The Instigator
16kadams
Con (against)
Losing
9 Points
The Contender
Contra
Pro (for)
Winning
13 Points

Resolved: The US should constitute a Single-Payer Health Care System

Do you like this debate?NoYes+2
Add this debate to Google Add this debate to Delicious Add this debate to FaceBook Add this debate to Digg  
Post Voting Period
The voting period for this debate has ended.
after 7 votes the winner is...
Contra
Voting Style: Open Point System: 7 Point
Started: 3/8/2012 Category: Politics
Updated: 5 years ago Status: Post Voting Period
Viewed: 3,639 times Debate No: 21840
Debate Rounds (4)
Comments (23)
Votes (7)

 

16kadams

Con

Single payer HC definition:

"Single-payer health care is medical care funded from a single insurance pool, run by the state."
http://en.wikipedia.org...

Rules:
1st round acceptance
no semantics with the title
8000 characters
Contra

Pro

I accept.

Plus, Single-Payer healthcare is a healthcare system payed by the government, with the care being in the hands of private medical professionals and patients.

Good luck
Debate Round No. 1
16kadams

Con

C1: Flaws in the current US goverment healthcare system

About 11% of children on US private insurance get declined from doctors, but or medicaid a whole 67% get rejected from doctors! [1] Ok before I go into other stats may I go into personal belief? (note my opponent DOES NOT NEED to refute this). My dad as a doctor hates medicaid, to many regulations. Ok back to evidence. there is a 74% higher death rate from surgeries when your insurance is medicaid over their private counter parts. [2] *stYes, pubic insurance in america means you are 74% likely to die, *start sarcasm* isn't that great kids? Government healthcare sounds great! Can't wait until we are all on medicaid type healthcare! *end sarcasm* the extensive paperwork (see my non needed refutable opinion) is the main reason doctors refuse seeing these people, says the GAO. [3] Another study indicates they are 8.5 times more likely to say no to you if yo have medicaid then if you have private insurance. [4] 17% of doctors and 31% of primary care doctors reject patients on medicare. [5] medicare part B is the cause for many drug shortages. [6] I could rest my case here, as current US programs for healthcare are terrible, and a national system woudl just spread the pain, but hey lets keep going.

C2: A doctors shortage may occur

In France (a country with universal health coverage) The doctors make about 1/3 of what US doctors do. [7] Doctors in Japan get relatively low pay. [8] The average meet with a US physician is is about 100 second longer, 668 seconds in the US, 505 in Japan. [9] This difference indicates they rush their patients through. US doctors spent more time in their social talk and follow up talk then the Japanese doctors. [9] In Japan the doctors had more silence then in the US. [9] 45% of doctors would quit if we switched to a Universal Healthcare plan as these plans have less pay. [10]

C3: Rationing of Healthcare

Many people under Universal plans go to the doctor many more times then needed. People go more often, this leads to worse overall treatment. [11] When healthcare is "free" people think they can go waste the resources, so they go to the doctors more often then they need to therefore using up the... (repetitiveness) resources. [12] In England each person goes on the ambulance about once a year, much of the time it is a non emergency purpose, about 90of the time no emergency. [13]

To combat the costs, they ration the healthcare. The Canadian system has long lines and the goverment chooses who ts what treatments. [14] Sweden has wait lines that cause higher mortality rates on certain procedures, a study proclaims. [15] Another estimate says their wait times are about 14 days. [16] Based on the source I trust 15 more. In Canada, a country wit universal healthcare, many are not treated in a timely manner and either die or the condition gets worse. [17] In the countries these emergency room needed procedures are terrible! They are given to late. Example:

"Sorry sir your tumor will be treated in 6 months"
"ok :( "

6 months later:

"Sir your surgery is up... Sir"
"He's dead ma'am, can I go?"
"wait for 6 months like everyone else please!!!"

Ok Back to stats. In England 21% of lung cancer patients receive long waiting lines before they acquire their treatment. [18] Once again, I am both surprised and worried about these statistics. Surprised as people in need of surgeries wait to get them, and is done in an efficient manner. I sincerely do not want this happening to my care, at all.

Also people claim the lists are set, and therefore it is fair as we all get HC right? Well... No. As stated above you die while waiting. Joyful surprise. But Canada's lists get hacked by the wealthy and the people with connections. [19] The rich get far better healthcare in Canada then the poor do. [20] In japan the rich bribe their way to becoming the front of the lists. [21] So the government rations care, unless your bill gates.

C4: Singapore model

Singapore spends less then 4% of GDP on HC, and at the same time have the most private healthcare in the world. [22] The low goverment intrusive in HC business reduces costs and taxes. [22] 1/3 of the people in Singapore pay for HC, in the US about 90% is paid by insurance, so personal responsibility is Singapore, not the goverment. [23]

Conclusion:

Current Government Healthcare is, well, bad, and how would putting more goverment in there be better? So your arm hurts in a crocodiles mouth, lets just jump in! No this logic is flawed. The Singaporean system of the people actually pay system seems work without the European universal system, and universal healthcare means you are now a ration. The goverment says there is to much HC cost? Time for more wait times, and people abuse the system. And some people (doctors) say a system like this would mean "see ya!!" A universal healthcare system may not be the way to go, rather a Singaporean system.

PS: I wasn't trying to source load :( Dang... Sources using up all my pace... :(



References:

[1] http://www.forbes.com...
[2] http://www.avikroy.org...
[3] http://www.forbes.com...
[4] http://www.forbes.com...
[5] http://www.usatoday.com...
[6] http://www.heritage.org...
[7] http://blogs.wsj.com...
[8] http://www.economist.com...
[9] http://fampra.oxfordjournals.org...
[10] http://www.foxnews.com...
[11] http://en.wikipedia.org...
[12] http://www2.uic.edu...
[13] http://www.independent.org...
[14] http://www.npr.org...
[15] http://ats.ctsnetjournals.org...
[16] http://en.wikipedia.org...
[17] http://online.wsj.com...
[18] http://www.ncbi.nlm.nih.gov...
[19] http://freemarketcure.com...
[20] http://voices.washingtonpost.com...
[21] http://www.independent.org...
[22] http://www.american.com...
[23] http://www.washingtonpost.com...
Contra

Pro

Thank you 16k for this debate.

--------------------Rebuttals----------------------


C1: Medicaid and Medicare:

The low reimbursement rates causes medical professionals to decline the patients. [1] With Single-Payer, physician income would stabilize, and raise in some cases, eliminating this problem. [2] Plus, with S.P., a streamlined, electronic confidential system would hugely improve efficiency.

The study that you showed, the authors actually admit is pretty flawed. [3] Medicaid patients also have several risks for being at higher mortality, such as low socio-economic status, having poor nutrition, and other health risks. [3]

The high commercialization of research is actually beginning to slow research, as well as in areas with high HMO penetration. [2] The National Institutes of Health actually pay for the majority of the research, with drug companies given the rights to sell the product and work on formulation. The reason - your source proves this - of Medicare's drug shortages is because of price caps.

C2: Doctor "Shortages":

With S.P. in the USA, doctor pay would most likely stabilize. If S.P. payed doctors per fee, doctors would actually get a pay increase - because S.P. would allow much more time to visit with patients because of a much more efficient system. [2] In fact, S.P. has been well received by doctors, as their pay remains high. [4] [5]

About your link that many doctors would quit, the same was expected before Medicare was enacted. Besides, your link is on the A.C.A., not S.Payer. With the new system, many more doctors could be trained, wages could rise, and over 59% of doctors said they would view national health care a positive change, with only 32% opposed. [6] This is because the doctors see the pain that the private for-profit system is doing to their patients, not counting the 45,000 that die a year because of a lack of insurance. [7]

C3: The Illogical Rationing Fears:


Your same source said that high co-pays also cause patients to not seek treatment and needed care.

Our healthcare is already rationed. It is rationed according to wealth; those who have it get it, and the more wealthy, the faster. [8]

In Canada and other Single-Payer nations, rationing is public information, which has led to recent falls in waits there. [2] In the USA, 51% of adults skip care due to cost. [9]

-----Rationing Isn't Needed

Several studies, some by the GAO and the Congressional Budget Office, have both found that we could cover all Americans with the costs currently spent on healthcare, with a surplus available. [10]

Including the facts that the USA already has abundant healthcare resources in place, and has enough funding, Dr. Ronald Glasser pointed out:

"An axiom of economics holds that nothing can be rationed that is itself not scarce, and, absent evidence of infinite demand and infinite cost, you can't ration healthcare when there are more than enough doctors, hospitals, and high-tech equipment distributed throughout the country to do everything and anything that needs to be done. American healthcare is an unsaturated demand market, and in such markets "rationing" is simply a code word for not spending the money to take care of the poor, uninsured, the underinsured, and the high-risk patient." [12]

I will give a similar comparison in a later round on a story on rationing --- U.S. style that is real!

Consensus on Rationing: We already do it. With our levels of spending on healthcare, everybody could be covered with comprehensive healthcare, and with our advanced, high levels of medical infrastructure, and with competition and affairs brought back to the doctor and patient, rationing and waiting lists would not be needed. With a smart streamlined, confidential system, overusage would be dealt with between effectively, possibly with co-pays used ethically.

C4: De-regulated, "Free Market" ideas:

We already spend more than enough to cover all medically necessary services for everybody in the nation. Libertarian proposals do not deal with the problem of the cost of healthcare, which is already unaffordable for the average people, and with no S.P., the problem will only get worse. [2]

Plus, Singapore's plan would not be as effective as S.P., and Singapore's plan cannot really be replicated across any other nation. [18]


Single Payer Healthcare
:

--Competition is brought back between patients and doctors. Doctors will be still well paid, and won't have to deal with nearly as much paperwork because of a streamlined, electronic, yet confidential system. Medical professionals still have to be competitive, or else they lose their business to other medical professionals.

--Rationing wouldn't occur. The U.S. has enough spending and medical infrastructure to cover all in a fair, ethical, and effective way. Over 60,000 Americans go overseas for medical treatment already.

--Innovation in the drug industry would increase, because of a lack of heavy commercialization.

--Total costs would decrease, with several medical experts saying the cost of the new patients and other initial transition costs to S.P. would be outweighed by the net savings of S.P. [13]

--Out of bankruptcies, 56% of them would be eliminated. [8]

--Businesses would be more competitive, with S.P. reducing total costs for business. Our lack of S.P. is one reason that U.S. automakers have lost ground to foreign autoworkers. [8] It modernizes America, while improving the economy.

--More physicians could be trained with higher amounts of investment.. Higher reimbursements could improve our medical workforce.

-Costs would be better contained effectively. The public sector is actually more efficient with healthcare than the private sector. From 1990-1996, costs in the USA rose higher in healthcare compared to S.P. nations. [14]

--Better health care. Nations with S.P. have better health care qualities than private nations. As well as other measures, health, life expectancy, and resources (MRIs, hospital beds, etc) are higher in S.P. nations. [15] [16]

--More Patient and Provider Freedom. The private industry actually regulates the medical field more than a S.P. system would in many ways. [17] Also, medical malpractice laws would not harm doctors as much because of the gov't picking up the tab. [17]


I have effectively defeated my opponent's arguments.

Funding for Single Payer:
-Move current costs to program
-7% payroll tax for businesses
-2% income tax hike
(saves money for the vast majority)

Healthcare Policy:
-Health Planning Board:
Composed of representatives of patients and medical policy experts. Decides what to cover based on community needs, and on what new investments should be funded based on need.


Sources:

[1] http://articles.orlandosentinel.com...

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

[3] http://mediamatters.org...

[4] http://pnhp.org...

[5] http://ajph.aphapublications.org...

[6] http://www.reuters.com...

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

[8] Conrad, Jessamyn. What You Should Know About Politics... But Don't. 1st ed. New York: Hachette Book Group, 2008. 104-124. Print.

[9] http://www.pnhp.org...

[10] http://www.democracynow.org...

Ronald J. Glasser, M.D., "The Doctor Is Not In: On the Managed Failure of Managed Health Care," Harper's, March 1998, p.35

Sherrow, Victoria. Universal Healthcare. 1st ed. New York: Infobase Publishing, 2010. Print.

[13] http://library.thinkquest.org...

[14] http://economistsview.typepad.com...

[15] http://www.photius.com...

[16] http://www.amsa.org...

[17] http://en.wikipedia.org...

Debate Round No. 2
16kadams

Con

Thanks for your response.

~~Defense of my arguments~~

C1: Current US government care

If a child even has a very bad problem, they still only get a 55% chance to see a doctor. [1] Yes one of the big reasons they decline is due to the reimbursement rates, but the paperwork too is extensive. [2] Now, all government insurance programs lead to lower reimbursement rates in the US, there is no reason to think totally switching over will help. [3] The extensive paperwork and extremely low rates cause doctors not to accept government health care. [4] Also drug shortages:"Experts attribute the shortage to a combination of increasing demand, struggles to obtain enough active ingredients and tight federal regulations that limit how much of the ingredients can be distributed to manufacturers per year." [5] Tight FEDERAL REGULATIONS, is listed as a reason. And yes, the government gets to price the drugs in the system, [6] if they do it terribly here how would they do it any better if they get more control? I think the logic is poor. Also note US doctors get better pay. [7]


C2: Doctor shortage

I am really mad, it deleted my arg so I'll be breif.

Pay:

US doctors get good pay in the US. [8]

DESCRIPTION

source: http://economix.blogs.nytimes.com...

SP reduces their pay. France has a doctor shortage as well. [9]



C3: Free Market Cures

Why would it not work? explain. The savings for a SP system are temorary and provide worse care. [10] The desicions are not even left to the people anymore. [10] SP SYSTEMS have higher mortality rates in cancer. [11]

(being breif... stupid delete my argument...)

C4: Rationing

Almost all SP systems ration care because cost savings are only temporary. [10]

"Canada’s Medicare allocates services primarily by time, forcing patients to wait weeks, or even months, to receive urgent diagnostic screenings and surgeries. A recent study by the free-market Fraser Institute found that the median wait for surgeries in Canada has grown to 18.2 weeks—141 percent longer than in 1993." [12]

So it happens in our continent, would it not happen here?

"Namely, once health care is nationalized, or mostly nationalized, rationing care is inevitable, and those who have lived the longest will find their care the most restricted. " [13]


Sorry for being breif.

SP System, his case

---> He doesn't justify his well paid and competitive, universal healthcare lowers competition. [14, 15]
---> if those 60k go overseas chances they'll come back if they prefer SP if we adopt that, that wold raise costs.
---> it would not help the drug industry. In the US we have better access to HC then SP countries. [16] We have bscreening. [17] And we have more technologies medically and have been better at creating them then otherr SP countries. [18] That argument makes no sense.
---> File:Health Care Spending in Switzerland Per Capita, 1998 to 2008.JPG
source: http://en.wikipedia.org...


Their SP costs for HC are rising!! Heakth coss are 17% of living in switzerland. [20]

---> "Not only do fewer people go bankrupt in the U.S. than critics claim, but people in other health care systems also incur high medical costs." [19] Sorry bankrupsies

---> The gpverment sets proces and controls the market creating inefficiencies that didn't exist before. [21]

---> Tell me how it would increase the amount of trained doctors? If it costs more and is inneficient how is this the case?

---> How will it lower costs? It increases taxes a megaload and as I stated 16% of income hasot be spent on care in switzerland. [22]

---> Better health, no. "Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. " [23]

"Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent)." [23]

"Twice as many American seniors with below-median incomes self-report “excellent” health compared to Canadian seniors (11.7 percent versus 5.8 percent)." [23]

"The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain. The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain." [23]

Your arguments are false.

--->Freedom, or not. SP raises regulations and changin insurance is a terrible proces sthat causes people to bhave to move to different areas. [24]


Funding for SP healthcare

--> THE majority of europe has higher taxes then us. their tax rate s near 60%. ours it around 35%, 25% tax hike. [25]
--> The employers pay 13% payroll tax. [26]
--> I just like bullets right now.

Healthcare policy

--> He just conceded rationing of care by saying he gets people to choose what the people need, not what the people want. Also this contradicts with his freedom argument.




http://onforb.es... [1]
http://1.usa.gov... [2]
http://bit.ly... [3]
Cunningham P, May J. "Medicaid patients increasingly concentrated among physicians." Track Rep. 2006 Aug;(16):1â€"5. [4]
http://bit.ly... [5]
http://bit.ly... [6]
http://n.pr... [7]
http://www.npr.org... [8]
http://www.connexionfrance.com... [9]
http://www.freemarketcure.com... [10]
Concord Working Group, "Cancer survival in five continents: a worldwide population-based study,.S. abe at responsible for theountries, in s chnologies, " Lancet Oncology, Vol. 9 [11]
http://www.weeklystandard.com... [12]
http://online.wsj.com... [13]
http://economix.blogs.nytimes.com... [14]
http://www.cato.org... [15]
http://www.cato.org... [16]
June O'Neill and Dave M. O'Neill, "Health Status, Health Care and Inequality: Canada vs. the U.S." [17]
Victor R. Fuchs and Harold C. Sox Jr., "Physicians' Views of the Relative Importance of 30 Medical Innovations," Health Affairs, Vol. 20 [18]
http://biggovhealth.org... [19]
Alice Dembner, “Soaring costs threaten universal coverage in Switzerland,” [20]
http://www.cato.org... [21]
OECD, “Taxing Wages 2006/2007: Special Feature: Tax Reforms and Tax Burdens,” (2008). [22]
http://blog.heritage.org... [23]
http://news.heartland.org... [24]
http://en.wikipedia.org... [25]
http://en.wikipedia.org... [26]
Contra

Pro

C1: ----------Rebuttals---------

Current Government Care

YOUR SOURCE said that the PRIMARY reason for children crisis is because of low reimbursement rates. The reason is because government reimbursement rates are too low in Medicaid, and thus doctors can't afford to see the children. [1]

With Single-Payer, the system is much more efficient because it is centralized, and because S.P. would lead to a streamlined, electronic, yet confidential system. So, extensive paperwork would be heavily cut. [2] [3]

You proved nothing about switching over = poor rates of physician pay.

Drug "Shortages"

About drug shortages, your source was about an isolated case on ADHD medications in Louisiana.

In S.P., the government doesn't price the drugs, it negotiates lower prices with the drug companies, because of the gov't bulk purchasing power. [3]

In Europe with S.P. systems, drug prices are more strictly controlled, but pharmaceutical companies are stilll very profitable and highly innovative. [4]

Doctor Pay and "Shortages"

If S.P. was implemented correctly, physician income would not likely change much, although the disparity of earnings among specialties would probably shrink. Billing would be very simple. The patient's N.H.P. card would be imprinted on a charge slip, the doctor would check the box for the complexity of the procedure or service, then send the computer record to a physician-payment board. [2] In S.P., for example in Canada, physician pay has been very well. [5]

With reimbursement reform, and helping train more medical professionals and having loan forgiveness under a S.P. plan, there wouldn't be a doctor shortage. [2]

Free Market "Cures"

S.P. wouldn't provide worse care. Your source didn't even demonstrate that - it was comparing the USA to a Socialized Medicine program - NOT Single-Payer.

Besides, the USA ranks poorly relative to other industrialized nations, DESPITE having the best health care providers and the best medical infrastructure of any industrialized nation. [6] For example, we are 23rd in infant mortalilty, 20th in life expectancy for women and 21st for men, (gradually declining over time), and we are 67th in drug immunization rates, BEHIND BOTSWANA. [6] This is sad.

Rationing

I said that rationing already occurs based on cost in the USA.

In other nations, the systems are publicy accountable, unlike our systems. As a result of the public information, wait times have decreased. [2]

In Canada, there are reasonable waits for specialists, but this is because of medical infrastructure. Elective surgery, such as cataract surgery, has longer wait times that you are likely describing. [7]

The government DOES NOT DECIDE WHO DOES AND DOESN'T GET TREATMENT. It is between the doctor and the patient. [7]

Consensus:

The USA already has enough funding to cover all American citizens with comprehensive health care. Also, because of our abundant healthcare resources in place, rationing and long waiting lists would not be needed. Any rationing that would remain would be nonexistent or minor, and with our ethical system, it would be based on need and for the public health based on community needs, not for stockholder profits.

Defending my S.P. case

--> Healthcare costs add $1500 to the cost of every US car, compared to only $500 for Japanese-built cars because they have Single-Payer [4]

--> We would still have enough money to cover their costs -- Single-Payer would lead to a surplus of about $100 billion or more even with covering the uninsured and increasing health benefits [6]

--> About medical infrastructure, new infra. would be payed for according to community needs (Health Planning Board). As I said earlier, drug companies still thrive under S.P. with high innovation and profits.

--> About bankruptcies, these would be because of elective procedures that are not life-necessary. [4] All medically necessary care would be covered.

--> Switzerland DOES NOT HAVE Single-Payer! Besides, the funding I described would ultimately save money for the vast majority of businesses and people. [2] In fact, employees would likely get higher wages because the business would have less in medical bills. [3]

--> About the Gov't creating inefficiences in the market, it only negotiates down prices. Your article was based on Socialized Medicine.

--> As I already said, the USA ranks poorly among industrial nations for health care, and with S.P. this would increase do to full coverage, more physicians, and other factors.

--> About freedom, tax increases would be modest, [3] and spending would be less than now. [6]

Funding for S.P.

Your figures are pretty confused. In Europe, they also have universal college education if they want it, and liberal welfare systems. In fact, in France, they have months of maternity leave, etc.

We are talking about a modest increase in taxes, that would not be very large. About the 13% payroll, the source discusses nothing about that.

Healthcare Policy

I never conceded rationing of care. All medically necessary care is covered. All other care can be paid for by -- private insurance.

To make it easier for all of us, I will use bullet points to conclude my arguments.

C2: Single Payer Healthcare

--Brings competition to doctors and patients. Medical decisions made between these groups. [7] [2]

--Rationing wouldn't occur. The USA already spends enough, and has a large enough medical infrastructure. [2] [8]

--Modernizes USA economy, by decreasing healthcare costs for businesses and individuals. Many bankruptcies are eliminated. [4] [3] [2]

--Improves US medical infrastructure. Many more physicians could be trained. Drug innovation could improve. [2]

--Costs would be better contained. S.P. healthcare costs rise slower than nations with private healthcare systems. [9]

--Better Health Care. Nations with S.P. have better healthcare results. [10] Plus, workers could get care when they need it, instead of skipping care and being less productive. [2] In the USA, it is less likely to see a doctor the same day as requested, after hours E.R. treatment was harder to get, and millions forgo treatment because of costs. [2]

--A Very Efficient System. With centralization of administration, costs would decrease by large amounts. With a streamlined, electronic, yet confidential system, any patient or doctor overusing care would be be recognized and dealt with swiftly. [2] [3] [6]


Sources:

[1] http://articles.orlandosentinel.com...

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

[3] http://www.amsa.org...

[4] Conrad, Jessamyn. What You Should Know About Politics... But Don't. 1st ed. New York: Hachette Book Group, 2008. 104-124. Print.

[5] http://pnhp.org...

[6] http://cthealth.server101.com...

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

[8] Ronald J. Glasser, M.D., "The Doctor Is Not In: On the Managed Failure of Managed Health Care," Harper's, March 1998, p.35

[9] http://economistsview.typepad.com...

[10] Sherrow, Victoria. Universal Healthcare. 1st ed. New York: Infobase Publishing, 2010. Print.

Debate Round No. 3
16kadams

Con

Current US government health care

Ok it is a well known fact people on current government health care find it hard to find doctors. [1] We agree on this, correct? The reimbursements and low/delayed pay make them wanna opt out correct? [1] We seem to agree the MAIN reason is reimbursements, but where we differ is how to control it.

In the US private Health care is far more efficient then the governments counter parts. [2] My opponent claims government central health care is more efficient? This makes no logical sense. If small scale government health care is poor why add more? Oh I cut my finger lets stab it more then it may stop hurting... Seriously that's similar logic, it makes no sense. My opponent implies the government subsidizes the electronic records to make health care better. When the government does this it actually increases inefficiency in the market and other areas in the sector. [3]

Drug shortages

Although it is correct there are many ways these drug shortages came into effect, the FDA, a government program, it ignoring many problems. [4] Now, if the government is already doing a poor job why would putting even more government help? My opponent must somehow justify how a small amount of government is doing bad, and somehow more will help, which is impossible. My hands in the alligators mouth, want my arm next?

Pharmaceutical companies in SP countries actually get less profit then in their counter parts here. [5] Free market competition and not government monopolies are the way to increase pharmaceutical success and lower prices without government inefficiencies. [5, 6]

My opponent also proves the government highly regulates the drug business, and they already are bad at doing it (see current government care and drug shortages). Once again, your hands already into the mouth of an alligator, why put in the whole arm?

Doctors pay and Shortages

In Cuba doctors get paid very low incomes under he SP system and often enter underground markets to gain money and provide quick HC. [7] (implying a wait list).

My opponent keep claiming all SP countries have no doctors shortage because they train more. Canada, an SP country, has a doctor shortage and it is predicted to get even worse. [8] Many universal HC systems have this problem. [8] The doctor shortages in the UK call for people going to India to get doctors and bring t. [9] So, if these SP had the reforms as you imply they have, then why do they have these problems?

Free Market Cures

Socialized medicines and SP health cares are both very similar. SP has insurance run by the state, the other government hospitals. [10, 11]

My opponent then cites info that we have poor Health care and have the best technology. Before I refute this may I add this contradicts with his improves medical infrastructure and modernizes US economy.

Ok my opponent cites stats trying to show the free market has failed us. He forgets a large amount of the population is already on government insurance. [12, 13] Since the government has done this the overall stats became worse. [12] The more the government has entered this system, the worse it gets. So reducing government intervention is better. [12] Remember, want to put the whole arm into the alligator mouth? Wanna make the paper cut on your finger bigger? The logic doesn't hold up here. (on your side :P)

Rationing

As I have stated the US does not ration! In the US you get care no matter what. You are basically saying no insurance no surgery, that is false. In the US even poor people get care in the emergency rooms, therefore there is no rationing as even poor people get care. [14]

Um how are their wait times getting shorter? Canada's is at an all time high. [15]

My opponent says the waits are short, in Canada you have to wait 18.3 weeks for a surgery. [15] Due to the fact the wait times are that high that's a very bad sign...

My opponent then claims the doctor and the patients choose, this is false. The government chooses certain drugs by highly regulating them and restricting their amount in the markets. [16] A man in Canada needed a surgery and the GOVERNMENT canceled the surgery as there was no bed. [16] Sound like the government lets you decide? In France the amount of doctors allowed to enter the schools are HIGHLY restrained. [19]

Consensus

The CBO says a SP system may save a very low amount of money, so small it wouldn't effect the long term budget. [3] They also said they would at most gain a very small amount, and most likely lose money or break even. [3] The SP system in france is 40% of their spending and they charge a 20% payroll tax to pay for the system. [17] How does this save costs?

His SP case

--> In the UK health costs make up to each person 670 ponds per week. [18]
--> The health planning board. This contradicts to your left up to the patients argument. Also if this pannel was correct then they would have great health care in Canada, they don't. [20]
--> Ok he wants a SP country, hello Canada how you doing? Wait doctors there say private health care is more efficient? [21] Their underpaid,under equipped, and the cost is high to the patent and the government? [22] good to know.
--> You know the goverment care in canada is highly inneficient and as I stated the doctors say private healthcare is superior. [23]
--> See frances 20% tax. It decreases cost at first then over the long run administrative cost rises. [24]

I need to skip some of his things as they are still debunked from earlier

--> The goverement actually has a cap on what doctors can do. [22]
--> explain why every SP country plan says this then it happens a few year later. [16]
--> I refuted that already. People in SP countries pay a lot more for HC as does buisness. [18]
--> The US is better at improving medical infustructure then any SP country. [25] SP hinders advancemens here. [25]

I refuted all of that earlier..

CONCLUSION:

SP costs more, current goverment HC sucks why make it worse with more goverment, reduce effeciencies, cause doctor shortages,and get rationed care and poor care. There is no reason too. VOTE CON

OUT OF ROOM :(


[1] http://online.wsj.com...
[2] http://home.windstream.net...
[3] "Seven bad Ideas for health reform" by Michael tanner, Cato Institute.
[4] http://www.aei.org...
[5] http://www.ronpaul.com...
[6] http://www.ricksantorum.com...
[7] http://en.wikipedia.org...
[8] http://www.fraserinstitute.org...
[9] http://www.bbc.co.uk...
[10] http://en.wikipedia.org...
[11] http://en.wikipedia.org...
[12] http://www.freemarketcure.com...
[13] http://en.wikipedia.org...
[14] http://www.freemarketcure.com...
[15] http://www.cbc.ca...
[16] http://www.freemarketcure.com...
[17] http://www.businessweek.com...
[18] OECD, “Taxing Wages 2006/2007: Special Feature: Tax Reforms and Tax Burdens,” (2008)
[19] “Cnam: Bachelot veut 4 milliard d’économie,” Nouvel Observateur, 8 July 2008; “Le déficit de la Sécurité sociale prévu à 8,9 milliards d’euros en 2008,” La Tribune, 18 June 2008,
[20] http://blog.heritage.org...
[21] “Health Care in Canada Survey,” Pollara, (2006)
[22] “Canada’s Health Care Shows Strains,” By Barbara Crossette, New York Times
[23] Health Services Access Survey, 2003. Statistics Canada.
[24] Nearly 10 percent of doctors trained in Canada work in USA” Canadian Medical Association Journal
[25] http://fraser.stlouisfed.org...
Contra

Pro

Government Involvement

"In the US private Health care is far more efficient then the governments counter parts."

Your source did not say that. It said that when a specific funding mechanism, such as private insurane, entered the free market, the costs increase by large amounts. However, the reason is mainly because of liability laws and thelack of awareness of healthcare prices. [1]

With Single-Payer, the government can negotiate lower drug prices. This is why other nation's have lower drug prices. [2] Drug companies are still highly innovative and profitable. [1] Single-Payer would cut administrative costs, and mandate reasonable pricing, and this would result in high savings. With the individual Health Planning Boards, they would determine what technology in and what to cover to reduce costs over the long run and reduce inflation in health care as well. [2]

"If small scale government health care is poor why add more?"

Public health care is more efficient for several reasons, such as lower costs. Small scale government health care is also better, Medicare patients have rate their health care better than private insurers. [3]

Drug Shortages

The FDA needs to be better modernized, that is a different concern. Besides, drug shortages aren't that common. You haven't listed any real drug shortages. In America, busloads of seniors commonly cross the border into Canada because of the cheaper prescription medications. In Canada, the pharmaceutical companies price drugs withing standards set by the government. These controls make patented drugs less expensive. [1]

The NIH funds many new drugs with federal funds. [1] [2]

With more private control of drugs, prices will still skyrocket because of marketing and profit costs. In fact, more of the costs of drugs is from marketing, profits, advertising, etc. than actual research. [2]

About doctors in Cuba, they have a weaker medical infrastructure than we do, and have Socialized Med.

More Doctors, More Care

"So, if these SP had the reforms as you imply they have, then why do they have these problems?"

Believe it or not, U.S. access to healthcare is poor relative to other SP nations, INCLUDING Canada. [5] About the people getting care in the USA, most of those people are already traveling in the US for other purposes. [6] With early care available, patients can get care when they need it, not at the last moment. This would actually lead to less clogging than we have now. [7]

In SP, reimbursement reform, loan forgiveness, increased funding for medical education, and other reforms, more physicians could be trained. Mostly untried elsewhere.

Single-Payer: Government financed health care, including payments and reimbursements. Physicians and medical groups/ professionals can choose to be either public or private.

Socialized Medicine: Government financing and delivery of health care.

Free Market "Cures"

You are saying that the market can effectively resolve the issues of access, cost, and quality problems. However, this doesn't usually benefit the consumer. [8] The market has found to result some advantages for particular groups, such as the insurers, while we have seen the pain. [9]

In fact, for-profit ownership of health care organizations provide lower quality care than nonprofit organizations. [10] More are denied care in a market HC system.

Rationing

"We all get care!"

We ration care according to cost. The more you have, the faster and better care you get. Besides, not everybody gets care, 45,000 people a year die to a lack of insurance. [11]

Does a visit to an overwhelmed emergency room for a non-serious problem, that puts other people's lives at risk count as sufficient? [9] Does the fact that adults who lack continous health insurance experience a decline in health or functional status than if insured count as "quality" care? [12] Dr. Ronald Glasser, on his comment about rationing pointed out that in the USA:

"Nothing can be rationed that is itself not scarce, and, you can't ration healthcare when there are more than enough doctors, hospitals, and high-tech equipment distributed throughout the country to do everything and anything that needs to be done. American healthcare is an unsaturated demand market, and in such markets "rationing" is simply a code word for not spending the money to take care of the poor, uninsured, the underinsured, and the high-risk patient." [3]

Even if we did ration, it would be minor, and the concern would be based on necessity, not on shareholder profits.

Costs of SP

The CBO said that we could save $100-200 billion dollars or more by switching to a SP system, while covering all the uninsured and everybody with comprehensive healthcare (as well as financing the SP plan with the terms I listed earlier). [13] [14] [2]

Defending SP Case

-- Canada doesn't have Health Planning Boards. HPB are more Democratic.

-- With SP, bureaucracy is decreased. A typical HMO has costs of about 15-25% in overhead, while Medicare just has about 3% overhead. [2] [1] SP, with a flexible cap, would be the best solution. [2]

Another thing, the administrative size of Canada's SP system is the same as Blue Care Network's administrative size in JUST Massachusetts. [3] Talk about efficiency.

Conclusion on SP:

Single-Payer systems have better results in healthcare. Efficency is much higher, due to a streamlined, electronic, and confidential system [3], and by having centralized administration. SP would save hundreds of billions, enough to cover the uninsured with comprehensive care, and all Americans would be covered with comprehensive care. [14] [15] With SP, businesses would become more competitive with less healthcare costs. [1] Access to care would be improved. [3] Rationing wouldn't occur, since our medical infrastructure and funding are already high in ranks. [3] More physicians could be trained. [2] Costs would increase at a slower rate, and hospitals would get a global budget to make sure their funding is sure. [14] Plus, medical decisions are left between the doctor and patient. With all of these advantages, SP would be the most Democratic, equal, fair, effective, and efficient choice. If a criminal gets a lawyer, a patient should get a doctor, especially if benefits come from this new system are numerous.

VOTE PRO

Thanks 16k for this debate.



Sources:

[1] Conrad, Jessamyn. What You Should Know About Politics... But Don't. 1st ed. New York: Hachette Book Group, 2008. 104-124. Print.

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

[3] Sherrow, Victoria. Universal Healthcare. 1st ed. New York: Infobase Publishing, 2010. Print.

[4] Marcia Angell, "The Truth About the Drug Companies," New York Review of Books, July 15th, 2004.

[5] http://www.pnhp.org...

[6] Katz, S. J., et al. Phantoms in the snow: Canadians’ use of health care services in

the United States. Health Aff. (Millwood) 21(3): 35–41, 2002.

[7] Derlet, R. W. Trends in the use and capacity of California’s emergency departments,

1990–1999. Ann. Emerg. Med. 39: 430, 2002.

[8] Schiff, G. D., Bindman, A. B., and Brennan, T. A. A better-quality alternative:

Single-payer national health system reform. JAMA 272: 803–808, 1994.

[9] http://www.pnhp.org...

[10] Himmelstein, D. U., et al., Quality of care in investor-owned vs not-for-profit HMOs.

JAMA 282(2): 159–163, 1999.

[11] http://www.reuters.com...

[12] Baker, D. W., et al. Lack of health insurance and decline in overall health in late middle

age. N. Engl. J. Med. 345: 1105, 2001.

[13] http://cthealth.server101.com...

[14] http://www.nytimes.com...

[15] http://economistsview.typepad.com...

Debate Round No. 4
23 comments have been posted on this debate. Showing 1 through 10 records.
Posted by tajshar2k 1 year ago
tajshar2k
this debate was epic...
Posted by 16kadams 5 years ago
16kadams
Contra, lol. People waiting for months for care is not, well, a benefit, so yes they see more patients! But they are so rationed and overloaded they do no good.
Posted by Contra 5 years ago
Contra
Wiploc: Doctors could be paid more with higher reimbursement rates, or the same reimbursement rates, but with a streamlined system, they could see more patients -- leading to more income. It would still leave room for hundreds of billions in savings.
Posted by wiploc 5 years ago
wiploc
Single-payer health care is not something I know about, so thank you both for an informative and interesting debate.
Posted by wiploc 5 years ago
wiploc
===continued===

Many of the claims were unsupported, and many of them didn't make sense on their face. How, for instance, does Pro propose to save money by paying doctors more? And why does Con object to rich people cutting in line in Canada, when he favors wealth-based health care distribution in the U.S.A.?

Paperwork vs. the Alligator:

Pro said we'd make life better for everybody by unifying paperwork under a single-payer system. That sounds good. But we should unify paperwork _regardless_ of whether we adopt a SP system. Would have been nice if Con had pointed this out.

Con said that doctors refuse medicare patients because of slow pay or low pay. He seemed to think that, under a single payer system, doctors would refuse all patients. But, in fact, under single payer, all payments would be equal, so there would be no reason to reject anybody. So Con's alligator analogy doesn't work. Would have been nice if Pro had pointed that out.

Turns:

Pro had several turns:

- Con argued against SP on the grounds that Switzerland has high healthcare costs, but Pro pointed out that Switzerland doesn't have SP. Con said SP countries have

- Con said drugs are harder to get in SP countries, but Pro pointed out that Americans often shop drugs in Canada because they are actually easier to get there.

There were other turns too, but those come to mind.

My impression is that Pro's argumentation was generally better than Con's, but, in my mind, these turns cemented the victory.
Posted by wiploc 5 years ago
wiploc
Let's start with irrelevant comments. That is, they don't affect my vote, but they may help the debaters in future debates.

- If you write your post in Word, on your own computer, then the internet can't eat your post, and you get better formatting by clicking on the Paste From Word icon.

- It confuses me when Con goes first. I have trouble keeping the players straight in my mind. I assume, with no evidence at all, that I represent a significant portion of your readers on this. Comprehension would have been easier the resolution were, "Resolved, the US should NOT constitute (sic) a Single-Payer Health Care System," and 16KAdams had been Pro.

Okay, points:

S&G to Pro. I don't vote S&G unless there is a significant problem. Con's posts had enough errors to make them hard to read.

Both sides made a lot of unsupported claims. I don't know what to do with that. If one of you says X, and the other says not-X, you haven't done yourselves any good unless you make an actual argument supporting your claims. But you made so many claims that you hardly had space to argue.

Con started off with a whopper that made me mistrust his bald claims. Con said the 74% higher death rate in medicare-funded surgeries means you have a 74% chance of dying. I'd have liked to see Pro point out that medicare is for old people, and old people are more likely to die regardless of who pays for the surgery. (But Pro did not say that, so we can think about something else.) And I'd have liked to see Pro point out that, if we assume a 1% death rate, then a 74% increase would bring us to 1.74% chance of dying, not a 74% chance of dying. Again, we should ignore this since Pro didn't make the point. But Con's gross misrepresentation would make it hard to take him at his word elsewhere.

===continued===
Posted by 16kadams 5 years ago
16kadams
There's a difference between not understanding this and not being able to make longer arguments like pros because your sources take up so much room :P But I see how my presentation makes my arguments kina sucky XD
Posted by Raisor 5 years ago
Raisor
What really swayed me to vote Pro was just the fact that he actually engaged the arguments rather than just spitfiring numbers. Dont get me wrong, Con has a lot of really good numbers to work with. But when all Con does is sort of vomit them up and Pro is able to take a good number and explain them away, it appears as though Con doesnt understand the material he is using.

So in the end both sides had argumentatively strong and weak points but Con's presentation really hurt him in this debate.
Posted by Raisor 5 years ago
Raisor
General comments:

Both sides had some pretty bad sources. Ronpaul.com? Really? Dont link to blogs. If the blogs make good arguments, summarize them in your own words. If they bring up good evidence, link directly to the evidence. I dont want to dig through some crappy blog post to see if your facts are straight.

Along the same line, it isnt enough to just state your opinion then list a link. Oh, some WSJ opinion piece agrees with you? Good for them, but it doesnt do anything to convince me. You need to actually construct a coherent argument. ITs nice that mediamatters explains how a study was misused, but dont expect the judges to read that- explain IN ROUND why the study referenced is being misused. This is a debate not a linkdump. Again that goes for both sides.

Con- your analogies are really poor and your vitriol and sarcasm are grating. I get it, you think going from Medicare to SP is making a bad situation worse. Talking about alligators 20 times does nothing to convince me- its a flat analogy that adds nothing to the debate. I probably wouldnt have mentioned it but youre really beating a dead horse (alligator?) with it.

At the end of the debate the thing that strikes me the most is just the lack of coherency by Con. Both sides could do a lot in terms of writing organized arguments, but Con often didnt even write in full thoughts. Reading Con's arguments just felt like getting shot in the face with a bunch of facts of dubious import. When Pro was able to take Con's facts and put them in context I actually felt relieved. Economics is a notoriously treacherous topic to navigate- without explaining what your numbers mean and the methods by which they were obtained your stats dont mean much.
Posted by 16kadams 5 years ago
16kadams
lol bias sources he and I where good at that, he has physicians for national health care, I had Forbes
7 votes have been placed for this debate. Showing 1 through 7 records.
Vote Placed by wiploc 5 years ago
wiploc
16kadamsContraTied
Agreed with before the debate:--Vote Checkmark0 points
Agreed with after the debate:--Vote Checkmark0 points
Who had better conduct:--Vote Checkmark1 point
Had better spelling and grammar:-Vote Checkmark-1 point
Made more convincing arguments:-Vote Checkmark-3 points
Used the most reliable sources:--Vote Checkmark2 points
Total points awarded:04 
Reasons for voting decision: RFD in comments.
Vote Placed by Greyparrot 5 years ago
Greyparrot
16kadamsContraTied
Agreed with before the debate:Vote Checkmark--0 points
Agreed with after the debate:Vote Checkmark--0 points
Who had better conduct:--Vote Checkmark1 point
Had better spelling and grammar:--Vote Checkmark1 point
Made more convincing arguments:Vote Checkmark--3 points
Used the most reliable sources:--Vote Checkmark2 points
Total points awarded:30 
Reasons for voting decision: Really disappointed in this debate that Con did not really bring up the fraud issue well and what entity was better at reducing fraudulent claims. In the absence of this, Pro can win easily on reduced paperwork issue alone. Pro did a poor job defending rationing and his quote that assumed non scarcity of medical services for an unquantified demand is ludicrous when already presented with the data of overflowing emergency rooms that are accessable to all. only 3 points for Con.
Vote Placed by Raisor 5 years ago
Raisor
16kadamsContraTied
Agreed with before the debate:--Vote Checkmark0 points
Agreed with after the debate:--Vote Checkmark0 points
Who had better conduct:--Vote Checkmark1 point
Had better spelling and grammar:--Vote Checkmark1 point
Made more convincing arguments:-Vote Checkmark-3 points
Used the most reliable sources:--Vote Checkmark2 points
Total points awarded:03 
Reasons for voting decision: RFD in comments
Vote Placed by 1dustpelt 5 years ago
1dustpelt
16kadamsContraTied
Agreed with before the debate:Vote Checkmark--0 points
Agreed with after the debate:Vote Checkmark--0 points
Who had better conduct:--Vote Checkmark1 point
Had better spelling and grammar:--Vote Checkmark1 point
Made more convincing arguments:--Vote Checkmark3 points
Used the most reliable sources:--Vote Checkmark2 points
Total points awarded:00 
Reasons for voting decision: This is a tie.
Vote Placed by FourTrouble 5 years ago
FourTrouble
16kadamsContraTied
Agreed with before the debate:--Vote Checkmark0 points
Agreed with after the debate:--Vote Checkmark0 points
Who had better conduct:--Vote Checkmark1 point
Had better spelling and grammar:-Vote Checkmark-1 point
Made more convincing arguments:-Vote Checkmark-3 points
Used the most reliable sources:-Vote Checkmark-2 points
Total points awarded:06 
Reasons for voting decision: Comments.
Vote Placed by 1Historygenius 5 years ago
1Historygenius
16kadamsContraTied
Agreed with before the debate:Vote Checkmark--0 points
Agreed with after the debate:Vote Checkmark--0 points
Who had better conduct:--Vote Checkmark1 point
Had better spelling and grammar:--Vote Checkmark1 point
Made more convincing arguments:Vote Checkmark--3 points
Used the most reliable sources:--Vote Checkmark2 points
Total points awarded:30 
Reasons for voting decision: With JimmyTimmy
Vote Placed by jimtimmy 5 years ago
jimtimmy
16kadamsContraTied
Agreed with before the debate:Vote Checkmark--0 points
Agreed with after the debate:Vote Checkmark--0 points
Who had better conduct:--Vote Checkmark1 point
Had better spelling and grammar:--Vote Checkmark1 point
Made more convincing arguments:Vote Checkmark--3 points
Used the most reliable sources:--Vote Checkmark2 points
Total points awarded:30 
Reasons for voting decision: RFD in comments.