate election ads.

No one can win a presidential by appealing only to their base. It comes down to who wins the independents. Trump is now the moderate candidate on social issues. The Democrats are pro-abortion extremists. They won’t win a majority of independents in a general election. They’ve just slid too far to the left.

How will Elizabeth Warren pay for her $52 trillion government-run health care plan?

So, in yesterday’s post, we talked about our current budget of $4 trillion dollars, our $3 trillion of revenues, our $1 trillion annual budget deficit, and our $23 trillion in accumulated national debt. We also talked about how Elizabeth Warren’s health care plan would add $5.2 trillion to our annual budget, and how we only get about $2 trillion in revenue if we take almost everything the wealthiest taxpayers earn.

Warren likes to talk about how her plan will reduce health care costs. She thinks that government workers (think of the DMV and the post office) will be more efficient about increasing quality and reducing costs than the private sector (think of Apple and Amazon) is. Is she correct?

Let’s take a look at this article from Reason:

Warren and her defenders will likely try to shift the discussion back to total costs, but that’s just a way of repeating the dodge that has dogged her campaign for much of the year. Warren will no doubt claim that costs would go down under her plan, but there are reasons to doubt this, including an analysis from health care economist Kenneth Thorpe finding that under a Sanders-style plan, more than 70 percent of people who currently have private insurance would see costs increase, as well as an Urban Institute analysis projecting that single-payer plans would raise national health care spending by $7 trillion over a decade.

There isn’t any magic in Warren’s plan that would lover the costs to the point where the middle class would not have to pay for her spending:

Indeed, much of Warren’s plan is based on unlikely, and at times outright fantastical, assumptions about what sort of additional revenue could be raised, what health care costs could be contained, and what might be politically feasible. Among other things, she proposes raising $400 billion by passing comprehensive immigration reform, which, given the politics of immigration policy, is only a little more realistic than planning to pay off your mortgage by winning the lottery. The Washington Examiner‘s Philip Klein has published a useful roundup of Warren’s less plausible ideas; the takeaway is that even if Warren somehow managed to raise the enormous amounts of tax she proposes, it probably would still not be anywhere close to enough to finance her plan. (More on this in a future post.)

In some ways, Warren’s plan amounts to a list of technically sophisticated magic asterisks. It is as much an attempt to obscure the economic and political feasibility of passing and implementing a single-payer health care plan as a good-faith attempt to describe what it would practically require.

Yet in another way, it reveals something about both Warren and the economic reality of single-payer: Despite running a campaign based on wonky academic credentials and detail-oriented policy chops, Warren has, until now, repeatedly refused to directly answer questions about precisely how she would finance Medicare for All and whether she would foist new taxes on the middle class. Turns out she didn’t dodge the question because the answer was complex or hard to explain. She dodged it because the answer was so simple it could be expressed in a single word: yes.

So, let’s just state the obvious. We’re talking about a person who pretended to be an Indian in order to get into Harvard, and who lied about being fired from her teaching job for being pregnant. If we’re looking at her education, we don’t find any evidence that she understands health care policy, or even basic economics. If we’re looking at her work experience, there’s no evidence there that she was ever able to produce results in health care administration. There are people who have been able to reform health care in a way that reduces costs, reduces taxes, improves quality of care, and covers more people. But not Elizabeth Warren.

Price of healthcare per Canadian household (Source: Fraser Institute)

Price of healthcare per Canadian household (Source: Fraser Institute)

What about Canada?

I think it’s worth remembering how much government-run health care costs in countries that have adopted “Medicare for All” plans.

I found two interesting studies from Canada’s Angus Reid Institute describing single payer health care in Canada. I’m very interested in find out what things are like in countries that have true government-run health care. A typical Canadian family pays $13,000+ per year per household for healthcare, or about $585,000 over their working lives. What are they getting for all that money?

Here is the first Angus Reid article:

The study finds more than 2 million Canadians aged 55 and older face significant barriers when accessing the health care system in their province, such as being unable to find a family doctor or experiencing lengthy wait-times for surgery, diagnostic tests, or specialist visits.

Moreover, most Canadians in this age group have at least some difficulty getting the care they want or need in a timely manner.

The study focuses on the health care experiences of older Canadians, as well as their assessments of the quality of care they receive.

According to the article, 31% of respondents (aged 55 and older) rated access to the government’s healthcare system as “easy”. 48% had “moderate” problems with access, and 21% had “major” problems with access.

The second Angus Reid article explains:

This second part of the study finds one-in-six Canadians (17%) in the 55-plus age group – a figure that represents upwards of 1.8 million people – say that they or someone else in their household have taken prescription drugs in a way other than prescribed because of cost.

One-in-ten (10%) have decided to simply not fill a prescription because it was too expensive, and a similar number (9%) have decided not to renew one for the same reason. One-in-eight (12%) have taken steps to stretch their prescriptions, such as cutting pills or skipping doses.

Some 17 per cent of Canadians 55 and older have done at least one of these things, and that proportion rises among those who have greater difficulty accessing other aspects of the health care system.

In a previous blog post, I reported on how Canadians have to wait in order to see their GP doctor. If that doctor refers them to a specialist, then they have to wait to see the specialist. And if that specialist schedules surgery, then they have to wait for their surgery appointment. The delays can easily go from weeks to months and even years. The MEDIAN delay from GP referral to treatment is 19.5 weeks.

Wait times in weeks (Source: Maclean's magazine)
Wait times in weeks (Source: Maclean’s magazine)

Also, the Canadian system does NOT cover prescription drugs.

Please share this article and yesterday’s because we have an election coming up, and votes need to know the facts.