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

I accept Pro's terms, but note Pro's resolution: guaranteeing health insurance does not guarantee healthcare.UHC=universal healthcareUHI=universal health insuranceI believe UHI will cost more than a free market solution. Healthcare is a scarce resource and, based on economic laws, adding tens of millions of consumers to the system while not adding doctors, hospitals, etc will drive up prices dramatically or result in rationing, or both. Pro's first contention is that UHC would be cheaper, with anticipated savings in admin costs. A common way to look at this is to compare Canada and the U.S. An often sited study showing Canada's low administrative costs comes from Himmelstein and Woolhandler [1] who state that these costs are 3 times as much in the U.S. than in Canada. It's interesting to read opinion pieces from these same two authors [2]:They [hospitals] reap surpluses, a.k.a. profit, which they use to buy fancy machines and superluxe buildings – usually situated where there’s already a surplus of such facilities. Investing in what’s needed instead of what’s profitable would save billions and improve care for both the poor and the affluent.It would appear they have an agenda. Don't consumers decide what is needed and demand the best technology, MRI machines, cat scans, etc? Given a choice between two hospitals, one dilapidated, which do you prefer? Note that Canada is one tenth the population of the U.S. and does not have the socio-political complexity of the U.S.. Would it not be more fair to compare to Medicare? Similar efficiency claims are made for Medicare, however John Goodman has this to say:Here is a brief review of the literature: Robert Book discovered that reported Medicare’s administrative costs per patient (not as a percentage of the bills) were actually higher than private insurance. A Milliman study concluded that when all costs are considered (including the cost of tax collection) Medicare’s cost as a percent of total spending is 66% higher than private insurance. Ben Zycher concludes that a government run system would have higher administrative costs than a private system. And Tom Saving and I showed (based on CBO numbers) that Medicare has not been more successful that the private section in holding down costs.[3]Even if we accept the claims of savings due to admin costs, I submit this savings is small compared to the impact of a free market. One of the most important concept in economics deals with prices and voluntary exchange, which results in equilibrium prices established by supply and demand [4]. In order for this to work, exchange must be voluntary, and those exchanging goods must directly bear some of the costs. Neither Medicare, PPACA or the Canadian system seems interested in this concept.Voluntary exchanges naturally balance supply and demand. If consumers desire more preventive services, demand increases, tending to drive up prices. But the increased prices attracts supply increase, mitigating these increased prices. Without these price signals, the only thing controlling price is what the market will bear. Examples of this can be seen when government attempts to control prices. In the 1970's Nixon set oil price limits adding to shortages [5]. On the other end of the spectrum, minimum wage laws create an oversupply of workers by setting an artificial upper limit on the price of labor [6].Fortunately there is a current and relevant example of free market healthcare in the U.S.: the Surgery Center of Oklahoma (SCO) was opened in 1997 by Dr. Keith Smith with a desire for a free market facility [7]. How is this facility different than a typical hospital? For one thing, they publish their prices on their web site [8]. Notably these prices are a fraction of typical fees from hospitals [9]:“complex bilateral sinus procedure.” At the Surgery Center, the all-inclusive price is $5,885. At nearby Integris Hospital the price in 2010 was $33,505 – but that did not include either the surgeon’s or the anesthesiologist’s fees.This facility does not generally take Medicaid or Medicare. Why? Because they are not free market systems and have bureaucratic overhead. SCO does deal with self-insured and consumers are obviously free to seek reimbursement as they wish.Now lest you think the SCO ignores the poor [9]:Dr. Smith said the center’s approach is helping to restore an old-fashioned medical ethic for provision of charity care. Many referrals to the hospital come from churches and other groups helping the poor. Patients are encouraged in those cases to pay what they can, while physicians and anesthesiologists can (and often do) waive their fees for individuals in need.So what would be the impact of a nation-wide roll out of the SCO model compared to single payer admin savings? If we use the most liberal data available (Himmelstein and Woolhandler), we get 31% admin overhead for the U.S. and 16.7% for Canada for a 14.3% savings [1]. In comparison, the average prices for a procedure at SCO is 1/3 that of competing hospitals [12]. Hospitals typically get paid 60% of a bill, but that still leaves a 50% reduction overall. But what is more important is the affects of free market pricing continually hold prices down, and in the case of certain technology-heavy services, will reduce prices over time. With admin cost reductions, this will always be based on a percentage of an ever increasing price structure.Pro's second contention is that productivity will go up with the assumption that UHC will ensure that workers comp cases will be reduced. I find this to be a giant leap of faith and most likely a total fallacy. One need only look at long wait times for health care in Canada. (low on space, will cover more later)Pro's third contention, sub-point A deals with the uninsured. I find it perplexing that Pro has an issue with paying for the healthcare of the uninsured through taxes and then wants a system whereby all insurance is paid for via taxes. The cost-shifting is irrelevant since Pro desires to shift all costs to taxation. Pro's main point here is the increase in cost due to services being more "drastic and risky". But how was this measured? Do hospitals make a judgement call for every non-insured emergency room patient like "It appears you delayed seeking medical treatment such that costs are now 30% more"? This is more than a bit hard to accept. Pro's third contention, sub-point B brings up the World Health Organization (WHO) and it's reports of the poor health care we receive in the U.S. It's fascinating that the WHO studies are still being referenced in these debates as there is abundant information pointing out it's flaws [13]. The 2000 WHO report was more about pushing it's political agenda then reporting facts. Just a few words from the above source:Flaws..have been repeatedly exposed in peer-reviewed literature by academic experts who have examined the study in detailand from WHO authors:respecting the ethical principle that it may be necessary and efficient to ration services.The WHO report is based purely on a socialist agenda (our of space, more later)[1] http://www.nejm.org... [2] http://pnhp.org...[3] http://healthblog.ncpa.org...[4] http://en.wikipedia.org...[5] http://mises.org...[6] http://wiki.mises.org...[7] http://www.drkelley.info...[8] http://www.surgerycenterok.com...[9] http://reason.com...[10] http://en.wikipedia.org...[11] http://www.freemarketcure.com...[12] http://www.theihcc.com...[13] http://www.commentarymagazine.com...