“We have a system of co-insurance and co-pays that's meant to discourage people obtaining so-called free care that maybe they don't need so much. And now you eliminate that. All of a sudden, you get a rush for people seeking care, increased demand. And because the medical supply doesn't increase, you may end up displacing people who have more urgent needs with people who have less urgent needs.”
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Asked whether Americans would accept a British- or Canadian-style national health system, he points to wait times and explains the economic mechanism: zero-cost care raises demand without raising supply.
…private insurance? Won't it mean that people who are dissatisfied with the government plan have nowhere to go, no options, no choices? He backtracks a bit and he says, oh, well, they'll have some choices. And which is contrary to what he's written before, contrary to what he's said before.
…and people are very frustrated about health costs. Do you think in that sense, people actually would accept this scale of change really sort of going to a British national health system or a Canadian national health system just out of frustration? and out of fear because of the cost of healthcare?
Well, I think it's interesting that you point out those two examples because all Americans have to do is look abroad and see what's happened in countries that have embarked on this adventure. So you look to Britain, which probably has the most famous single payer system in the world, the National Health Service. Only 21% of the British public is satisfied with that program. And in fact, 60% are either highly dissatisfied or quite dissatisfied. And that's the highest it's ever been since they started polling that issue back in 1983. You look at Canada, where they have a system like what's proposed here, bans private insurance if its service is covered by the single government-run plan. The result is Canadians get frustrated. They have to wait for more than 29 weeks to obtain care. And they leave Canada and come to the United States to seek care. There's no question that Canadians report many more access problems than what we have here. It sounds great. We are going to get free care. But when you get free care, you have problems with increased demand. All of a sudden, people who in the past... had to pay something. We have a system of co-insurance and co-pays that's meant to…
Do you have any sense of whether in Britain or Canada there will be any serious effort to reform the system?
Britain, there's a lot of dissatisfaction, a lot of proposals to change the system. And I think it's telling that in Britain, about half the population is has private insurance because they are so dissatisfied with the government-run NHS. We're not going to have that option under these proposals…
You point out in your op-ed that when you began telling people about when they learned that private insurance would be eliminated, support fell to 52%. When they were told it could threaten the current Medicare program, it fell to 38%. When they were told they'd pay higher taxes, it dropped to 35%.…