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The United States Should Switch to a Single Payer Healthcare System

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Voting Style: Open with Elo Restrictions Point System: Select Winner
Started: 12/22/2015 Category: Politics
Updated: 9 months ago Status: Post Voting Period
Viewed: 569 times Debate No: 84199
Debate Rounds (5)
Comments (12)
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The US Should Switch to a Single Payer System.


1. Acceptance only
2. Opening arguments
3. Clash
4. Closing arguments/clash

For the purposes of this debate, the term Single-payer national health insurance, also known as “Medicare for all,” shall be defined as a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. [1]



I accept.
Debate Round No. 1


I'd like to thank lannan13 for accepting this debate challenge. I will divide my arguments into two sections: a moral case, and an economic case. I will show why single payer is both the proper moral plan as well as the proper economic plan.


Health care for all is a moral issue. The United States is the only industrial nation that does not have some type of national health program. While other countries have declared health care to be a basic right, the United States treats health care as a privilege, only available to those who can afford it. In this sense, health care in America is treated as an economic good like a TV or VCR, not as a social or public good.[1]

The Uninsured and Underinsured

The most vulnerable victims of the current American health care system are the uninsured and under-insured. Because of the high medical and insurance costs, there have been countless needless deaths.

Because of the Affordable Care Act, it is estimated that upwards to 50,000 lives have been saved[2]. However, an estimated 20 million people will still be uninsured or underinsured by the year 2020.

Compared with the health systems of other industrialized nations, the U.S. system is an outlier in terms of health care cost, access, and affordability. One-third (37%) of Americans went without recommended recommended care, did not see a doctor when they were sick, or failed to fill a prescription because of costs; compared with as few as 4% to 6% in the UK and Sweden. (Cathy Schoen, 2013)

Prevent Bankruptcies

A Harvard medical study showed that medical debt the number one cause for bankruptcy:

“Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical and 92% of these had medical debts over 5,000 or 10% of pretax family income.” (Himmelstein, 2009)

Even those who are employed and have insurance are not immune to bankruptcies due to medical debt. Indeed, the same report found that of those whose illness contributed to their bankruptcies, 77% were insured, 60% had private insurance. By the time of bankruptcy, the portion of patients with private coverage had fallen to a mere 54%. (Himmelstein, 2009)

Part II: The Economic Case for Single Payer

Significantly Reduce Cost

The Affordable Care Act (ACA) introduced major reforms to the health care system that will improve the lives of many Americans. However, we must go further to fully solve the healthcare crisis.

The U.S. government spent $4,197 per person in 2013 on health care. In contrast, the UK spent just 2,802 per person (Mangan, 2015).

Dr. Gerald Friedman, a professor of economics at University of Massachusetts, found that single payer would save an estimate of $592 billion annually by slashing the administrative waste associated with the private insurance industry ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion). These savings would be enough to cover all 44 million uninsured and upgrade benefits for everyone else. No other plan can achieve this magnitude of savings on health care. (Friedman, 2013)

Restore Physician-Patient Relationship and Increase Patient Choice

A universal health care system would restore the physician-patient relationship and free physicians from the bonds of managed care and overwhelming paperwork, while still giving patients a free choice of physicians and hospitals.


Cathy Schoen, R. O. (2013). Access, Affordability, and Insurance Complexity Are Often Worse in the United States Compared to 10 Other Countries. Health Affairs. Retrieved from

Friedman, G. (2013). Funding HR 676: The Expanded and Improved Medicare for All Act. Retrieved from

Himmelstein, D. T. (2009). Medical Bankruptcy in the United States, 2007:. The American Journal of Medicine, 1-6.

Mangan, D. (2015, October 8). US health-care spending is high. Results are...not so good. Retrieved from CNBC:



I thank my opponent for this debate and I believe that I will start this debate with a political cartoon to lighten the mood.

Contention 1: Kant's Categorical Imperiatives

P1.The Government should only act to enforce the imperatives of Perfect Duties.
P2.Universal health care does not meet the standard of a Perfect Duty.
C1: Thus, the Government should not act to enforce universal health care.

""Kant's first formulation of the CI states that you are to “act only in accordance with that maxim through which you can at the same time will that it become a universal law... Perfect duties come in the form ‘One mustnever (or always) φ to the fullest extent possible in C’, while imperfect duties, since they enjoin the pursuit of an end, come in the form ‘One must sometimes and to some extent φ in C’" [1]

According to the above we see that Kant establishes two duties of that of the government; Perfect Duties and Imperfect Duties. Perfect Duties are those things of which the government must provide to ensure that the government and that society is fully functional. What are these things you may ask? These things are the simple things ensured under that of the Social Contract that you give up for a Civilized Society (not to kill, rape, steal, etc...). These things are indeed key as we can see that this ensures that of a Minarchy at the minimum. What that means is that the Government is to ensure that the people are safe. Everything else falls into that of the Imperfect Duties. Now note that these things may protect and benefit the public, we can see that if they're not of the Social Contract like ideals that they automatically fall into this category and SHOULD NOT be carried out by the government, but by Private entities.

“Any action is right if it can coexist with everyone's freedom in accordance with a universal law, or if on its maxim the freedom of choice of each can coexist with everyone's freedom in accordance with a universal law” [2]

We can see that if the government intervenes on the behalf on the people to infringe on that of an Imperfect duty that they would undermining humanity to achieve their due ends. We can see and must ensure that the Imperfect Duties are carried out by the Private Entites as things like people's health and Private debt is something that is to be delt with by the individual NOT the government. [3]

Contention 2: Universal Health Care is inneffective.

"Britain's Department of Health reported in 2006 that at any given time, nearly 900,000 Britons are waiting for admission to National Health Service hospitals, and shortages force the cancellation of more than 50,000 operations each year. In Sweden, the wait for heart surgery can be as long as 25 weeks, and the average wait for hip replacement surgery is more than a year. Many of these individuals suffer chronic pain, and judging by the numbers, some will probably die awaiting treatment.” [4]

Here we can see that even in nations that have this health system that it actually makes this issues worse in terms of waiting for treatment and to extend the damage we can see this hurts the freedom of the individual and that is something that needs to be preserved.

“The employee is better off to charge a $50 doctor bill to the insurance company—even if the [insurance] company spends $20 to process it—and have the employer pay the extra $70 in a higher premium to cover the bill and the processing cost. The alternative—having the employer pay [the employee] an extra $70 in cash– yields the employee only about $42 [because of federal income, social security, and Medicare taxes] and costs the employer $75.36 ($70 + $5.36, the employer’s portion of the social security and Medicare tax on $70).” [5]

Here we can see that the affects of the Universal Health Care is disasterous to our economy as the costs are keeping pace with that of one of the Top US economic movers. We can see that this will severely harm our nation and that this law will cost our nation a total of 2.9 MILLION jobs. [6] This is abserd, because instead of focusing on national healthcare it would be better for our nation to focus on economic growth and advancement, but this is doing the exact opposite by killing jobs for the sake of a lost cause as this doesn't ensure that you will get better treatment. No, it's a loss of jobs, economic growth, and finially a great loss in Medical Treatment. This is something that my opponent cannot account for, because even if it's free to get your brains blown out it doesn't mean you're going to do it and you sure wouldn't want to do it. The only economic growth you may see is that on the insurance companies side due to the federal government colluding with Insurance Companies to require that everyone purchases their product. [7] Even at that the Insurance Companies are finding themselves down in profits by 0.3% in late last year from the year before. This is another threat to freedom as the federal government is creating an economic monopoly which poses on Economic Freedom. Here I would like to quote Economist Milton Friedman on the matter, "There is no special role for government in the medical care field at all. There is the same role for government in this area, as there is in every other field – to enforce laws against fraud and deception, to help some people who are in dire distress. For ordinary medical care, there is no case for government financing at all. The costs of ordinary medical care are well within the means of the average American family. And the problem of sometimes it being large and sometimes it being small is readily handled through the availability of private insurance arrangements." [Youtube video]

Here we can see that the federal government, nor any nation's government, should involve themselves in this field as for it harms the economic freedom by limiting the choice of health care and this is the type of collusion that Saul D. Alinsky would support.

The system my opponent is purposing is a form of price Control and price controls can harm a buisness for one of two reasons.

1. That the Government sets the price to high and the public buys less and less of the product and as a result this harms the buisness and the economy and it shows that the people do not want said product. This product's price then raises again in order to make up for the lack of growth forcing the government out of buisness.
2. The governemtn sets the price to low and people will buy the product out and there will be a shortage of said product. [8]

Many people state the rising premiums is due to the collusion of the private industry, but one can see that this isn't due to the collution of the Private Companies, but this is more or less the collecting and merging of Private Industry in this industry. We can see the lack of Competition harms the pricing and option as with more competition there are more companies competitng for lower prices to get custumors who try to get a better deal. We can see that this merging has harmed the economy and that Nationalization will harm it even more. [9] Furthering we just need to look at the Yugos which is a car from the former Yugoslavia. Due to the industry being Nationalized we can see that the quality of the car never improved due to no incentive to improve buisness due to the lack of the market competition. The same thing can and will happen to the health care if you nationalize it.
Debate Round No. 2


Health Care is a Perfect Duty

1. The purpose of the state is to protect our external freedom.
2. This (i.e. the duty of the state) should be understood as a protection of the means we possess.
3. Health care is a necessary way of protecting our means.
4. Thus, the state ought to provide health care

If we were to accept the first premise that the state is to protect our external freedoms (i.e., our right to
life, liberty, means etc.), then one must come to the conclusion that providing health care is a duty of the state.

Over 45 million people are uninsured and underinsured. As I pointed out in round one, the effects of not being able to afford insurance is quite significant:

1) Two-thirds of bankruptcies are due to medical illness.
2) The uninsured are less likely to be able to fill prescriptions and more likely to pay much more of their money out-of-pocket for prescriptions. In a recent survey, one-third of uninsured Americans reported that they were unable to fill a prescription drug in the last year because of the cost.[2]
3) The uninsured are 3-4 times more likely than those with insurance to report problems getting needed medical care, even for serious conditions [Ibid]

Thus the effects of being uninsured and unable to receive proper health care absolutely plays into the fundamental right to life, liberty, and means. Thus, the government should absolutely ensure that everyone can have access to health care.

The Government Sometimes Needs to Act on Imperfect Duties

The second premise to my opponent's first argument is that that Government should never perform imperfect duties. The first problem with this premise is that "there is virtually no philosophical consensus on what, exactly, imperfect duties are." (Schroeder) Secondly, and perhaps most importantly, there are times when the government should perform imperfect duties. If I can show either health care is an perfect duty or that the government should act on imperfect duties then I have successfully negated con's argument.

In The Wealth of the Nations, by Adam Smith, Adam lists three duties of government (Smith):

1. The first duty of the sovereign, that of protecting the society from the violence and invasion of other independent societies, can be performed only by means of a military force. But the expense both of preparing this military force in time of peace, and of employing it in time of war, is very different in the different states of society, in the different periods of improvement
2. The second duty of the sovereign, that of protecting, as far as possible, every member of the society from the injustice or oppression of every other member of it, or the duty of establishing an exact administration of justice, requires, too, very different degrees of expense in the different periods of society.
3. The third and last duty of the sovereign or commonwealth is that of erecting and maintaining those public institutions and those public works, which, though they may be in the highest degree advantageous to a great society, are, however, of such a nature that the profit could never repay the expense to any individual or small number of individuals, and which
it therefore cannot be expected that any individual or small number of individuals should erect or maintain. The performance of this duty requires, too, very different degrees of expense in the different periods of society.

The first two duties that Adam Smith lists are within the perfect duty of Klan. The third duty, however, is an imperfect duty. Here are some examples:


Space exploration has enriched our understanding of our world and universe, and also our everyday lives. Many products that we use on
regular basis are a direct result of the government funding of NASA and space exploration. [4]

Bill Gates notes: "Why should the government fund basic research? For the same
reason that companies tend not to: because it is a public good. The benefits to society are far greater than the amount that the inteventer can capture. One of the best examples of this is the creation of the Internet. It has led to innovations that continue to change our lives, but none of the companies who deliver those innovations would ever have built it." - Bill Gates[5]


I have shown that con's basic argument is completely false. Health care is absolutely a perfect duty, and even if we say that it wasn't, the government sometimes needs to perform imperfect duties. The resolution is still affirmed.



Schroeder, S. "Imperfect Duties, Group Obligations, and Benevolence." t
Smith, A. "An Inquiry into the Wealth of the Nations"



My opponent and I have agreed to tie this debate and start another one due to time restraints.
Debate Round No. 3


Please do not vote on this debate. This debate is tied.
Debate Round No. 4
Debate Round No. 5
12 comments have been posted on this debate. Showing 1 through 10 records.
Posted by davidpneff 10 months ago
If you need to restart the debate, then we can do so
Posted by lannan13 10 months ago
Should we just restart the debate?
Posted by davidpneff 10 months ago
This was the latest that I could have posted my arguments. Apologies to con for any inconvinence.
Posted by lannan13 10 months ago
1. (
2. (Lectures and Drafts on Political Philosophy, translated Frederick Rauscher and Kenneth Westphal (in preparation). Relevant contents: "Naturrecht Feyerabend" course lecture, fragments on political philosophy, and drafts of works in political philosophy.)
3. (Johnson, Robert. "Kant's Moral Philosophy." The Stanford Encyclopedia of Philosophy. 2012.)
4. (Tanner, Michael, and Michael Cannon. "Universal Healthcare"s Dirty Little Secrets." Los Angeles Times. 2007.)
5. (Hsieh, P and Zinser, L. "Moral Health Care vs. "Universal Health Care"" The Objective
Standard. 2007. Pg. 4)
6. (
7. ( [Full article]
8. ( Commanding Heights the Battle for the World Economy. 2004.)
9. Paul, Rand. Taking a Stand. N.p.: Center Street, n.d. Print.
Posted by lannan13 10 months ago
It's usually just a C&P.

Can I put sources in the comments section?
Posted by davidpneff 10 months ago
I have some graphics, they just didn't copy. How do I add images to debates?
Posted by davidpneff 10 months ago
Not a problem.
Posted by lannan13 10 months ago
Please wait out for as long as you can before you respond.
Posted by lannan13 10 months ago
I'll accept next week due to the Christmas Holiday.
Posted by lannan13 10 months ago
1. I'll happily accept.

2. This is possible for me to accept, so you might want to check your setting on the debate.
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