The Instigator
Zanoty
Pro (for)
Losing
0 Points
The Contender
ax123man
Con (against)
Winning
31 Points

The United States ought to guarantee universal health care for its citizens.

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Post Voting Period
The voting period for this debate has ended.
after 5 votes the winner is...
ax123man
Voting Style: Open Point System: 7 Point
Started: 12/18/2012 Category: Health
Updated: 4 years ago Status: Post Voting Period
Viewed: 3,317 times Debate No: 28403
Debate Rounds (3)
Comments (0)
Votes (5)

 

Zanoty

Pro

Universal Health Care Affirmative

I affirm the resolution, "Resolved: The United States ought to guarantee universal health care for its citizens."

I offer the following definitions for clarity within the round.
Ought: "Used to express justice, moral rightness, or the like" Source:
Dictionary.com
Guarantee:" Something that assures a particular outcome or condition" Source:
Dictionary.com
Universal: "applicable everywhere or in all cases" Source: Dictionary.com
Health care: "The field concerned with the maintenance or restoration of the health of the body or mind." Source: Dictionary. Com
Citizen: "a native or naturalized member of a state or nation who owes allegiance to its government and is entitled to its protection." Source: Dictionary.com
United States: defined by a country of central and northwest North America with
the Coastlines of the Atlantic and Pacific oceans. This is relevant to the round as this is not a debate over other countries and their healthcare policy rather what is better for the U.S.
Source: thefreedictionary.com
Wellbeing: a contented state of being happy and healthy and prosperous. Source: Princeton.edu

My value for this round is "utilitarianism", according to Jeremy Bentham stated it is derived from the rule of utility that the good is the whatever brings the greatest happiness to the greatest number of people.

My Criterion is economy which is defined as the wealth and resources of a country or region, esp. in terms of the production and consumption of goods and services. This is the
Best criterion to consider in this debate as we are deciding what is best for this nation. A country cannot function without a good economy and without a good economy my value and every other value would be useless as we could not afford to make these things a possibility.

Contention 1: Universal Healthcare would be cheaper for the individual.
Sub point a universal health care would decrease the administrative costs.
Abolishing and prohibiting private healthcare would have a huge financial impact on the individuals in the US. Financially, providing every citizen healthcare would decrease the administrative costs. Physicians for a National Health Program explain, "In a single payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don"t have it." Money would also be saved in the timing of the care. When individuals fear hospital bills, they resist seeking treatment until the absolute latest time, resulting in much higher costs for everyone involved. Universal healthcare ensures all people would have access to palliative care, which, according to Diane Meier of Mt. Sinai Medical Center "translates into better quality care and cost savings. Taken to a national scale, palliative care could save $6 billion annually."
Sub point B the cost of Medicare is going up
Universal Healthcare would cut costs for the state. According to CBO long term budget outlook there is a growing trend. CBO states that in 2009 we were spending 5.3% of our income it also predicts that by 2035 we will be paying 10% of our income.

Contention 2: Universal healthcare would help sustain the work force. If we had universal healthcare everyone would be cared for. Putting people back into the workforce and the more people we have in the workforce the better our economy would be. But without universal healthcare every time someone who cannot afford it gets injured or sick. They drop out of the workforce. There for the business"s they work for lose money because that person is not there to help bring in the profit causing the country to also lose money. In 2011 in Washington State there were 64000 claims for workers composite. By accepting universal healthcare we can quickly and efficiently deal with these workers and put more workers in the work force.

Contention 3: premiums are going up because of the uninsured

Sub point a- Insured people are paying for the people who can"t afford health care through taxes.
According to a CNN report, 16.3% of US citizens don"t have health
Insurance. Having so many people lacking insurance cause"s healthcare costs to tax-payers to skyrocket. When an uninsured person cannot afford care, that owed money doesn"t just go away- hospitals have to raise overhead prices to cover it or the charge can be passed off to the federal government, who has to regain the loss through taxes. According to the Supreme Court of the United States, "Thirty-seven percent of the uninsured"s health care costs, totaling $43 billion, was "uncompensated care" "i.e., care received by uninsured patients but not paid for by them or by a third party on their behalf. Congress found that this cost-shifting increases the average premium for insured families by more than $1000 per year." This cost increase is due to the nature of the healthcare the uninsured seek. Uninsured individuals often wait until emergency before going to a hospital for fear of the price-tag associated with the care. This means that more drastic and risky services are necessary at the point at which the patient needs attention immediately, and, as emergency rooms cannot turn someone on the brink of death away, they must be treated. After treatment, when the person can"t pay, the hospital has to swallow the cost, resulting in that $1,000 increase for everyone else.

Sub point B: The current system is costly and ineffective.
The United States has been found by the World Health Organization to be the 37th best system of health care in the world. The problem is we"re number one for healthcare expenses. We are paying "more than twice as much as relatively rich European countries such as France, Sweden and
Britain that provide universal health care," according to the New York Times. Americans are funneling a lot of money into a system that doesn"t work, making us one of the least efficient systems in the developed world.
ax123man

Con

I accept Pro's terms, but note Pro's resolution: guaranteeing health insurance does not guarantee healthcare.

UHC=universal healthcare
UHI=universal health insurance

I believe UHI will cost more than a free market solution. Healthcare is a scarce resource and, based on economic laws, adding tens of millions of consumers to the system while not adding doctors, hospitals, etc will drive up prices dramatically or result in rationing, or both.

Pro's first contention is that UHC would be cheaper, with anticipated savings in admin costs. A common way to look at this is to compare Canada and the U.S. An often sited study showing Canada's low administrative costs comes from Himmelstein and Woolhandler [1] who state that these costs are 3 times as much in the U.S. than in Canada. It's interesting to read opinion pieces from these same two authors [2]:

They [hospitals] reap surpluses, a.k.a. profit, which they use to buy fancy machines and superluxe buildings – usually situated where there’s already a surplus of such facilities. Investing in what’s needed instead of what’s profitable would save billions and improve care for both the poor and the affluent.

It would appear they have an agenda. Don't consumers decide what is needed and demand the best technology, MRI machines, cat scans, etc? Given a choice between two hospitals, one dilapidated, which do you prefer?

Note that Canada is one tenth the population of the U.S. and does not have the socio-political complexity of the U.S.. Would it not be more fair to compare to Medicare? Similar efficiency claims are made for Medicare, however John Goodman has this to say:

Here is a brief review of the literature: Robert Book discovered that reported Medicare’s administrative costs per patient (not as a percentage of the bills) were actually higher than private insurance. A Milliman study concluded that when all costs are considered (including the cost of tax collection) Medicare’s cost as a percent of total spending is 66% higher than private insurance. Ben Zycher concludes that a government run system would have higher administrative costs than a private system. And Tom Saving and I showed (based on CBO numbers) that Medicare has not been more successful that the private section in holding down costs.[3]

Even if we accept the claims of savings due to admin costs, I submit this savings is small compared to the impact of a free market. One of the most important concept in economics deals with prices and voluntary exchange, which results in equilibrium prices established by supply and demand [4]. In order for this to work, exchange must be voluntary, and those exchanging goods must directly bear some of the costs. Neither Medicare, PPACA or the Canadian system seems interested in this concept.

Voluntary exchanges naturally balance supply and demand. If consumers desire more preventive services, demand increases, tending to drive up prices. But the increased prices attracts supply increase, mitigating these increased prices. Without these price signals, the only thing controlling price is what the market will bear. Examples of this can be seen when government attempts to control prices. In the 1970's Nixon set oil price limits adding to shortages [5]. On the other end of the spectrum, minimum wage laws create an oversupply of workers by setting an artificial upper limit on the price of labor [6].

Fortunately there is a current and relevant example of free market healthcare in the U.S.: the Surgery Center of Oklahoma (SCO) was opened in 1997 by Dr. Keith Smith with a desire for a free market facility [7]. How is this facility different than a typical hospital? For one thing, they publish their prices on their web site [8]. Notably these prices are a fraction of typical fees from hospitals [9]:

“complex bilateral sinus procedure.” At the Surgery Center, the all-inclusive price is $5,885. At nearby Integris Hospital the price in 2010 was $33,505 – but that did not include either the surgeon’s or the anesthesiologist’s fees.

This facility does not generally take Medicaid or Medicare. Why? Because they are not free market systems and have bureaucratic overhead. SCO does deal with self-insured and consumers are obviously free to seek reimbursement as they wish.

Now lest you think the SCO ignores the poor [9]:

Dr. Smith said the center’s approach is helping to restore an old-fashioned medical ethic for provision of charity care. Many referrals to the hospital come from churches and other groups helping the poor. Patients are encouraged in those cases to pay what they can, while physicians and anesthesiologists can (and often do) waive their fees for individuals in need.

So what would be the impact of a nation-wide roll out of the SCO model compared to single payer admin savings? If we use the most liberal data available (Himmelstein and Woolhandler), we get 31% admin overhead for the U.S. and 16.7% for Canada for a 14.3% savings [1].

In comparison, the average prices for a procedure at SCO is 1/3 that of competing hospitals [12]. Hospitals typically get paid 60% of a bill, but that still leaves a 50% reduction overall. But what is more important is the affects of free market pricing continually hold prices down, and in the case of certain technology-heavy services, will reduce prices over time. With admin cost reductions, this will always be based on a percentage of an ever increasing price structure.

Pro's second contention is that productivity will go up with the assumption that UHC will ensure that workers comp cases will be reduced. I find this to be a giant leap of faith and most likely a total fallacy. One need only look at long wait times for health care in Canada. (low on space, will cover more later)

Pro's third contention, sub-point A deals with the uninsured. I find it perplexing that Pro has an issue with paying for the healthcare of the uninsured through taxes and then wants a system whereby all insurance is paid for via taxes. The cost-shifting is irrelevant since Pro desires to shift all costs to taxation. Pro's main point here is the increase in cost due to services being more "drastic and risky". But how was this measured? Do hospitals make a judgement call for every non-insured emergency room patient like "It appears you delayed seeking medical treatment such that costs are now 30% more"? This is more than a bit hard to accept.

Pro's third contention, sub-point B brings up the World Health Organization (WHO) and it's reports of the poor health care we receive in the U.S. It's fascinating that the WHO studies are still being referenced in these debates as there is abundant information pointing out it's flaws [13]. The 2000 WHO report was more about pushing it's political agenda then reporting facts. Just a few words from the above source:

Flaws..have been repeatedly exposed in peer-reviewed literature by academic experts who have examined the study in detail

and from WHO authors:

respecting the ethical principle that it may be necessary and efficient to ration services.

The WHO report is based purely on a socialist agenda (our of space, more later)

[1] http://www.nejm.org...
[2] http://pnhp.org...
[3] http://healthblog.ncpa.org...
[4] http://en.wikipedia.org...
[5] http://mises.org...
[6] http://wiki.mises.org...
[7] http://www.drkelley.info...
[8] http://www.surgerycenterok.com...
[9] http://reason.com...
[10] http://en.wikipedia.org...
[11] http://www.freemarketcure.com...
[12] http://www.theihcc.com...
[13] http://www.commentarymagazine.com...
Debate Round No. 1
Zanoty

Pro

Zanoty forfeited this round.
ax123man

Con

Arguments carried forward
Debate Round No. 2
Zanoty

Pro

Zanoty forfeited this round.
ax123man

Con

sugar nuts
Debate Round No. 3
No comments have been posted on this debate.
5 votes have been placed for this debate. Showing 1 through 5 records.
Vote Placed by Canadian-In-Florida 4 years ago
Canadian-In-Florida
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Vote Placed by 1Devilsadvocate 4 years ago
1Devilsadvocate
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Vote Placed by DoctorDeku 4 years ago
DoctorDeku
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Vote Placed by lannan13 4 years ago
lannan13
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Vote Placed by Ron-Paul 4 years ago
Ron-Paul
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Reasons for voting decision: FF.