Myth: The United States Adopting a Medicare for All Model Would Create Catastrophic Wait Times

The 'wait times' argument rests on a false comparison. Critics point to Canada or the UK and describe a system where everyone waits in a queue — meaning everyone eventually gets care. The United States also rations care, but by price instead of queue. More than 30 million Americans are uninsured and face no queue at all because they cannot enter the system. They skip routine care, delay treatment until conditions worsen, and end up in emergency rooms for problems that should have been caught at a primary care visit months earlier. A queue is not comfortable, but it is not the same as a locked door.

When you compare apples to apples — the actual average time to get a primary care appointment — the US looks worse than the myth suggests. According to AMN Healthcare's 2022 physician appointment survey of more than 1,000 practices across 15 major US cities, the average wait for a family medicine appointment was 20.6 days. By contrast, in France the average wait for a general practitioner appointment is about 6 days, and in Switzerland it is about 2 days. The UK averages around 10 days. Americans are already waiting significantly longer for primary care than citizens of countries with universal systems, even before accounting for the tens of millions who cannot schedule an appointment at all because they lack insurance.

The 2023 Commonwealth Fund International Health Policy Survey asked adults in 10 wealthy countries whether they could get a same-day or next-day appointment the last time they were sick and needed care. The Netherlands led with 54%, followed by Germany at 51%, the UK at 47%, Switzerland at 45%, and the US at 43%. That puts the US squarely in the bottom half of the pack, below three countries with universal coverage. Canada, the country critics most often cite as a cautionary tale, was the worst performer at 26% — driven largely by a physician shortage that Canada is actively working to address. But even Canada's poor primary care access does not change the basic picture: the US middle of the pack on timely primary care, not a leader.

Where the US does perform well is in specialist access for patients with good private insurance. Americans with employer-sponsored coverage who need a cardiologist or orthopedic surgeon generally wait fewer weeks than patients in Canada or the UK. This is a real advantage — but it applies only to a segment of the population, and it comes at enormous cost. The US spends roughly twice as much per person on healthcare as the average wealthy country. A system that produces middling primary care access and good specialist access for the insured, while leaving 30 million people without any coverage, is not one worth defending on efficiency grounds.

If universal coverage were adopted, the most likely short-term effect on wait times is an initial increase in demand for primary care as newly insured people seek care they have been deferring. This happened in Massachusetts after its 2006 health reform. But researchers tracking that expansion found wait times subsequently improved between 2012 and 2016 for both Medicaid and privately insured patients. The reason: when people have regular primary care access, they stop using emergency rooms for routine problems. ER crowding drops. The whole system becomes less congested. The wait-times argument treats the current system as the baseline — but the current system is already producing long primary care waits and catastrophic access gaps for millions of Americans.