Will the seventh time be the charm? Sen. Bernie Sanders sure hopes so.
Vermont's senior senator just introduced his latest bid to install Medicare for All in the United States. In seven of the last eight Congresses, dating back to 2011, he's offered legislation to launch a government takeover of health insurance.
His latest bill may not gain much traction, what with unified Republican control of Washington. But Sanders's cause continues to attract fans across the country. Colorado Gov. Jared Polis signed legislation this month ordering a study of how the state might implement single-payer health care within its borders.
Decades of evidence from Canada — my native land — illustrate that single-payer offers a one-way ticket to healthcare ruin. Long waits, restrictions on access to cutting-edge treatments, and unnecessary suffering are endemic to single-payer.
Canadians are waiting longer than ever for specialty care, according to the latest research from the Fraser Institute, a Vancouver think tank. Last year, the median wait for care from a specialist following referral by a general practitioner was 30 weeks — more than seven months. In some specialties, the waits are far longer — more than 57 weeks for orthopaedic surgery and 46 weeks for neurosurgery.
Many Canadians struggle to get that referral from their GP in the first place. Over 14% of the country's 41.5 million people do not have a regular healthcare provider.
Canadian patients also have less access to medical technology. There are just 14 CT scanners per million residents north of the border; the United States has 44 per million. Canada has just 10 MRI machines per million — one-fourth the rate in the United States.
It's no wonder that Canadians can expect to wait more than eight weeks for a CT scan and more than 16 weeks for an MRI. Those waits can result in diagnoses delayed — and can transform potentially treatable conditions into irreversible chronic illnesses or permanent disabilities.
Canada's government-run health insurance system denies access to innovative medicines, too. The country's Patented Medicine Prices Review Board regulates drug prices. Those price controls dissuade drug companies from launching their products in Canada.
Of the 460 medicines launched globally between 2012 and 2021, Canadians had access to just 21% of them within their first year on the market. Americans had access to 78% of those novel drugs.
Over that period, Canadians had to wait 52 months, on average — more than four years — for their public health insurance system to pay for those novel drugs after they'd first been launched on the global market. Americans had to wait four months.
So Canadians may see a new drug that could treat or even cure their disease on the market elsewhere — and have to wait years for their single-payer healthcare system to grant access to it. In that time, their conditions may worsen. Some may die.
Canadians pay dearly for the privilege of waiting for care. The average family of four pays more than $17,700 Canadian — roughly US$12,700 — in taxes just to cover the cost of their public health insurance.
Canadians gloat about their universal health coverage. Soon after taking office earlier this year, Prime Minister Mark Carney proudly asserted that health care is a right in Canada.
But what good is universal coverage if someone has to wait months or even years to put it to use — and actually secure care? And how can Canada defend a supposed right to care when it refuses to make cutting-edge medicines available to its citizens?
Those are questions Americans should ask the likes of Sen. Sanders and Gov. Polis, as they try to bring single-payer here to the United States.
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. Read Sally Pipes' Reports — More Here.
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