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Doctors Debate Universal Health Care: Pros and Cons From the Experts universal-health-care-1.gifOne of the top issues on your mind this year is likely to be health care. Buzz word: universal.
Great Debate Medicare Reform Click image
“Health insurance is expensive, and not everyone can afford it,” goes one argument. "The government should provide everyone with access to paid-for health care.” “That's not fair," goes the other. “For example, why should everyone have to pay for people who choose not to take care of themselves, such as smokers?”
newsletter-graphic-free2And the debate rages on, with many more pros and cons, facts and figures and ideologies making the details of each argument downright interesting and utterly important. We asked two doctors with strong opinions on the topic to share their side. Here’s what they had to say. You can get in on the debate here.
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We invited each participant to write an argument, then read the opponent’s argument and, if desired, write a rebuttal. Neither was allowed to read the other’s initial argument before writing his own, and neither could read the other’s response before rebutting. FOR
How can there be a debate over whether universal health care is itself a desirable goal? A 2002 Institutes of Medicine study concluded that more than 18,000 Americans die every year because they’re uninsured. Some kind of health coverage for every citizen would mean fewer child deaths from asthma, fewer cancer deaths in minority communities and fewer veterans who depend on emergency rooms for their primary care. The real questions are how universal care would be paid for and who would decide levels of reimbursement For ---
universal-health-care-2 Patrick Whelan, M.D, Ph.D., practicing rheumatologist, national executive director of Catholic Democrats (a public-advocacy organization) and Catholic member of the Democratic National Committee's Faith Advisory Council.
The first myth concerns what universal health care is: a broad term that could mean anything from government financing (as in Medicare/Medicaid for all) to use of tax law to bring everyone into the private health-insurance system (as recently enacted in Massachusetts under Republican Governor Mitt Romney). Health insurance companies spend heavily to condemn something called “socialized medicine,” recognizing that any single-payer plan would likely result in heavy losses for their industry. But no major organizations or national political figures have advocated creating a system like Great Britain’s, where the government owns all the facilities and employs all the doctors and nurses.
Two other myths about universal care are that doctors oppose it and that quality of care would suffer. But a plurality of physicians, particularly primary-care doctors, supports national health insurance. And there is now strong evidence that, even in developed countries with addiction problems like ours, universal coverage correlates with improved quality of health across the socioeconomic spectrum. ---------------------------------------------------------------------
AGAINST Against -------
universal-health-care-3.jpg John S. O’Shea, M.D., M.P.A., F.A.C.S., practicing general surgeon and former fellow with conservative think tank The Heritage Foundation.
America is often criticized for its lack of a universal health-care system comparable to the Europeans and Canadians, even though Germany, the United Kingdom and even Canada are increasingly turning to the private sector in order to relieve the financial burden on government and solve serious delivery problems, most notably “rationing by queue,” the prolonged wait times for many services, including cancer treatment and cardiac surgery. Compared to the private sector, government programs are inefficient and the higher costs have to be paid for with higher taxes or spending cuts in other areas such as defense, education, or even medical research and development. This is a tradeoff that most Americans would not be willing to make. Get in on the Debate! ---------------------
Sound off! Share your opinions about universal health care in the comments section below. If low-income persons find health-care coverage unaffordable, they should be subsidized by the government, but they should retain ultimate ownership of their health-care resources and the choice about how those resources will be utilized. Such patient ownership and choice will create the demand for price and quality transparency necessary to make value-based health-care decisions.
The fundamental flaw in universal health-care systems is a misplacement of incentives. The decisions that drive health-care costs and quality of care are made by individual patients and their health-care providers. These decisions should not be influenced by universal government mandates, administered pricing systems or expenditure targets, but should instead be based on an adequately informed assessment by individual patients and their providers about the value of services in a particular clinical situation. REBUTTALShands pulling rope
Dr. O’Shea’s The author is correct that “universal health care” is a desirable goal. However, this goal will not be achieved by simply expanding the role of government or mandating universal coverage.
Coverage is not the same as health care. For example, according to CDC statistics, Medicaid/SCHIP beneficiaries use the emergency room for non-urgent problems at even a higher rate than the uninsured, due to a lack of access to primary care. More money is also not the answer. Changing incentives to give patients ownership and control of their health-care resources will lead to a more efficient, higher quality, value based health care system.
Dr. Whelan’s Government already covers more than half our health care. Expanding Medicare to include the 20 percent of costs covered by employers (plus coverage for the uninsured) isn’t inevitably more inefficient or costly. It’s false to label all government programs as inefficient since Medicare’s overhead is one-tenth that of private insurance.
Public financing doesn’t automatically disincentivize quality health care—considering that our government dominates U.S. biomedical research funding, and the world’s greatest scientists are competing intensely for those dollars. Groups like The Heritage Foundation , sponsored by the insurance industry, offer these arguments to hide their major concern with universal health care: that it jeopardizes insurance industry profits. newsletter-graphic-free2RELATED ARTICLES
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Last updated and/or approved: February 2010. Original article appeared in Jan/Feb 2008 print issue . Bookmark Email This Trackback(0)trackbackTrackBack URI for this entryComments (130)add commentfeedSubscribe to this comment's feed 1 2 3 4 5 > Last ›0No kidding... written by Joshua , April 13, 2010
Tru dat, Ted, tru dat. (@Teresa) Yes it is a very nice convenience to have health care. paying for doctor visits is difficult without. But why do those big nasty insurance companies charge different prices or deny coverage and stuff? Math. Wait are you sure it isn't discrimination? Nope. It's just math. If your a bad driver, you're more likely to cost them money so you need to pay more so that you are statistically not a financial risk. In health care, a hemophiliac, cancerous, cripple with HIV will cost them much more money than they could possibly make. To force companies to cover such people would bankrupt the company. Now no one has health insurance, Way to go! Wanna know how this issue is often fixed? Charity. there are hundreds of organizations or charities or funds for different medical situations; even multi-billion dollar companies donate money. 'Poor people' get more from others than just about anyone. report abusevote downvote up Votes: +2 0It's what we don't know that will get us written by Ted , April 12, 2010 Joke? We know it screws seniors out of "Advantage" , we know it steals half a trillion from seniors who have paid into the system for many years and gives it those who haven't paid a dime and will probably never pay a dime.
We know it has no cost controls to reduce the cost of insurance. We know that lawyers will still make a killing on malpractice insurance cases as doctors (patients) really pay for it.
We know that congress will continue to tinker with the laws per their special interests demands. We know that those with insurance will pay for those that don't.
We know that government will redistribute health care per their "fairness" doctrine. We know that there is not enough doctors, hospitals and health care workers to take care the coming load so it will be rationed.
What we don't know is how long it will take for our idiots in DC to bankrupt the country. report abusevote downvote up Votes: +0 0A JOKE TO WHO? written by Teresa Branson , April 12, 2010
You know in some ways and to some people the Health Care Reform may be a joke. But what if it turns out to be one of the best things that ever happened to Americans? Then who will the joke be on? And if it turns out to be another government money rackett well the joke has been on the American people for so long already that it isn't funny! So what are we to do? We must set back and take what comes I mean we voted him in right!?! report abusevote downvote up Votes: +1 0This is what universal healthcare is (a joke) written by Anonymous , April 11, 2010 AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAHHHHHHHHHHHAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAaH AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAaHAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAaHAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAaHAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAa report abusevote downvote up Votes: -3 0Option not law! written by Teresa Branson , April 09, 2010
I believe that it could be quite helpful if there was insurance out there that the poor American poeple could afford. There are some that fall into a brakett where they are not eligible for medicaid but cannot afford health insurance. I don't agree with the fact that if those people can't get insurance then they get pentalized. But the government should help those folks. Everyone needs health care. report abusevote downvote up Votes: +3 0Misdirection written by Gene , April 08, 2010 Healthcare is not in the bill that passed. It is a bill that control all aspects of paying for help; hence, everyone becomes a ward of the state. People are misdirected and follow the directions. To make sure you pay the amount the FEDERAL government is extorting, the IRS was granted, in the bill, 16,000 more agents. I highlight "federal" because there is no provision in the Constitution that permits any federal business, save the post office. Mr. Obama has already said he dismisses the Constitution because it is only negative. By that, he means it is a road block to tyrants and fascists which was exactly what the founders, those rich white men, wanted. You advocates are selling your children's souls for a warm feeling. I used to be covered by OHIP in Canada, there is no "national" plan, and the people use more drugs than anyone else and receive tardy and sloppy care. Of course, I can't know what I am talking about because I was just living there and not privy to socialist talking points. report abusevote downvote up Votes: -2 0no free for me written by joe blow , April 07, 2010
no such thing as free is absalutly right! report abusevote downvote up Votes: +2 0Expected Luxuries written by Joshua , April 07, 2010 Whats so special about insurance? It is just a person/group that calculates the likelihood of an expense, and is willing to pay that price at that time if you pay a much smaller charge at other times. Get a lot of people doing this, and you have an insurance agency. Its people trading money for a convenient service that happens to be really helpful when you need it. No magic or shiny halos. Business. Just like a plumber, the problem sucks, but it is by no means a requirement to be productive or to be an equal citizen. I guess I can accept mandatory car insurance, that way you can pay for the other guy's bills if you mess up. Your health insurance has little to do with me. report abusevote downvote up Votes: -2 0Why it won't work here... written by sparkler , April 06, 2010
In other countries that have Universal HC 1) They are are not "sue" happy and 2) those governments pay for part or all of the physician's training. Neither of those issues were addressed in the legislation that was just passed. Let me tell you where I sit, before I tell you where I stand. My husband is a physician, first generation. He has an enormous amount of debt from both 4yr undergrade and 4yr med school and 3 years intership/residency training. During those training years he has worked long and hard at a level most of us could not handle, including 80 hours/wk during his residency. Why? Because he loves what he does, he's good at it and he wants to help people - just like most physicians. His first year in practice (at the age of 28, making his first "real" salary where he could actually pay bills), he was shocked, as med school did not prepare him for dealing with insurance companies, or the gov't. run programs medicare and medcaid. He was most outraged when he had a an insurance company telling him over the phone that a procedure that he was recommending for a patient was not neccessary - he asked the person, "Are you a doctor?" - No, she was a nurse. He asked "Did you see the patient?", she replied "NO" He asked, "Then how can you possibly know what my patient needs!? Let me talk to your medical director." And he proceeded to get the authorization. He left the small practice the next year when they wanted him to see more patients per hour AND cut his pay by over $5,000. because the ins companies AND the gov't was cutting reimbursement. He went out on his own and started a cash practice because he works for the patient NOT the Ins. Co. or the Govt. His patients appreciate his skills and services and don't mind paying his fees. He sees each patient anywhere from 45 mins to 1.5 hours. Besides his enormous school loan debt, we were also paying enormous amounts to his Professional Liability Insurance company - even though he has never had an incident (The saying in medicine goes, "it's not IF you get sued - it's WHEN) until we moved to a state that has Caps on awards. I do not like this bill because it gives the gov't too much control and say in our healthcare. When the gov't mandates it's people to PURCHASE something - that just can't be the right direction, or constituional. Also, by expanding medicaid,It becomes a matter of access to care VS quality care. More people have "access", but there are very few doctor's who actually accept medicaid because reimbursement is so poor, that the provider is actually sometimes taking a loss! And then they are suppose to start reimbursing provider's of medicaid at medicare levels, which is great except the gov't just cut medicare levels by 21%, so now more provider's will be be dropping medicare. What other profession would put up with decreasing salaries, increased workloads, working in a "sue" happy environment? And our doctor's don't strike! (Perhaps they should start forming unions!) And the figures I heard is that the 43 million uninsured include people who are here illegally (i.e., they don't pay any income taxes)and people who choose NOT to be insured (i.e.they could afford it, but choose to go without). I agree that the rest need to be covered in some way, and the fastest and easiest way would have been deregulation of the insurance industry (deregulation did wonders for the airlines!) that way the ins. co. could compete across state lines, just like car insurance...and more competition means more affodable prices - I bet even the teens on this board know that much! And when I think of other govt programs that are suppose to help us, like Social Security...and I see how badly the gov't has run that - why would anyone want the gov't anywhere near our health?!?!? Our elected leaders should not be excused from ANY law they make! Can we all agree on that? report abusevote downvote up Votes: +3 0RE: All you people who choose to to curse. IDIOTS written by Aliyah , March 28, 2010
First off, who are you to say what things we have done for our 'fellow man', you have no idea of the extent of my charities and everyone's for that matter who happens to oppose this idea-not a very good argument. That's a beauty in our country, freedom of choice. Freedom to choose where/what/who we 'pay a little bit more' to, and not being told this. Second, there is a big difference between complaining and defending something, something being our constitutional rights. Not trying to belittle you, in fact I sympathize with your situation and lift you up. Read our Constitution. Understand it and what's really going on. Fundamental stuff. report abusevote downvote up Votes: -3 1 2 3 4 5 > Last › Write comment Title
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