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Home HOME-0006 · Standing topic · Exhibit MC-0006 · Exhibit version 3.0 draft · Home version 1.0
Jurisdiction and deciding body: Canada, and England within the United Kingdom (the exhibit's NHS figures are for England, not for the whole United Kingdom)
Instrument: Instrument text not yet certified
No single decision date in the record. Lifecycle stage: Open file
Validation: Last validated 2026-10-28. Next review date: Not stated in the record
Filed under: Health care. Entered by the Clerk. Stamped: record checked, October 28, 2026.
Medicare for All is not right for America, because Canada and the United Kingdom run government health systems and the care in those systems is poor.
Stated in its common form. This claim circulates in many wordings, and it is rephrased here so that no one person's exact words are singled out.
Canada and Britain cover everyone, nobody receives a bill when they are treated, the systems spend roughly half per person what the United States spends, and the public in those countries still supports the model.
Stated in its common form. This claim circulates in many wordings, and it is rephrased here so that no one person's exact words are singled out.
What follows is the record underneath both claims.
The record, in brief: The waiting times in Canada and England are real, they are documented in the systems' own published figures, and they have been getting worse. The same systems cover every resident, charge nothing at the point of care, and spend roughly half per person what the United States spends, and the British public records deep dissatisfaction with the performance of its system alongside firm attachment to the model itself.
What follows from the record: Canada's median wait from a family doctor's referral to treatment was 30.0 weeks in 2024, the longest median in the recorded series, up from 27.7 weeks in 2023 and 9.3 weeks in 1993, and the median wait for orthopedic surgery was 57.5 weeks, with about 1.5 million procedures being waited for (Fraser Institute, Waiting Your Turn 2024). England had 7.37 million treatments on the NHS waiting list at the end of August 2026, with about 65 percent of those still waiting having waited 18 weeks or less, against a target of 92 percent (NHS figures, as reported). Both systems cover every resident and charge nothing at the point of care, and both spend roughly half per person what the United States spends, with the United States figure at $15,474 per person in 2024 (CMS and comparative OECD figures). The British public records both halves of its position in the same survey tradition: satisfaction with the NHS at 26 percent, and 89 percent saying the NHS should remain free at the point of use (British Social Attitudes 2025).
What does not follow from the record: It does not follow that the waiting times carry a whole-system verdict on their own, because the same record that documents the waits documents universal coverage at roughly half the per-person cost and a British public that wants the model kept and the performance fixed. It does not follow that universal coverage answers the queue, because coverage does not shorten a single one of the waits in the record; the two facts sit side by side and neither one moves the other. It also does not follow that these systems cost nothing, because free at the point of use means no charge when care is received in a system prepaid through taxes.
The next data point that could change the record: The next editions of the Fraser Institute's Waiting Your Turn series, the NHS waiting list statistics, and British Social Attitudes would each update a part of this record. Expected date: Not stated in the record.
No projection filed. Too many other decisions sit between this subject and any outcome we could measure, so the record does not support a projection.
What is true in the Exhibit 1: timeliness in Canada and England is poor by the published numbers, and Canada's median wait is the longest its recorded series has produced.
What is true in the Exhibit 2: coverage in both systems is universal, bills at the point of care are zero, and spending per person is roughly half the United States figure.
Last validated 2026-10-28. Filed updates: 0. Latest: none filed.
Both claims are stated in their common form. Each circulates in many wordings, and each is rephrased here accurately and in the same way, so that no one person's exact words are singled out. The first claim, in full, also names the veterans medical system and the Indian Health Service, and those are different systems with different records, so this brief checks the Canada and the United Kingdom part of the claim, which is the part the figures below cover. The second claim is stated in its common form, because it circulates in many wordings and no single person's sentence can honestly be quoted for it. This brief checks both claims against the record, figure by figure, and then leaves the part that is genuinely debatable where it belongs, which is with the reader.
Underneath both claims sits a trade-off, and it is how a health system limits care. A system that covers everyone and charges nothing at the point of care rations by queue, and a system that charges at the point of care rations by price, and every system does one of these or a designed mix of the two. The first claim rests on the premise that the queue is the measure of the whole system. The second claim rests on the premise that coverage, cost, and public support are the measures that matter. Whether the trade these systems make is acceptable is a question about values and design, and reasonable people answer it differently. How long the queue is, what the coverage is, and what the public says about its own system are not values questions. Those are in the record, and the record is below.
The first claim holds on the waiting times themselves, because the figures are the systems' own published numbers and they are at full strength in the record above. Canada's median wait of 30.0 weeks is the longest its series has recorded, the trend runs across three decades, and England's list holds 7.37 million treatments. The claim also holds in its underlying warning, because CBO's single-payer modeling flags the same failure mode for a United States design, with demand rising faster than supply at zero cost-sharing. The claim breaks where one dimension is asked to carry a judgment about the whole system, because the same record that documents the waits documents universal coverage at roughly half the per-person cost, and it documents a British public that wants the model kept and the performance fixed. The cited data carries the word "slow" precisely, and it does not carry a whole-system verdict on its own.
The second claim holds on coverage, because both systems cover every resident, and it holds on cost, because both spend roughly half per person what the United States spends, and it holds on public support, because the British figures record attachment to the model at 89% for free at the point of use, 81% for tax-funded, and 74% for available to everyone, recorded in the same survey that put satisfaction at 26%. The claim breaks where coverage is offered as an answer to the queue, because the two facts sit in the record side by side and neither one moves the other. Thirty weeks is the longest median Canada has recorded, and England's 7.37 million treatments waiting is a count, and universal coverage does not shorten a single one of those waits.
Strip both claims down and they describe the same two systems from different ends. The waits are long and documented. The coverage is universal and documented. The spending is roughly half, and the public attachment is recorded in the same surveys as the public dissatisfaction. Every system limits care somehow, and the shared ground under both claims is that the limit in these systems is time, while the limit in the United States system is mostly price. Which limit a society should choose is the actual debate, and it cannot be settled by a dataset, including this one.
30.0 weeks. The first claim, taken at full strength, treats this figure as the whole story of two health systems. The second claim, taken at full strength, proceeds as though the figure does not have to be answered. The Fraser Institute measured the figure, and the measured figure is 30.0 weeks, and it sits inside a record that also contains universal coverage, $0 bills at the point of care, and spending at roughly half the United States level.
No projection filed. Too many other decisions sit between this subject and any outcome we could measure, so the record does not support a projection.
The factual part is already settled, because both halves of it are documented above, and no further evidence is needed to establish how long the waits are or what the coverage is. What the record cannot settle is which rationing mechanism a society should choose, by queue, by price, or by a designed mix, and it cannot settle how much timeliness a system owes its patients. Those are values and design questions. They belong to the reader, and they are real ones.
The Fraser Institute's median combines specialties and provinces with wide variation, and some provinces and procedures are far faster while others are slower. The NHS figures in this brief are for England, not for the whole United Kingdom.
Fraser Institute, Waiting Your Turn 2024 · NHS England waiting list statistics (Aug 2026), as reported · British Social Attitudes 2025 · CMS National Health Expenditure data, 2024 · CBO single-payer analysis (congestion). Receipt Pack MC-0006 available on request.
No filed updates.
You can debate what to do about the facts here. The facts are not the debate.