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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

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“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?”

NewsletterAnd 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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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

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.

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.

REBUTTALS
hands 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.

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Last updated and/or approved: February 2010. Original article appeared in Jan/Feb 2008 print issue .

Comments (105)add comment
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READ THIS BITCH
written by Allen Williams , March 15, 2010

FUCK OBAMA AND UNIVERSAL HEALTHCARE


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universal healthcare
written by unanamous , March 15, 2010

Universal Healthcare is a waste of money that America can't afford. It may not effect those who pass it, but im 14 and it will greatly impact my future America and will affect the many generations that come after me.


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Medical costs need controls
written by Roberta Richardson , March 04, 2010

I worked in health care for 25 years, and my experience led me to strongly support efforts to develop a universal health care program in the USA. A recent personal experience has strengthened my resolve to support this legislation.

In January, I had foot surgery at a Holland, Michigan, outpatient surgery center. I was in and out of the center in three hours, but the center billed Medicare more than $26,000 for its services. This amount does not include the surgeon’s fees, anesthesiology or medical equipment. Of course, Medicare didn't pay that amount - they paid the center $2,084, which seems about right for the services provided. Would I have been responsible for paying this exorbitant charge if it had been denied by Medicare?

I wonder, based on my sister’s similar experience recently. She went to an urgent care center for her son's school athletic exam. The center advertised $45 for the exam, but when she went to pay, the center told her they would bill her insurance. Rather than $45, the center billed her insurance $150. In her case, the insurance denied the charge and she had to pay the $150 rather than $45 as she had been originally quoted.

Medical costs need controls. I don't see how this will be accomplished without universal health care. Please support our President in his efforts to pass some kind of bill to protect the public’s right to affordable health care.



0
Bethany you dpmt understand how richest country is chosen
written by brian , February 25, 2010

Bethany richest country is chosen the GDP of the country, which we are rank one. It is not chosen by how rich the government is


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Health Care
written by Bethany , February 24, 2010

Why does everyone think that America is the richest nation in the world?! DOn't you know that we are so in debt that we can never get ourselves out of it? The only thing that makes us better than other nations is that we have lots of nuclear weapons. So PLEASE stop saying we are a rich country! It's making me sick!


0
Universal Coverage For ALL!!
written by Kristina Ayala , February 24, 2010

Sooo I watche Michael Moores SICKO movie last week and i was deeply moved. It talkes about universal health care in other countries such as europe and canada... EVEN CUBA!!!

Its true we are the RICHEST country in the world, but we are the MOST SELFISH and GREEDY as well.

I think with money comes greed, and greed comes selfishness!!

IF we all werent sooo selfish and cared for our country than we SHOULD have UNIVERSAL HEALTHCARE because that would make our country even more stronger!!

I believe there is good in all people and that we should all come together as a nation regardless of the tax increase, or why should i pay for someones medical bill because they are smokers or what not.

THINk about it, the people that do this to there selves well eventually wilt away, but THEY too are paying for everyone else.

We are a chain, that supports one another! we need each other!!

WAKE UP AMERICA!!!!!!!!



0
...
written by sabrina , February 19, 2010

i was sam by the way


0
...
written by sam , February 19, 2010

its not gonna help us it's only going to make things worse. I igree
with doctor o'shea coverage is not the same as health care. People think that just because it's free it's good but it isn't.
The sooner we figure this out the better



0
Universal Healthcare
written by Victor , February 12, 2010

U.S.A. is the richest country in the world. With that said, how do poor European countries provide free universal healthcare?


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just listen
written by Bethany , February 06, 2010

im fifteen years old. dont ignore this comment only because of that fact though. all that american adults seem to be worried about right now is money. people say that jobless people are lazy and all they need to do is get up and get a job. what those people WITH jobs dont realize is that they CANT. america is in a recession. companies are constantly laying off more and more people. what makes you think that if they have to lay people off then they can just turn around and hire more people? it doesnt happen.
imagine this scenario if you will: two men are driving down the road after work. both are going home to a wife and two children. one man can afford health insurance. the other cannot. suppose they got in a crash and both were horribly injured. does the uninsured man deserve to suffer simply because he cant afford insurance?
exluding people from medical help only because they cant pay for insurance is barbaric.
maybe im young and naiive, but i dont understand why the government doesnt just tax the richer people who actually CAN afford to pay the taxes. here are movie stars and famous singers spending hundreds of dollars on botox and perfume. really? have a heart.
adults need to get off their high horses and think about other people instead of themselves for a change. if can barely afford to pay the taxes you have right now, thats understandable. but you can really afford to sit by a pool all day sipping on drinks simply because you can pretend to be someone else? take some of that stored away money that your never going to use in your lifetime and help other people who cant even afford the luxery of a shower every day.
you always tell us teenagers to grow up. why dont you watch some of us for a day? we care about other people. not just money. maybe adults need to take us as an example and open your damn cold hearts.



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