Instigator / Pro
0
1598
rating
20
debates
65.0%
won
Topic
#798

Access to and the distribution of health-related services ought to be handled by the free market.

Status
Finished

The debate is finished. The distribution of the voting points and the winner are presented below.

Winner & statistics
Winner
0
4

After 4 votes and with 4 points ahead, the winner is...

RationalMadman
Parameters
Publication date
Last updated date
Type
Standard
Number of rounds
5
Time for argument
Two days
Max argument characters
30,000
Voting period
One week
Point system
Winner selection
Voting system
Open
Contender / Con
4
1687
rating
555
debates
68.11%
won
Description

Round 1: Opening Arguments
Round 2: Rebuttals
Round 3: Rejoinders
Round 4: (Double) Rejoinders
Round 5: Closing Arguments.

Stipulations:

1. This debate will not be restricted to juxtapositions of private and public health insurance. Arguments for health insurance, however, may be submitted.

2. Since the proposition over which we argue is normative, moral arguments may be submitted.

3. This debate will primarily focus on the economics of the issue.

Round 1
Pro
#1
Opening Argument

The premise on which I argue that "access to and distribution of health-related services ought to be handled by the free market" is the vast and complex set of subjective values which inform a transaction. And these subjective values are best expressed through free-flowing prices, which is fundamental to a free-market. The absence of price controls allows buyers and sellers to meet and conduct transactions on their own terms, and serve the benefit of each party involved. Health-related services as with any good or service has a cost. These costs, rather than being addressed in terms of economics, are often politicized and reduced to referendums on who has which right, legal or moral. There are a couple of issues which would arise in the attempt to sustain a "right to health care":

  1. Physicians and nurses have no authority over the labor, services, or goods they provide and would be coerced into submitting the aforementioned in order to satisfy the claim that is one's "right."
  2. By "right," claimants mean "free of costs," or "free at the point of use" when consuming health-related services. The former makes little sense if we don't indulge the enslavement of physicians and nurses, and the latter is a euphemism for debt deferment. If the government is going to subsidize the consumption of these services, then the costs of said services will be addressed through taxation--the forceful seizure of property where in the absence of compliance, death can be a result.
Perhaps, however, these costs can be addressed in a manner that wouldn't involve the prospect of crippling debt, satisfying nonsensical claims, or worst case scenarios: enslavement or death. I propose, as the subject of this debate suggests, freeing up the market. First, we must discern the regulations and/or restrictions imposed, and how each play a role in the exorbitant costs of health-related services. I will be using the access and distribution of health-related services in the United Stated as an exemplar.

  • The American Medical Association
       The American Medical Association is a government subsidized organization which functions as a cartel for physician labor. The AMA is able to restrict the amount of physician labor through the LCME (Liason Committee on Medical Education,) which is responsible for accreditation, and the ACGME (Accreditation Council for Graduate Medical Education,) which is responsible for internships, residencies, and fellowships. The American Medical Association which has been partnered with the Association of American Medical Colleges since 1942 sponsors the LCME, and is in part responsible for the creation of the ACGME for which it has four seats on its board of directors. In 1910, the American Medical Association lobbied the Republican administration under William Taft to close or merge half of American Medical Schools. The pretext was to prevent substandard medical training; however, the report (The Flexner Report) on this substandard medical training was authored by a person, Abraham Flexner, who not only had no expertise at all in allopathic, homeopathic, or even osteopathic medicine, but also was a critic of the American College System. In some of his inspections of medical schools, he was accompanied by N.P. Colwell (page 9,) the secretary of the American Medical Association's Council on Medical Education. Not to mention, Flexner was hosted in Chicago by the American Medical Association when finishing his report.

         By artificially restricting the supply of physician labor, the American Medical Association is essentially creating creating a shortage (page 15 and onward,) especially in the advent of increased demand borne from government subsidized consumption, which consequently produces inflated physician salaries. These physician salaries in part are extended to the final product contributing to the inflated costs of health related services. By removing the government preference for the American Medical Association, as well as removing the government subsidy, we can reduce costs of health related services as well as spare billions in federal spending on health care.

Drug Patents

In 1925, the United States under the the Coolidge administration allowed for government-licensed drug monopolies through the patent system. This allows select drug companies exclusive preference in the drug industry. By removing the patent system, the entry of cheaper generics will enter the market.The consequential reduction in the inflated prices will, Once again, Be extended to the final products: health goods and services.

The FDA

This is more of an extension of the previous arguments. Much like the American Medical Association, The FDA is very much an inhibitor to the availability of promising drugs (as opposed to physician labor with the former. ) The FDA determining which drugs are approved, Creates a shortage of available drugs. The costs of getting approval by the FDA is just south of $3 billion dollars. We must ask ourselves whether we need the FDA in order to prevent the dissemination of toxic or death-inducing drugs. We also must consider that no drug is free from the prospect of toxicity or inducing death. There are several scenarios that would happen if we freed up the market and allowed more boards to over see the dissemination of drugs:

1. Drug companies produce drugs that are ineffective and have adverse side effects,

2. Drug companies produce drugs that are effective but have adverse side effects.

3. Drug companies produce drugs that are ineffective which lack adverse side effects.

4. Drug companies produce drugs that are effective which lack adverse side effects.

A solution which doesn't require taxation or large amounts of federal subsidy is the use of social media. With the expansion of social media, information about adverse effects of chemical drugs would not only reach larger audiences, but also information would be disseminated much quicker. I'd remiss if I didn't inform you that the FDA hasn't always lived up to the standard it allegedly upholds especially when 35 prescription drugs had to be recalled. Not to mention that 1 in 3 drugs were concluded to have safety concerns in a 16 year span.

It is my argument that addressing these restrictions and regulations would see dramatic decreases in costs in health related services; also, consequently, it is my argument that this is a better solution to the costs of health-related services as opposed to meeting these costs through debt deferment, nonsensical claims, enslavement or death. As we continue our debate, I will expand on these points, and even add supplementary points wherever necessary.

My opponent, the floor is yours.
Con
#2
Easily 80% of Con's case is rebutting the fully privatised healthcare system. Con cannot stick to debate structure unless to post an extremely simplistic in this opening case as all the angles beyond what is in this opening Round are direct rebuttals to the fundamentals and specifics of Pro's case.

To be clear, Con is not representing full Socialism of the healthcare system. The hybrid system of Social Democracy variants where the utmost power and means of distributing healthcare to the masses is the one that Con takes. Private Healthcare has its place, Con concedes this and only this. The place it has is beneath and around Public Healthcare, which is at the core. The Private Healthcare is good for competing on whacky, new ways to heal something or treat something. It may even be better at the non-essential elements of Healthcare provision such as the comfort of the beds and chairs being more extremely high in the Private hospitals and old people's homes etc. The quality of medicine, however, is something where Con takes a Socialist stance in that it should be just as good medication and even therapy when it comes to mental health therapy services, that the poor can get as the rich.

The concepts of Utilitarianism and Human Development Index will be key to this debate. Pro states that HDI is the only (yes, only) world-renowned reliable way to compare how Utilitarianism-oriented nations are in the world, with 'oriented' and its severity including how successful that are at implementing the values of Utilitarianism (practise, not just theory).

1. Utilitarianism: Overall View
Utilitarianism is a philosophical view or theory about how we should evaluate a wide range of things that involve choices that people face. Among the things that can be evaluated are actions, laws, policies, character traits, and moral codes. Utilitarianism is a form of consequentialism because it rests on the idea that it is the consequences or results of actions, laws, policies, etc. that determine whether they are good or bad, right or wrong. In general, whatever is being evaluated, we ought to choose the one that will produce the best overall results. In the language of utilitarians, we should choose the option that “maximizes utility,” i.e. that action or policy that produces the largest amount of good.

Utilitarianism appears to be a simple theory because it consists of only one evaluative principle: Do what produces the best consequences. In fact, however, the theory is complex because we cannot understand that single principle unless we know (at least) three things: a) what things are good and bad;  b) whose good (i.e. which individuals or groups) we should aim to maximize; and c) whether actions, policies, etc. are made right or wrong by their actual consequences (the results that our actions actually produce) or by their foreseeable consequences (the results that we predict will occur based on the evidence that we have).

a. What is Good?
Jeremy Bentham answered this question by adopting the view called hedonism. According to hedonism, the only thing that is good in itself is pleasure (or happiness). Hedonists do not deny that many different kinds of things can be good, including food, friends, freedom, and many other things, but hedonists see these as “instrumental” goods that are valuable only because they play a causal role in producing pleasure or happiness. Pleasure and happiness, however, are “intrinsic” goods, meaning that they are good in themselves and not because they produce some further valuable thing. Likewise, on the negative side, a lack of food, friends, or freedom is instrumentally bad because it produces pain, suffering, and unhappiness; but pain, suffering and unhappiness are intrinsically bad, i.e. bad in themselves and not because they produce some further bad thing.

Many thinkers have rejected hedonism because pleasure and pain are sensations that we feel, claiming that many important goods are not types of feelings. Being healthy or honest or having knowledge, for example, are thought by some people to be intrinsic goods that are not types of feelings. (People who think there are many such goods are called pluralists or“objective list” theorists.) Other thinkers see desires or preferences as the basis of value; whatever a person desires is valuable to that person. If desires conflict, then the things most strongly preferred are identified as good.
1

Definition of 'ought'
1 Used to indicate duty or correctness, typically when criticising someone's actions.
1.1 Used to indicate a desirable or expected state.
Con asserts that 'ought' is at the essence Utilitarian when it comes to Politics and how to ethically go about the provision of healthcare in it. Con believes there is simply no other coherent morally justifiable scaling along which 'ought' is to be measure other than Utilitarianism, when it comes to healthcare and that this is near axiomatic. Con challenges Pro to concede this basis of 'ought' or to bring a better one.

The topic 'healthcare' is massive:

Clinical Healthcare
These are the doctors, nurses, and assistants who work with patients to diagnose and treat health issues, and often provide preventative care to help patients maintain good health. A few examples of clinical specializations include:

  • Cardiology
  • Dentistry
  • Emergency medicine
  • Gerontology
  • Pediatrics
  • Psychiatry
  • Radiology
  • Therapy and Rehabilitation
These services help patients recover their independence after an injury, illness, or surgery. Some main areas of focus could be:

Pain management
  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Healthcare Administration
If you want to help people and have a knack for leadership, Healthcare administration could be a great career choice. According to the Healthcare Leadership Alliance, there are five main areas of expertise in this field:

Hospital administration
  • Medical practice administration
  • Nursing administration
  • Healthcare financial management
  • Healthcare information management
  • Public Health
While careers in clinical Healthcare treat individual patients, public health professionals focus on groups. Most jobs in this field require at least a master’s degree, and you’ll study the role of society in a community’s quality of life and overall health. There are five traditional core disciplines that you’ll study in a public health master’s degree program:

Biostatistics
  • Environmental Health Sciences
  • Epidemiology
  • Health Policy and Management
  • Social and Behavioral Sciences
3

For Biostatistics, Clinical Healthcare and Hospital Administration, Pro may argue that audits are viable. Con, with foresight, pre-rebuts that the audits would need to be publicly (state-funded) done to be truly reliable especially for something where the entire climate change and other massive world-impacting studies as well and actual murder of people on a hospital bed either under the knife or more indirectly are things that can happen if things aren't correctly monitored by people whose motive it is to stay voted in power by the people, as opposed to those who only want to get rich from the activities. The impacts are huge if those 2 are sold out to the Private sector at the highest level of authority in the field(s).

Pain management still matters and to suggest poor people should have no access to it whatsoever is to put them through more agony and thus stress and potentially depression, which results in them needing psychiatric help anyway. Imagine working a blue collar job, which tends to be very physically demanding, and being incapable of affording even a panadol. It would be hell. Imagine getting not speech therapy for a severe slur or speech impediment of any kind (even not having cleft lip properly operated on as your parents couldn't afford to fix it well), you would fail interviews and struggle socially in workplaces and anywhere just due to that alone. the Pain Management section must ultimately be provided by the public sector, even readily in schools to help children of all income brackets deal with speech impediments and any such thing at a young age and help the poor cope, in general. 

Clinical Healthcare is the most important one to be available to people who are even the very poorest. This is literally the difference between someone dying of a car accident or living. Imagine being injured, being too poor to get it treated which means you can't work so your family and you have to starve if you're the breadwinner. That's the undeniable outcome and trap of poverty that happens in truly Capitalist nations when it comes to their healthcare and the poor.


Human Development Index (HDI)
The HDI was created to emphasize that people and their capabilities should be the ultimate criteria for assessing the development of a country, not economic growth alone. The HDI can also be used to question national policy choices, asking how two countries with the same level of GNI per capita can end up with different human development outcomes. These contrasts can stimulate debate about government policy priorities.
The Human Development Index (HDI) is a summary measure of average achievement in key dimensions of human development: a long and healthy life, being knowledgeable and have a decent standard of living. The HDI is the geometric mean of normalized indices for each of the three dimensions.

The health dimension is assessed by life expectancy at birth, the education dimension is measured by mean of years of schooling for adults aged 25 years and more and expected years of schooling for children of school entering age. The standard of living dimension is measured by gross national income per capita. The HDI uses the logarithm of income, to reflect the diminishing importance of income with increasing GNI. The scores for the three HDI dimension indices are then aggregated into a composite index using geometric mean. Refer to Technical notes for more details.

The HDI simplifies and captures only part of what human development entails. It does not reflect on inequalities, poverty, human security, empowerment, etc. The HDRO offers the other composite indices as broader proxy on some of the key issues of human development, inequality, gender disparity and poverty.

A fuller picture of a country's level of human development requires analysis of other indicators and information presented in the statistical annex of the report.


4

Every single year since its introduction, especially snowballing over time, it has found that the nations who are the worst in the world at HDI have the most unfair and brutal systems on their poor. This even can include strange exceptions to the Private-only Healthcare rule like, Venezuela and/or Cuba but what's clear is the top nations are the ones more towards Social Democracy while the ones towards the bottom are towards brutal, unfettered Capitalism or pseudo-Marxist Tyrannical Communism (but this is not due to the public healthcare, it's due to all the other issue with Communism in application).

Let's look at the top 10 nations in the past 2 years.

1 Norway
2 Switzerland
3 Australia
4 Ireland
5 Germany
6 Iceland 
7 Hong Kong, China (SAR)
7 Sweden
9 Singapore
10 Netherlands


  1. Norway 0.891
  2. Australia 0.860
  3. Netherlands 0.854
  4. Switzerland 0.847
  5. Germany 0.846
  6. Iceland 0.843
  7. Sweden 0.840
  8. Denmark 0.838
  9. Canada 0.833
  10. Ireland 0.832



Go ahead, Pro, admit to everyone that all these nations have a core, upmost provision of healthcare via Public means of funding and distribution while enabling the Private to evolve very scarcely around it in relation.

2017

Sources - formatted Harvard style via http://www.citethisforme.com/:
[1] Nathanson, S. (n.d.). Utilitarianism, Act and Rule. [online] Internet Encyclopedia of Philosophy. Available at: https://www.iep.utm.edu/util-a-r/#H1 [Accessed 28 Apr. 2019].
[3] College Choice. (2019). What Is Healthcare?. [online] Available at: https://www.collegechoice.net/faq/what-is-healthcare/ [Accessed 28 Apr. 2019].
[4] United Nations Development Programme | Human Development Reports. (2019). Human Development Index (HDI). [online] Available at: http://hdr.undp.org/en/content/human-development-index-hdi [Accessed 28 Apr. 2019].
Round 2
Pro
#3
Forfeited
Con
#4
Throughout the entirety of Pro's R1 we see no reason to favour private healthcare to public healthcare. Drug patents don't disappear in a public healthcare system, especially not a hybrid one that Con is supporting.

When the market is 'freed' it comes at the cost of the poor being 'enslaved' to have no healthcare at all. This concept is why right-wing Libertarianism is among the most self-contradictory of all political systems possible. Once you free up the market, the rich are entirely able to make things inaccessible to the poor. You literally cannot work harder to make more money if you're too physically ill to and/or if your time and energy at going to help your sick family member.

This trap is 100% the argument against 'freedom' in the 'free market healthcare' plan and is proven by every single capitalist nation where there's barely any taxation or possible 0 public healthcare at all, having severe poverty.

This is also supported by the inverse; that all that score highest on HDI are social democracies.
Round 3
Pro
#5
Forfeited
Con
#6
Round 4
Pro
#7
Forfeited
Con
#8
Thusly forth I thrust my sword.
Round 5
Pro
#9
Forfeited
Con
#10
FULL FORFEIT