The line stretches around the block for a food pantry offering fresh fruit and vegetables in my Brooklyn neighborhood. I’m lucky enough not to need it, but even I spend much of my day waiting around. When I take my kid to a scheduled doctor’s visit, we wait about a half hour. If he gets an injury — as he often does, playing sports — and we have to go to urgent care, we will wait for hours. The emergency room at the hospital is longer still. And who can even track how long we are to stay on hold when we call our health insurance company? And then there’s the wait for the subway or bus.
Whenever the subject of socialism comes up, we hear about long lines and long waits. Breadlines in the Soviet Union. Long waits for Canadian healthcare. But we seem to do plenty of waiting without socialism.
Soviets did wait in line a lot, less often for “bread” than for meat, cheese, or more exciting commodities like port. On the other hand, except during wartime, most Soviets seem to have enjoyed food security, unlike one in nine adults in Brooklyn (and 11 percent of children in the same borough), hence the long lines at my local food pantry. Capitalism, on the other hand, has greatly increased Russians’ vulnerability to health problems associated with an unhealthy diet and poor nutrition.
As Medicare for All becomes a more popular political demand, this right-wing talking point on waits for Canadian health care grows ever more shrill. Even some good liberals fret about the long waits our northern brethren suffer. They’re not completely wrong, but the problem isn’t nearly as salient as people think it is. Christopher Hayes — not the MSNBC host, but the medical director of St. Michael’s Hospital in Toronto, who has studied wait times in both countries — told Shanoor Servai of the Commonwealth Fund last year,
So if you are in a hospital and you need surgery, you don’t wait. It gets done in — if it needs to be done in thirty minutes, it will be done in thirty minutes. If you need an MRI for care provided in a hospital you will get it whenever — depending on where you are because not every hospital has an MRI, but you will be prioritized and that will happen probably as quickly as it can be done anywhere.
In the Canadian health care system, if you have cancer and need surgery to remove it, it will be provided right away, because cancer gets worse if left unaddressed. Similarly, I took a kid with a concussion to a Montreal hospital once, and he was seen immediately (also, I never got a bill, and the pediatric nurse was terribly knowledgeable about concussions, because hockey). Canadians do face long waits for cataracts and hip replacements and other nonemergency procedures. Sometimes rich people complain about these because they feel their money should entitle them to get attention more quickly than other people, but socialized medicine doesn’t work that way, and of course, it shouldn’t.
Canadian wait times for doctor appointments, after-hours care, emergency room care, and specialists are also higher than those in other countries. But this isn’t intrinsic to equitable and accessible medicine, as the Fraser Institute’s copious yearly data show. France has the lowest emergency room wait times. The Netherlands has the shortest wait for after-hours care. Wait times aren’t even intrinsic to a single-payer system; after all, in the United States, Medicare is a single-payer system and recipients don’t face long wait times for hip replacements. As the (hardly socialist) AARP points out, the way to fix wait times is to “spend more money,” and Canada hasn’t done that.
In any case, health outcomes and health care are better and far more universally distributed in Canada than in the United States, so even with a bit of waiting, theirs is still a better system than ours. The Commonwealth Fund has found that the United States is the country whose denizens are most likely to go without needed health care because of the cost.
Even in the United States — where people are dying because they can’t get insulin — I’m not the only person waiting around. Within the profession, doctors are told to make patients wait, as a marketing ploy; it teaches patients that the doctor’s time is more important than theirs. More seriously, patients here wait an average of twenty-four days to get an appointment with a doctor, even in large urban areas with plenty of doctors, according to a 2017 study, and that represents an increase of 30 percent from 2014.
Every time I’ve been to the emergency room (always with an elderly person or a child), we have waited for hours. A ProPublica study found emergency rooms at a breaking point from overcrowding, with patients leaving without even being seen. Once I took a baby with an alarmingly high fever to the emergency room; we waited so long that the baby got better just sitting there. Many aren’t so fortunate. In fact, this problem is killing people: a study of California emergency rooms found that patients who went to a very crowded emergency room had a 5 percent greater chance of dying.
Neoliberal austerity imposes plenty of waiting for public services, too. A 2017 New York City Comptroller’s office study found New Yorkers in every borough, on every subway line, enduring significant delays more than half the time they used mass transit. These delays have real consequences for working people’s lives: 65 percent reported being late to pick up a child, 22 percent late to a job interview, 18 percent were reprimanded by a supervisor for being late to work, 13 percent lost wages, and 2 percent were fired.
Transit delays are caused mainly by lack of funding for needed things like signal repair, and failure to expand the system in response to increasing numbers of riders. But there’s another way that our system generates train delays: homelessness, which doesn’t exist in even the most flawed socialist societies. In June, the New York Times reported that delays caused by “disruptions involving homeless people” — walking on tracks, blocking train doors, being unruly — increased by 54 percent from 2014 to this year.
Socialist systems clearly entail some waiting, but next time some conservative American trots out this objection, ask him how much time he spends waiting around in the land of the free.