You Decide

…that many argue that a universal health care system is ripe for abuse by both patients and doctors?

For some opponents of single-payer health care, one of the biggest obstacles is the threat that both doctors and patients will take advantage of the system when they realize that doctor visits are essentially free for both parties.

“When you are paying your own money, you sort these things out accordingly,” writes Thomas Sowell in Townhall.com. “But when someone else is paying, then the trivial and the urgent are both likely to find their way to the doctor's office. This means that both are likely to get less time and that patients with serious problems are the biggest losers.” It’s a matter of incentive, some say: if someone else — such as the government — is paying the bill, consumers won’t exercise prudence and thus will not demand efficiency of their health care provider.

A free-market approach diminishes the risk of inefficiency, some experts argue, by allowing patients and doctors to keep each other in check, ensuring that the quality of medical care is sustained. A brief from the Cato Institute states, “When health care appears to be free or very cheap, people buy more than they would if they were paying the full cost. The resulting casual attitude toward shopping for health care drives up prices, drives up insurance premiums, and creates hardship for business and those without insurance.”

Other critics, like Sowell, point to the experiences in other countries as examples of how universal health care systems can financially and medically fail patients. In his Townhall.com editorial, he argues that it is human nature to devalue something that is given away free of cost. “China, Britain and other countries have been surprised to discover that the costs of government-provided health care greatly exceeded the costs initially projected,” he writes. “But they should not have been surprised. It is one of the oldest and simplest principles of economics that people demand more when they pay a lower price, especially when that price is zero.”

…that some assert that health care is a human right that should not be denied anyone based on employment or financial status?

Some believe that free universal health care is a human right whose time has come. It’s a basic tenet of the American belief system that all Americans be treated with equal rights, despite employment status or financial capabilities.

The Patients’ Bill of Rights passed by the Senate in 2001 was meant to give Americans more control over their choice of doctors and in legal matters, but for many advocates, the Bill of Rights falls short by ignoring a basic need — health care coverage for all.

The government reports that approximately 47 million Americans are without health insurance and are, therefore, without a safety net. As the American College of Physicians (ACP) states, “The benefits of American medicine are available only to those with access to the health care system.”

According to ACP research, uninsured Americans are:

• less likely to have a regular source of care.
• less likely to have had a recent physician visit.
• more likely to delay seeking care.
• more likely to report they have not received needed care.
• less likely to use preventive services.
• experience a generally higher mortality and a specifically higher in-hospital mortality.
• up to four times as likely as insured patients to require both avoidable hospitalizations and emergency hospital care.

The bottom line, some say, is that private-sector medicine is not only inefficient, but also uncaring. Physicians for a National Health Program argue that the American health care system behaves as if health care were a “commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need.” In this market-driven system, they assert, investor-owned firms compete not by increasing quality or lowering costs, but rather by avoiding “unprofitable” patients and shifting costs back to patients or other payers. The end result is a health care system that fails to tend to the sick. And a model that promotes competition and profit over treating the sick, they argue, is unethical.