Debate Rounds (3)
universal healthcare would save American lives where as insurance companies threaten to kill friends and loved ones. some peoples pets even receive better healthcare that 46 million Americans do. there is something wrong with that picture and because of this, America is 37th in healthcare for its citizens.
we need to understand that healthcare is a moral issue, not just economic and it should be a human right. universal healthcare is just the decent thing to do and it would be a victory for the sanctity of life. so it baffles my mind that some people who oppose universal healthcare call themselves pro life Christians. pro life = universal health care because the right to life doesn't just end after you're out of the womb. who would Jesus want us to deny health coverage to? wouldn't he want us all to be equally covered or would he want some to be more covered than others?
what many opponents of universal healthcare don't understand is that it would actually benefit them, as well as the rest of us. just think, no more being tied to a dead end job for the benefits, no more discrimination against people including children with pre-existing conditions, no more dropped coverage on patients in the middle of their treatments and no more discrimination based on salary.
it would help improve our economy because more people would receive preventative care. this would help detect illness before its too late and in turn, it would save lives and tax dollars as opposed to the system we have now where we let things go until the last moment when the illness worsens and tax dollars are used to pay for even more expensive treatments.
people complain that universal healthcare would actually cost more money in taxes but people already give a huge chunk of their paycheck away for insurance and many of their plans don't even meet their needs.
the truth is that the U.S. actually spends more tax dollars on healthcare per person than any other country, yet has a lower life expectancy than most industrialized nations. in fact we are the only industrialized country without universal health care, even though we are the richest country in the world and should be more able to afford it than other countries who actually do have it.
universal healthcare is also good for small business because it makes it easier to compete with larger companies who can more easily afford to insure employees.
it also helps U.S. companies compete with foreign companies that do not offer their employees liveable wages or health benefits.
although opponents of universal healthcare may think that govt run healthcare seems scarey, many of these people will eventually be recipients of medicare, which is govt run healthcare that actually has higher approval ratings than insurance companies have.
a CBS news poll reported that 50% of republicans, 87% of democrats and 72% of independents would favor a govt administered health insurance plan like medicare for all Americans. overall 65% of respondents favored it, while only 26% opposed it and 9% had no opinion. also, a New England journal of medicine poll reported that 63% of U.S. doctors supported a public option similar to medicare while only 27% opposed it.
another example of government run healthcare is the military healthcare system and if govt administered health care is good enough for our soldiers then its good enough for the rest of Americans.
members of congress who oppose universal healthcare also receive govt administered healthcare, so i think that we should get the same coverage that our congressmen have.
opponents claim that countries with universal healthcare like Canada have low quality care but the fact is that Canada voted Tommy Douglas as the greatest Canadian ever because of his implementation of a national health system.
more proof that universal healthcare works really well is the fact that Germany has been implementing it since the late 18th century. so although there will always be complaints no matter what system is in place, people love universal healthcare because it makes things better for them by eliminating greed out of the equation.
a system that rewards you for denying life saving operations is broken and health insurance companies are not capable of putting people before profits because the less they cover, the more they make. so it is insane to put medical decisions in the hands of those whose job it is to fatten their own profits because denying healthcare is profitable.
So my opponent appears to be broadly arguing the moral and economic advantages to universal care, and so I'll group accordingly.
Here, my opponent makes a few arguments: 'you shouldn't have to go broke to pay for your healthcare and no one should ever die just because they cant afford it' being fairly representative.
My opponent doesn't place a line on death--i.e., we all eventually die, so the more accurate concern is extended/ameliorated life against cost. Or, Quality Adjusted Life Year (QALY). Implicit to my opponent's attitude here is that death is absolute and so we have an infinite justification to avoiding it. In other words, that we should spend without limit to achieve improvements to the QALY. But there isn't a system in the world that doesn't place limits on the care that can be received. And of course, there's no reason to think the US can do otherwise, even ignoring the obvious crowding out of other investment. Therefore, my opponent cannot argue against the concept of rationing care, but rather must argue for a specifically different ration. It will be difficult for him to resolve the tension between the inevitable rationer of care and his seeming intolerance for that outcome.
Here my opponent argues various shades of 'other countries do it better'. Of course, this is completely insufficient, as it ignores environmental and population differences. For example, the US is among the most obese countries [1,2] (child 2nd, adult 4th: Nauru, Lebanon, Saudi Arabian in 1, 2, 3). Obesity already accounts for 21% of US healthcare spending . And through 2020, we currently expect 31% of the growth in health costs to be directly attributable to obesity .
So, we should also look at these other healthcare systems. It's frequently reported the US spends the most per capita. This is true. Also true is that from 1990-2008, the US healthcare system experienced a slower rate of cost growth than Australia, Belgium, Netherlands, Spain, and the UK . From 2000-2008, the US had the same cost growth as did Canada . That's curious. The rate of growth in US spending (pre PPACA) has been trending down. If this is maintained, we'd actually be better situated than these peer countries.
Perhaps my opponent would like to argue the distribution of care--regardless of the rate of growth in costs, other systems spend more money from the government, and so their health resources have a better distribution. Good narrative, conforms to biases: completely untrue. In 2008, the US spent more public money (as a share of GDP) than did Australia, Switzerland, Spain, Japan, Italy, Norway, UK, and Canada (we spent the same as Belgium and Netherlands) . Further, the US underestimates the amount of money it spends from public programs. Public programs ritualistically underpay for services, leading to significant cost shifting to private payers. Medicare pays roughly 91% of medical costs (that's before profit), Medicaid pays 88%, and so private payers cross subsidize to the tune of 115%+ [6,7,8] And in fact, US hospitals lost money on Medicare patients overall in 2011 .
Clearly the single-payer is a nice buzzword for people who thinks there's an easy solution to the distribution of health resources, but it isn't so. Systems around the globe are hastening to control the growth of costs, which threaten to crowd out other useful investment.
So why do we spend so much on health services? A combination of factors, highlighted by the proportion of care deemed ineffective or redundant, >30% . A number of factors here as well: EMRs have driven consumption of redundant tests, etc. ; defensive medicine, fearful of litigation ; fee for service ; and most importantly, moral hazard incentives at the point of care (even Canada has higher out of pocket expenses than does the US, lower percentage of nearly all other developed countries ) .
We can explore better solutions later.
you claim that obesity is the reason that the U.S. spends more on healthcare. one of the reasons that other countries like Canada have lower obesity rates is because they have universal healthcare. their greater emphasis on health for their citizens and preventative care contributes to a healthier lifestyle. we also have a higher infant mortality rate than many other countries, even though we spend the most on healthcare. im not saying that we should have the highest life expectancy and lowest infant mortality rate just because we spend a massive amount more on healthcare than other countries, there are always other factors involved but its not right that we are so far behind. you would think that if we are spending 90% more on healthcare than many industrialized nations, that we wouldn't be ranked 37th in the world on healthcare for our citizens. i don't think you can completely rule out the fact that a lot of it is the result of everyone having quality coverage in countries with universal healthcare, while many Americans don't.
you bring up the cost growth rate in countries with universal healthcare. Americas slowed cost growth rate isn't surprising because we are in a recession and people have less money to spend on their health but you must remember that an increasing healthcare expenditure is normal and if the cost growth slows, that is a bad sign that people are becoming less able to afford care they need in America. increased healthcare spending in countries with universal healthcare isn't always an entirely bad thing because that means people are receiving care they need. no system is perfect, and there will always be complaints but if canadas health system is ranked higher than ours, then that goes to show how much better our system could be with universal healthcare because we have way more money than Canada.
you claim that hospitals lose money on medicare. the cost of health services and drugs in America is higher than it is in countries that have universal healthcare, this is the other problem with non govt run healthcare. hospitals charge much more for services in America than in other countries, because universal healthcare drives down the cost of services and goods. this is an example of how universal healthcare helps eliminate greed out of the equation, not only for coverage, but also for care providers. i think we've all heard the stories of hospitals charging $100 for a rag that was used, there is a Washington post article that goes into this subject, titled "Why an MRI costs $1,080 in America and $280 in France".
i have responded to your claims, now please address the rest of my points that i made in round one.
Unresponsive. There isn't a system in the world that doesn't ration, and there isn't a system in the world that doesn't ration based on 'how much money you make'. Extend my argument through. My opponent fails his own 'morals' burden where "no one should ever die just because they cant afford it."--this outcome is unavoidable.
You mistreat basically my entire argument. I don't claim obesity is the reason the US spends more on healthcare, I provide evidence that it is a unique reason we spend more on healthcare. In other words, that the US can't be well-compared to foreign countries.
You make a claim about universal care leading to lower obesity rates. Considering the drivers of obesity--sedentary lifestyles, suburbia, fast food, etc.--this claim seems ridiculous on its face. Moreover, you provide no evidence to support your claim. You then bring up the perennial 'preventive care' fallacy. Most prevention is individual behavior: eat healthy, exercise. Or, CMS regularly funds efforts to increase chronic care patients' compliance with drug, etc., regimens. They haven't yet found a method that can give consistent success . I.e. CMS literally paid a company to call chronic care patients daily to remind them to take medications, measure weight, etc. If the patients had complied, CMS would have seen $millions$ in savings. Instead, it lost million$ [2,3].
You then go on to suggest the US healthcare system, (presumably pre-PPACA) is not 'good'. I agree. I don't have to defend the status quo. What I'm arguing is that single-payer can only exacerbate our problems.
On the growth in costs, your argument first, has no evidence, and second argues it can be entirely explained by recession. This is a fallacy for two reasons: 1. Europe and the US went through the recession; 2. the trend encompasses decades of cost growth. Please don't strawman, it's rude. Impact: single-payers have seen costs increase more quickly than has the US.
Let's see. Now you go on to ignore one of the most important arguments. If a government spending on healthcare can be expected to deliver huge gains independent of external considerations, it would have already done so for the US.
*WE SPEND MORE PUBLIC MONEY ON HEALTHCARE THAN THE COUNTRIES YOU'RE SUGGESTING WE EMULATE*.
It was important to stress this point. Given this, we have no rationale for single payer.
You ask me to respond to your 'points'. I've done so in aggregate--most have no impact--, but I guess I can go line by line.
Pro-life Christians: Irrelevant
'It would actually benefit them': Cross apply--single payers are seeing more cost growth, cost rations, ergo TURN, it actually harms.
Employer/Employment harms: Non-unique. We could eliminate these harms without adopting single-payer.
Pre-existing conditions: Non-unique, we could reinsure insurers. This essentially eliminates insurer incentive to cherry-pick.
Prevention saves money: Frequent claim, completely untrue. In aggregate, healthcare preventive services will cost more money than they save [4,5,6]
Small businesses: non unique
Foreign companies: non unique
CBS poll: And a third of Americans think aliens are visiting earth. Who cares? People are wrong. Appeal to the masses = fallacy.
Military health system: subsidized, homogeneous population.
Congressional health insurance: Expensive. We have to ration somewhere, there is no panacea.
Better solutions: transparent pricing information, less subsidy and more direct payment--i.e. people should directly pay for the care they receive and not use insurance, especially for routine care.
sure you can compare aspects of other countries, that's what you did when you compared our cost growth rate with Canada. yes, there are other variables to consider, but it is hypocritical to tell me that i can't do it when you did it yourself.
i know you aren't a believer in preventative care but doctors will tell you that it can help prevent illness and catch it early on. if people could see a doctor more often, it would at least help with their obesity problems in most cases. im not saying that this is the only factor in other countries lower obesity rates but it does contribute. but even if 2 countries obesity rates were close, life expectancy would still be longer in a country with universal healthcare. lets look at the UK for example. they have a close obesity rate to the U.S. except they spend less than half of what we do per person on healthcare and they are ranked 13th in life expectancy while we are ranked 38th. this is because, even illness in obese people can be prevented with the right care, believe it or not.
i don't think the US health system is as bad as you do. i just think its not very accessible to everyone and as a result, we have exacerbated health problems in the U.S. everyone being covered would help fix these problems.
what you are basically saying is that you need evidence that people spend less when they have less money to spend... healthcare is becoming less affordable so people are having less and less access to it. our economy is also in bad shape which hurts the situation even more. in countries where there is universal healthcare, people still receive the care they need regardless of the situation, so their cost growth continues while ours slows. our costs are still more than any other countries even though their populations are more fully covered.
you restate my point that we spend more on public healthcare than countries with universal healthcare. this point hurts your argument instead of helping it. it shows that money goes a lot further under universal healthcare for many reasons, including the fact that health services are cheaper under universal healthcare.
you claim single payers see more cost rations. when i made the argument that our health system rations care based on salary, you acted like that was irrelevant because all systems ration. now you are being a hypocrite by claiming that universal healthcare harms because you believe that single payers see cost rations.
you claim that people are wrong on medicare by comparing a poll on peoples satisfaction rates with a service to a poll on peoples opinion of aliens. in other words you are saying that you know what people want better than what they do. this is like going to a restaurant that serves food that nobody likes, yet the chef keeps serving the same crap because he thinks he knows better than his customers. first of all this is a poor argument in the technical sense because its like comparing apples to oranges, but it also expresses your opinion of people. it shows that you are not the person that people should listen to about issues that have such a big impact on them because their satisfaction is not a priority of yours. you also just bad mouthed democracy. i know that you don't think people can know if they're satisfied with a service but im part of the military health system and although you would probably disagree with me, i know that i am satisfied and i would like to see the same services provided to the rest of Americans.
in conclusion, i thank people for reading and my opposition for the debate, but i don't think that i should have had to exhaust these points as much as my opponent made me. my argument was very simple and very clear, while his is a vague attempt at stonewalling the debate. not only have i shown the weakness in his arguments but i think that i have done a better job than him at expressing my logic so i hope that people can see that, regardless of their stance on the subject.
please help me out by voting for pro.
First Voter: My opponent fails his own burden. I've stressed this burden repeatedly and he's failed to address. This is the judge's easiest decision as my opponent has valiantly muddles other arguments. Essentially, my opponent states that the harm of our status quo system is that "no one should ever die just because they cant afford it", that this happens in our status quo system, and so we should reject it. I challenged him in R1 and R2 to stipulate an acceptable rationer of healthcare that avoided the harms of the status quo. He's failed to do so. Hence, the harm he specifies in the status quo is non-unique and he fails his burden of proof to provide a unique advantage to universal care. Reference #5
Second Voter: This is an extension of the burden. Essentially, since we prefer the system that rations least, and since the cost of care is the ultimate rationer, then we look to the rate of medical inflation as a litmus. The US has seen less medical inflation than the OECD average over the previous two decades, hence we prefer maintaining the status quo. Related, we already have sufficient 'prevention'. Reference, #'s 2, 3 , 4..
Voter Three: Basically a question of what is driving the perverse health outcomes. I've argued (without response) it's the over utilization of care. That 30% of care is redundant. This is exacerbated by single-payer, which has a significant moral hazard distortion. The average percent of care financed by copay or coinsurance in the OECD is 20%. In the US, it's 11.8%. This discrepancy helps explain why Americans consume care so frivolously. My opponent hasn't explained how single-payer solves for the unique drivers of cost in the US while I've explained how it actually exacerbates them.
1. On the comparison of countries, i.e. R3 1st paragraph, my opponent misunderstands the statistics and the legitimacy of comparison. It's because unique morbidities in the US run contrary to the US having held down the rate of medical inflation better than the OECD average for the last decade that this comparison is relevant where others aren't. It's because unique morbidities explain the degree and not the rate of change.
2. On the question of prevention, the judge should feel free to disregard my opponent's entire argument. I've cited peer reviewed literature questioning the cost effectiveness of preventive care. Note: this is not the same as saying preventive care can't be effective, but rather that its effectiveness is often completely insufficient to justify its cost in aggregate. I.e., in hypothetical, it would be difficult to justify screening 1 million people at a cost of $100 each to find cancer in a single person. Yes, it's hyperbole, but it illustrates the point: systems don't spend $100 million to save a single life.
3. My opponent is incorrect about the rationale for the US having held down medical inflation, but then, his claim is without warrant, so we can disregard. (I.e. the US economy has outperformed Euro average, hence res ipsa loquitur, it's false on face)
4. On the question of public spending, I have to say this is very frustrating. My opponent is claiming that the US could get better healthcare if it spent less money privately and more money publicly. He's claiming that we could get the same cost/benefit as a system like the UK if only we spent as much public money as they do. BUT WE ALREADY SPEND MORE PUBLIC MONEY THAN THE UK DOES!!!!!!!!!!!!!!!!!! I.e. in order for my opponent's argument to be tenable, the judge would have to accept that private spending on healthcare creates negative health outcomes so as to negate the positive from public financing he assumes. Or, it would have to be the case that while the US gets poor marginal value per dollar spent, it still has aggregate better outcome. But this isn't the case either. If public health financing were a panacea, we'd see its benefit in the US because we spend more public money than the systems my opponent touts.
5. On the subject of "cost rations" it's not clear to me what my opponent is responding to. Truly, it's difficult to follow his organization, but I think what he's doing is admitting that rationing is a part of every health system. Or in other words, admitting he fails his own burden.
6. On the poll, this really doesn't matter. Medicare is popular because it feels freer to people since it's costs have been hidden for so long. Or because the average Medicare recipient is receiving $140,000 in benefits not paid for. Not that my opponent has responded to any of the unique harms in Medicare I've stressed throughout the debate. (i.e. hidden costs, payments below cost, lost money overall, etc.)
As in life, vote con, and thank you for your attention.
1 votes has been placed for this debate.
Vote Placed by Contra 4 years ago
|Agreed with before the debate:||-||-||0 points|
|Agreed with after the debate:||-||-||0 points|
|Who had better conduct:||-||-||1 point|
|Had better spelling and grammar:||-||-||1 point|
|Made more convincing arguments:||-||-||3 points|
|Used the most reliable sources:||-||-||2 points|
|Total points awarded:||1||4|
Reasons for voting decision: Con generally had better arguments, Pro had arguments that lacked capitalization. I really liked Pro's moral argument (I'll probably use it more often), and he did very well based on his experience. Also, some of Con's arguments were technically incorrect. For example, the reason HC costs are lower is because we aren't investing in IC technology. I re-read the arguments, Con introduced some incorrect arguments, but they were left unrefuted by Pro (such as 30 over use of care).
You are not eligible to vote on this debate
This debate has been configured to only allow voters who meet the requirements set by the debaters. This debate either has an Elo score requirement or is to be voted on by a select panel of judges.