Improved Medicare for All (USA)

I also pointed out that both of these systems are lacking in medical technology compared to the USA (MRIs and CT scanners specifically). In this round, I plan on going into more detail on the failings of both these systems. First, a 2007 study from the NBER compared Canadian and USA HC. It found that Canadians had longer waiting times, less access to preventative treatments, worse disease survival rates, and lower satisfaction rates than Americans. For instance, only 5% of Canadian men and women, aged 40-69, had ever had a colonoscopy compared to 30% in the USA. Likewise, only 16% of men, aged 40-69, had ever gotten a PSA test in Canada compared to 54% of men in the USA. Similiar gaps exist for other types of preventative screening and testing [1]. As for waiting times, 57% of Canadians reported having to wait 4 or more weeks to see a specialist compared to 23% of people in the USA. Similiarly, 82% of Canadians had to wait more than 4 weeks to get elective surgery compared to 42% of Americans. The median wait time for a hip replacement was 12 weeks in Canada compared to 5 weeks in the USA [1]. As far as satisfaction goes, 51.3% of people in USA aged 18-64 and 63.8% aged 65 report being "very satisfied" with the health services they receive compared with only 41.5% of Canadians aged 18-64 and 55.4% for Canadians 65 [1]. Note that asking people about the heath care they receive is different from asking them about the entire health care system. Asking them about the health care system is more relevant for the debate because it is shaped by their personal experience as opposed to the media's presentation of the larger system. As for the UK system, on top of having very high health inflation and lacking in medical technology, as I showed last round, they also have very bad cancer care. A major cancer study from Lancet Oncology found that the UK lagged behind other nations and especially the USA when it came to cancer survival rates [2]. When it came to prostate cancer, folks in the USA had a survival rate of 92% compared to only 51% in the UK. The difference was largest for prostate cancer, but all other types of cancer had large gaps. The USA had anywhere from a 15 percentage point to 20 percentage point advantage on the other types of cancer, which included breast cancer among other types of cancer (note that it is percentage points not percent) [2]. Some people counter that the reason that the USA has high cancer survival rates is because we screen more agressively so we catch cancer earlier. This is. .. absolutely right. I think it was assumed that it was common knowledge that early detection means people are more likely to survive. All in all, both the Canadian and UK SP systems have higher health inflation and much worse access to health care than the USA. Now, I will respond to my opponent's R2 arguments. SP Does Not Save MoneyMy opponent claims that SP will save money. This is an interesting claim. However, it is inconsistent with two things I brought up in R1. First, health cost growth has been higher in both the UK and Canada, with SP systems, than the USA over the past 10 years. And, within the USA, health cost growth has been higher in the public sector than private sector. My opponent, for his part, has claimed that the reason Canada and the UK have had higher cost growth is that they are "investing" in technology that will save money in the long run. Unfortunatley, my opponent did not offer a source for either of these claims. The BoP is on my opponent to show that this is the reason for cost growth AND that these will in fact save costs in the future. With regards to public health spending in the USA, my opponent has a chart showing private premiums rising at a faster rate than medicare spending per benificiary since 1969. However, this is an extremely misleading comparison. The reason for this is that, in private insurance, there has been a huge shift from out of pocket spending to prepaid private health plans. What pro is essentially doing is only showing half the equation. After all, out of pocket health spending took up 35% of health spending in 1969, when my opponent's chart started but only took up 12% in 2008 when his chart ended [3]. An apples to apples comparison would be to look at all of private health spending and compare it to all of public health spending. And, when we look at this, over the same time period of 1969 to 2009, we see that private health spending grew about 2,000% per capita compared with an even higher 3,386% for public health spending per capita [3]. Once we look at a true apples to apples comparison, we can see that the public sector has been far worse in terms of cost growth. Okay, but how about administrative costs? Well, this is another misleading way of looking at things. In fact, administrative costs have little to do with efficiency and more to do with accounting. Government programs, by nature, tend to focus on this sort of thing because it makes them LOOK more efficient than they actually are. And, of course, we have to look at all relevant costs [4]. As shown here, Medicare's low administrative costs are more an accounting gimmick than actual efficiency, and, even despite these gimmicks, Medicare still has HIGHER administrative costs per benificiary, which is the correct measre [5]. Pro Business? Pro claims that SP would be a big boon to business. After all, we all know how much businesspeople like it when the federal government takes over a major sector of the economy. But, in all seriousness, we have to look at this rationally. I don't think even my opponent would deny that SP would entail a tax increase. And, it seems that his entire argument on this point rests upon the view that SP reduces costs, a view that is incorrect as shown above. The Simplicity of Big GovernmentIf there's one thing we all know about large government programs, it is that they are always simple and efficient. .. before they are implemented. Once they are actually implemented, I think we all know the rest. However, it should be noted that the health care sector is not simple. So, I have to wonder why my opponent has such faith in the ability of a few central bureacrats to set prices and wages within this major sector. As we should all know at this point, it is simply impossible for a few bureacrats to better allocate health resources than the 300 Million individuals who actually are using them. Again, the history of central planning should have made this common knowledge. You would think that after the fall of communism in just about every country, belief in the ability of supposedly intelligent government planners to run an entire economy or large sector of an economy would not persist but, as shown by support for SP, it does. My opponent claims that SP really isn't a centrally planned system. This is obviously not true. Under SP, the government has a monopoly on the financing of basic health services. This means that the government, with all it's power and lack of pricing mechanism, will force providers down to extremely low prices. And, with patients having an incentive to overutilize, there will be more and more pressure for the fed to pay less and less or to tax more and more. .. or both. In the long run, this means higher taxes and less availability of health services. ConclusionI will finish responding to Pro in R4. Sources:[1] . http://www.nber.org...;[2] . http://healthcare.procon.org...[3] . http://www.oecd.org...[4] . http://marginalrevolution.com...[5] . http://www.forbes.com...