Sen. Bernie Sanders (I-VT) again iterated his now well-worn “I wrote the damn plan” when Medicare for All was brought up in the most recent Democrat debate. The fact that he wrote it has been a self-inflicted thorn in Sen. Elizabeth Warren’s (D-MA) side since she signed on to Bernie’s Medicare for All plan early in her campaign.
Sanders, not initially honest about his goal of taxing every American at every income level above poverty, finally admitted that yes, his “Medicare for All” plan will increase taxes on America’s middle classes. This put Warren in a bind.
She had been insisting that the middle class would not see a tax increase, but Bernie supporters and various leftstream media outlets started pressing the issue. Just how was Warren going to pay for her extravagant Medicare for All plan without raising taxes as Bernie insisted was necessary?
So she rolled out a disastrous Medicare for All plan that has regressives cringing, the right laughing, and independents fleeing in droves.
She is stuck with her early embrace of Bernie’s Medicare for All, so let’s take a look at where one of his “model” countries is in terms of its vaunted (by Bernie) healthcare system.
Back in March, I blogged that Finland’s government had collapsed due in no small part to its massive socialized medicine program.
Finland: Government Collapses Over Universal Health Care Costs, #Bernie2020 Hardest Hit
Since then, Finland has struggled to keep its promises to its people and has found that the costs of healthcare under their socialized structure are daunting, even prohibitive.
Nothing that follows will be news to thinking people, so the tldr; version is as follows: the government cannot provide quality healthcare to the masses. Period.
Long waiting times are one of the most predictable consequences of anything that is government-run, and this includes health care. In addition to long wait times, the government’s efforts to cut costs mean that ill people, including at emergency care facilities, don’t even see a physician until they can “justify” the need to a nurse.
Imagine going to your nearest doctors’ surgery at 9am on a weekday with your sick six-year-old daughter because you cannot make an appointment over the phone. After your drive to another part of the city, you can’t simply book a time with the receptionist. There isn’t one. Instead, you must swipe your daughter’s national insurance card through a machine, which gives you a number. Then you and your feverish child simply sit and wait. Or rather, you stand, because the room is so crowded that people are sitting on the floor, on steps, or leaning against walls.The numbers come up on a screen every 10 minutes or so, in no particular order so you’ve no idea how long your wait will be as your daughter complains of feeling cold then hot and then cold again.By 10.45, another patient’s dad exclaims he’s been there since 8.15, he’s had enough, and he’s going to go to a private GP. “You used to just be able to make an appointment with a doctor!” he says angrily.You see, you are not even waiting to see a GP. You’re waiting to a see a nurse in order to justify to her how quickly your child needs to see a GP or whether she needs to see one at all. At 11.30, you give up and take your daughter to see a private doctor as well, forking out £50 for the privilege.This isn’t some nightmare vision of the NHS after 10 years of Tory cuts. This happened to me recently in a country I have moved to from Britain that is normally lauded as the shining example of a successful welfare state.Finland receives such a positive press in Britain. Its schools consistently have the best international student assessment results in the western world; there’s high social equality; all its teachers have master’s degrees. But it has one of the worst health services in Europe.Finland’s health service has been in a parlous state for decades and it is getting worse.
This summer, CNN wrote about the “dark side” of the Finnish health care system that Sanders holds up as his model. Among the problems are few doctors, long wait times, and of note to American voters, fiscal unsustainability.
In his search for examples of a more equitable society, Bernie Sanders has long looked north … to Northern Europe, that is.. . . . A publicly run and funded health care system — known as “Medicare for All” — is now one of the senator’s big ideas as a candidate for the 2020 Democratic nomination, and he still appears to be drawing inspiration from the Nordic model, recently referencing the low cost of delivering a baby in Finland on Twitter.Of course, drawing comparisons between a country like Finland (which has the population of Minnesota) and the entire United States is difficult. No health care system — rooted as each country’s is in both its history and geography — could ever provide a perfect model for the other.. . . . In March, just after Juha Sipila’s government resigned, the governor of the bank of Finland, Ollie Rehn, warned that reform remained urgent “from the point of view of fiscal sustainability.”As the country’s population ages and birth rates fall, the number of taxpayers paying into the system is diminishing—while the overall population is living longer and putting greater strain on resources. In 2018, the average single Finn faced a net average tax rate of 30%, compared to 23.8% in the United States.”Finns are having less and less children. People are getting older. So we need more people here because we need taxpayers,” says Juha Tuominen, the CEO of the largest hospital in Finland, which provides one in four Finns with specialized care.”So if you think of sustainability, either we get more people to Finland or we have to cut the cost,” he adds.. . . . Unless it is reformed, he says, the Finnish system could become more unequal, with poor people and those who live in remote areas increasingly excluded from the very system that was designed to serve them — perhaps something for Sanders to keep in mind, as he mulls the Nordic model’s applications in America.”People outside of Finland tend to see only the good sides of the system,” says Hiilamo.”Normally, we show people the sunny side of the street, but there is a dark side of the street. And health care is on the dark side, and for many years we have had a problem.”
Doctors and patients who can get out of Finland’s centralized health care system are doing so in droves. This is made possible by the continuation of private health care and insurance, items both Sanders and Warren want to limit here in the U. S.
According to [Samuli] Saarni, [president of the Finnish Medical Association], the number of doctors has not increased on par with the larger workload – for example, in the last 15 years 4,200 new doctors have entered the workforce but only 330 of them have gone to work in healthcare centres.Doctors are now responsible for extra paperwork, including renewing electronic prescriptions and these time-consuming tasks take away from the time they spend with patients.“The current set-up doesn’t support doctors spending as much time as possible with patients,” Saarni told HS.As a result of the backlog, which has caused long line-ups for medical appointments, both patients and doctors have gone elsewhere. About 1.1 million people living in Finland have now opted for private medical insurance, according to HS. Every second child has private medical insurance, which means that they don’t need to use the public healthcare centres. Despite this, the public healthcare centres are still under strain.Public healthcare centres have lost experienced doctors and gained more young doctors (those under 30 and those between 30-39).“As a result, burnout by young doctors at healthcare centres is more common and not surprisingly,” Saarni told HS.
They don’t mention salaries, but under Medicare for All, doctors would be salaried, presumably, by the government. In Finland, there is a problem with the government hiring more specialized physicians than GPs.
One of the sectors that would face deep trouble without responses to an ageing Finnish population base is national health care, which has been taking lots of hits in recent years. Minister of Family Affairs and Social Services Krista Kiuru announced on Tuesday that each and every citizen should be guaranteed a doctor’s appointment within seven days of asking for one.Tampere daily Aamulehti reported on Wednesday that the challenge is great: in the city’s municipal clinic at Hatanpää, patients waited for an appointment for a median of 42 days. The Tammela health centre reported average waiting periods of 11 days, while private Mehiläinen clinics in the city saw patients in just two days.Kiuru said in HS that the crux of the problem is that the government has overlooked primary health care overwhelmingly in favour of specialised medicine. The paper wrote that since 2005, a total of 3,700 doctors have been employed in specialised health care, while basic health services have hired only about 300 doctors in the same period.”The situation simply cannot continue,” Kiuru said.
The Finnish government is pouring more of its taxpayers’ money into the flailing system, but it’s not clear that throwing money at the myriad problems is the answer.
Finland is planning to plough some 200 million euros into municipal healthcare services in the next four years to try and reduce waiting times for non-urgent appointments.In 2020 an initial 70 million euros will be available as part of the new government’s drive for reform of health and social care reform, as stated by the Minister of Family Affairs and Social Services Krista Kiuru.”Now is the time for the money to flow to grassroots level,” said Kiueru at a press conference on Tuesday. “If we don’t hire the doctors we need to attract, then how can it be done?”There are currently some 300 vacancies for doctors at health centres across the country, and the government has vowed to hire an additional 1,000 doctors by 2023.The money is to be directed at local health centres, rather than specialist care units, as the government aims to get the waiting time for non-urgent doctor’s appointments below seven days.At present some 43 percent of health centres achieve that.
The Finland model on which Bernie, and by extension Warren, are willing to gamble Americans’ (and illegal immigrants’) health is not only more capitalist than the one they propose, but is still failing despite efforts to decentralize with private insurance and health care providers.
This should be alarming to every American voter assessing these candidates.
As Politico astutely notes, “No country on earth, no matter how socialist, has been able to make Bernie Sanders’ vision work.”
In defending Medicare for All on the campaign trail, Sanders, Elizabeth Warren and their allies frequently point to the many other developed countries that have successfully implemented a universal health care regime. But Sanders’ bill — which makes every health service available to every U.S. resident free of charge — would create a system more generous and far-reaching than any other country in the world. Its ban on nearly all forms of private health insurance other than for niche procedures like cosmetic surgery is also unlike anywhere else on earth.Denmark, the United Kingdom and Germany, for example, all charge patients for some pharmaceuticals and hospital stays. Australia charges copays for visits to a specialist. In the Netherlands, residents have to pay down a nearly $500 deductible before their insurance kicks in. In Canada, the country Sanders points to most frequently as a model, supplemental private insurance is widely used to cover things not covered by the government, including mental health, vision, dental care and many prescription drugs.Every country with some form of universal health care either requires some out-of-pocket costs or puts a limit on the benefits available in order to make the system work. And many, if not most of them, still have thriving parallel private insurance industries.
Long waiting times, few physicians, ill-equipped and poorly-maintained hospitals, and a long list of other failures have resulted in broad discontent with the extremely expensive Finnish healthcare system.
There is no evidence to suggest that Bernie or Warren can accomplish what no other nation on earth has ever managed, let alone one that is the size of the United States.
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