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Health care often accounts for one of the largest areas of spending for both governments and individuals all over the world, and as such it is surrounded by controversy. For example, it is now clear that medical debt is now a leading cause of bankruptcy in the United States.[1] Though there are many topics involved in health care politics, most can be categorized as either philosophical or economic. Philosophical debates center around questions about individual rights and government authority while economic topics include how to maximize the quality of health care and minimize costs.

Contents

Background

The modern concept of health care involves access to medical professionals from various fields as well as medical technologies such as medication and surgical techniques. One way that a person gains access to these goods and services is by paying for them. Many governments around the world have established universal health care, which attempts to provide the same level of access to every person in a country. Many citizens are against universal health care for a variety of reasons.

Philosophy

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Right to Health Care

The United Nations' Universal Declaration of Human Rights (UDHR) asserts that medical care is a right of all people. Many religions also impose an obligation on their followers to care for those in less favourable circumstances, including the sick. Humanists too would assert the same obligation and the right has been enshrined in many other ways too.[2][3]

An opposing school of thought rejects this notion.[4] They assert that providing health care funded by taxes is immoral because it is a form of legalized robbery, denying the right to dispose of one's own income at one's own will.

Government Regulation

A second question concerns the effect government involvement would have. One concern is that the right to privacy between doctors and patients could be eroded if governments demand power to oversee health of citizens.[5]

Another concern is that governments use legislation to control personal freedoms. For example, some Canadian provinces have outlawed private medical insurance from competing with the national social insurance systems for basic health care to ensure government controlled allocation of national resources. Laissez-faire supporters argue that this severely erodes the effectiveness of the system, and that those who can afford private health care should be encouraged to use it, so as to take pressure off the public system. [6]

Controlling the Industry

When a government controls the health care industry, it defines what health care is available, and how it is paid for, privately or with taxes. Public regulation, investor owned HMOs and medical insurance companies (which are forced to act in the best interests of their customers so as to stay afloat) may all determine what health care a person might get.

Universal health care requires government intervention and oversight.

Economics

Impact on quality of health care

One question that is often brought up is whether publicly-funded health care provides better or worse quality health care than market driven medicine. There are many arguments on both sides of the issue.

Arguments which see publicly-funded health care as improving the quality of health care:

  • For those people who would otherwise go without care, any quality care is an improvement.
  • Since people perceive universal health care as free, they are more likely to seek preventative care which makes them better off in the long run.[7]
  • A study of hospitals in Canada found that death rates are lower in private not-for-profit hospitals than in private for-profit hospitals.[8]

Arguments which see publicly-funded health care as worsening the quality of health care:

  • It slows down innovation and inhibits new technologies from being developed and utilized. This simply means that medical technologies are less likely to be researched and manufactured, and technologies that are available are less likely to be used.[9]
  • Free health care can lead to overuse of medical services, and hence raise overall cost.[10][11]
  • Publicly-funded medicine leads to greater inefficiencies and inequalities. [4][12][13]
  • It is alleged that uninsured citizens can simply pay for their health care. Even indigent citizens can still receive emergency care from alternative sources such as non-profit organizations. Some providers may be required to provide some emergency services regardless of insured status or ability to pay, as with the Emergency Medical Treatment and Active Labor Act in the United States.

Impact on medical professionals

Proponents of universal health care contend that universal health care reduces the amount of paperwork that medical professionals have to deal with, allowing them to concentrate on treating patients.

Impact on Medical Research

Those in favor of universal health care posit that removing profit as a motive will increase the rate of medical innovation.[14] Those opposed argue that it will do the opposite, because removing the incentive of profit removes any incentive to innovate.[13]

Economic Impact

Universal health care affects economies differently than private health care.

Those in favor of universal health care contend that it reduces wastefulness in the delivery of health care by removing the middle man, the insurance companies, and thus reducing the amount of bureaucracy.[15]

Those opposed to universal health care argue that socialized medicine suffers from the same financial problems as any other government planned economy. They argue that it requires governments to greatly increase taxes as costs rise year over year. Their claim is that universal health care essentially tries to do the economically impossible.[16] Opponents of universal health care argue that government agencies are less efficient due to bureaucracy.[12] However, supporters note that modern industrial countries with socialized medicine tend to spend much less on health care than similar countries lacking such systems.

In the United States, opponents of universal health care also claim that, before heavy regulation of the health care and insurance industries, doctor visits to the elderly, and free care or low cost care to impoverished patients were common, and that governments effectively regulated this form of charity out of existence.[17] They suggest that universal health care plans will add more inefficiency to the medical system through additional bureaucratic oversight and paperwork, which will lead to fewer doctor patient visits.[18].

Means

Many forms of universal health care have been proposed. These include mandatory health insurance requirements, complete capitalization of health care, and single payer systems among others.[19]

See also

References

  1. ^ "Medical Debt Huge Bankruptcy Culprit - Study: It's Behind Six-In-Ten Personal Filings". CBS. 2009-06-05. http://www.cbsnews.com/stories/2009/06/05/earlyshow/health/main5064981.shtml. Retrieved 2009-06-22.  
  2. ^ National Health Care for the Homeless Council.[1] "Human Rights, Homelessness and Health Care".
  3. ^ Center for Economic and Social Rights. "The Right to Health in the United States of America: What Does it Mean?" October 29, 2004.
  4. ^ a b Sade RM. "Medical care as a right: a refutation." N Engl J Med. 1971 Dec 2;285(23):1288-92. PMID 5113728. (Reprinted as "The Political Fallacy that Medical Care is a Right.")
  5. ^ Universal Health Care Won't Work - Witness Medicare
  6. ^ Cato-at-liberty » Revolt Against Canadian Health Care System Continues
  7. ^ "The Best Care Anywhere" by Phillip Longman, Washington Monthly, January 2005.
  8. ^ Devereaux PJ, Choi PT, Lacchetti C, Weaver B, Schunemann HJ, Haines T, Lavis JN, Grant BJ, Haslam DR, Bhandari M, Sullivan T, Cook DJ, Walter SD, Meade M, Khan H, Bhatnagar N, Guyatt GH. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. CMAJ. 2002 May 28;166(11):1399-406. PMID 12054406. Free Full Text.
  9. ^ Miller, Roger Leroy, Daniel K. Benjamin, and Douglass Cecil North. The Economics of Public Issues. 13th Ed.th ed. Boston: Addison-Wesley, 2003.
  10. ^ Heritage Foundation News Release, "British, Canadian Experience Shows Folly of Socialized Medicine, Analyst Says," Sept. 29, 2000
  11. ^ The Cure: How Capitalism Can Save American Health Care
  12. ^ a b Goodman, John. "Five Myths of Socialized Medicine." Cato Institute: Cato's Letter. Winter, 2005.
  13. ^ a b Friedmen, David. The Machinery of Freedom. Arlington House Publishers: New York, 1978. p 65-69.
  14. ^ For example, the recent discovery that dichloroacetate (DCA) can causes regression in several cancers, including lung, breast and brain tumors.Alberta scientists test chemotherapy alternative Last Updated: Wednesday, January 17, 2007 The DCA compound is not patented or owned by any pharmaceutical company, and, therefore, would likely be an inexpensive drug to administer, Michelakis added. The bad news, is that while DCA is not patented, Michelakis is concerned that it may be difficult to find funding from private investors to test DCA in clinical trials.University of Alberta - Small molecule offers big hope against cancer. January 16, 2007
  15. ^ William F. May. "The Ethical Foundations of Health Care Reform," The Christian Century, June 1-8, 1994, pp. 572-576.
  16. ^ Lawrence R. Huntoon, "Universal Health Coverage --- Call It Socialized Medicine"
  17. ^ David E. Kelley, A Life of One's Own:Individual Rights and the Welfare State, Cato Institute, October 1998, ISBN 1-882577-70-1
  18. ^ Cato Handbook on Policy, "Chapter 7: Health Care," Cato Institute 6th Edition (2005)
  19. ^ Kereiakes DJ, Willerson JT. "US health care: entitlement or privilege?." Circulation. 2004 Mar 30;109(12):1460-2.

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