DEBATE: Health Care
Submitted by baker on Sat, 02/23/2008 - 12:26
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The Crux of the Issue
Universal Health Care
- Universal health care aligns itself with the belief that medical care should be a civil right. Does everyone deserve the best medical care our technology can provide? Or should the best medical care only go to those people who can afford the exorbitant costs?
- Is it even possible to afford giving the best medical care to everyone who needs it? Medical technology advances so quickly that new procedures costs hundreds of thousands of dollars. And that doesn't even include the millions of dollars required during the patient's recovery and rehabilitation. Thus, is it not fair that a capitalist society's most successful citizens (i.e. the ones savvy enough to make the most money) should be rewarded by being able to afford the best health care technology, while less affluent citizens can afford a level of medical care that corresponds to their level of financial earnings?
- Next, let's just assume that the proportion of healthy people to sick people is favorable enough to be able to afford universal health care in the first place. Won't that mean that we'll have to fork over more than half of our paychecks in taxes to the government? Just how bad would the taxes be? Is it fair that those of us who work hard and earn more money should pay for the medical care of the poor and those who don't contribute to society?
- Doesn't universal health care mean it would be overrun with government bureaucracy, inefficiency, long waiting lines, mounds of paperwork, and inferior quality of care?
- Health care cannot be left entirely to the free market because an individual person cannot just go out and buy health insurance for a reasonable price. This is because the only people who'll be willing to pay the high premiums are people who are sick already or are likely to get sick in the future. People that are young and healthy aren't going to waste their money on the low probability that they'll need health insurance. Since only sick people purchase the insurance, the insurance companies end up paying more to heal its customers than it takes in from monthly premiums. Thus, the premiums skyrocket until they're not affordable. Insurance companies can only offer fair rates when their customer base is a large cross section of mostly healthy people and some unhealthy people. The premiums of the healthy people help cover the unhealthy people or those people that suffer from an unusually serious accident. This is why you can't go out and buy insurance at a fair rate as an individual (e.g. COBRA). Yes, you can get it so that there's no break in your health coverage history, but only for minimal coverage at a high premium. The result is that Americans must get health insurance through their job. People who can work a job are generally healthy, with fewer sick people, and thus the insurance company can make a profit. Unfortunately, the employer is the one who pays for the health plan. Since firms are always trying to cut costs and maximize profits, employers will typically choose cheaper health insurance plans. Yes, companies that require talented professionals will compete for those talented workers by providing better health insurance. But companies that only need unskilled laborers don't have to compete as much for employees and thus don't provide good health insurance. This is also bad because people are generally scared to quit their jobs, regardless of how badly they are treated, because they would lose their health insurance and have to find a new job with health insurance immediately. If there is a break in health insurance coverage, there are significant penalties that cause future rates to be higher, or else coverage is denied all together.
- MY ANSWER: I don't believe that medical care is a civil right. We should not force doctors to work for free. Doctors should be compensated for their services just like any other profession. Nevertheless, even though medical care is not a civil right, society as a whole has a vested interest in keeping its citizens healthy and productive. Additionally there is the moral imperative that when a person is sick or injured that we should do everything in our power to help them. That means doing everything we can to heal them, and failing that, doing everything we can to maintain quality of life for the time they have left. It is inhumane to deny medicine because someone is not rich. A person's job should not determine how much medical care they receive. As for the belief that government run health care would be a train wreck of inefficiency and poor service, I would suggest looking at the quality of socialized medicine in Canada and Europe. It may surprise you.
Privately Owned Hospitals and Health Insurance Companies
- The free market is great because of Adam Smith's "Invisible Hand" concept. People pursuing their own best interests will result in benefiting everyone else. Private hospitals and private health insurance companies would theoretically provide the best quality services at the lowest possible prices because they have to compete with other private hospitals and private health insurance companies. However, because these companies make so much money, has their power to lobby Washington politicians resulted in too much government interference in the health care industry? Do we really have fair competition in health care?
- Now let's assume that we do have fair competition in the health care industry. Is it wise for companies with their sole goal of maximizing profit to be entrusted with providing what is best for our personal health? Won't private hospitals cut corners and choose less expensive treatments, not for our benefit, but in order to maximize profits? Won't private health insurance companies strive to make their insurance plans as wordy and convoluted as possible to ensure that most people won't understand them so that when they actually need the insurance to pay, they find out about some fine print clause that screws them over? Would it make more sense to have public health care in which money is not involved in making medical care decisions? Wouldn't it make more sense to have the doctors making the decisions about your treatment instead of corporate management?
- MY ANSWER: The current structure of private hospitals and private health insurance companies makes so much money that have essentially achieved an oligopoly (a monopoly achieved by illegal collusion between multiple companies). The vast profits of these companies have convinced the government to get involved, provide subsidies, and inhibit fair business competition. Furthermore, our legal tort system regarding malpractice lawsuits forces doctors to purchase gargantuan malpractice insurance, essentially binding them into this oligopoly structure. I think privately owned hospitals and health insurance companies could yield a free market health care industry that provides top notch quality at competitive prices. However, such a free market does not exist in health care, so we don't know if it would be good or not. To achieve this in the first place, we would need to withdraw government involvement in the health care industry to enable fair competition. That means perhaps revamping our whole political lobbying system, which is a monstrous task in itself. If we could achieve that, maybe then we could judge if the free market is the best place for health care.
The goal of intelligent debate is the joining of ideas and perspectives in order to arrive at a general consensus on the crux of the issue. Good debate is NOT about winning and losing. By persuading with logical arguments, participants might not leave the debate with an altered stance on the issue, but hopefully everyone will better understand the complexities of the issue and respect opposing viewpoints. Eventually, this awareness of the complexity of an issue leads to fair and balanced laws. Many of the problems of the world occur when debate turns into irrational, emotional word-fighting. Such word-fighting deteriorates into insults and hatred, leading to a breakdown of communication which, at best leads to an attitude of "us versus them", and at worst leads to violence and war.
Remember, the goal of debate is to offer insightful ways of looking at the issue so that all participants can work towards a common consensus on the crux of the issue. It is about common understanding, that builds the groundwork for fair and balanced law.