Single-payer health care means you might be denied surgery for being too fat -- no, really

Do people who are overweight or obese deserve health care? In the United Kingdom's socialized health care system, the answer appears to be "no." And if Democrats get their way, the same could be true in the United States.

To save money, the U.K. National Health Service recently announced it will ban obese patients from many surgeries for up to a year. Such rationing is standard in single-payer health care systems. Americans will face the same fate if Democrats can enact Medicare for All here. 

Sen. Bernie Sanders, I-Vt., recently introduced his Medicare for All bill backed by 15 other Democratic senators. His call to create such a single-payer health care system was a major part of his failed campaign for the Democratic presidential nomination last year.

Known as "lifestyle rationing," the new British policy debunks the myth that single-payer systems deliver truly universal health care.

In addition, Sen. Elizabeth Warren, D-Mass., is urging Democrats to make single-payer a centerpiece of their upcoming campaigns.

Known as "lifestyle rationing," the new British policy debunks the myth that single-payer systems deliver truly universal health care.

The rule applies to patients with a body mass index of 30 or higher. It would hit a 5-foot-10 man who weighs more than 209 pounds, or a 5-foot-4 woman who weighs more than 174 pounds. These patients will have to wait a year, or lose 10 percent of their weight, before they can receive elective surgeries like hip or knee replacements.

The National Health Service in Britain believes such discriminatory rationing is the "best way of achieving maximum value from the limited resources available."

Of course, overweight people aren't the only ones denied care in single-payer systems. The bureaucrats who run them have little choice but to ration care for everyone.

When patients pay virtually nothing for health care, they have little incentive to limit their consumption. If someone feels even slightly under the weather, he or she can immediately go to the doctor and demand medicine, rather than simply rest up and hydrate. So patients flood doctor's offices and hospitals.

With no market forces at work to regulate demand, the only way for the government to keep costs under control is to forcibly limit the supply of medical services.

Single-payer systems do so by offering doctors and hospitals relatively paltry sums for their services. The average general practitioner in the United Kingdom earns about $130,000 per year. By contrast, a general practitioner in America earns over $200,000 annually, on average.

This combination of lower pay and seemingly limitless demand for care is causing many British doctors to leave the medical field – or go elsewhere to practice. There are 7,000 fewer doctors in the United Kingdom today than in 2005. In just the first month of this year, nearly 300 doctors applied for certificates to work overseas.

In addition, fewer medical students are completing their educations. In 2016, half of junior doctors left the National Health Service after their first two years of training. That is an abrupt increase from 2011, when less than three in ten junior doctors exited.

As a result, the National Health Service is in the midst of an unprecedented staffing shortage. More than 30,600 positions are currently vacant. Almost 40 percent of those openings are for nurses and midwives.

So patients wait. More than 4 million are standing by for surgery – the highest figure in a decade.

The single-payer system in Canada is hardly better, particularly for patients seeking specialist care. According to the Fraser Institute, the median wait time between referral from a general practitioner and treatment by a specialist in 2016 was 20 weeks – the longest on record.

America's own experiment with single-payer – the Veterans Health Administration in the Department of Veterans Affairs – is a national embarrassment. A federal investigation found that more than 200 veterans died while waiting for care at a Phoenix VA facility in 2015. The same is true of almost 100 veterans at a Los Angeles VA hospital between October 2014 and August 2015.

These horror stories are worth remembering now that the apparent failure of the GOP's health care reform effort has revived calls for single-payer in the United States.

Some U.S. doctors appear to be falling in line behind liberal icons Bernie Sanders and Elizabeth Warren. According to a new survey from Merritt Hawkins, a physician recruiting firm, 42 percent of doctors strongly support single-payer. Fourteen percent are somewhat supportive.

Supporters of single-payer health care should realize the error of their ways, because single-payer isn't a shortcut to universal health care. As the experiences of other countries prove, it's a pathway to grotesque rationing, long waiting lines and needless suffering. 

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 Way Out of Obamacare (Encounter 2016). Follow her at @sallypipes.