About a year and half ago, I went to my primary care physician to see what could be done about knee pain. I was thinking that a cortisone shot might be in order. He took x-rays and referred me to a local orthopedic surgeon’s office. I had to wait 4 to 5 weeks before I could be seen and rather than meeting a doctor, I met with a nurse practitioner. She told me that I had knee osteoarthritis, which is common in people my age, but that it was not advanced. She recommended over the counter pain medication such as acetaminophen and told me that it might never get to the point when I would need a cortisone treatment let alone knee replacement. I left feeling very much relieved.
That experience came to mind after reading a comment someone left in response to my last op-ed “UHC is not free healthcare.”
ICYMI
“(E)ver since Obamacare, how have wait times went to see a doctor, urgentcare, or er? That should tell you all you need to know about government involvement in Healthcare” [sic]
I’ve mentioned before that Republicans and the conservative media mislabel universal healthcare (hereafter UHC) as socialized medicine and free healthcare, which are untrue and purposely misleading. They also like to make the case that because it is government health care it results in long waiting times for treatment. If my personal experience is any indication, wait times aren’t that excessive, but that is purely anecdotal. So, I decided to see what the research says about wait times in the U.S. versus other countries with some form of UHC.
In my profession, evaluation, which is a form of applied social research, one of the first things you do is to define your research question so that you know what to measure and how to measure it. As it turns out, how you define waiting times will influence the findings you come up with.
Case in point, waiting times are typically categorized as the: (1) time you wait before you can see a physician, which can vary considerably depending on the whether it is a primary health care provider or a specialist, (2) time to wait between being tested and evaluated to the time you receive a diagnosis, (3) time to wait before being scheduled for an elective procedure, and (4) time you wait to be seen in a clinic or emergency department once you arrive. (Waiting Time as an Indicator for Health Services Under Strain: A Narrative Review – PMC, 2020.)
Each of these categories will produce different measurements, such as hours, days, weeks, and months, and should be reported separately. It is important to make these distinctions so that when comparing wait times between countries, particularly the U.S. to countries with UHC, you’re comparing apples to apples.
Let’s start with waiting times to see a health care provider (first visits are often with a nurse practitioner or physician’s assistant and not a medical doctor). Right away we know that the time you must wait before you can see your PCP is typically shorter than waiting times to see a specialist. For example, a 2025 survey conducted by AMN Healthcare, a company that recruits and hires health care providers, found that the average time in the U.S. to see a health provider varied between 31 days to see a primary care physician to 42 days for an ob/gyn. Compared to previous years, the study found that average wait times in the U.S. have increased for new patient appointments by as much as 48 percent since 2004. They attributed the longer wait times to several factors, including workforce shortages, an aging patient population, and increased demand for chronic disease management.
The study also cautioned that average wait times can be misleading, as the number of patient waiting days ranged from 1 to more than 200 days based on regional differences: “Smaller metropolitan areas and rural regions consistently show longer delays, often due to physician shortages and hospital consolidation.” (Average Waiting Times for Common Medical Procedures in the United States – What the Latest Data Shows, North American Community Hub) This is likely to get worse as the budget cuts that Republicans and the Trump administration have made to Medicaid and the ACA (Obamacare) affect rural areas more than urban. The takeaway here is that even before we compare waiting times between the U.S. and countries with UHC, there is a lot of variation and using average wait times may produce ambiguous results.
Another study measured waiting times to see a specialist. (Health Care Wait Times by Country 2026) For example, Switzerland, Netherlands, and Germany all reported shorter waiting times to see a specialist than the U.S., with France not far behind the U.S. Except for the U.S., these other countries have UHC. While it’s true that some countries with UHC had much longer waiting times than the U.S., these countries also had much longer waiting times than other countries with UHC, i.e., it wasn’t UHC that caused the difference in waiting times to see a specialist.
Assuming that we are comparing apples to apples, another study looked at the average wait time patients experienced waiting to be seen in the emergency room. The shortest was Germany, at 22 minutes, second, the U.S. at 24 minutes, Japan at 35 minutes, Italy at 38 minutes, and India at 45 minutes. Several countries reported a range rather than an average, such as Australia with a waiting time between 18 minutes to 5 hours. U.S. wait times are not significantly different from countries with UHC; i.e., a government operated single-payer system does not necessarily result in longer wait times. (Which Countries Have the Worst Health Care Wait Times?)
Republicans and conservative media often compare the U.S. to Canada. In the above study looking at emergency department waiting times, Canadians waited an average of 2.1 hours before being seen, putting them in the bottom third. And a 2025 study found that wait times in Canada for a variety of services are longer than other countries with UHC, particularly when comparing outlays for health services. (Comparing Performance of UHC Countries, 2025 | Fraser Institute.) The study found that waiting times were influenced by the availability of resources such as the number of practicing physicians and the number of MRI and CT scanners. However, these things are influenced by several factors beyond having single payer health insurance. Nonetheless, while Canada rates lower than other countries with UHC, 100% of Canadians have access to health services. In comparison, about 90% of Americans have some form of health insurance, with that number decreasing due to Republican and Trump administration budget cuts to Medicaid and Obamacare subsidies.
There is also considerable variation over time between countries with UHC. For example, the average waiting time in Poland for cataract surgery was more than 80 days in 2014 but down to 13 days in 2024, an 84% decrease. Conversely, for Norway it was about 45 days in 2014 but up to 81 days in 2024, an 80% increase. (Waiting times: Health at a Glance 2025 | OECD) Since these countries have some form of UHC, it is highly unlikely that UHC is the cause for waiting times to dramatically increase or decrease over time, i.e., other causes are involved.
Yet another challenge in assessing waiting times is the quality of the data. Many studies of wait times are based on self-report which can be influenced by several factors, such as a person’s perception of the amount of time they had to wait versus the actual time. For example: “a new national survey of U.S. adults conducted in April 2023 that found more than 40% of respondents have experienced a “longer than reasonable” wait for health care. mong those surveyed, 26% reported waiting more than two months to gain access to a health care provider.” (Two in Five Americans Report Unreasonable Health Care Wait Times).
Because the information was gathered through a survey, we don’t know if the respondent kept good records and knows exactly how many days they had to wait to get an appointment or if the respondent reported the number of days based on their memory and perception of the event. What is striking about this study is that, even when we don’t compare waiting times in the U.S. to countries with UHC, Americans are increasingly reporting delays in receiving health services.
And then there is the problem of reporting the average number of hours, days, or months someone must wait. If there are ten people in a room, nine of whom earn less than $35,000 a year and the tenth person is a multimillionaire, then computing the average will make all of them millionaires. When comparing waiting times between and among countries, unless the standard deviation is also reported (and many of the studies I looked at didn’t), we don’t have an idea of how much variation exists in the data set. Therefore, when Germany reports that on average someone waits 22 minutes to be seen in the emergency department versus 24 minutes in the U.S., how many emergency departments does this relate to and how many have much longer waiting times? The average will not give us that information.
So, what can we learn from this analysis? First, measuring waiting times for health services is complicated and not always easy to measure to ensure we are making reliable comparisons.
Second, the information that we do have does not support the perception that wait times for health services are always better in the U.S. compared to countries with UHC. Depending on the service being measured, in some cases waiting times in the U.S. are better, as good as, or worse than countries with UHC, and that varies considerably between and among countries. In other words, a blanket statement that countries with UHC have longer waiting times for health services cannot be made. Nor can we assume that waiting times in the U.S. are always better than countries with UHC, because waiting times vary by service, over time and location.
Third, as part of their One Big Beautiful Bill Act, Republicans have cut more than a $1 trillion from Medicaid and the Affordable Care Act (Obamacare) as well as cuts to the budget of Health and Human Services agencies such as the National Institutes of Health. In response, hospitals and clinics are cutting services, and many Americans are delaying seeking health care, which is contributing to longer wait times when people do need care.
Finally, you now know more about the issue of waiting times than most journalists and politicians with a media platform and a large following. If you watch Fox News, and a Republican makes this claim, the Fox reporter will likely agree with the politician. However, if you watch MSN or CNN, and a Republican makes this claim, the journalist probably won’t know how to refute it, nor would a Democratic politician, even though he or she might advocate for UHC. So, if you have the ear of Democratic politician, you might want to send them the link to this article, as they might learn a thing or two.
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