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Education

Fact Checker: Prescription for 'Medicare for All' critique is context

Democratic presidential candidate Sen. Bernie Sanders on April 10 introduces the Medicare for All Act of 2019 on Capitol Hill. He is one of three Democratic presidential candidates pushing for a version of the policy that would eliminate private health insurance plans. (Olivier Douliery/Tribune News Service)
Democratic presidential candidate Sen. Bernie Sanders on April 10 introduces the Medicare for All Act of 2019 on Capitol Hill. He is one of three Democratic presidential candidates pushing for a version of the policy that would eliminate private health insurance plans. (Olivier Douliery/Tribune News Service)

“How long will you wait for care? In other countries with socialized health care, patients wait weeks, even months, for treatment. Everyone forced into the same government plan, no matter how serious. Medicare for All would eliminate private insurance for 180 million people. You and every American waiting in the same, government-run plan. How long will you wait?”

Source: An ad paid for by the conservative One Nation PAC features this voice-over while images appear of people describing their wait times for various medical procedures: “heart surgery: 10 weeks,” “MRI: 11 weeks,” “asthma: 4 weeks,” cataract surgery: 20 weeks,” “brain surgery: 26 weeks,” “hip replacement: 28 weeks,” “cancer: 4 weeks” and “ultrasound: 4 weeks (and counting)”.

Analysis

We’ll take a look at the wait times listed on the signs first.

The only citation in the “Signs” ad is for the Fraser Institute’s “Waiting Your Turn” 2018 report, though a sourcing document shared with the Fact Checker team additionally — and accurately — cites the Canadian Lung Association for its claim regarding asthma wait times.

The bulk of the ad’s claims come from the Fraser Institute’s report, which draws from a survey of Canadian physicians in 12 specialties. In the Fraser report’s methodology, the authors write that the overall response rate to the survey was 17 percent — or 1,718 practitioners.

Aside from the asthma claim, all of the wait times listed on the ad’s signs match the Fraser Institute’s data, if not word-for-word: doctors who responded to the survey estimated that their patients waited for elective cardiovascular surgery for 9.9 weeks on average (“heart surgery: 10 weeks”) and for an MRI about 10.6 weeks (“MRI: 11 weeks”), as examples.

However, the Fraser Institute and its “Waiting Your Turn” report has been criticized by Canadian medical professionals and researchers for its methodology and low participation rates.

The survey asks doctors who do respond to only estimate the wait times, a method one health policy consultant compared to “asking people for their opinion about the weather” instead of using a thermometer, according to an analysis published by the Canadian Broadcasting Company in 2016.

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Perhaps a clearer picture of wait times for Canadians seeking medical treatment is found at the Canadian Institute for Health Information, an independent nonprofit. Information it published from 2018 drew from data on tens of thousands of patients, and it analyzed whether evidence-based bench marks for wait times were being met.

Although it does not analyze wait times for every medical procedure included in the “Signs” ad, the CIHI reported that the benchmark for receiving a hip replacement is 26 weeks, and 75 percent of about 21,400 patients were treated in that time. The “Signs” ad reports Canadians wait a bit longer, 28 weeks.

The benchmark for cataract surgery is 16 weeks, and 70 percent of about 177,850 Canadians received treatment in that time frame according to the CIHI, compared with the ad’s claim of 20 weeks.

Radiation therapy, which often is used to treat cancer, has a wait time benchmark of four weeks in Canada. According to the CIHI, 97 percent of about 46,500 patients were treated within that time. That matches the ad’s claim that the average wait time is four weeks.

While the wait times listed on the ad line up with the Fraser Institute’s survey, and those that are also measured by the CIHI come close, the ad presents these delays as dire. But they could be seen as indicators that most patients are being treated within acceptable time frames, when considering Canada’s care bench marks.

It’s hard to compare those bench marks with Americans’ wait times, largely because they are incredibly varied depending on an American’s socioeconomic status and region.

There is data on Americans’ average wait time for an initial appointment with a doctor from Merritt Hawkins, a health care staffing company. Its survey found the average wait time in a major metro area for a cardiologist was three weeks, and about 11 days for a specialist in orthopedic surgery.

The American Cancer Association, on its website, notes that “for most cancers, it won’t hurt to wait a few weeks to begin treatment” — similar to Canada’s four-week stall — and can be typical as treatment plans take time to develop.

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The “Signs” ad closes by claiming “Medicare for All would eliminate private insurance for 180 million people.” About 180 million Americans have employer-based health insurance, and some Democratic presidential candidates have said their Medicare for All plans would eliminate all private insurance — Bernie Sanders, Elizabeth Warren and Bill de Blasio have indicated as much during debates.

But Democrats’ definitions of Medicare for All vary widely and many of them, such as Kamala Harris, say they support it but at the same time would not get rid of private insurance options.

Conclusion

While the basis of the wait times listed in this ad is a questionable survey, those claims Fact Checker could verify elsewhere are similar enough. What this ad leaves out, though, is that the wait times it gloomily presents are pretty close to Canada’s benchmark goals.

It’s inaccurate to say each of the candidates’ Medicare for All proposals would eliminate 180 million people’s private plans. Some would, but only three Democrats running for president — out of about two dozen — have expressed support for that version.

While the ad is partially accurate, enough context is missing that we give it a C.

Criteria

The Fact Checker team checks statements made by an Iowa political candidate/officeholder or a national candidate/officeholder about Iowa, or in ads that appear in our market. Claims must be independently verifiable.

We give statements grades from A to F based on accuracy and context.

If you spot a claim you think needs checking, email us at factchecker@thegazette.com.

This Fact Checker was researched and written by Molly Duffy of The Gazette.

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We value your trust and work hard to provide fair, accurate coverage. If you have found an error or omission in our reporting, tell us here.

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