The Instigator
dovakiin4thera
Pro (for)
Losing
0 Points
The Contender
Contra
Con (against)
Winning
6 Points

National Healthcare

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Post Voting Period
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after 1 vote the winner is...
Contra
Voting Style: Open Point System: 7 Point
Started: 4/22/2013 Category: Politics
Updated: 3 years ago Status: Post Voting Period
Viewed: 1,914 times Debate No: 32761
Debate Rounds (3)
Comments (0)
Votes (1)

 

dovakiin4thera

Pro


With America’s infant mortality rate at 50th in the world, most of the countries we’re behind have universal health care. Instead of progressing with the rest of the world, we let corporations profit on our sick and weak, at the expense of our economy. The economy has the potential to go far up if healthcare was put into government hands due to companies having to spend less on employee benefits. Because of these advantages, a universal healthcare system would improve the lives of all Americans.



America’s infant mortality rate is 50th in the world* behind a vast majority of countries in whom have a universal healthcare system. In America, one of the few countries that privatizes healthcare, our babies are dying at a faster rate of that of even Cuba. If America is the best country in the world, as has been stated by every politician taken seriously, why are we so behind on this issue? The only way to fix this is to form a government-funded healthcare system in which everyone benefits. To deny anyone coverage and allow them to die, simply for lacking a private health company is, in anyone with a moral clock, barbaric.



Corporations who deny healthcare to someone due to their lacking enough money is barbarism, and should be treated as inadvertent murder. If a gang rounds up a bunch of people and tells them that if they do not hand over enough money that they will die, that would not go unpunished. The fact that free-market capitalism can put a smiley face on the previous scenario is reason in-and-of itself to add a universal healthcare system to the way things work in America.


If an American Universal Healthcare system is adopted, the US economy would increase by a significant margin, as companies that include health benefits would not have to provide these, due to the government covering that previously. The companies spending less on their workers health benefits would allow for a higher company profit, making business more successful, thus increasing US economic growth. Universal Healthcare would decrease, becoming lower than that of Cuba, which is a good start. Fewer American people would be denied benefits due to not having enough money, and the economy would increase.
Contra

Con

Thanks Pro for challenging me to this debate. It is important that issues like this one are discussed so that we can decide the best course of action for our future.


I guess I will start with rebuttals, than move forward with my arguments.


Rebuttals


R1) Economic Benefits?


My opponent argues that the economy "would increase by a significant margin, as companies that include health benefits would not have to provide these, due to the government covering that previously".


There is a simple economic fallacy here. All economic decisions revolve around the concept of how to manage scarce resources.


Regardless of the way how health care is funded, it requires resources. This could be through health care benefits as part of an overall compensation package, or indirectly through higher taxes.


However, since consumer driven health care is more efficient, gov't health care will require a higher input of resources, resulting in inefficiency.



R2) Quality of Care


In a system where there is no competition, there is little to no reason to provide quality care.


In the Soviet Union, the hospitals have been noted for their "the filth, odors, [the] cats roaming the halls, drunken medical personnel, and absence of soap and cleaning supplies".


In the places you noted Pro, like in Cuba, infants are only counted as infants once they are several months old. [2]


In a free market, there is competition. Medical professionals must compete for patients. The profit motive reigns supreme; profits incentivize producers to provide the best service at the most affordable price, and to innovate — so they can maximize their profits. So you can see, both sides benefit from this mutual, voluntary exchange.


Rationing


Countries with government health care experience rationing and stagnant health care R&D. There are facts to support this assertion:


More than 50% of Swedish people have to wait longer than 3 months for surgery. [1]


The World Health Organization recently called [England's NHS] a deliverer of 'third world cancer care'. [3]


Innovation


The United States is a world leader concering the topic of health care innovation and R&D. Due to the high costs of single-payer health insurance, Canada has virtually eliminated spending on R&D. [4]


In other words, this results in the loss of 10 to 13 new drug launches per year per country. [5]



R3) Morality?


"Corporations will deny health care to someone due to their lacking enough money is barbarism."


Actually, the denial rate is only about 3%. [6]


The framework of our health care system is fundamentally disastrous — we should use health insurance for only catastrophic events, and have people pay for their own general medical care.



Arguments


C1: The Free Market Alternative


Free market health care involves competing businesses. Businesses will compete with each other, and try to keep to keep prices down and their products affordable. They will also come up with innovative solutions and increase the efficiency of their businesses, thus maximizing output, while minimizing input.


Where private markets truly have existed in the health care sector, they have succeeded.


Lasik eye surgery has one of the highest satisfaction rates of any surgery, and the price has fallen by over $600 when adjusted from inflation (from 1999 - 2010). [7]


Cosmetic procedures have rapidly became commonplace, and even before inflation, the cost has declined. [8]


With competition, health care providers must provide a high quality product as well. In the USA, we have higher survival rates for cancer. [14]


Empirical evidence is on the side of personal responsibility as well. The RAND Health Insurance experiment examined two groups, one that had 95% cost sharing, and another group with "free" health care. The results showed that those with the "free" health care used 40% more health care and were "no healthier" compared to those bearing the full brunt of their health care costs. [9] [10]


In other words, consumers can be prudent with their personal health care dollars and live a healthy lifestyle.



C2: The Cure for American Health Care


I will outline the cure I suggest for our health care malaise.


1. Personal Health Savings Accounts


Consumers should pay for their own general health care costs through a personal health savings account. Health savings accounts should be linked to high deductible insurance.


We should make all savings accounts, include health savings accounts — tax free.


Through competition and personal responsibility, consumers will shop around for the lowest cost health care, which overall in the economy will dramatically lower health care costs, and improve efficiency.


2. Allow Insurance Competition Across State Lines


Some states impose many rules, restrictions, and mandates on health insurance. This artificially drives up the cost of health care.


For example, the average annual health insurance premium in Iowa is less than a third the cost of health insurance in New Jersey. [11]


In the whole country, the red tape of health care restrictions imposes a net harm of $169 billion per year. [12] We should eliminate the red tape, so individuals can find a plan crafted for their needs, and rely on personal HSA's to improve overall market efficiency.


3. Reform Government Programs


Medicaid should be transformed into a voucher payment, so that those up to 200% of the poverty line receive subsidies for their personal health savings accounts.


Medicare should allow more choice and individual control. Seniors should be able to choose their own health insurance plan.


The FDA should focus only on safety evaluations, not efficacy. It should be partially privatized, contracting out some of its operations.


This has been tried, and has been a success:


"The FDA took up the challenge, embarking upon a two-year pilot program. New Drug Applications were reviewed at the FDA, but also evaluated by the Mitre Corporation, a nonprofit company. For all five applications, the FDA analysts reached the same conclusions as their nongovernmental peers. Significantly though, the Mitre Corporation's reviews cost a fraction of the FDA's and were completed in an amazingly short two to four months." [13]


Faster drug approvals = lower pharmaceutical costs.



Conclusion


America has an economy that's mostly a market economy.


A consumer-driven health care market will be focused soley on providing high quality health care at an affordable price to the people. It is basic competition; businesses will compete and try to maximize their efficiency and innovate, so they can increase their profits. Both the consumers and the producers are better off.


Individuals also make their choices based on their own unique and personal circumstances.


America needs a state of the art, high quality, affordable, and innovative health care system. We can achieve these results by relying on personal responsibility, competition, and free enterprise; which has succeeded in all other areas of our economy.


Sources:


[1] http://ats.ctsnetjournals.org...


[2] hhttp://mises.org...


[3] http://www2.uic.edu...


[4] http://www.independent.org...


[5] http://www.ita.doc.gov...


[6] http://www.ama-assn.org...


[7] http://www.americanthinker.com...


[8] "The Cure: How Capitalism Can Save American Health Care", By Dr. Gratzer, 94


[9] http://www.hcmsgroup.com...


[10] "The Cure: How Capitalism Can Save American Health Care", By Dr. Gratzer, 70


[11] "The Cure: How Capitalism Can Save American Health Care", By Dr. Gratzer, 195


[12] http://www.cato.org...


[13] "The Cure: How Capitalism Can Save American Health Care", By Dr. Gratzer, 152-155


[14] http://www.ncbi.nlm.nih.gov...

Debate Round No. 1
dovakiin4thera

Pro

dovakiin4thera forfeited this round.
Contra

Con

The options are clear.

With single payer, gov't decides what and what isn't covered. If it isn't covered, you are out of luck. There is a lack of choice and a bureaucrat makes the insurance decisions.

Also, with a $616 billion projected deficit (CBO), is it really the time for the gov't to expand and increase spending by an additional $1.5 trillion or so, which would require a doubling of current income and corporate taxes and more so? All of these tax and spending escapades all to destroy our current health care system?

We should listen to reason.

Important Facts to Consider

R1: Rationing

Wait times are longer in single-payer systems.

- More than 50% of Swedish people have to wait longer than 3 months for surgery. [11]

- The World Health Organization has recently called [England's NHS] a deliverer of 'third world cancer care'. [11]

- In Canada, "only half of ER patients are treated in a timely manner by national and international standards." And most emergency room patients are in dire need of treatment. [11]

R2: Medical R&D

Canada has virtually eliminated spending on R&D [12]. Private markets incentivize innovation naturally, while gov't doesn't.


What is the better alternative?

- A system where millions of individuals make their own personal health care decisions based on their unique needs, or

- A system where a handful of bureaucrats write up a system of thick red tape which imposes top down governmental rule and tyranny upon the populace.

.....................................................

Free Market Health Care

Firm Competition

With free and open competition, personal responsibility is the self-regulator of the market. Insurance can be crafted to fit individual's health care needs at the most efficient cost. Individuals make decisions based on their own unique situations, and the market provides the care they need.

Net harm of regulation in health insurance is $169 billion, or $2,200 a family. [1]

Health insurance regulations increase costs and decrease choice, leading to 7 million uninsured, and is the source of 22,000 deaths annually. [1]

Allowing free markets, with free entry, and tight competition strongly reduces health care costs.

In contrast, imposing regulations, red tape, and mandates, such as guaranteed issue makes health care more expensive.

Health care insurance premiums in heavy regulated New Jersey cost three times as much than in Iowa. [2]

We should allow people to buy health insurance across state-lines for more health insurance competition.

Firm competition in some marginal areas of health care has resulted in lower costs. That's why in Lasik eye surgery and cosmetic surgery, costs have fallen relative to inflation -- due to competition. [9] [10]

Health Care Access

People with pre-existing conditions can get health insurance by paying higher premiums because they have a higher risk.

Insurers honor contracts to protect reputations. That's why only 3% of medical claims are rejected. [3]

Health Savings Accounts (HSAs)

Every HSA has two components:

- A personal savings account

- A catastrophic health insurance policy with a high deductible.

Individuals can set set aside tax-free funds and utilize these funds for routine medical care under the deductible.

Personal responsibility causes people to be prudent with their health care spending, which reduces total health care costs.

Funds accumulate over time to maximize middle-class health care security.

Voluntary mutual aid societies can provide free health care to the poor.

Portability of health insurance funds.

Private Evaluation of Prescription Drugs

Private evaluators certify drugs and self regulate markets. Causes greater economic efficiency and causes drug companies to pay attention to details and provide high quality products or face social backlash.

FDA currently focuses on safety and efficacy. The FDA should only focus on safety if anything; the market will - through competition and choice - eliminate poor performing drugs. The efficacy trials add probably 40% to the total cost of bringing a drug to the market. [4]

Economists have estimated that when a change in procedure caused the FDA to review drugs more quickly, the health benefits of quicker access to new drugs were roughly 12 times as great as the costs of additional adverse drug reaction, and that the change resulted in no increase in deaths. [5] [6]

Voluntary Licenses

Mandatory licensing fosters monopolized markets and increases costs.

Voluntary licensing across state lines enhances competition, quality, and lowers costs.

Greater medical supply = lower costs to consumers, greater efficiency, and greater growth, and similarly undermines monopolies and political power of the medical complex.

Consumers would rely on credentials to make informed decisions and what medical professionals they would go to, making market forces improve quality. Credentials include medical degrees from Universities.


Market Innovation

Some medical providers would specialize to certain needs.

A person with congestive heart failure could choose a clinic that specializes in exactly this, with data available on health outcomes and cost (markets have an incentive to provide this). Specialized and personalized care at a better price, and with better outcomes through competition.

Markets, and businesses also have a strong motivation to innovate and invest in R&D. Cures for diseases and conditions yield financial gains for innovaters, and thus the profit motive incentivizes healthy creativity and R&D.

-----Conclusion------

By making individuals embrace responsibility for their own health care, you cut the moral hazard and cause households to shop around for the lowest costs.

Free market healthcare would create a system that maximizes economic efficiency, drastically lowers costs, lowers health care inflation, and incentivizes innovation through the "invisible hand" of the free market.

Health care is about 17% of total USA GDP, which equals out to about $2.601 trillion in spending. [7]

As stated, we spend about 12% of our healthcare ourselves. The RAND Health Insurance experiment [8] compared two groups. The first group had free care. The second group had 95% cost sharing. The first group with "free" care used 45% more care. However, both had the same health results.

Using simple math, in a consumer healthcare system we would use about 39.316% less healthcare (rough estimate) than we do now. With probably minimal effects on actual health.

-----This is for a total of at least $1.023 trillion in savings, or $3,200 a person.

"When individuals are free to choose, and personal responsibility is aligned with prudent individual spending, markets can work to improve quality and lower costs in health care."


Benefits from Consumer-Driven Health Care

- State of the Art Quality

- More Affordable Care

- Expanded Access to Care

- Greater Innovation and R&D

- Stronger Middle Class Security

- Economic Growth

- Maximized Efficiency

- Personal Freedom and Responsibility

- American Competitiveness

Sources:

[1] http://tinyurl.com...

[2] "The Cure: How Capitalism Can Save American Health Care", By Dr. Gratzer, 195

[3] http://tinyurl.com...

[4] "The Cure: How Capitalism Can Save American Health Care", By Dr. Gratzer, 152-155

[5] Olson, Mary K. "Are Novel Drugs More Risky for Patients than Less Novel Drugs?" Journal of Health Care: Government, market Processes, and the Public Interest, edited by Roger Feldman. New Brunswick, NJ: Transaction, 2000.

[6] Philipson, Thomas J., and others. "Assessing the Safety and Efficacy of the FDA: The Case of the Prescription Drug User Fee Acts." National Bureau of Economic Reserch Working paper no. 11724, 2005.

[7] Zakaria, Fareed, prod. "Overhauling Healthcare." CNN Presents. CNN: 2012. T.V.

[8] http://tinyurl.com...

[9] http://tinyurl.com...

[10] "The Cure: How Capitalism Can Save American Health Care", By Dr. Gratzer, 94

[11] *Sources are found easily in R1*

[12] http://www.independent.org...

Debate Round No. 2
dovakiin4thera

Pro


Rebuttal to opponents prior argument:



In the beginning of your statement, paragraph 4, you state, “However, since consumer driven health care is more efficient…” I’d just like to point out that this is tautology, as you have made a claim prior to argument, however, I’d rather I get into the real argument, as opposed to semantics.



In R2, P2 you said that, “ In the Soviet Union the hospitals have been noted on the filth, odors, [the] cats roaming the halls, drunken medical personnel, and absence of soap and cleaning supplies etc.” This would be a valid argument, however, this was in the Soviet Union, a place where the citizens were treated like garbage and existed prior to 1991. In a more modern Universal Healthcare System like Singapore, the hospitals look like this, http://www.sgh.com.sg.... Is this riddled with filth or drunken personnel? Probably not :).



Furthermore, in R2, P3, You stated that Cuba did not consider infants ‘infants’ until several months old. I apologize if this is my fault, but I might not have linked my source, here it is, https://www.cia.gov.... In this, it shows infant mortality rates as the USA considers what infants are. The article you used for this is a biased think-tank and is insufficient.



In Innovation, P2, link#5 is a biased conservative think tank. I truly believe that you should find more neutral sources. The government supports R&D and has spent billions of dollars on AIDS research among other things. (http://aids.gov... ) Private corporations would never have the capability to do something like this without government spending, and there are far better government charities than private ones. (Humane Society of the United States, for one.)



In R3, P2, you say that American healthcare denial is only 3%, however you neglected to mention that plenty of people are denied any health insurance at all, for example, when Blue Cross Blue Shield denied a woman care because of seeing a chiropractor prior to applying. (http://usatoday30.usatoday.com...)



In R3,P3 You say that care should only be given in catastrophic events. Really? What of severe obesity or starvation? The rights to ‘Life liberty and the Pursuit of Happiness’ includes ‘Life’. If someone is suicidal, they are struggling with life and the pursuit of happiness, but would ‘Catastrophic’ encompass them? Or what of someone with an awful past of unimaginable torment and anguish, who are murderous, angry and say they want to kill people, or something along those lines? Would they be denied coverage because they did not get harmed recently or physically? I stand by my belief that the system is barbaric. It says here (http://www.medhealthinsurance.com...) that people with pre-existing conditions are not eligible for catastrophic care. Should they just die?





In C1, P2, You say that when free markets have existed, they have succeeded, then why, according to http://www.who.int... are we 37th in the world behind Canada, Italy, the UK, Japan, and even the United Arab Emirates? If capitalism was so good for healthcare, why are we so far down the list as a 1st world country, no less?



In C1, P3,4 You make references to things like Lasik Eye Surgery and varied Cosmetics, but as I have mentioned from the rebuttal in P4 of my argument, the governments funding has gone into aids research (http://aids.gov... ) cancer research (http://www.cancer.gov...) among other things. The government is far better funded than a capitalistic organization, and I know the American people would be proud to say that a portion of their taxes goes to cancer research.




I believe that this final argument I am about to make might be ever so slightly off-topic, but I feel it should be stated because yours is a simple fallacy. In conclusion P4, you say that the free market has succeeded in all other areas of our economy. This is incredibly false. The entire recession has been caused by the free markets follies, the average rich person is 288 times as wealthy as a regular household (http://www.huffingtonpost.com...) and they continue to pay less and less money to their workers so that they can profit, this gives the worker less money to spend, therefore, the economy is plummeting.




Thank you Con for reading my argument. I apologize for not getting to you last match, I was very busy that day and the time got away from me.


Contra

Con

Thanks for instigating the debate Pro.

-----Rebuttals-----

R1: Singapore has a modern Health Care System

"In a more modern Universal Healthcare System like Singapore, [the quality is good]."

Thanks Pro!

Here, people have individual HSAs to pay for general medical care.

"Singapore has, arguably, the most market-oriented system in the world." [1]

R2: Cuba's infant mortality scheme

"Cuba has a lower infant mortality then the U.S.A.!"

Again, this is nonsense.

A total of 62% of all pregnancies end as an abortion. [2]

"Since the Cuban gov't keeps a very close track of the performance of each doctor at Cuba's maternity hospitals, any doctor who has to report a death of a baby that would impact the infant mortality rate could get in trouble." [3] This information is from a former Cuban doctor.

So it is propaganda. The Soviet Union also promulgated propaganda about their health care sytem, which I brought up in an earlier round. We shouldn't trust closed off Socialist gov'ts.

R3: Innovation

The United States leads the world when it comes to innovation in health care, specifically in the area of basic science, diagnostics, and therapeutics. The U.S. "has contributed more than any other country, and in some cases, more than all other countries combined." [4]

R4: Denial Rates

First, I put forth the case for a free market in health care. I said that individuals should have personal health savings accounts, from which they would pay for their personal health care needs.

With HSAs, individuals would have direct control of their health care expenditures and decisions, for general care such as a checkup.

Through much more vigorous competition and choice, through the reforms I've suggested, this problem would drop. If an insurance company gains a bad notoriety for dropping its clients, its profits would drop. This insurance company would be forced to change or would be removed from the market via the invisible hand -- with a dropping customer base.

Besides, single payer presents the same problems. If a certain health care procedure isn't covered, you are out of luck. That's why a former NHS (National Health Service -- in Britain) basically summarized, "not all procedures are covered. We are forced to pick and choose." [5] (paraphrased)

We also are aware of the recent legislation -- Obamacare -- which basically creates "death panels".

The fact is this. Government health care administrators will be forced to cover only a number of procedures. If your procedure is not covered, it sucks for you.

A consumer-driven health care market relies on the free and voluntary exchanges between individuals, and the competition and open markets which arise from these interactions. People generally know what their health care needs are, and so they can usually plan accordingly, and find an insurance plan suited for their needs.
-----

"We are guaranteed the right to life!"

My opponent brings up a vague and confusing argument.

Just because you haven't planned, does not give you the right to violate my right to liberty. Stealing from taxpayers, and forcing doctors to provide care violates people's inherent rights to liberty.

I already brought this up. Insurance companies will be more likely to offer coverage to those with preexisting conditions if they pay a higher premium.

And this is fair because they have a higher risk. Competition among insurance companies should bring down costs additionally.

R5: Quality of Health Care

In the last few rounds I have debated that consumer-driven health care would lead to better outcomes due to competition and individual responsibility.

Also remember the facts on how rationing harms many people overseas. Waiting lists are detrimental to health care outcomes.

The World Health Organization's measures should not be taken seriously.

"First, [this ranking system] often rel[ies] on unadjusted aggregate data -- such as life expectancy, or mortality from heart disease -- that can be affected by many non- health care factors, including nutrition, exercise, and even crime rates. Second, they often use process measures, such as how many patients have received a pap smear or mammogram in the past three years. Process measures tell us what doctors do, but provide only an indirect measure of doctors' productivity. Third, some of these studies inappropriately incorporate their own biases about financing their statistics, which makes market-driven health care systems appear worse even if their outcomes are similar or better." [4]

So let it be clear here.

In a single payer system, it is sort of like a lottery. If you are lucky, gov't will cover your procedures. Covering everything would require enormous taxes, more so than we would expect already.

I advocate for a laissez faire health care sector. Individuals are free to choose what insurance they want, so they can find insurance that is best fit for their individual and unique circumstances! Open markets and competition will drive down health care costs, as will innovation and personal responsibility for one's health.

R6: Medical Research and Results

The government does subsidize health care research. We could dedicate any percentage of GDP towards any activity (ignoring the difficulty in collecting revenues), but gov't lacks the productive incentives of the private market economy.

Nearly all of the scientific innovations, from which we all benefit, have arisen from the free market. Such examples include penicillin, the cure for polio, recent cancer treatments, etc.

It is simply the profit motive. Private researchers would reap profits by providing cures and treatments for various illnesses.

R7: The Philosophy of Economic Freedom

Government intervention has been destructive. First, the Community Reinvestment Act forced the banks to lend to those with poor credit, and thus the market was set up to fail and crash.

The Federal Reserve has artificially inflated the money supply, which significantly caused the housing bubble, and when this bubble burst, the market crashed and hence the recession occurred.

Our regulatory and tax policies are hellish for our economy, and we deserve better.

The top quintile on average earns about three times as much as the bottom quintile. [6] And the cause of poverty is usually lower IQs and individual decisions.

Allowing free market prosperity would facilitate more savings and capital investment, leading to more production. With more wealth being created, we are all wealthier and are thus all better off.

Conclusion

Among all of its other flaws of top down, central economic planning -- single payer would cost probably $1.5 trillion, after we include current federal health care spending. This would require more than a doubling of current individual income tax rates. [7]

Allowing a private health care system, with true laissez faire policies that foster voluntary, mutually beneficial exchanges through markets and competition, will improve America's health care system.

Competition will force providers to provide high quality care, at dramatically lower costs, and/ or to innovate. Regardless, people are served the best through competing providers.

With a much more affordable health care system, we can expand health care access, as well as improve American competitiveness, which will lead to higher living standards and higher rates of take-home pay.

I urge the voters to vote Contra.


Sources:

[1] http://www.theatlantic.com...

[2] http://www.pop.org...

[3] http://www.cubaverdad.net...

[4] http://www.cato.org...

[5] Zakaria, Fareed, prod. "Overhauling Healthcare." CNN Presents. CNN: 2012. T.V.

[6] Fullerton and Rogers, Lifetime Tax Burden, table 4-10, p. 114. They do not give these facts and figures, but they can be calculated from those in the table.

[7] C.B.O Budget Outlook FY2013 - FY2023. PDF

Debate Round No. 3
No comments have been posted on this debate.
1 votes has been placed for this debate.
Vote Placed by 1Historygenius 3 years ago
1Historygenius
dovakiin4theraContraTied
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Total points awarded:06 
Reasons for voting decision: Conduct to Con for Pro's FF. Con used more sources that were less biased than Pro's. Finally, Con's arguments were largely kept intact and were held compared to Pro's.