Instigator / Pro

The US would benefit from a Universal Healthcare System.


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Contender / Con

-I didn't know what category this fit better as but selected politics as the debate I see on it is largely by politicians not actual health professionals-
The US is often criticised (and mocked) for not having a Universal Healthcare system.
Pro will therefore argue that a Single Payer Universal Healthcare system is preferable and, despite potential fears, practicable for the US to implement.
Con will argue the other side, asserting that the Status quo of non-universal private healthcare is instead preferable.

Round 1
I must first thank those of you who have visited this debate and my opponent for their respective input to this quite stupidly divisive discussion. I will first aim to establish that the status quo is inadequate before then addressing a few issues that universal healthcare is often attacked for, namely cost.

The current Private Insurance system of Healthcare is rightly criticised, primarily for forcing people to in essence pay-to-live, this being reinforced by public Surveys such as Here where just under a third of those surveyed admit to not seeking medical treatment due to cost, even with the reinforced fears of a pandemic behind them, with other surveys such as this one referenced by Forbes polling as high as 44%. Of these people there is no disputing, a large chunk are in poverty and as a result can’t afford sometimes crippling costs with even maternity payments costing as much as $30,000 for simply failing to pay insurance which can roughly only half the cost for childbirth assuming a family rate is applied. 

These costs for insurance also very heavily affect poorer families with 75% those earning less than $25,000 (including those earning the standard minimum wage of $11.80) choosing to forego insurance due to not being able to afford it. This overall then leads to poorer people not being able to go to the hospital or a doctor as yet enhanced costs are expected for not having an already crippling insurance scheme, whilst richer individuals can be as reckless as they like due to comfortably affording it. Therefore we can see the private insurance system profits off of those who may never have to use the insurance whilst also exploiting those who have to go to a doctor by forcing them to either die or bankrupt their family, put simply, it's a ransom.

Before I give way to Con to contest I must then put in, how America could afford it, firstly however I’ll note, even less economically prosperous countries such as the Republic of Ireland can afford a single payer healthcare system. So how could America afford it? The short answer is, taxation. This word scares most (wealthy) Americans as it breaks into their profits, however the alternative is greater GDP spent on Healthcare. This is seen with America dedicating 18% of its GDP to healthcare compared to the UK dedicating little more than half of that GDP percentage to their Single Payer healthcare system. And so we see that the argument of cost does not work as even adopting a more inefficient Healthcare system as the UK does the US would be halving their total expenditure put to the healthcare system.

That is all the argument I have at the moment as I don’t want to risk creating a strawman, as such Any further argument on my end will have to await Con’s opposition.

Thank you, Brit.


PRO's R1 highlights some problems of the status quo. Yet in the description, PRO asserts that I must argue for the status quo. That is a ridiculous claim, I should not be forced to argue that these problems should continue to exist. BoP is not shared in this debate. PRO is the maker of claims, and I have no duty to provide evidence or arguments beyond what is necessary to debunk PRO's claims. Specifically, I am here to disprove PRO's claim that switching to a single-payer system is the beneficial and correct solution.

PRO: The US would benefit from a universal healthcare system
CON: Debunk that claim and especially PRO's arguments

BoP is not shared -- it lays solely on PRO.

PRO's extraordinary claim
The resolution is without any "THBT" or "On Balance", meaning PRO is claiming that with absolute certainty, attempting to implement the single-payer system in the USA will both be successful and beneficial. PRO has to provide evidence that this is DEFINITELY true. Any chance (no matter how small), of the single-payer system failing or not benefiting USA, would be detrimental to PRO's case --- especially chances of governmental mismanagement scandals or economic problems caused by such a system. What is true to even higher regard is that PRO loses if I can show that his proposed solution is generally risky and that other safer options exist. I will now proceed.

PRO has not provided any argument for his proposed solution. Nothing he has said proves that the US would benefit from a universal healthcare system. He has only highlighted current issues, which is not the same as proving that a certain change would be beneficial. There are multiple inherent flaws of democracy; would that prove that rearranging our society would be beneficial? Of course not. The fault of one system does not prove the virtue of another. Neither my criticism of democracy nor PRO's criticism of the current healthcare system proves that it would be beneficial to transition away from those systems. Thus PRO lacks any actual argument to support his case.

Challenging PRO to provide evidence
  • Please provide evidence that nearly all Americans will support this new single-payer system, lest you want to force an unwilling population into paying a stiff price to get a dubious result.
  • Please provide evidence that America has a high enough level of wealth, organization and government efficiency to actually implement this system, lest you will let significant percentages of GDP slip right into the hand of bureaucrats while not providing adequate healthcare as promised.
  • Please provide evidence that the single-payer system can function properly in the US, and that it can solve the problems PRO described. 
It would be irresponsible to claim that the resolution before addressing these issues.


Economical risk
The USA is a very unstable country politically and economically compared to European nations, and especially the government is not reliable and trustworthy. Neither the economy nor the administration of the USA is proven capable of such immense responsibility as taking care of its citizens, as so far only stable, rich and homogenous European nations have successfully implemented a single-payer system and have it benefit the country (if it even has). In the USA it is very unclear if the system is even possible, and far from its benefit has been established even in thought experiments. PRO's resolution fails because one cannot properly determine the future. Consider the dangers of making such a swap into a Universal Healthcare System. The US economy is fragile enough, with big government spending and enormous debt which continues to increase. 

Health care costs continue to increase faster than the economy, and as interest rates rise. By 2030, the debt is headed toward 118%. While the recent increases in debt seem quite manageable, the federal debt cannot grow faster than the economy indefinitely []
According to the same article, if interests rise, the debt might get out of control. Merely the fear of this happening can lead to government cuts to welfare. Thus, PRO's system risks having people suddenly get much worse healthcare because of government mismanagement. If this debt does get out of control, which becomes increasingly more likely as governmental spending on healthcare increases, then we will face another economic crisis that might last for decades (because of the nature of debt).

Political risk
The USA is a very divided nation politically. Even subsequent administrations distrust their predecessors and have the guts to counteract or reverse the achievements of each other, thus preventing a stable process for change -- especially on controversial issues like healthcare. Moreover, the government isn't guaranteed to be able to handle the extra layer of responsibility if they are to take on themselves the duty to provide Healthcare to everyone. We have no way to ensure proper political management of resources, and no way to ensure the government can maintain a stable system. We are talking about the country that fled from its responsibility to future generations and broke its promise to the international community --- on such an important issue as climate change. The USA led by Trump literally ditched the Paris agreement previous governments had agreed to due to the urgency and importance of stopping climate change. Because of this inconsistent political leadership and political landscape, one cannot trust the American government to act reliably, keep its promises or follow long-term plans --- not even on all-important issues.

The American government, as an institution, can't be trusted. And neither is it trusted.
For years, public trust in the federal government has hovered at near-record lows. That remains the case today, as the United States struggles with a pandemic and economic recession. Just 20% of U.S. adults say they trust the government in Washington to “do the right thing” just about always or most of the time. [pewresearch]
More than 40% of Americans explicitly distrust the American government's ability to provide adequate healthcare services. 

Contrary to European nations, the US is neither economically nor politically capable of maintaining safe and reliable healthcare services. It's not a matter of prize; money is abundant, but mismanagement and bad prioritization among politicians --- as well as expensive and complicated bureaucracy. These problems are far more impactful than PRO's straw man "lack of money" in terms of being barriers and problems preventing the US from having a functional and effective single-payer system.

I claim that PRO's R1 criticism of a free market healthcare service fails miserably. You can't call out Putin's consistent popularity of 99.99% of votes and then claim that democracy is a failure. Putin's power is specifically a result of a non-democratic nation that is more or less non-democratic. Similarly, PRO's criticism of the current healthcare system fails, because the industry is regulated to such a degree that it can no longer be called a free market. I further claim, backed by evidence, that the government caused the problems of the current healthcare service, by regulating the market in a way that prevents sufficient competition. Let me elaborate.

Economic theory
If you know economics you know that the driving force of companies is money, money and money. If you have studied economics and learnt about capitalism you also know that this craving for money leads to better products, cheaper products and better service --- because competition is stiff and only companies making services people are willing to pay to earn money. But without competition, for example in the case of monopolies, the prices rise and rise and the virtues of capitalism are turned into flaws.

Perhaps most alarming, patients have worse health outcomes when hospitals face less competition. []
The article above explains how the number of competitors and the dynamics of competition shapes the results, in other words, the services people have access to. Studies find that hospital and insurance companies are merging and becoming centralised, which means the competition becomes absent and the monopolizing causes a rise in price without a similar rise in quality. Once again, the absence of competition directly harms consumers.

The real problem - flawed regulation systems - and the real solution
"Restricted entry leads to markets with fewer providers and, thus, reduced market competition among agencies. In a market with regulated prices, such as in home health, reduced competition may have a negative effect on the quality of home health care delivered." [ncbi]. "CON programs were conceived with the goal of controlling healthcare costs and increasing access to care. But they have been proven to do the opposite. States with CON laws have higher healthcare costs and fewer medical services per capita. The overwhelming evidence, including the unwavering opinion of the federal government for more than three decades, has been that CON laws are a policy failure. The solution, then, is obvious. States should repeal CON laws." [Institue For Justice]

Ban anti-competitive practices. For example, hospitals frequently write contracts that prevent insurers from telling patients about less expensive or higher quality competitors. Similarly, dominant insurers insist that contracting hospitals not offer their services to other payers at lower prices. These sorts of practices should be prosecuted or outlawed.

Ensure that dynamic new competitors can enter the market. New companies can inject much-needed innovation into healthcare--for example, through the use of newer technologies like tele-medicine—and also keep prices lower and quality higher for everyone. 
Our package contains many more detailed proposals, some of which have already been embraced by federal and state regulators.

Rather than risk our economical stability in a chaotic and controversial transition with more government spending, the much more effective strategy is to remove regulations proven to hurt consumers and re-establish a set of laws that incentivises competition and all of its virtues. This solution is best in virtually every way, and it does not involve large risks and time-consuming transitions. We can keep capitalism, choice and competition and will get the benefits these provide as opposed to dubious results from PRO's plan.

I have shown that a single-payer system has the potential to eventually destabilise the economy, and the increasing cost of public healthcare might become the final spike in the coffin for the already struggling American economy. Moreover, the system can't be assured to function efficiently because the American government and bureaucracy isn't even close to as reliable as their European counterparts. PRO has not proved that the single-payer system is compatible with America, and I have argued for the opposite being the case. Not only that, but the problems of the current system are actually caused by the government and federal law more so than the healthcare market itself, and the superior solution is to reform the law system to allow for actual competition rather than monopolies.

PRO has not yet offered a single argument as to why the resolution is true. 

The resolution fails. The US would not evidently benefit from a single-payer healthcare system being implemented. I rest my case.

Round 2
My opponent forfeited in a 2 round debate