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Debate: Single-payer universal health care

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 +<seo title="Debate on Universal Health Care" metak="universal health care, universal health care debate, UHC, single payer, insurance, medicine" metad="By definition Universal Health Care is the idea that health care coverage ought to be extended to all citizens and sometimes to permanent residents of a certain geographic area. The idea was first unofficially implemented in Germany by Otto von Bismarck in the 1880s.
 +
 +The system was first officially used in the United Kingdom in 1948. According to the Institute of Medicine and the National Academy of Sciences, the United States is the only wealthy, developed nation without a system of Universal Health Care. Almost every nation in Europe has established a system of Universal Health Care. Some states and regions can decide on their own accord whether or not they will establish some form of Universal Health Care for their citizens.
 +
 +The problem essentially stems from the question of whether or not the government should be hands-off in its legislation and regulation as the establishment of this system would require much of both. Proponents of a more hands-off government do not believe in Universal Health Care because they think the government should allow people to deal with Health Care as they see fit. Those who encourage at least a form of Universal Health Care are those who believe in a government's strong obligation to its people directly through its legislations. However, while such a system has the ability to create more justice amongst social classes, it also has the ability to significantly raise taxes." />
 +
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-===Write debate main question here...===+===Is single-payer health care a good idea?===
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 +===Background and context ===
 +
 +By definition Universal Health Care is the idea that health care coverage ought to be extended to all citizens and sometimes to permanent residents of a certain geographic area. The idea was first unofficially implemented in Germany by Otto von Bismarck in the 1880s.
 +[[Image:Hospital.jpg|right|200px]][[Image:Person in hospital bed.jpg|left|160px]]
 +The system was first officially used in the United Kingdom in 1948. According to the Institute of Medicine and the National Academy of Sciences, the United States is the only wealthy, developed nation without a system of Universal Health Care. Almost every nation in Europe has established a system of Universal Health Care. Some states and regions can decide on their own accord whether or not they will establish some form of Universal Health Care for their citizens.
 +
 +The problem essentially stems from the question of whether or not the government should be hands-off in its legislation and regulation as the establishment of this system would require much of both. Proponents of a more hands-off government do not believe in Universal Health Care because they think the government should allow people to deal with Health Care as they see fit. Those who encourage at least a form of Universal Health Care are those who believe in a government's strong obligation to its people directly through its legislations. However, while such a system has the ability to create more justice amongst social classes, it also has the ability to significantly raise taxes.
-===Background and Context of Debate:===+'''Other background resources:''' [http://en.wikipedia.org/wiki/Universal_health_care See Wikipedia:Universal health care], [http://en.wikipedia.org/wiki/Publicly-funded_health_care See Wikipedia: Publicly-funded healthcare], [http://en.wikipedia.org/wiki/Single-payer_health_care Wikipedia: Single-payer health care], [http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared Canadian and American health care systems compared]
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 +|}
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-===Write Subquestion here...===+===Analogous services: Is universal health care analogous to other government services?===
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====Yes==== ====Yes====
-*[[Argument:Health care is a basic human right or entitlement| Health care is a basic human right or entitlement]] 
-*Coverage should be provided to all citizens regardless of ability to pay.+*'''[[Argument: The government funds fire-stations, why not universal health care?| The government funds fire-stations, why not universal health care?]]''' The government taxes citizens to fund and provide numerous services universally, including policemen and firemen. These services are comparable to physician services in many ways, particularly in the sense that they help protect the life, safety, or health of citizens. Why shouldn't health care also be provided universally through the same means - taxes?
-*The current US system is already funded 64% by tax money with the remaining 36% split between private and employer spending. A universal healthcare system would merely replace private/employer spending with tax revenues. Total spending would go down for individuals and employers.+ 
 +*'''Health is often out of an individual's control; like fires.''' You will see that the other side of this argument makes a distinction between things that an individual can control and those he/she cannot. The argument is that fire and police protection are things beyond the control of individuals, but that healthcare is not. This argument is seriously flawed. Many healthcare issues are very much out of the control of individuals. Consider a bus accident. Many accidents are out of the control of individuals. While many accidents are a result of an individual being stupid or not being careful, so are many fires. There is no real distinction here. Either you should be opposed to fire/police protection and universal healthcare, or should support both. Picking one is a logical inconsistency.
-*Several studies have shown a majority of taxpayers and citizens across the political divide prefer a universal healthcare system over our current system[50][51][52] 
-*Health care is increasingly unaffordable for businesses and individuals.[53] 
-*Universal health care would provide for uninsured adults who may forgo treatment needed for chronic health conditions.[54] 
-*Providing access to medical treatment to those who cannot afford it reduces the severity of epidemics by reducing the number of disease carriers. 
-*Wastefulness and inefficiency in the delivery of health care would be reduced.[citation needed] 
-*America spends a far higher percentage of GDP on health care than any other country, and has worse ratings on a variety of subjects such as quality of care, efficiency of care, access to care, safe care, equity, right care and wait times according to the commonwealth fund. New Zealand, which spends one third per capita what the US spends on health care beats the US on every marker of efficiency and care. Although not definitive, this does lend credence to the idea that universal health care is more efficient than our for profit health care system as the US was inferior to Germany, the UK, Australia, New Zealand and to a lesser degree Canada in nearly all health care quality issues. This despite the fact that the US system costs 2-3x more per capita than the systems in these other countries.[55] 
-*A universal system would align incentives for investment in long term health-care productivity, preventive care, and better management of chronic conditions.[56] 
-*By reducing paperwork a universal system would allow doctors to spend more time with patients, thereby increasing physician productivity.[57] 
-*Patients would be encouraged to seek preventive care enabling problems to be detected and treated earlier.[53] 
-*A centralized national database would make diagnosis and treatment easier for doctors.[53] 
-*Universal health care could act as a subsidy to business, at no cost thereto. (Indeed, the Big Three of U.S. car manufacturers cite health-care provision as a reason for their ongoing financial travails. The cost of health insurance to U.S. car manufacturers adds between USD 900 and USD 1,400 to each car made in the U.S.A.)[58] 
-*Managed care networks, with their extensive provisions and guidelines, reduce doctor flexibility and limit patient choice. 
-*The profit motive adversely affects the cost and quality of health care. If managed care programs and their concomitant provider networks are abolished, then doctors would no longer guaranteed patients solely on the basis of their membership in a provider group and regardless of the quality of care they provide. Theoretically, quality of care would increase as true competition for patients is restored. 
-*The profit motive adversely affects the motives of healthcare. Because an applicant with a pre-existing condition (possibly from birth) would require more care, they are often blackballed from being able to obtain health insurance at a reasonable cost. Health insurance companies have greater profits if fewer medical procedures are actually performed, so agents are pressured to deny necessary and sometimes life-saving procedures to help the bottom line. 
-*According to an estimate by Dr. Marcia Angell roughly 50% of healthcare dollars are spent on healthcare, the rest go to various middlemen and intermediates to providing healthcare. A streamlined, non-profit, universal system would increase the efficiency with which money spent on healthcare goes to healthcare. 
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====No==== ====No====
-*Health care is not a right.[61][62][63]+ 
-*Providing health care is not the responsibility of government.[64]+*'''Health problems are more about individual choices than fires and crime.''' While many people compare health care to police stations and fire stations, they are not the same services. Health care is largely about providing a service to the individual that compensates, often, for poor individual choices. Fire stations and police departments, on the other hand, provide services to a community and focus on protecting individuals against things they have no control over (crime and fires). The differences are very significant in regard to what the state is obligated to provide. The state is obligated to protect citizens from one-another. But, the state is not obligated to protect citizens from themselves. Universal health care is wrongheaded to the extent that it involves protecting individuals from themselves.
-*Universal heath care would result in increased wait times, which could result in unnecessary deaths.[61][65]+ 
-*Poorer quality of care.[61][53]+*'''Whether universal health care is analogous to other services is inconsequential.''' Whether universal health care is analogous or a legitimate burden on tax payers does not answer whether a universal system provides the results proponents argue.
-*Unequal access and health disparities still exist in universal health care systems.[61]+ 
-*Universal health care plans will reduce efficiency because of more bureaucratic oversight and more paperwork, which could lead to fewer doctor-patient visits.[66] Advocates of this argument claim that the performance of administrative duties by doctors results from medical centralization and over-regulation, and may reduce charitable provision of medical services by doctors.[67]+
-*Profit motives, competition, and individual ingenuity lead to greater cost control and effectiveness.[53]+
-*Uninsured citizens can sometimes still receive emergency care from alternative sources such as nonprofits and government-run hospitals.[53]+
-*Government-mandated procedures would reduce doctor flexibility.[53]+
-*Healthy people who take care of themselves should not have to pay for the burden of those who smoke, are obese, etc. [53]+
-*Loss of private practice options and possible reduced pay would dissuade many would-be doctors from pursuing the profession.[53]+
-*Likely loss of insurance industry jobs and business closure in the private sector.[53]+
-*Universal health care would eliminate the right to privacy between doctors and patients.[68]+
-*Empirical evidence on single payer-insurance programs demonstrates that the cost exceeds the expectations of advocates.[69]+
-*Universal health care systems, in an effort to control costs by gaining or enforcing monopsony power, sometimes outlaw medical care paid for by private, individual funds.+
|- |-
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-===Economics: Is health care beneficial to an economy?===+===Choice: Does universal health care deprive some choice? Is this OK?===
|- |-
-|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"| +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +*'''[[Argument: When the wealthy must use public health care, the system improves| When the wealthy must use public health care, the system improves]]''' If the wealthy are not allowed to buy better health insurance, and are forced to use public single-payer health care, they come to realize that the only way to ensure good care is to pressure for good universal health care. As a result of the wealthy pressuring for improvements, all individuals of all classes will enjoy better health care.
 +
 +*'''Many single-payer systems give patients free choice of practitioners.''' In some countries with socialized medicine, such as the UK, patients are offered a choice of general practitioner, all of whom are self-employed or work in private partnerships employing all practice nurses, doctors and clerical staff. In addition, some hospital services are sub-contracted to the private sector, so that patients can choose from a range of providers International comparisons of quality of care and health outcomes generally rank the UK above the U.S.
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Argument: People have a right to pay more for better health care| People have a right to pay more for better health care]]''' [http://seattletimes.nwsource.com/html/opinion/2003592432_harrop28.html Froma Harrop. "Canada's the wrong model for universal health care". Seattle Times. February 28th, 2007] - "There's also the freedom argument. People don't want to be told that they can't spend their own money on goods that would benefit them — and who can blame them?"
 +
 +*'''[[Argument: Universal health care will have rules that decrease patient flexibility| Universal health care will have rules that decrease patient flexibility]]''' [http://www.balancedpolitics.org/universal_health_care.htm "Should the Government Provide Free Universal Health Care for All Americans?" Balanced Politics.org] - "Government-controlled health care would lead to a decrease in patient flexibility. At first glance, it would appear universal health care would increase flexibility. After all, if government paid for everything under one plan, you could in theory go to any doctor. However, some controls are going to have to be put in to keep costs from exploding. For example, would "elective" surgeries such as breast implants, wart removal, hair restoration, and lasik eye surgery be covered? [...] The compromises that result will put in controls that limit patient options. The universal system in Canada forces patients to wait over 6 months for a routine pap smear. Canada residents will often go to the U.S. or offer additional money to get their health care needs taken care of."
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Needy: Is free health care important for those in dire need?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
====Yes==== ====Yes====
-[[Argument:Ensuring the health of all citizens benefits a nation economically| Ensuring the health of all citizens benefits a nation economically]] 
-*A single payer system could save $286 billion a year in overhead and paperwork. Administrative costs in the US health care system are estimated to be substantially higher than in other countries and than in the public sector in the US: one estimate put the total administrative costs at 24 percent of US health care spending.+*'''Free, universal health care helps the unhealthy in times of need.''' When an individual is sick, they shouldn't have to think about how to pay for their treatment. In free, universal health care systems, when one is sick, they are simply told to rest and get better. This is essential for proper healing. Conversely, in a non-free-universal-health-care system, a sick person is required to figure out how to pay for their health care, rather than simply focusing on getting better. The stresses this causes hampers healing.
 + 
 +*'''[[Argument: It is wrong to make more vulnerable people pay more for insurance| It is wrong to make more vulnerable people pay more for insurance]]''' The modus operandi of the insurance industry is that the vulnerable (people of higher risk of becoming ill) pay more for health insurance. But, this is unfair and contrary to the higher moral principles upon which societies should be founded. Society should strive to defend and care for the needy and vulnerable, instead of subjecting them to a system that punishes them for their disadvantages.
 + 
 +*'''Unacceptable to leave health care of millions to rare charity orgs/docs.''' It is morally unacceptable to leave the health care of millions of American who cannot afford to pay insurance to the hands of the few rare doctors and charity health care services. Also, charity health services would not have enough equipment and funds to treat expensive, life-threatening diseases like cancers.
-*For profit healthcare has been shown to have higher expenses and worse results. 
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-====No==== +====No====
-''Click on the pencil icon and research and write arguments here''+ 
 +*'''[[Argument: Single-payer systems make it harder to get care when it's most needed| Single-payer systems make it harder to get care when it's most needed]]''' Delays are a common feature of single-payer systems. This means that, when a person is sick and most needs an appointment, they may be unable to get one.
 + 
 +*'''A right to health care is not necessary in taking care of sick patients.''' Indigent patients have been taken care of by physicians with dignity and compassion in the name of genuine charity, pro bono. This model can provide adequate care to the needy. And, of course, this model can be expanded out further, if need be, to aid the needy.
 + 
 + 
|- |-
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-===Write Subquestion here...===+===Human rights: Is health care a human right?===
|- |-
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 +====Yes====
 +*'''[[Argument:Health care is a basic human right or entitlement| Health care is a basic human right or entitlement]]''' Health is fundamental to the preservation of all other individual rights. If one is sick in a hospital bed, they cannot be said to have equal opportunity or the ability to exercise free speech and religion. And, of course, one cannot pursue happiness if they are in a hospital bed. This is why health must be considered a basic human right.
 +
 +*'''Universal health care protects healthy citizens from many health risks'''. If citizens have a right to be healthy, they are due some protections from the sickly. By providing for the sickly, government is helping protect the rights of the healthy.
 +
 +*'''Health care is considered a right in international law.''' [http://www.un.org/en/documents/udhr/index.shtml#a25 Article 25] of The UN Universal Declaration of Human Rights enumerates medical care as a universal right.
 +
 +*'''[[Argument: Universal health care is a social good, not merely an economic good| Universal health care is a social good, not merely an economic good]]''' Universal health care generally decreases human misery and increases human welfare. It is, therefore, a social good, not merely an economic good. In general, the ability to afford something does not play a role in whether it is just or not. If there is a conflict between life and money life should prevail because it is a right while money is a want not a need.
 +
 +*'''Universal health care is a legitimate "burden" on the tax payer.''' People pay for public utilities such as road and people pay for education as well. But do people who don't drive recklessly ask for money back when roads are damaged? Do people who send their children to private school ask for all their money back? We place this burden on the state because of equality of opportunity. No man should be denied the right to live his life.
 +
 +*'''Universal healthcare helps foster greater equality across classes.''' In the United States, the poor commonly cannot afford health care. Universal health care helps them get the care that they need. Without health care, the poor are more vulnerable and have a harder time achieving their goals. This violates their right to equal opportunity.
 +
 +
 +|WRITE ABOVE THIS TABLE CODE width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Argument: Universal health care violates individual freedom and responsibility| Universal health care violates individual freedom and responsibility]]''' It is important that individuals be treated as free moral agents, accountable to their own actions, and not held accountable to the actions of others. Universal health care holds some individuals accountable for the actions of others.
 +
 +*'''[[Argument: Free, universal health care is an illegitimate "positive" right| Free, universal health care is an illegitimate "positive" right]]'''. The main premises here is that "rights" should only protect individuals from harm from others and allow them certain freedoms, but a right to universal health care entails individuals burdening other members of society (possibly violating the liberties of innocents) for things that are perceived as needed or desirable. The extreme of this argument is the circumstance in which a careless smoker is given the "right" to burden others for their expensive health care costs.
 +
 +*'''The necessity of medical care does not make it a right.''' Food, for example, is not considered a right, and companies are allowed to sell it, as well as to withhold it from those that need it but can't afford it. This is the right of grocery stores to do, and receives no complaint from society in general.
 +
 +*'''[[Argument: People leading healthy lives will be burdened by the unhealthy| People leading healthy lives will be burdened by the unhealthy]]''' It is not fair for those that lead healthy lives to have to pay for those that lead unhealthy ones. Those that make decisions to smoke cigarettes and eat excessively should pay the consequences.
 +
 +*'''[[Argument: People should pay only for health services they themselves receive| People should pay only for health services they themselves receive]]''' Why should one person pay for the health services of another person? With the possible exception of life-threatening circumstances; isn't it better that individuals pay for the services they receive.
 +
 +*'''[[Argument: Securing a "right" to universal health means impeding on other rights| Securing a "right" to universal health means impeding on other rights]]''' Providing universal health care means increasing costs to certain taxpayers. This in itself impedes on certain freedoms and rights. Securing one right by impeding on other is illegitimate.
 +
 +*'''[[Argument: Universal health care systems suffer from inequality of care| Universal health care systems suffer from inequality of care]]''' Some studies have found that universal health care systems are vulnerable to socio-economic inequalities in the care provided.
 +
 +*'''[[Argument:Government-funded universal health care would violate patient privacy| Government-funded universal health care would violate patient privacy]]''' - [http://www.cato.org/pub_display.php?pub_id=3057 Sue Blevins. "Universal Health Care Won't Work -- Witness Medicare". Cato Institute. 2001.] - "Currently, many Americans choose to pay privately for health services to maintain their medical privacy. However, a single-payer health plan would eliminate that option and all citizens would be forced to give up their ability to maintain a confidential doctor-patient relationship. Just look at what has happened with Medicare.
 +
 +*'''Whether health care is a right under i-law is inconsequential.''' The mere act that a UN body on Human Rights has added that to their charter is not definitive of anything. Using it as an argument fails as it's only an appeal to authority.
 +
 +*'''Whether universal health care is a legitimate "burden" on the tax payer should be considered inconsequential.''' Since health care is currently 1/7th of the US Economy, simply asking whether the tax payer can be burdened to help provide others with health care does nothing to ask whether allowing more government control will end with the results proponents predict.
 +
 +*'''Whether universal health care is a social good is inconsequential.''' Again, this question's answer has no bearing on whether a universal system can provide the level of service proponents claim.
 +
 +*'''It is impossible to answer whether universal health care fosters greater equality.''' Since the word equality necessitates a value judgment as to what is "equal" when it comes to health care and class status, a universal definition is not possible. For instance - would it be equal if no one had access to MRI's? If only 80% of those requiring an MRI could get it - what would determine how to define those individuals "equally"?
 +
 +*'''[[Argument: Government-funded universal health care is no right| Government-funded universal health care is no right]]''' [http://reason.org/blog/show/questioning-a-the-right-to-hea Anthony Randazzo. "Questioning the "Right" to Health Care". Reason Foundation. 2009.] - "People sometimes argue in favor of a universal human right to health care by saying that health care is different from all other human goods or products. It is supposedly an important precondition of life itself. This is wrong: There are several other, much more important preconditions of human existence, such as food, shelter and clothing...."
 +
 +
 +
 +|-
 +|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Uninsured: Do large numbers of uninsured give cause to universal health care?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
====Yes==== ====Yes====
-''Click on the pencil icon and research and write arguments here''+ 
 +*'''[[Argument: Most uninsured simply can't afford it; it's not a choice| Most uninsured simply can't afford it; it's not a choice]]''' [http://www.amsa.org/uhc/uhc_counterarguments.pdf Kao-Ping Chua, "Arguments and counterarguments about universal health care". AMSA] - "It's the uninsured's fault that they're uninsured. 8 out of 10 of the uninsured work or come from working families. They play by the rules, work hard just like the rest of Americans, and yet they can't get insurance from the employer because it's not offered, or they can't afford it if it is offered. Is that their fault?"
 + 
 +*'''[[Argument: Universal care would protect doctors/hospitals from free-loaders| Universal care would protect doctors/hospitals from free-loaders]]''' Uncompensated care is a problem for hospitals and doctors. In a single-payer system, doctors would not be vulnerable to free-loading (as rare as willful free-loading is).
 + 
 +*'''[[Argument: Universal health care is not welfare; its benefits are diverse/widespread| Universal health care is not welfare; its benefits are diverse/widespread]]''' Universal health care is about cutting costs, streamlining patient care, simplifying care, and providing high quality health care to all citizens. The benefits are far to diverse to pigeon-hole universal health care as just "welfare".
 + 
 +*'''[[Argument: It is a myth that the uninsured are being provided for now| It is a myth that the uninsured are being provided for now]]''' While some argue that the uninsured being provided for currently with access to emergency rooms and social programs, it is false to claim that this is a substitute for these individuals actually having health insurance.
 + 
 +*'''[[Argument: The well insured also face risks without universal health care| The well insured also face risks without universal health care]]''' The uninsured are not the only concern when a society lacks universal health care. The insured are subject to major costs and risks, for instance when they are fired from a job and lose their employer-provide health insurance.
 + 
 + 
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 +====No====
 +
 +*'''[[Argument: If people are uninsured, that's their choice| If people are uninsured, that's their choice]]''' [http://article.nationalreview.com/?q=ZWFkZDBlNjk3YjFhMDE1MWVlODc5NGM4MmQ4MmRhMTM= "Against Universal Coverage". National Review Online. June 21, 2007] - "Some people, especially young and healthy people, may choose not to buy health insurance even when it is cheaper[...]So what should the government do about the holdouts? Leave them alone. It’s a free country."
 +
 +*'''Many uninsured are lazy free-loaders who don't deserve care''' Many uninsured are simply lazy, and believe they can get a free ride off of the system. These people do not deserve free, universal care from the system.
 +
 +*'''Universal health care would amount to welfare for the uninsured.''' The government should not create a health care system that is aimed primarily at helping the poor and uninsured. As such, it becomes merely another wealth-transfer program.
 +
 +*'''[[Argument: Many uninsured can easily afford it so should not receive sympathy| Many uninsured can easily afford it so should not receive sympathy]]''' A significant proportion of the uninsured can easily afford insurance. They choose not to get it for reasons other than their means (i.e., their laziness).
 +
 +*'''[[Argument: The uninsurance problem should be solved by less, not more government| The uninsurance problem should be solved by less, not more government]]''' [http://www.haciendapub.com/article49.html Lawrence R. Huntoon, MD, PhD. "Universal Health Coverage --- Call It Socialized Medicine". Association of American Physicians and Surgeons. 2000.] - "Collectively, the uninsured pay about $17.1 billion in extra taxes each year because they do not receive the same tax break as insured people with similar income... Where, we must ask, is the compassion for these overtaxed, hard-working people? This is clearly a government-created problem. What we don't need is more government (nationalized health care) to "fix it." What we need is to get government out of our wallets so people can have their own money needed to purchase and own their own health insurance."
 +
 +*'''Do large numbers of uninsured give cause to universal health care?''' No, as it does nothing to answer how many would be without in a hypothetical universal system. For instance, what if we knew that instead of 50 million uninsured, we would end up with 60 million uninsured due to additional inefficiencies and failure to predict actual cost?
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Socialized medicine: Is it wrong to call single-payer systems socialized medicine?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Single-payer systems involve government paying for private services| Single-payer systems involve government paying for private services]]''' Most single-payer systems in Europe, as well as ones proposed in the United States (building on Medicare), involve the government paying for the insurance of individuals. This means that individuals would still go to private hospitals and doctors. The only difference is that the government-funded insurance pays for services instead of the money coming from your own insurance company.
 +
 +*'''[[Argument: Rationing already exist in the US; universal health care won't change this| Rationing already exist in the US; universal health care won't change this]]''' [http://www.pnhp.org/facts/singlepayer_faq.php "Single Payer FAQ". Physicians for a National Health Program. Retrieved May 30th, 2008] - "The U.S. already rations care. Rationing in U.S. health care is based on income: if you can afford care, you get it; if you can’t, you don’t."
 +
 +*'''[[Argument: A single-payer system will not cause government to intrude in medical decisions| A single-payer system will not cause government to intrude in medical decisions]]''' There is nothing in universal health care that would indicate that the government would intrude on the medical decisions of citizens.
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Argument: Single-payer health care is "socialized medicine"| Single-payer health care is "socialized medicine"]]''' Lenin said, "medicine is the keystone in the arch of socialism." Government should not be in control of medicine and should generally not be in too many features of our lives. It is both inefficient and an intrusion on our fundamental rights.
 +
 +*'''Universal health care leads to rationing.''' Medical resources are rationed in socialized systems so that some people are either denied care or have to wait for it. If a person is "rationed out" of the public health care service (perhaps because the treatment is not considered effective or cost effective enough to warrant intervention) they will be able seek alternative treatment in the private sector. If they cannot afford private care, they may have to go without.
 +
 +*'''Government intrudes in medical decisions in a single-payer system.''' Government will involve itself in decisions between doctors and patients under a single-payer system.
 +
 +*'''[[Argument: Universal health care creates dependencies on government| Universal health care creates dependencies on government]]''' Whenever the government provides free services to individuals, a dependency is created. Dependency is an unhealthy mind-set, and can cause problems down the line.
 +
 +*'''"Is it wrong to call single-payer systems socialized medicine?" is another inconsequential question.''' It's answer is meaningless to which system provides the most benefits to the most people. It's a semantic argument which will hang more on specific definitions or words that anything resembling rational health care debate. Having said that - the answer is "yes". Socializing anything involves taking individual decisions and "socializing" any negative effects to the community instead of limiting it to the individual.
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Physicians: Is free, universal health care fair to physicians? ===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: The majority of doctors in the US support universal health care| The majority of doctors in the US support universal health care]]''' A 2008 survey of over 2,000 American doctors found that 59 percent support legislation to establish a national health insurance program, while 32 percent said they opposed it, researchers reported in the journal Annals of Internal Medicine[http://www.commondreams.org/archive/2008/04/01/8018/]
 +
 +*'''[[Argument: Universal health care can actually strengthen doctor pay| Universal health care can actually strengthen doctor pay]]''' If there are more insured patients within a universal health care system, more people will seek health care. As such, there will be more paying patients in a universal health care system, which will result in more income for doctors. Doctors will also spend less time on paper work, be more efficient, service more patients, and so make more money.
 +
 +*'''[[Argument: Single-payer systems insure individuals, but don't restrict doctors| Single-payer systems insure individuals, but don't restrict doctors]]''' A universal health care system does not mean that the private market should be abolished. Doctors can chooses to operate private practices in a two-tier system. This will attract consumers who require either more personal service, those who know or want a personal doctor, and those who want better quality of care than the public system provides.
 +
 +*'''Universal health care grounds doctors in professionalism, not commercialism.''' Doctors are currently businessmen that sell health services. But, realizing that this is not a good model for dealing people's lives and health, many doctors see universal health care as a way to better root their profession in professionalism instead of this commercialism.
 +
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Arguments:A right to health care violates the rights of physicians| A right to health care violates the rights of physicians]]''' One cannot have a right to other people's services. Does a physician not have the free right of association and contract with patients? Why would physicians be forced to perform free or government-set prices for their labor? Why shouldn't they be able to charge market value for their services? Did they enter into their practices with the understanding that they would not be able to charge fair market value? No. They are generally service providers like any other that expect fair, market-based compensation. Universal health care would deprive physicians of this freedom to charge market-value by imposing government pricing on their services, almost certainly at a discounted rate.
 +
 +*'''Universal health care will cut physician cash-flow and disrupt living-standards.''' It is important to recognize that many private physicians have oriented their private practices around a certain level of cash-flow. They have rented office space at a certain level, taken out mortgages at a certain level, and sent their kids to private schools all on the assumption that their existing cash-flow in their private practices would continue into the future. It is unfair to suddenly and dramatically curtail this cash-flow and force physicians to re-adjust their lives accordingly. For some, this will be impossible or unbearable.
 +
 +*'''[[Argument: Universal health care would lower pay so reduce quality of physicians| Universal health care would lower rewards so reduce quality of physicians]]''' With fewer financial incentives, fewer individuals would decide to become physicians in the first place. Talent would be lost from the industry and the quality of doctors and health care would fall.
 +
 +*'''[[Argument: Single-payer health care over-loads doctors and burns them out| Single-payer health care over-loads doctors and burns them out]]''' Because more people seek care, doctors in a universal health care environment often are over-loaded. Hoping to meet their patients needs, they work over-time. Yet, by doing this, they often burn out and leave their practice early, exacerbating the problem even further.
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Quality: Does free, universal health care provide superior care? ===
 +
 +|-
 +|WRITE SUBQUESTION ABOVE THIS CODE BETWEEN "=== ===" width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: For-profit insurance companies often put patients at risk to cut costs| For-profit insurance companies often put patients at risk to cut costs]]''' - Health insurance claims are considered a "loss" for profit insurance companies. These companies are designed to maximize profits by cutting costs. How can these companies act in the best interests of their patients if their incentive structure is designed to minimize health coverage?
 +
 +*'''[[Argument: Insurance companies screen out those that need health care the most| Insurance companies screen out those that need health care the most]]''' Insurance companies have a interest in maximizing profits that drives them to screen out individuals that are unhealthy, old, and "high-risk". These are the people that need health care the most, and the insurance industry has a direct interest in making it difficult or more expensive for them to obtain health insurance.
 +
 +*'''Universal health care systems incentivize improving patient health.''' Many free universal health care systems provide incentives to doctors to improve the health of their patients. This contrasts with for-profit health care systems that do not provide financial incentives to doctors to improve the health of their patients, largely because healthier patients would mean lower profits.
 +
 +*'''[[Argument: Universal health care will allow doctors to concentrate on patients| Universal health care will allow doctors to concentrate on patients]]''' In private and managed health care networks, doctors typically have to check with insurance companies before they perform a service. Such a system does not relate to the patients needs, but corresponds only to financial considerations.
 +
 +*'''Universal health care allows investments in longer-term patient relationships.''' This happens because there is a long term relationship with the patient and the preservation of records has long term benefits. Investment in IT is one often cited example where health care providers in socialized systems have access to electronic records of patients tests online and where computer systems can check for example incompatible drug combinations and that drugs are administered to the right patient. Some for profit systems find this investment hard to justify because the provider-patient relationship is not guaranteed to last long enough to justify the investment.
 +
 +*'''Universal health care decreases the likelihood of health related problems.''' The single most destructive issue regarding health care in America is the lack of preventative care. Patients wait until their disease progresses to a dangerous level before they seek care because otherwise they can not afford medical cost. Universal health care offers them access, thus increasing the patient's incentive to seek care when the health threat is minimal, and in the long run reducing the burden to the state.
 +
 +
 +|WRITE ABOVE THIS TABLE CODE width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''The markets are better at providing quality; same with health care.''' The markets and competition generally help produce higher quality goods for the least money (the highest value). The same applies to health care.
 +
 +*'''[[Argument: Government-mandated procedures would reduce doctor flexibility/quality| Government-mandated procedures would reduce doctor flexibility/quality]]''' [http://www.balancedpolitics.org/universal_health_care.htm "Should the Government Provide Free Universal Health Care for All Americans?" Balanced Politics.org] - "Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care. When government controls things, politics always seep into the decision-making. Steps will have to be taken to keep costs under control. Rules will be put in place as to when doctors can perform certain expensive tests or when drugs can be given. Insurance companies are already tying the hands of doctors somewhat. Government influence will only make things worse, leading to decreased doctor flexibility and poor patient care."
 +
 +*'''Quality of health care is much worse under universal health care.''' According to Reuters in London, one in 10 patients admitted to National Health Service hospitals in Britain is unintentionally harmed and almost a million safety incidents, more than 2,000 of which were fatal, were recorded last year, according to a report on July 6, 2006. Such figures were "terrifying enough", the report by parliament's public accounts committee said, but the reality may be worse because of what it called "substantial under-reporting" of serious incidents and deaths in the NHS
 +
 +*'''IT investments do not require government intervention.''' Some have argued that IT enhancements in a universal system will provide efficiency improvements. Most technological advancements which includes universal IT standards for online financial transactions, messenger protocols, FTP protocols, and many, many others have been standardized within the industries without government intervention.
 +
 +*'''Lack of preventative care does not significantly contribute to life expectancy or quality of life.''' Most of what determines length and quality of life (excluding human issues such as traffic accidents, homicides...) is genetics and life style choices (eating/exercise). Early detection will certainly weigh heavily on life expectancy for certain diseases, but no amount of "prevention" will stop cancer if you genes are highly susceptible. As most people know, most doctor's visits end with "take this and call me if it doesn't get better" which should hardly be seen as "preventative" of anything.
 +
 +|-
 +|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Prevention: Is free universal health care important to preventive care?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Free universal health care motivates people to seek preventive care| Free universal health care motivates people to seek preventive care]]''' Preventing illnesses before they arise is a very important strategy in public health. Universal health care encourages people to seek preventive treatments because it is free. This cuts health care costs substantially down the line.
 +
 +*'''[[Argument: Government has a cost incentive to invest in preventive care| Government has a cost incentive to invest in preventive care]]''' [http://www.nybooks.com/articles/18802 Paul Krugman, Robin Wells. "The Health Care Crisis and What to Do About It". New York Times Review of Books. Volume 53, Number 5 · March 23, 2006] - "The VA also invests heavily and systematically in preventive care, because unlike private health care providers it can expect to realize financial benefits from measures that keep its clients out of the hospital."
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''Better technologies and treatments in private health care aids prevention.''' Private health care societies are known for having better innovation and higher investment in equipment and high-end treatments. These treatments can be a part of prevention or early treatment, and can have better results than what exists in universal health care systems.
 +
 +*'''Higher-end treatment is important; sometimes you can't prevent illness.''' With higher-end treatments in privatized health care societies, treatment is often superior. For those that will contract illnesses or cancers regardless of any preventative measures they take, such high-end treatment is welcome.
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Innovation: Do single-payer systems support medical innovation?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Medical innovation has little to do with investment and profit| Medical innovation has little to do with investment and profit]]''' [http://tnr.com/politics/story.html?id=51faeaa7-5021-40d0-95d3-0f260b25edd4 Jonathan Cohn. "Creative Destruction. The best case against universal health care." The New Republic. November 12, 2007] - "[...]The development of DBS was one part basic knowledge--an understanding of how Parkinson's works and how the brain responds to electrical stimulation--and one part sheer luck. Profits, on the other hand, had relatively little to do with it. ."
 +
 +*'''[[Argument: Most investment in medical innovation does not come from companies| Most investment in medical innovation does not come from companies]]''' Private companies make up a smaller portion of the total investment in medical innovation. This means that a single-payer health care system would not see a major reduction in funding for medical innovation. Depending on how the system is designed, it could even see an increase in such investment.
 +
 +*'''[[Argument: Profit interests corrupt investments in medical innovation| Profit interests corrupt investments in medical innovation]]''' Drug and medical companies are driven, in large part, by the bottom-line of profits. Their investments in new drugs and medical innovations are driven by these interests. But, what is likely to make the most money is often at odds with public and patient interests.
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Argument: Single-payer health care hinders medical investment and innovation| Single-payer health care hinders medical investment and innovation]]''' The primary cause of this is a reduction in economic incentives for innovation. In general, the only way that people will take the time, energy, and risks involved with innovation is if there are substantial returns for their investment. This notion underpins the markets and capitalism generally, but is undermined by universal health care. Universal health care, therefore, could be expected to see fewer innovations and medical advancements.
 +
 +*'''Under investment in single-payer system leads to capacity shortages''' A lack of willingness to invest in expensive technology leads to shortages in areas such as MRI scanning. Some would argue that only the price mechanism in free market health care can allocate resources efficiently and that political pressure often leads to shortages in socialized systems.
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Standards: Would universal health care set a good standard of care?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Universal health care creates a universal standard of care| Universal health care creates a universal standard of care]]''' [http://www.nathannewman.org/archives/000575.shtml Nathan Newman. "Medical Malpractice and Universal Health Care". Progressive Populist. October 01, 2002] - "The other advantage of universal health care is that it creates a clear standard of care. What government pays for becomes the reasonable standard of care, a standard that can be debated democratically at appropriations time for the health care budget rather than haggled for erratically in the courts."
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +
 +====No====
 +
 +*'''[[Argument: Government will set an inferior standard of health care| Government will set an inferior standard of health care]]''' [http://seattletimes.nwsource.com/html/opinion/2003592432_harrop28.html Froma Harrop. "Canada's the wrong model for universal health care". Seattle Times. February 28th, 2007] - "Private competition also helps assure quality. Without an alternative, the monopolistic system becomes an "uncontested standard" that may be inferior."
 +
 +|-
 +|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Delays: Do universal health care systems address concerns of delays?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[It is a myth that the United States' private system has fewer delays]]''' In the United States, delays are often caused by insurance companies trying to save money.
 +
 +*'''[[Argument: Public health care is good; it just receives more scrutiny/criticism| Public health care is good; it just receives more scrutiny/criticism]]''' Public health care systems receive more scrutiny by the public because they are publicly accountable. This often gives the impression that these systems are worse. But, this impression is simply a bi-product of the higher level of scrutiny these systems receive.
 +
 +*'''[[Argument: Single-payer health care reduces complexities faced by patients| Single-payer health care reduces complexities faced by patients]]''' Insurance companies often make life as difficult as possible for patients through complicated rules and qualifications. Again, profit-interests motivate this because it makes it less likely that patients will seek a claim. This is all very stressful and time-consuming for patients. A single-payer system would simplify things.
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Argument: Single-payer, universal health care results in long waits for patients| Single-payer, universal health care results in long waits for patients]]''' Canada is a prime example of this. Many people find themselves waiting for long periods for care in Canada, and sometimes come to the United States to receive faster and higher quality care.
 +
 +:'''John Goodman, president of the National Center for Policy Analysis, wrote,''' "rationing by waiting is pervasive, putting patients at risk and keeping them in pain."[http://www.medicalnewstoday.com/articles/21677.php]
 +
 +*'''Frequent cancellations are a feature of universal health care systems.''' A function of "rationing", doctors sometimes have to cancel visits in a single-payer system.
 +
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Competition: Is competition a bad thing in health care?===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Competition in health care is generally a bad idea| Competition in health care is generally a bad idea]]''' While competition can make sense when it relates to the production of goods, it is not good when it relates to dealing with human life. The main problem is that a primary means of "cost-cutting" is by skimping on services to people in need.
 +
 +*'''[[Argument: Competition causes the wasteful duplication of expensive forms of care| Competition causes the wasteful duplication of expensive forms of care]]''' [http://www.pnhp.org/facts/singlepayer_faq.php "Single-Payer FAQ". Physicians for a National Health Program. Retrieved May 30th, 2008] - "When, for example, hospitals compete they often duplicate expensive equipment in order to corner more of the market for lucrative procedure-oriented care. This drives up overall medical costs to pay for the equipment and encourages overtreatment."
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Argument: Single-payer health care erodes competition in price and value| Single-payer health care erodes competition in price and value]]''' The notion of the free markets as a source of efficiency dates back to Adam Smith. The health care industry is no exception to this rule. If it is open to the free-markets, consumers will shop for and purchase the best price and value. Pressure will be placed on insurance companies to cut costs and sell their surface at a lower price for greater value. Free universal health care would interrupt this, reduce efficiency, and increase costs.
 +
 +*'''Governments might attempt to control costs by gaining or enforcing monopsony power.''' For example, governments, such as Canada, have outlawed medical care if the service is paid for by private individual funds.
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Economic efficiencies: Would universal health care be more economically efficient? ===
 +
 +|-
 +|WRITE SUBQUESTION ABOVE THIS CODE BETWEEN "=== ===" width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +
 +====Yes====
 +*'''Universal health care makes people healthier so more productive.'''
 +
 +*'''Universal health care systems are more economically efficient.''' America spends a far higher percentage of GDP on health care than any other country, and has worse ratings on a variety of subjects such as quality of care, efficiency of care, access to care, safe care, equity, right care and wait times according to the commonwealth fund. New Zealand, which spends one third per capita what the US spends on health care beats the US on every marker of efficiency and care. Although not definitive, this does lend credence to the idea that universal health care is more efficient than our for profit health care system as the US was inferior to Germany, the UK, Australia, New Zealand and to a lesser degree Canada in nearly all health care quality issues. This despite the fact that the US system costs 2-3x more per capita than the systems in these other countries.
 +
 +*'''[[Argument:Universal health care lowers long-term health costs| Universal health care lowers long-term health costs]]''' Universal health care systems better encourage patients to seek preventive care. The result is a dramatic reduction in the long-term health care needs, and thus costs, of individuals citizens in a society.
 +
 +*'''[[Argument: There are major hidden costs associated with the uninsured| There are major hidden costs associated with the uninsured]]'''
 +
 +*'''[[Private healthcare providers are more expensive than public providers]]''' They take more money for overhead as well as profit than a public system would. Some claim that private providers take as much as 30% of every healhcare dollar, versus estimates of below 10% for public providers.
 +
 +*'''[[Argument: Single-payer health care gets rid of wasteful middlemen| Single-payer health care gets rid of wasteful middlemen]]''' According to an estimate by Dr. Marcia Angell roughly 50% of healthcare dollars are spent on healthcare, the rest go to various middlemen and intermediates to providing healthcare. A streamlined, non-profit, universal system would increase the efficiency with which money spent on healthcare goes to healthcare.
 +
 +*'''[[Argument: Cost savings with universal health care will outweigh program costs| Cost savings with universal health care will outweigh program costs]]''' It is important in this analysis to consider that, even if universal health care were to cost more now, that these costs could easily be outweighed by long-term cost-savings. In other words, the costs of not implementing universal health care would be greater than the costs of implementing it.
 +
 +*'''Costs are inconsequential if health care is considered a universal right.''' It may very well be true that universal health care increases costs. Yet, if we presume that health care is a right, then such added costs are insignificant; they must be born to secure the right of universal health care.
 +
 +*'''[[Argument: No universal health care leads to excessive, expensive use of the ER| No universal health care leads to excessive, expensive use of the ER]]''' It is true that when people do not have health car, they more frequently utilize the ER for care. The ER is a costly alternative.
 +
 +*'''[[Argument: Aging countries contain health care costs without difficulty| Aging countries contain health care costs without difficulty]]'''
 +
 +|WRITE ABOVE THIS TABLE CODE FOR "YES" width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
====No==== ====No====
-''Click on the pencil icon and research and write arguments here''+ 
 +*'''[[Argument: Free health care leads to overuse of medical services and higher costs| Free health care leads to overuse of medical services and higher costs]]''' Whenever something of value is provided free of charge in society, it is used more. This means that the overall costs of health care will rise.
 + 
 +*'''[[Argument: Universal health care can't be reversed even if costs explode| Universal health care can't be reversed even if costs explode]]''' Universal health care, like any government benefit, is eventually going to be interpreted as a "right" by the public, making it politically impossible to curtail the program when it becomes too costly.
 + 
 +*'''[[Argument: Single-payer systems create rigid prices unresponsive to shortages/gluts| Single-payer systems create rigid prices unresponsive to shortages/gluts]]''' [http://www.cato.org/pub_display.php?pub_id=8686 Michael F. Cannon. "Socialized Medicine is Already Here". CATO Institute. September 6, 2007] - "Consider two distinguishing features of socialist economies. The first is that the government decides what individuals may produce, what they consume, and the terms of exchange.
 + 
 +:That is largely true of America's health care system. Government controls production and consumption by determining the number of physicians; what services medical professionals can offer and under what terms; where they can practice; who can open a hospital or purchase a new MRI; who can market a drug or medical device; and what kind of health insurance consumers may purchase.
 + 
 +:Government bureaucrats even set the prices for half of our health care sector directly, and indirectly set prices for the other half. When you read about Medicare over-paying imaging centers and hospitals, or that it's impossible for Bostonians to get an appointment with a general practitioner, it's largely because the bureaucrats got the prices wrong, and those rigid prices do not automatically eliminate shortages and gluts like flexible market prices do."
 + 
 +*'''Aging countries cannot afford universal health care.''' When a country's population ages, the strain of a universal health care program grows, with a larger percentage of the population reaching an age in which they require health care. Therefore, in countries where the population is aging, it may be important to avoid a universal health care program.
 + 
|- |-
-|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;"|+|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
-===References:=== +===Administrative costs: Would it reduce administrative costs or add to them?===
 + 
|- |-
-|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;"|+|WRITE SUBQUESTION ABOVE THIS CODE BETWEEN "=== ===" width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
-===Related pages on Debatepedia:===+====Yes====
 + 
 +*'''[[Argument: US has a big bureaucracy now; universal care won't make it bigger| US has a big bureaucracy now; universal care won't make it bigger]]''' [http://www.pnhp.org/facts/singlepayer_faq.php "Single-Payer FAQ". Physicians for a National Health Program. Retrieved May 30th, 2008] - "''Won’t this just be another bureaucracy?'' The United States has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc."
 + 
 +*'''[[Argument: Universal health care reduces administrative costs (i.e. paper work)| Universal health care reduces administrative costs (i.e. paper work)]]''' Medical professionals are often challenged with massive amounts of paperwork in private health care systems. A universal health care system will help coordinate and reduce paperwork, allowing doctors to concentrate on treating patients. A single payer system could save $286 billion a year in overhead and paperwork. Administrative costs in the US health care system are estimated to be substantially higher than in other countries and than in the public sector in the US: one estimate put the total administrative costs at 24 percent of US health care spending.
 + 
 +*'''[[Argument: A profit health care environment results in more frivolous lawsuits| A profit health care environment results in more frivolous lawsuits]]''' When profits are driving doctors to gave favor to patients with good, private insurance, an environment is created that is prone to lawsuits. Indeed, in the United States, this is one of the reasons why malpractice lawsuits are so common.
 + 
 + 
 +|WRITE ABOVE THIS TABLE CODE width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 + 
 +*'''Universal health care creates a big, inefficient bureaucracy.''' The cause of this is greater bureaucratic oversight and more paperwork. This lowers the productivity of hospitals, and thus increases the costs for the same amount of work done.
 + 
 +*'''The costs of transition to a universal health care program would be large:''' It would involve lost insurance industry jobs, business closures, and new patient record creation, among other things. Creating a new administrative framework and patient database would be a massive under-taking.
 + 
 +*'''[[Argument: Universal health care would increase frivolous malpractice lawsuits| Universal health care would increase frivolous malpractice lawsuits]]''' [http://www.balancedpolitics.org/universal_health_care.htm "Should the Government Provide Free Universal Health Care for All Americans?" Balanced Politics.org] - "Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.
 + 
 + 
|- |-
-|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;"| +|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Price: Is the price to the individual taxpayer significantly lower?===
-===External links and resources:===+|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +*'''[[Argument: Private health care has become increasingly unaffordable for individuals| Private health care has become increasingly unaffordable for individuals]]'''
 +
 +*'''[[Argument: The lack of universal health care is a leading cause of bankruptcy| The lack of universal health care is a leading cause of bankruptcy]]''' A Harvard study indicates that a lack of universal health care is a leading cause in 50% of bankruptcies filed annually in the United States.
 +
 +*'''Total costs for individuals would be reduced by universal health care:''' The current US system is already funded 64% by tax money with the remaining 36% split between private and employer spending. A universal healthcare system would merely replace private/employer spending with tax revenues. Total spending would go down for individuals and employers.
 +
 +*'''[[Argument: Single-payer health care allows bargaining for lower drug prices| Single-payer health care allows bargaining for lower drug prices]]''' [http://www.pnhp.org/facts/singlepayer_faq.php "Single-Payer FAQ". Physicians for a National Health Program. Retrieved May 30th, 2008] - "When all patients are under one system, the payer wields a lot of clout. The VA gets a 40% discount on drugs because of its buying power. This “monopsony” buying power is the main reason why other countries’ drug prices are lower than ours. This also explains the drug industry’s staunch opposition to single-payer national health insurance."
 +
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +*'''Universal health care is not free; people pay with their taxes.''' It is a myth that universal health care could somehow be free or lower the costs to the patient. People pay through their taxes instead of in direct payments to their health insurance providers.
 +
 +*'''Single-payer systems typically mean higher taxes.''' A country which adopts a totally tax funded socialized form of health care will have to increase the average tax rate by an amount equivalent to the cost of providing health care and administering the system.
 +
 +*'''Allowing for pooling of resources to force drugs to lower prices will reduce overall innovation.''' Reducing profit, reduces motive and the money necessary to get a drug through FDA trials. Without profit motive, drug companies will naturally move away from the rare and complex, yet fatal, diseases if they only affect a small percentage of people. Without the ability to set the price, their resources will naturally be moved almost exclusively into benign treatments which will have a larger percentage of the population as potential users.
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Businesses: Would a universal health care system be good for businesses?===
 +
 +|-
 +|WRITE SUBQUESTION ABOVE THIS CODE BETWEEN "=== ===" width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Single-payer systems create new job opportunities| Single-payer systems create new job opportunities]]''' Many of those working in the private insurance industry can get new jobs in the new public health care industry.
 +
 +*'''[[Argument: Many businesses cannot pay the private health insurance of employees| Many businesses cannot pay the private health insurance of employees]]''' (Indeed, the Big Three of U.S. car manufacturers cite health-care provision as a reason for their ongoing financial travails. The cost of health insurance to U.S. car manufacturers adds between USD 900 and USD 1,400 to each car made in the U.S.A.).
 +
 +*'''[[Argument: Health insurance strains on businesses damage global competitiveness| Health insurance strains on businesses damage global competitiveness]]'''
 +
 +*'''[[Argument: No universal health care causes "job lock"| No universal health care causes "job lock"]]''' [http://www.amsa.org/uhc/CaseForUHC.pdf "The Case for Universal Health Care". American Medical Student Association (AMSA). 2005-2006] - "“Job lock”: Job lock refers to the idea that people stay with their jobs when they would rather work elsewhere because their current job offers health insurance. For example, many individuals opt to stay with their job instead of starting their own business because they are unsure of whether they can get health insurance on the individual market, which has higher premiums and often denies people with pre-existing conditions."
 +
 +
 +|WRITE ABOVE THIS TABLE CODE width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''[[Argument: Free, universal health care would devastate the insurance industry| Free, universal health care would devastate the insurance industry]]''' [http://www.balancedpolitics.org/universal_health_care.htm "Should the Government Provide Free Universal Health Care for All Americans?" Balanced Politics.org] - "A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation. A universal health plan means the entire health insurance industry would be unnecessary. All companies in that area would have to go out of business, meaning all people employed in the industry would be out of work. A number of hospital record clerks that dealt with insurance would also be out of work. A number of these unemployed would be able to get jobs in the new government bureaucracy, but it would still be a long, painful transition. We'd also have to once again go through a whole new round of patient record creation and database construction, which would cost huge amounts of both time and money."
 +
 +*'''Universal health care risks monopsony:''' Universal health care systems, in an effort to control costs by gaining or enforcing monopsony power, sometimes outlaw medical care paid for by private, individual funds.
 +
 +
 +
 +
 +
 +|-
 +|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +=== World vs. US: What does a comparison between the US and world reveal? ===
 +
 +|-
 +|WRITE SUBQUESTION ABOVE THIS CODE BETWEEN "=== ===" width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +*'''[[Argument: Universal health care internationally is better than US system| Universal health care internationally is better than US system]]''' [http://www.nybooks.com/articles/18802 Paul Krugman, Robin Wells. "The Health Care Crisis and What to Do About It". New York Times Review of Books. Volume 53, Number 5 · March 23, 2006] - "Single-payer and beyond. How do we know that the US health care system is highly inefficient? An important part of the evidence takes the form of international comparisons. Table 1 compares US health care with the systems of three other advanced countries. It's clear from the table that the United States has achieved something remarkable. We spend far more on health care than other advanced countries—almost twice as much per capita as France, almost two and a half times as much as Britain. Yet we do considerably worse even than the British on basic measures of health performance, such as life expectancy and infant mortality."
 +
 +*'''[[Argument: High US health care costs are not attributable to poor American health| High US health care costs are not attributable to poor American health]]'''
 +
 +*'''[[Argument: High US health care costs are not attributable to premiums for rapid care| High US health care costs are not attributable to premiums for rapid care]]'''
 +
 +*'''[[Argument: Universal health care provides insurance to millions without in US| Millions don't have health insurance in US; universal health care would address this]]''' [http://www.balancedpolitics.org/universal_health_care.htm "Should the Government Provide Free Universal Health Care for All Americans?". Balanced Politics.Org] - "The number of uninsured citizens has grown to over 40 million. Since health care premiums continue to grow at several times the rate of inflation, many businesses are simply choosing to not offer a health plan, or if they do, to pass on more of the cost to employees. Employees facing higher costs themselves are often choosing to go without health coverage. No health insurance doesn't necessarily mean no health care since there are many clinics and services that are free to indigent individuals. However, any costs not covered by insurance must be absorbed by all the rest of us, which means even higher premiums."
 +
 +*'''[[Argument: US is the only industrial country without universal health care| US is the only industrial country without universal health care]]'''
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''US health care costs more because Americans are less healthy.'''
 +
 +*'''US health care costs more because Americans pay to avoid waiting.'''
 +
 +*'''[[Argument: Just because Americans are uninsured doesn't mean they can't get health care| Just because Americans are uninsured doesn't mean they can't get health care]]''' [http://www.balancedpolitics.org/universal_health_care.htm "Should the Government Provide Free Universal Health Care for All Americans?" Balanced Politics.org] - "Just because Americans are uninsured doesn't mean they can't receive health care; nonprofits and government-run hospitals provide services to those who don't have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance. While uninsured Americans are a problem in regards to total system cost, it doesn't mean health care isn't available. This issue shouldn't be as emotional since there are plenty of government and private medical practices designed to help the uninsured. It is illegal to refuse emergency treatment, even if the patient is an illegal immigrant."
 +
 +*'''[[Argument: So many are uninsured in America due to government regulations| So many are uninsured in America due to government regulations]]'''
 +
 +*'''[[Argument: Greater access to health insurance does not improve public health| Greater access to health insurance does not improve public health]]'''
 +
 +*'''[[Argument: Emergency hospital visits of the uninsured is a manageable problem| Emergency hospital visits of the uninsured is a manageable problem]]'''
 +
 +*'''[[Argument: Advanced care improves Americans' chances of surviving cancer| Advanced care improves Americans' chances of surviving cancer]]''' The American Cancer Society notes, "U.S. patients have better survival rates than European patients for most types of cancer."[http://www.heartland.org/Article.cfm?artId=23230]
 +
 +*'''[[Argument: Medicare is a failure that should not be expanded into universal care| Medicare is a failure that should not be expanded into universal care]]'''
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Paying for it: Are there sound proposals for paying for added costs? ===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Many ways to pay for added costs of universal health care| There are many ways to pay for any added costs of universal health care]]''' Some proposed means of dealing with these added costs include a cigarette tax and repealing tax cuts for the wealthy.
 +
 +*'''[[Argument: A payroll tax could help fund universal health care| A payroll tax could help fund universal health care]]'''
 +
 +*'''[[Argument:A cigarette tax is a socially responsible way to pay for health care| A cigarette tax is a socially responsible way to pay for health care]]'''
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*This puts government in the role of arbiter of what practices are healthy and unhealthy.
 +*The collection and enforcement of these taxes is not free, but will entail additional bureaucracy.
 +*Some controversial practices could be taxed. e.g. medical marijuana.
 +*Such taxes are likely to be regressive, especially taxes on tobacco.
 +*The healthfulness of some things is dependent on context, e.g. pain killers.
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Mixed private-public: Is single-payer better than mixed private-public universal health? ===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''Only the government can provide a coherent universal health care system.''' Such a system is important from the standpoint of providing quality care, in that only a standardized system and unified database can enable doctors to treat any patient that comes in front of them. Privatized systems often see doctors unable to access the history and files of patients that come before them. The main reasons include the cost and complexity of unifying and standardizing a system as well as the lack of a private-industry interest in seeing such a system emerge.
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''A mixed private-public system would preserve existing industries.''' Any proposal to shift to a single-payer universal health care program from a private health care system involves destroying the private health care industry. This is a highly disruptive act that would involve massive job loss. The advantage of a mixed private-public universal health care system is that it is not as destructive and damaging in this way. It acknowledges the existence of a private health care industry and the need to preserve at least some of the interests of such a massive, and important, industry.
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Database: Would a centralized database be a good idea? ===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*'''[[Argument: Universal health care makes a centralized national database possible| Universal health care makes a centralized national database possible]]''' [http://www.balancedpolitics.org/universal_health_care.htm "Should the Government Provide Free Universal Health Care for All Americans?". Balanced Politics.org] - "We can develop a centralized national database which makes diagnosis and treatment easier for doctors. Most doctor's offices maintain a separate record-keeping system. This is why you always have to fill out a lengthy health history whenever you go to a new physician."
 +
 +*'''Government-control of databases better protect privacy than companies.''' It is important to recognize that this is not a choice between a government-controlled database and no database. The alternative to a government-controlled health care database is only a privately owned health care databases. With these choices in mind, it is better that health care information be held by the government than by less-regulated companies. The government is better able to protect the privacy of individuals.
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*'''Health care databases threaten to violate the privacy of patients.'''
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Pro/con resources ===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*[http://www.pnhp.org/news/2007/july/the_waiting_game.php Krugman, Pual. "The Waiting Game". New York Times. July 16, 2007]
 +*[http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=482678 Commonwealth Fund. "Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care".]
 +*[http://www.nathannewman.org/archives/000575.shtml Nathan Newman. "Medical Malpractice and Universal Health Care". Progressive Populist. October 01, 2002]
 +*[http://www.amsa.org/uhc/CaseForUHC.pdf "The Case for Universal Health Care". AMSA. 2005-2006]
 +*[http://www.americanthinker.com/2007/12/a_conservative_case_for_univer.html Randall Hoven. "A Conservative Case for Universal Health Coverage". American Thinker. December 12, 2007]
 +*[http://obama.senate.gov/speech/070125-the_time_has_co/ Barack Obama. "The Time Has Come for Universal Health Care". January 25, 2007]
 +*[http://www.americanchronicle.com/articles/57334 Bryan Belrad. "The Case for Universal Health Care". The American Chronicle. April 02, 2008]
 +*[http://www.slate.com/id/2082988/ Robert Shapiro. "Premium Blend. Why is it so difficult to provide universal health care?". Slate. May 15, 2003]
 +*[http://www.nybooks.com/articles/18802 Paul Krugman, Robin Wells. "The Health Care Crisis and What to Do About It". New York Times Review of Books. Volume 53, Number 5 · March 23, 2006]
 +*[http://tnr.com/politics/story.html?id=51faeaa7-5021-40d0-95d3-0f260b25edd4 Jonathan Cohn. "Creative Destruction. The best case against universal health care." The New Republic. November 12, 2007]
 +*[http://www.pnhp.org/facts/singlepayer_faq.php "Single-Payer FAQ". Physicians for a National Health Program. Retrieved May 30th, 2008]
 +*[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1925024 Laura K. Altom, BS, MSIII and Larry R. Churchill, PhD, Ann Geddes Stahlman Professor of Medical Ethics Laura K. Altom, Vanderbilt School of Medicine, Nashville, Tennessee. "Pay, Pride, and Public Purpose: Why America's Doctors Should Support Universal Healthcare". 2007]
 +*[http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm John R. Battista, M.D. and Justine McCabe, Ph.D. "The Case For Single Payer, Universal Health Care For The United States". Outline of Talk Given To The Association of State Green Parties, Moodus, Connecticut on June 4, 1999]
 +*[http://www.amsa.org/uhc/SinglePayer101.pdf "Single Payer 101". American Medical Student Association (AMSA). Retrieved May 31st, 2008]
 +
 +
 +|width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*[http://article.nationalreview.com/?q=ZWFkZDBlNjk3YjFhMDE1MWVlODc5NGM4MmQ4MmRhMTM= "Against Universal Coverage". National Review Online. June 21, 2007]
 +*[http://www.latimes.com/news/opinion/la-oe-tanner5apr05,0,2227144.story?coll=la-opinion-rightrail Michael Tanner and Michael Cannon, of the CATO institute. "Universal healthcare's dirty little secrets". Los Angeles Times. April 5th, 2007]
 +*[http://www.heartland.org/Article.cfm?artId=23230 Brian Schwartz. "Universal Health Care Is the Wrong Prescription". The Heartland Institute. June 1, 2008]
 +*[http://seattletimes.nwsource.com/html/opinion/2003592432_harrop28.html Froma Harrop. "Canada's the wrong model for universal health care". Seattle Times. February 28th, 2007]
 +*[http://www.google.com/search?q=%22Sufferers+pull+out+teeth+due+to+lack+of+dentists.%22+&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a Matthew Moore. "Sufferers pull out teeth due to lack of dentists." Daily Telegraph. April 19th, 2008]
 +*[http://news.bbc.co.uk/1/hi/health/359265.stm "500 heart patients die on waiting lists". BBC. June 3rd, 1999]
 +*[http://www.cato.org/pub_display.php?pub_id=8686 Michael F. Cannon. "Socialized Medicine is Already Here". CATO Institute. September 6, 2007]
 +*[http://www.haciendapub.com/article49.html Lawrence R. Huntoon, MD, PhD. "Universal Health Coverage --- Call It Socialized Medicine". Association of American Physicians and Surgeons. 2000.]
 +
 +
 +
 +|-
 +|colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +===Organizations and actors pro and con ===
 +
 +|-
 +|width="45%" bgcolor="#FFFAE0" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====Yes====
 +
 +*[http://www.amsa.org/uhc/ American Medical Student Association (AMSA) - Statement supporting universal health care]
 +*[http://www.onecarenow.org/index.html California OneCareNow Campaign]
 +*[http://cthealth.server101.com/ Connecticut Coalition for Universal Health Care]
 +*[http://www.healthcareforall.org/ Health Care for All—California]
 +*[http://www.pnhp.org/ Physicians for a National Health Program]
 +*[http://www.sicko-themovie.com/ ''Sicko'' - Official site]
 +*[http://www.uhcan.org/ Universal Health Care Action Network (UHCAN)]
 +*[http://www2.umdnj.edu/omcweb/1999/universalhealthcare.htm Universal Health Care / National Health Insurance]
 +
 +
 +
 +
 +
 +|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" width="45%" bgcolor="#F2FAFB" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +====No====
 +
 +*American Medical Association.
 +*[http://www.heritage.org/Press/NewsReleases/NR092900.cfm British, Canadian Experience Shows Folly of Socialized Medicine, Analyst Says.] Press release, [[Heritage Foundation]]. Sept. 29, 2000.
 +*[http://www.capmag.com/article.asp?ID=4511 Capitalism Magazine]
 +*[http://www.onthefencefilms.com/video/deadmeat/ Dead Meat] On The Fence's short film about Canada's socialized healthcare system.
 +*[http://www.heartland.org/Article.cfm?artId=10333 The Heartland Institutes' Health Care Issue Suite]
 +*[http://www.liberty-page.com/issues/healthcare/socialized.html/ The Problems with Socialized Health Care] from Mark Valenti's Liberty Page
 +*[http://laissezfairehealthcare.com/2008/01/20/a-case-against-universal-health-care/ Laissez Faire Health Care.com]
 +Cato.org
 +*[http://www.cato.org/pub_display.php?pub_id=10218 Obamacare to Come: Seven Bad Ideas for Health Care Reform]
 +*[http://www.cato.org/pub_display.php?pub_id=10382 Fannie Med? Why a "Public Option" Is Hazardous to Your Health]
 +
 +*[[Actor:Rudy Giuliani opposes universal health care|Rudy Giuliani]]
 +
 +|-
 +|WRITE "NO" CONTENT ABOVE THIS CODE AND BELOW "===NO===" colspan="2" width="45%" bgcolor="#F2F2F2" style="border:1px solid #BAC5FD;padding:.4em;padding-top:0.5em;"|
 +==See also==
 +*[[Debate: French health care system]]
 +*[[Debate: Limiting public medical care for smokers]]
 +*[[Debate: Mandatory universal health insurance in the United States]]
 +*[[Debate: Health insurance mandates]]
 +*[[Debate: Public health insurance option]]
 +*[[Debate: Health insurance cooperatives]]
 +==External links==
 +
 +*[http://www.balancedpolitics.org/universal_health_care.htm BalancedPolitics.org - "Should the Government Provide Free Universal Health Care for All Americans?"]
 +*[http://www.nap.edu/catalog/10719.html Hidden costs, value lost: uninsurance in America.] Institute of Medicine Committee on the Consequences of Uninsurance. Washington, DC: National Academies Press, 2003.
 +*[http://www.who.int/inf-pr-2000/en/pr2000-44.html World Health Organization.] Assesses The World's Health Systems," Press Release, WHO/44, June 21, 2000.
 +*[http://www.opposingviews.com/questions/should-the-us-adopt-a-single-payer-health-care-program Opposing Views debate on single payer and universal health care]
 +*[http://www.nytimes.com/interactive/2009/09/29/health/health-care-conversations.html Health Care Conversations - Sep. 2009, NY Times]
|} |}
 +
 +[[Category:Health]]
 +[[Category:Health care]]
 +[[Category:Politics]]
 +[[Category:Political systems]]
 +[[Category:US politics]]
 +[[Category:Individual rights]]
 +[[Category:Society]]
 +[[Category:Human welfare]]
 +[[Category:Government funding]]
 +[[Category:Government ownership]]
 +[[Category:Progressive]]
 +[[Category:Taxes]]
 +[[Category:Privatization]]
 +[[Category:Capitalism]]
 +[[Category:Socialism]]
 +[[Category:Disease]]
 +[[Category:Health insurance]]
 +[[Category:International]]

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Is single-payer health care a good idea?

Background and context

By definition Universal Health Care is the idea that health care coverage ought to be extended to all citizens and sometimes to permanent residents of a certain geographic area. The idea was first unofficially implemented in Germany by Otto von Bismarck in the 1880s.

The system was first officially used in the United Kingdom in 1948. According to the Institute of Medicine and the National Academy of Sciences, the United States is the only wealthy, developed nation without a system of Universal Health Care. Almost every nation in Europe has established a system of Universal Health Care. Some states and regions can decide on their own accord whether or not they will establish some form of Universal Health Care for their citizens.

The problem essentially stems from the question of whether or not the government should be hands-off in its legislation and regulation as the establishment of this system would require much of both. Proponents of a more hands-off government do not believe in Universal Health Care because they think the government should allow people to deal with Health Care as they see fit. Those who encourage at least a form of Universal Health Care are those who believe in a government's strong obligation to its people directly through its legislations. However, while such a system has the ability to create more justice amongst social classes, it also has the ability to significantly raise taxes.

Other background resources: See Wikipedia:Universal health care, See Wikipedia: Publicly-funded healthcare, Wikipedia: Single-payer health care, Canadian and American health care systems compared

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Analogous services: Is universal health care analogous to other government services?

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Yes

  • The government funds fire-stations, why not universal health care? The government taxes citizens to fund and provide numerous services universally, including policemen and firemen. These services are comparable to physician services in many ways, particularly in the sense that they help protect the life, safety, or health of citizens. Why shouldn't health care also be provided universally through the same means - taxes?
  • Health is often out of an individual's control; like fires. You will see that the other side of this argument makes a distinction between things that an individual can control and those he/she cannot. The argument is that fire and police protection are things beyond the control of individuals, but that healthcare is not. This argument is seriously flawed. Many healthcare issues are very much out of the control of individuals. Consider a bus accident. Many accidents are out of the control of individuals. While many accidents are a result of an individual being stupid or not being careful, so are many fires. There is no real distinction here. Either you should be opposed to fire/police protection and universal healthcare, or should support both. Picking one is a logical inconsistency.


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No

  • Health problems are more about individual choices than fires and crime. While many people compare health care to police stations and fire stations, they are not the same services. Health care is largely about providing a service to the individual that compensates, often, for poor individual choices. Fire stations and police departments, on the other hand, provide services to a community and focus on protecting individuals against things they have no control over (crime and fires). The differences are very significant in regard to what the state is obligated to provide. The state is obligated to protect citizens from one-another. But, the state is not obligated to protect citizens from themselves. Universal health care is wrongheaded to the extent that it involves protecting individuals from themselves.
  • Whether universal health care is analogous to other services is inconsequential. Whether universal health care is analogous or a legitimate burden on tax payers does not answer whether a universal system provides the results proponents argue.
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Choice: Does universal health care deprive some choice? Is this OK?

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Yes

  • When the wealthy must use public health care, the system improves If the wealthy are not allowed to buy better health insurance, and are forced to use public single-payer health care, they come to realize that the only way to ensure good care is to pressure for good universal health care. As a result of the wealthy pressuring for improvements, all individuals of all classes will enjoy better health care.
  • Many single-payer systems give patients free choice of practitioners. In some countries with socialized medicine, such as the UK, patients are offered a choice of general practitioner, all of whom are self-employed or work in private partnerships employing all practice nurses, doctors and clerical staff. In addition, some hospital services are sub-contracted to the private sector, so that patients can choose from a range of providers International comparisons of quality of care and health outcomes generally rank the UK above the U.S.


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No

  • Universal health care will have rules that decrease patient flexibility "Should the Government Provide Free Universal Health Care for All Americans?" Balanced Politics.org - "Government-controlled health care would lead to a decrease in patient flexibility. At first glance, it would appear universal health care would increase flexibility. After all, if government paid for everything under one plan, you could in theory go to any doctor. However, some controls are going to have to be put in to keep costs from exploding. For example, would "elective" surgeries such as breast implants, wart removal, hair restoration, and lasik eye surgery be covered? [...] The compromises that result will put in controls that limit patient options. The universal system in Canada forces patients to wait over 6 months for a routine pap smear. Canada residents will often go to the U.S. or offer additional money to get their health care needs taken care of."


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Needy: Is free health care important for those in dire need?

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Yes

  • Free, universal health care helps the unhealthy in times of need. When an individual is sick, they shouldn't have to think about how to pay for their treatment. In free, universal health care systems, when one is sick, they are simply told to rest and get better. This is essential for proper healing. Conversely, in a non-free-universal-health-care system, a sick person is required to figure out how to pay for their health care, rather than simply focusing on getting better. The stresses this causes hampers healing.
  • It is wrong to make more vulnerable people pay more for insurance The modus operandi of the insurance industry is that the vulnerable (people of higher risk of becoming ill) pay more for health insurance. But, this is unfair and contrary to the higher moral principles upon which societies should be founded. Society should strive to defend and care for the needy and vulnerable, instead of subjecting them to a system that punishes them for their disadvantages.
  • Unacceptable to leave health care of millions to rare charity orgs/docs. It is morally unacceptable to leave the health care of millions of American who cannot afford to pay insurance to the hands of the few rare doctors and charity health care services. Also, charity health services would not have enough equipment and funds to treat expensive, life-threatening diseases like cancers.


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No

  • A right to health care is not necessary in taking care of sick patients. Indigent patients have been taken care of by physicians with dignity and compassion in the name of genuine charity, pro bono. This model can provide adequate care to the needy. And, of course, this model can be expanded out further, if need be, to aid the needy.


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Human rights: Is health care a human right?

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Yes

  • Health care is a basic human right or entitlement Health is fundamental to the preservation of all other individual rights. If one is sick in a hospital bed, they cannot be said to have equal opportunity or the ability to exercise free speech and religion. And, of course, one cannot pursue happiness if they are in a hospital bed. This is why health must be considered a basic human right.
  • Universal health care protects healthy citizens from many health risks. If citizens have a right to be healthy, they are due some protections from the sickly. By providing for the sickly, government is helping protect the rights of the healthy.
  • Health care is considered a right in international law. Article 25 of The UN Universal Declaration of Human Rights enumerates medical care as a universal right.
  • Universal health care is a social good, not merely an economic good Universal health care generally decreases human misery and increases human welfare. It is, therefore, a social good, not merely an economic good. In general, the ability to afford something does not play a role in whether it is just or not. If there is a conflict between life and money life should prevail because it is a right while money is a want not a need.
  • Universal health care is a legitimate "burden" on the tax payer. People pay for public utilities such as road and people pay for education as well. But do people who don't drive recklessly ask for money back when roads are damaged? Do people who send their children to private school ask for all their money back? We place this burden on the state because of equality of opportunity. No man should be denied the right to live his life.
  • Universal healthcare helps foster greater equality across classes. In the United States, the poor commonly cannot afford health care. Universal health care helps them get the care that they need. Without health care, the poor are more vulnerable and have a harder time achieving their goals. This violates their right to equal opportunity.


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No

  • Free, universal health care is an illegitimate "positive" right. The main premises here is that "rights" should only protect individuals from harm from others and allow them certain freedoms, but a right to universal health care entails individuals burdening other members of society (possibly violating the liberties of innocents) for things that are perceived as needed or desirable. The extreme of this argument is the circumstance in which a careless smoker is given the "right" to burden others for their expensive health care costs.
  • The necessity of medical care does not make it a right. Food, for example, is not considered a right, and companies are allowed to sell it, as well as to withhold it from those that need it but can't afford it. This is the right of grocery stores to do, and receives no complaint from society in general.
  • Whether health care is a right under i-law is inconsequential. The mere act that a UN body on Human Rights has added that to their charter is not definitive of anything. Using it as an argument fails as it's only an appeal to authority.
  • Whether universal health care is a legitimate "burden" on the tax payer should be considered inconsequential. Since health care is currently 1/7th of the US Economy, simply asking whether the tax payer can be burdened to help provide others with health care does nothing to ask whether allowing more government control will end with the results proponents predict.
  • Whether universal health care is a social good is inconsequential. Again, this question's answer has no bearing on whether a universal system can provide the level of service proponents claim.
  • It is impossible to answer whether universal health care fosters greater equality. Since the word equality necessitates a value judgment as to what is "equal" when it comes to health care and class status, a universal definition is not possible. For instance - would it be equal if no one had access to MRI's? If only 80% of those requiring an MRI could get it - what would determine how to define those individuals "equally"?


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Uninsured: Do large numbers of uninsured give cause to universal health care?

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Yes


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No

  • Many uninsured are lazy free-loaders who don't deserve care Many uninsured are simply lazy, and believe they can get a free ride off of the system. These people do not deserve free, universal care from the system.
  • Universal health care would amount to welfare for the uninsured. The government should not create a health care system that is aimed primarily at helping the poor and uninsured. As such, it becomes merely another wealth-transfer program.
  • Do large numbers of uninsured give cause to universal health care? No, as it does nothing to answer how many would be without in a hypothetical universal system. For instance, what if we knew that instead of 50 million uninsured, we would end up with 60 million uninsured due to additional inefficiencies and failure to predict actual cost?
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Socialized medicine: Is it wrong to call single-payer systems socialized medicine?

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Yes

  • Single-payer systems involve government paying for private services Most single-payer systems in Europe, as well as ones proposed in the United States (building on Medicare), involve the government paying for the insurance of individuals. This means that individuals would still go to private hospitals and doctors. The only difference is that the government-funded insurance pays for services instead of the money coming from your own insurance company.


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No

  • Single-payer health care is "socialized medicine" Lenin said, "medicine is the keystone in the arch of socialism." Government should not be in control of medicine and should generally not be in too many features of our lives. It is both inefficient and an intrusion on our fundamental rights.
  • Universal health care leads to rationing. Medical resources are rationed in socialized systems so that some people are either denied care or have to wait for it. If a person is "rationed out" of the public health care service (perhaps because the treatment is not considered effective or cost effective enough to warrant intervention) they will be able seek alternative treatment in the private sector. If they cannot afford private care, they may have to go without.
  • Government intrudes in medical decisions in a single-payer system. Government will involve itself in decisions between doctors and patients under a single-payer system.
  • "Is it wrong to call single-payer systems socialized medicine?" is another inconsequential question. It's answer is meaningless to which system provides the most benefits to the most people. It's a semantic argument which will hang more on specific definitions or words that anything resembling rational health care debate. Having said that - the answer is "yes". Socializing anything involves taking individual decisions and "socializing" any negative effects to the community instead of limiting it to the individual.
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Physicians: Is free, universal health care fair to physicians?

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Yes

  • Universal health care can actually strengthen doctor pay If there are more insured patients within a universal health care system, more people will seek health care. As such, there will be more paying patients in a universal health care system, which will result in more income for doctors. Doctors will also spend less time on paper work, be more efficient, service more patients, and so make more money.
  • Single-payer systems insure individuals, but don't restrict doctors A universal health care system does not mean that the private market should be abolished. Doctors can chooses to operate private practices in a two-tier system. This will attract consumers who require either more personal service, those who know or want a personal doctor, and those who want better quality of care than the public system provides.
  • Universal health care grounds doctors in professionalism, not commercialism. Doctors are currently businessmen that sell health services. But, realizing that this is not a good model for dealing people's lives and health, many doctors see universal health care as a way to better root their profession in professionalism instead of this commercialism.


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No

  • A right to health care violates the rights of physicians One cannot have a right to other people's services. Does a physician not have the free right of association and contract with patients? Why would physicians be forced to perform free or government-set prices for their labor? Why shouldn't they be able to charge market value for their services? Did they enter into their practices with the understanding that they would not be able to charge fair market value? No. They are generally service providers like any other that expect fair, market-based compensation. Universal health care would deprive physicians of this freedom to charge market-value by imposing government pricing on their services, almost certainly at a discounted rate.
  • Universal health care will cut physician cash-flow and disrupt living-standards. It is important to recognize that many private physicians have oriented their private practices around a certain level of cash-flow. They have rented office space at a certain level, taken out mortgages at a certain level, and sent their kids to private schools all on the assumption that their existing cash-flow in their private practices would continue into the future. It is unfair to suddenly and dramatically curtail this cash-flow and force physicians to re-adjust their lives accordingly. For some, this will be impossible or unbearable.
  • Single-payer health care over-loads doctors and burns them out Because more people seek care, doctors in a universal health care environment often are over-loaded. Hoping to meet their patients needs, they work over-time. Yet, by doing this, they often burn out and leave their practice early, exacerbating the problem even further.


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Quality: Does free, universal health care provide superior care?

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Yes

  • For-profit insurance companies often put patients at risk to cut costs - Health insurance claims are considered a "loss" for profit insurance companies. These companies are designed to maximize profits by cutting costs. How can these companies act in the best interests of their patients if their incentive structure is designed to minimize health coverage?
  • Insurance companies screen out those that need health care the most Insurance companies have a interest in maximizing profits that drives them to screen out individuals that are unhealthy, old, and "high-risk". These are the people that need health care the most, and the insurance industry has a direct interest in making it difficult or more expensive for them to obtain health insurance.
  • Universal health care systems incentivize improving patient health. Many free universal health care systems provide incentives to doctors to improve the health of their patients. This contrasts with for-profit health care systems that do not provide financial incentives to doctors to improve the health of their patients, largely because healthier patients would mean lower profits.
  • Universal health care allows investments in longer-term patient relationships. This happens because there is a long term relationship with the patient and the preservation of records has long term benefits. Investment in IT is one often cited example where health care providers in socialized systems have access to electronic records of patients tests online and where computer systems can check for example incompatible drug combinations and that drugs are administered to the right patient. Some for profit systems find this investment hard to justify because the provider-patient relationship is not guaranteed to last long enough to justify the investment.
  • Universal health care decreases the likelihood of health related problems. The single most destructive issue regarding health care in America is the lack of preventative care. Patients wait until their disease progresses to a dangerous level before they seek care because otherwise they can not afford medical cost. Universal health care offers them access, thus increasing the patient's incentive to seek care when the health threat is minimal, and in the long run reducing the burden to the state.


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No

  • The markets are better at providing quality; same with health care. The markets and competition generally help produce higher quality goods for the least money (the highest value). The same applies to health care.
  • Quality of health care is much worse under universal health care. According to Reuters in London, one in 10 patients admitted to National Health Service hospitals in Britain is unintentionally harmed and almost a million safety incidents, more than 2,000 of which were fatal, were recorded last year, according to a report on July 6, 2006. Such figures were "terrifying enough", the report by parliament's public accounts committee said, but the reality may be worse because of what it called "substantial under-reporting" of serious incidents and deaths in the NHS
  • IT investments do not require government intervention. Some have argued that IT enhancements in a universal system will provide efficiency improvements. Most technological advancements which includes universal IT standards for online financial transactions, messenger protocols, FTP protocols, and many, many others have been standardized within the industries without government intervention.
  • Lack of preventative care does not significantly contribute to life expectancy or quality of life. Most of what determines length and quality of life (excluding human issues such as traffic accidents, homicides...) is genetics and life style choices (eating/exercise). Early detection will certainly weigh heavily on life expectancy for certain diseases, but no amount of "prevention" will stop cancer if you genes are highly susceptible. As most people know, most doctor's visits end with "take this and call me if it doesn't get better" which should hardly be seen as "preventative" of anything.
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Prevention: Is free universal health care important to preventive care?

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Yes


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No

  • Better technologies and treatments in private health care aids prevention. Private health care societies are known for having better innovation and higher investment in equipment and high-end treatments. These treatments can be a part of prevention or early treatment, and can have better results than what exists in universal health care systems.
  • Higher-end treatment is important; sometimes you can't prevent illness. With higher-end treatments in privatized health care societies, treatment is often superior. For those that will contract illnesses or cancers regardless of any preventative measures they take, such high-end treatment is welcome.


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Innovation: Do single-payer systems support medical innovation?

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Yes

  • Most investment in medical innovation does not come from companies Private companies make up a smaller portion of the total investment in medical innovation. This means that a single-payer health care system would not see a major reduction in funding for medical innovation. Depending on how the system is designed, it could even see an increase in such investment.
  • Profit interests corrupt investments in medical innovation Drug and medical companies are driven, in large part, by the bottom-line of profits. Their investments in new drugs and medical innovations are driven by these interests. But, what is likely to make the most money is often at odds with public and patient interests.


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No

  • Single-payer health care hinders medical investment and innovation The primary cause of this is a reduction in economic incentives for innovation. In general, the only way that people will take the time, energy, and risks involved with innovation is if there are substantial returns for their investment. This notion underpins the markets and capitalism generally, but is undermined by universal health care. Universal health care, therefore, could be expected to see fewer innovations and medical advancements.
  • Under investment in single-payer system leads to capacity shortages A lack of willingness to invest in expensive technology leads to shortages in areas such as MRI scanning. Some would argue that only the price mechanism in free market health care can allocate resources efficiently and that political pressure often leads to shortages in socialized systems.


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Standards: Would universal health care set a good standard of care?

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Yes

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No

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Delays: Do universal health care systems address concerns of delays?

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Yes

  • Single-payer health care reduces complexities faced by patients Insurance companies often make life as difficult as possible for patients through complicated rules and qualifications. Again, profit-interests motivate this because it makes it less likely that patients will seek a claim. This is all very stressful and time-consuming for patients. A single-payer system would simplify things.


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No

John Goodman, president of the National Center for Policy Analysis, wrote, "rationing by waiting is pervasive, putting patients at risk and keeping them in pain."[2]
  • Frequent cancellations are a feature of universal health care systems. A function of "rationing", doctors sometimes have to cancel visits in a single-payer system.


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Competition: Is competition a bad thing in health care?

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Yes

  • Competition in health care is generally a bad idea While competition can make sense when it relates to the production of goods, it is not good when it relates to dealing with human life. The main problem is that a primary means of "cost-cutting" is by skimping on services to people in need.


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No

  • Single-payer health care erodes competition in price and value The notion of the free markets as a source of efficiency dates back to Adam Smith. The health care industry is no exception to this rule. If it is open to the free-markets, consumers will shop for and purchase the best price and value. Pressure will be placed on insurance companies to cut costs and sell their surface at a lower price for greater value. Free universal health care would interrupt this, reduce efficiency, and increase costs.
  • Governments might attempt to control costs by gaining or enforcing monopsony power. For example, governments, such as Canada, have outlawed medical care if the service is paid for by private individual funds.


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Economic efficiencies: Would universal health care be more economically efficient?

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Yes

  • Universal health care makes people healthier so more productive.
  • Universal health care systems are more economically efficient. America spends a far higher percentage of GDP on health care than any other country, and has worse ratings on a variety of subjects such as quality of care, efficiency of care, access to care, safe care, equity, right care and wait times according to the commonwealth fund. New Zealand, which spends one third per capita what the US spends on health care beats the US on every marker of efficiency and care. Although not definitive, this does lend credence to the idea that universal health care is more efficient than our for profit health care system as the US was inferior to Germany, the UK, Australia, New Zealand and to a lesser degree Canada in nearly all health care quality issues. This despite the fact that the US system costs 2-3x more per capita than the systems in these other countries.
  • Single-payer health care gets rid of wasteful middlemen According to an estimate by Dr. Marcia Angell roughly 50% of healthcare dollars are spent on healthcare, the rest go to various middlemen and intermediates to providing healthcare. A streamlined, non-profit, universal system would increase the efficiency with which money spent on healthcare goes to healthcare.
  • Cost savings with universal health care will outweigh program costs It is important in this analysis to consider that, even if universal health care were to cost more now, that these costs could easily be outweighed by long-term cost-savings. In other words, the costs of not implementing universal health care would be greater than the costs of implementing it.
  • Costs are inconsequential if health care is considered a universal right. It may very well be true that universal health care increases costs. Yet, if we presume that health care is a right, then such added costs are insignificant; they must be born to secure the right of universal health care.


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No

That is largely true of America's health care system. Government controls production and consumption by determining the number of physicians; what services medical professionals can offer and under what terms; where they can practice; who can open a hospital or purchase a new MRI; who can market a drug or medical device; and what kind of health insurance consumers may purchase.
Government bureaucrats even set the prices for half of our health care sector directly, and indirectly set prices for the other half. When you read about Medicare over-paying imaging centers and hospitals, or that it's impossible for Bostonians to get an appointment with a general practitioner, it's largely because the bureaucrats got the prices wrong, and those rigid prices do not automatically eliminate shortages and gluts like flexible market prices do."
  • Aging countries cannot afford universal health care. When a country's population ages, the strain of a universal health care program grows, with a larger percentage of the population reaching an age in which they require health care. Therefore, in countries where the population is aging, it may be important to avoid a universal health care program.


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Administrative costs: Would it reduce administrative costs or add to them?

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Yes

  • Universal health care reduces administrative costs (i.e. paper work) Medical professionals are often challenged with massive amounts of paperwork in private health care systems. A universal health care system will help coordinate and reduce paperwork, allowing doctors to concentrate on treating patients. A single payer system could save $286 billion a year in overhead and paperwork. Administrative costs in the US health care system are estimated to be substantially higher than in other countries and than in the public sector in the US: one estimate put the total administrative costs at 24 percent of US health care spending.


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No

  • Universal health care creates a big, inefficient bureaucracy. The cause of this is greater bureaucratic oversight and more paperwork. This lowers the productivity of hospitals, and thus increases the costs for the same amount of work done.
  • The costs of transition to a universal health care program would be large: It would involve lost insurance industry jobs, business closures, and new patient record creation, among other things. Creating a new administrative framework and patient database would be a massive under-taking.


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Price: Is the price to the individual taxpayer significantly lower?

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Yes

  • Total costs for individuals would be reduced by universal health care: The current US system is already funded 64% by tax money with the remaining 36% split between private and employer spending. A universal healthcare system would merely replace private/employer spending with tax revenues. Total spending would go down for individuals and employers.


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No

  • Universal health care is not free; people pay with their taxes. It is a myth that universal health care could somehow be free or lower the costs to the patient. People pay through their taxes instead of in direct payments to their health insurance providers.
  • Single-payer systems typically mean higher taxes. A country which adopts a totally tax funded socialized form of health care will have to increase the average tax rate by an amount equivalent to the cost of providing health care and administering the system.
  • Allowing for pooling of resources to force drugs to lower prices will reduce overall innovation. Reducing profit, reduces motive and the money necessary to get a drug through FDA trials. Without profit motive, drug companies will naturally move away from the rare and complex, yet fatal, diseases if they only affect a small percentage of people. Without the ability to set the price, their resources will naturally be moved almost exclusively into benign treatments which will have a larger percentage of the population as potential users.
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Businesses: Would a universal health care system be good for businesses?

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Yes


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No

  • Free, universal health care would devastate the insurance industry "Should the Government Provide Free Universal Health Care for All Americans?" Balanced Politics.org - "A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation. A universal health plan means the entire health insurance industry would be unnecessary. All companies in that area would have to go out of business, meaning all people employed in the industry would be out of work. A number of hospital record clerks that dealt with insurance would also be out of work. A number of these unemployed would be able to get jobs in the new government bureaucracy, but it would still be a long, painful transition. We'd also have to once again go through a whole new round of patient record creation and database construction, which would cost huge amounts of both time and money."
  • Universal health care risks monopsony: Universal health care systems, in an effort to control costs by gaining or enforcing monopsony power, sometimes outlaw medical care paid for by private, individual funds.



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World vs. US: What does a comparison between the US and world reveal?

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Yes


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No

  • US health care costs more because Americans are less healthy.
  • US health care costs more because Americans pay to avoid waiting.


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Paying for it: Are there sound proposals for paying for added costs?

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Yes

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No

  • This puts government in the role of arbiter of what practices are healthy and unhealthy.
  • The collection and enforcement of these taxes is not free, but will entail additional bureaucracy.
  • Some controversial practices could be taxed. e.g. medical marijuana.
  • Such taxes are likely to be regressive, especially taxes on tobacco.
  • The healthfulness of some things is dependent on context, e.g. pain killers.
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Mixed private-public: Is single-payer better than mixed private-public universal health?

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Yes

  • Only the government can provide a coherent universal health care system. Such a system is important from the standpoint of providing quality care, in that only a standardized system and unified database can enable doctors to treat any patient that comes in front of them. Privatized systems often see doctors unable to access the history and files of patients that come before them. The main reasons include the cost and complexity of unifying and standardizing a system as well as the lack of a private-industry interest in seeing such a system emerge.


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No

  • A mixed private-public system would preserve existing industries. Any proposal to shift to a single-payer universal health care program from a private health care system involves destroying the private health care industry. This is a highly disruptive act that would involve massive job loss. The advantage of a mixed private-public universal health care system is that it is not as destructive and damaging in this way. It acknowledges the existence of a private health care industry and the need to preserve at least some of the interests of such a massive, and important, industry.


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Database: Would a centralized database be a good idea?

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Yes

  • Government-control of databases better protect privacy than companies. It is important to recognize that this is not a choice between a government-controlled database and no database. The alternative to a government-controlled health care database is only a privately owned health care databases. With these choices in mind, it is better that health care information be held by the government than by less-regulated companies. The government is better able to protect the privacy of individuals.


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No

  • Health care databases threaten to violate the privacy of patients.


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Pro/con resources

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Yes


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No


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Organizations and actors pro and con

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Yes



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No

Cato.org

See also

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