The Affordable Care Act (a.k.a. “ObamaCare”) became law nearly eight years ago. Since then, the Democratic Party has moved sharply to the left on health care — so much so, in fact, that America’s next presidential election will likely be, at least in part, a referendum on Bernie Sanders’s call for a universal single-payer system.

Back in September, Los Angeles Times correspondent Cathleen Decker noted that most of the potential 2020 Democratic presidential candidates — including Sanders, Elizabeth Warren, Kamala Harris, Kirsten Gillibrand, and Cory Booker — have publicly embraced single-payer.

That same month, a Quinnipiac poll found that 65 percent of Democratic voters believe it would be a good idea to replace the current healthcare system with a “Medicare for all” program. The poll also found that 59 percent of Democratic voters believe it would be a good idea to establish a universal single-payer system with no health-insurance premiums even if it meant their taxes would go up.

When touting the benefits of single-payer, Democrats frequently point to Canada, which has offered a decentralized universal public healthcare system for decades. The most obvious benefit of a Canadian-style system is that everyone has guaranteed coverage. The most obvious downside is that people often have to endure painfully long wait times before receiving care.

Writing in the Wall Street Journal, healthcare expert Sally Pipes, the president and CEO of the Pacific Research Institute, provides some important perspective on the duration of wait times in Canada’s single-payer system.

“Last year,” she reports, “the median wait between referral from a general practitioner and treatment from a specialist was 21.2 weeks, or about five months — more than double the wait a quarter-century ago. Worse, the provincial governments lie about the extent of the problem. The official clock starts only when a surgeon books the patient, not when a general practitioner makes the referral. That adds months and sometimes much longer. In November an Ontario woman learned she’d have to wait 4½ years to see a neurologist.”

Surely Canadians can avoid such wait times by visiting a private clinic and paying in cash or with private insurance? Not necessarily. “Canadian law bans private coverage for ‘medically necessary care’ the public system provides and effectively forbids clinics from charging patients directly for such services,” Pipes explains. “The government views this behavior as paying doctors to cut in line. Doctors who accept such payments can be booted from the single-payer system.”

To learn more about the realities of Canadian health care, and about an ongoing lawsuit in British Columbia that could change things rather significantly, go here.