Trump Reiterates Support for Single-Payer

Published August 20, 2015

Republican presidential candidate Donald Trump says Obamacare is a disaster, yet he continues to publicly support the idea of a national single-payer health care system for the United States.

In a single-payer system, the government is the sole insurance company, thus becoming the “single payer” of all health-insurance claims.

“As far as single-payer, it works in Canada, works incredibly well in Scotland,” Trump said during the first Republican presidential debate in early August.

‘Intentions Are Insufficient’

Jason Clemens, executive vice president of the Fraser Institute, says single-payer health insurance definitely does not work in Canada.

“Mr. Trump has it quite wrong,” Clemens said.

“The single-payer idea is admirable in its intentions, but intentions are insufficient,” Clemens said. “The reality of Canada’s single-payer model is an expensive system which doesn’t deliver reasonable or acceptable health care for Canadians.”

Canada’s system works so poorly, patients must purchase additional, private health insurance in order to have access to suitable treatment, according to a report released in July by the Advisory Panel on Healthcare Innovation, chaired by David Naylor, the former president of the University of Toronto (UT) and UT’s former dean of medicine.

Since 1993, wait times for medically necessary treatment in Canada have nearly doubled, now averaging 31 weeks for neurosurgery and more than 42 weeks for hip, knee, or back surgery, a 2014 study by the Fraser Institute noted.

“The Canadian system is one to be avoided rather than emulated,” Clemens said.

While noting Trump has repeatedly recognized the importance of competitive insurance and providers as part of the U.S. health care system, Clemens says Trump  “seems oblivious to the reality of Canadian health care, wherein private providers are limited and competitive insurance is prohibited.”

‘Consumer-Driven Approach Needed’

Restoring competition among insurers and providers by removing damaging rules, regulations, and government interference is the key to getting a more efficient, consumer-driven health care system, says John Garen, an economics professor at the University of Kentucky and chairman of the Bluegrass Institute Board of Scholars.

Obamacare is one of the impediments that must be removed, Garen says.

“A single-payer system takes the Obamacare approach and plays to its weakness,” Garen said. “It would be a step further away from the consumer-driven approach we need to be moving toward.”

Garen notes a single-payer system would offer “no choice for consumers and no competition among providers or insurers, while treatments would be handed down from above by bureaucracies.”

Trump garners support among experts favoring a free-market approach toward health care with his statements about consumers and businesses being able to cross state lines to purchase insurance.

However, without moving toward a market-based system, that proposal may be largely moot, says Clemens.

“Such reforms are insufficient unless state-based mandates, tort reform, and the discriminatory treatment of employer-based benefits are also changed,” Clemens said.

Jim Waters ([email protected]is president of the Bluegrass Institute, Kentucky’s free-market think tank.

Internet Info

David Naylor, et al., “Unleashing Innovation: Excellent Healthcare for Canada,” Report of the Advisory Panel on Healthcare Innovation, July 2015:

Bacchus Barua, Frazier Fathers, “Waiting Your Turn: Wait Times for Health Care in Canada, 2014 Report,” Fraser Institute, November 26, 2014: