Universal Health Care

I don't think most objective readers would agree taxes are "slavery" and use that to justify any position. If democratic institutions can provide a superior service, then I'm willing use them. I enjoy living in society and I recognize taxes are the price of using those benefits. To remain objective, I will also stick with non-political sources (NGOs, Government reports, medical journals, mainstream publications). I have to admit I am probably taking the easy side of this debate, as every other industrialized country has already debated this issue and settled on universal healthcare. Only the poorest countries have no such systems. Your ideology says universal systems will cause fewer people to become doctors. The facts show the US produces FEWER doctors and nurses than most universal systems. MORE people become doctors in universal systems because the government usually subsidizes their education. http://www.oecd.org... You say there will be less research, but the facts show the countries that spend largest share of their economy on medical research are the Nordics, France, UK, and Japan. The Nordics have the largest public share of healthcare and still perform much better in all areas of research. http://www.oecd.org... Even in the US, most of the discoveries are made by government funding - not the private sector. The NBER and Congressional JEC Commission found 75% of the most significant US pharmaceutical drugs came directly from GOVERNMENT R&D. They also found a 700% rise in private research was mainly to alter existing drugs for new patents, without offering any new advantage or discoveries. R&D is only 1-2% of US medical spending - I think we have a lot of room to cut without impacting research. http://www.pnas.org... I see no reason to believe there will be fewer doctors or less research when many universal systems already do better in both these measures, and the US' primary discoveries are already made by public spending, not private. So, here are my arguments for public health insurance for all: 1) Universal systems cost less because they are more efficient. The US spends about twice as much per person (18% GDP compared to 9% or $7000 vs $3000), but remains the only country unable to insure 20% of its population. The largest cost difference is overhead and administrative waste, which accounts for 31% of the private sector costs and 1/3 of healthcare jobs. If the US could only increase efficiency to Canadian levels (one of the least efficient systems, at 15%), we could extend insurance to all Americans without spending an extra dime. The US medicare and medicaid programs are much more efficient, covering older and poorer people for much less than the private sector. High private sector overhead costs are due to marketing, inability to share information across competitors, the research to identify & deny high risk individuals, profit, lower economies of scale, etc. Universal systems scale well and medical records are often digitized, available to all medical providers. They do not face the waste you see with thousands of different providers trying to negotiate with countless insurers in the US. http://www.pnhp.org... http://content.healthaffairs.org... 2) Universal systems create a healthier society. When individuals are sick or develop conditions, they are treated earlier in universal systems before they become life-threatening or have to use more expensive emergency services. "U.S. patients are more likely to report experiencing medical errors, to go without care because of costs, and to say that the health care system needs to be rebuilt completely. U.S. patients are also the least likely to be able to get a same-day appointment with their physicians when sick and the most likely to seek care in emergency rooms as an alternative." http://www.commonwealthfund.org... 3) A universal insurance system allows Americans to be more mobile, take greater risks, and hire workers. Unexpected health conditions are the largest cause of bankruptcies in the US and most of these people had homes, health insurance, and good jobs. People can start businesses without risking their health and they can be more competitive as they can add employees without incurring additional insurance costs. http://www.bloomberg.com... 4) Public services are regulated by democratic participation. People care a lot about their health and every program is measured by agencies and watched closely by the public. A well-funtioning society balances both democratic institutions and market-mechanisms and doesn't rely on one exclusively. 5) We know universal systems cost less and generally have better results than the current US system because we have other examples to look to. It would be prudent to pick the best from each system and adapt it in an American way. SOME countries have wait times, but many do not. As market-friendly Businessweek pointed out, "In reality, data shows the American people are already waiting as long or longer than patients living with universal health-care systems". And Economist Paul Krugman noted, "America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice... [and] is the worst place if you need care after hours or on a weekend." Wait times are almost exclusively found for non-emergency procedures, especially for the elderly (cataract surgery, hip surgery) in countries like Canada. Although the US does not typically have wait-times for such procedures, they are currently funded by the US GOVERNMENT already through medicare. This advantage is not provided by a superior private system, but a better funded PUBLIC system. http://www.businessweek.com... http://economistsview.typepad.com... Canada is the closest system to the US. They have state-run universal insurance, but doctors and hospitals are private. They are one of the least efficient models, but nowhere near as expensive or poor-performing as the US. Joint US-Canada government studies show Canadians were more likely to receive care than Americans (despite wait lines for the elderly). Canada's problems are isolated to a sharp cutback in health spending in the 90s, when it was determined there were TOO MANY doctors. Physicians felt their wages were suffering from too much competition. http://www.cdc.gov...