A Reasoned Debate About Universal Health Care

The tea-baggers are trying all they can do to disrupt reasonable debate about health care. It is anti-democratic, anti-intellectual and anti-social. In fact, it is downright un-American, because we believe in free speech. Shouting down people with whom we disagree is nothing but bullying and does nothing to advance anyone's cause.

Proponents of universal health care have done a lousy job at explaining the benefits. It all come down to a few basic, clear arguments:

Universal Health Care saves everybody money.

It is simply right and decent and the proper role of society to take care of basic health.

While we prefer private enterprise to do most things, we don't expect the military, the police or fire protection to operate on a for-profit basis. Why would we insist upon that for health care?

The number of uninsured citizens has grown to over 45 million. Health care has become increasingly unaffordable for businesses and individuals. We can eliminate wasteful inefficiencies such as duplicate paper work, claim approval, insurance submission, etc. We can develop a centralized national database which makes diagnosis and treatment easier for doctors, and it could be done without identifying individual patients. Medical professionals can concentrate on healing the patient rather than on insurance procedures, malpractice liability, etc. Free medical services would encourage patients to practice preventive medicine and inquire about problems early when treatment will be light; currently, patients often avoid physicals and other preventive measures because of the costs. Patients with pre-existing conditions can still get health coverage. And big companies such a General Motors, which compete internationally with companies in countries where health care is not the responsibilty of the employer, may be able to compete fairly.

There may be some reasonable arguments against universal health care. Below is a little exercise is a reasoned debate - from my perspective as a "lay" person - not a medical professional. I did take some license here: I pretended I was engaging someone who could advance reasonable complaints, not just shout "liar" and other right-wing "talking" points. (Read "shouting points.") Here goes, for what it is worth.

There isn't a single government agency or division that runs efficiently; do we really want the government handling something as complex as health care?

The "nameless, faceless" government bureaucracy is an easy target when it is convenient. If the government is so ineffective, should we privatize the police, the fire departments and the military? We already see the effects of private contractors escalating costs of war in Iraq.

"Free" health care isn't really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc.

Right. There is no free lunch. It will cost taxpayer money. But it will also save money, because those who are uninsured still get health care when they go to an emergency room for treatment, for example. And because they often can't pay for it, hospitals have to make up for it by charging more to everyone who can pay for it. By insuring those without coverage, it will create a much greater efficiency. People with insurance are more likely to get routine exams, sp it will encourage wellness, rather than paying for sickness.

Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.

Universal health care will not necessarily do away with competition. It certainly won't eliminate individual ingenuity among doctors, nurses and other health care providers. And profit motives seldom benefit the consumer - only the provider of services.

Government-controlled health care would lead to a decrease in patient flexibility.

There is no evidence to support this argument. This depends upon how the laws are written. The health care proposals now before Congress all support a patient's right to choose health care providers and insurance carriers.

Patients aren't likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.

This is fairly easy to control. Reasonable cost-control measures are already in effect through insurance companies. Co-pays on prescriptions for drugs for which there is a generic equivalent, for example, is a reasonable cost-control measure. Another example would be elective cosmetic surgery; insurance companies justifiably won't pay for a facelift - neither should a universal health care plan. The big problem is that there is no appeal process for a patient. If an insurance company decides to deny payment, the patient has no recourse.

Just because Americans are uninsured doesn't mean they can't receive health care; nonprofits and government-run hospitals provide services to those who don't have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance.

Exactly. But generally, uninsured people only seek these means when there is a catastrophic need. And that drives up the overall costs for everybody. Where does the government get its money to pay for this? From your tax dollars. Wouldn't you rather pay to prevent flu than to pay for pneumonia?

Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.

That's already true. Uninsured people still get health care when it reaches catastrophic proportions. But then it is much more expensive to treat them, and the outcomes are much poorer. And revamping the health care system is an opportunity to create disincentives for unhealthy behaviors. (Example of a disincentive: Because of taxation, the price of cigarettes has already increased by over 200% in the past seven years.)

Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.

Again, this has not happened in other counties offering universal health care. Doctors are still affluent in those systems - and they deserve it. Few other professions are so important and few call for the extensive and expensive training required.

Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.

The current legislation has nothing to do with covering caregivers' malpractice insurance, and would not cause the government any exposure to legal liability, other than allowing for some recourse in a patient's right to petition for reasonable treatment. The costs of malpractice insurance have been rising steadily under the current system - and insurance companies have been exempt from lawsuits. Talk about sheltering a major player from responsibility! This is certainly an important issue, its relevancy to whether we offer universal health care is absurd. The government can disallow lawsuits or limit liability or change the rules.

Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms.

This is another fallacious argument based upon a "This will lead to..." scenario. We are a society that agrees upon establishing certain rules for the general good. We all must take responsibility for protecting our perceived freedoms. If we don't like smoking regulations or fast food restrictions, those are battles we can take on separately. Does the act of installing traffic lights lead to police check points and the suspension of the right to be free of unreasonable search?

Patient confidentiality is likely to be compromised since centralized health information will likely be maintained by the government.

This is erroneous. The government need not centralize health information, and even if it did, records can be kept anonymously. And failing all that, why would you assume the government is incapable of keeping information private. Have you ever tried to get your neighbor's tax records? If so, send me the information on my 2009 tax return. I dare you.

Health care equipment, drugs, and services may end up being rationed by the government. In other words, politics, lifestyle of patients, and philosophical differences of those in power, could determine who gets what.

Undeniably, in a democracy, there is always the danger of the tyranny of the ideology of those in power. In is incumbent upon reasonable people to construct reasonable legislation. But rationing is unlikely. No other country with universal health care has ever rationed drugs or services.

Patients may be subjected to extremely long waits for treatment.

The average wait for medical care in countries with universal health care - such as Canada or most European counties - is considerably less than it is in the United States.

Like social security, any government benefit eventually is taken as a "right" by the public, meaning that it's politically nearly impossible to remove or curtail it later on when costs get out of control.

First, the presupposes that health care is not a right; yet the Declaration of Independence, in its opening sentence, proclaimed the inalienable right of people to "life, liberty and the pursuit of happiness." Isn't good health inherent in "life?" The fact that the United States is the only modern industrialized nation that doesn't have universal health care suggests that something is deeply amiss in our definition of rights of citizens. As for the impossibility of change once a program is established, we need look back no further than the 1990s, when Welfare Reform changed many of the rules - rightly or wrongly.

Universal health care will mean forced euthanasia for the elderly.

I have three letters for this concern: WTF? Where did this ridiculous notion come from? I'd respond, but I was going to limit this to "reasonable debate," suggesting reasonable concerns. This is just an absurd scare tactic.

So that's it. I presented the best arguments against universal health care that I could find and answered them honestly, factually and with reason. I'd welcome any reasonable, non-shouting, non-tea-bagging debate.