Health care politics

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. 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.

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. Now, many governments around the world have established universal health care, which essentially puts every person in a country on the same level of access.

Philosophy

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.National Health Care for the Homeless Council. [http://www.nhchc.org/humanright.html] "Human Rights, Homelessness and Health Care".] Center for Economic and Social Rights. [http://cesr.org/ushealthright "The Right to Health in the United States of America: What Does it Mean?"] October 29, 2004.]

An opposing school of thought rejects this notion.Sade RM. "Medical care as a right: a refutation." "N Engl J Med." 1971 Dec 2;285(23):1288-92. PMID 5113728. (Reprinted as [http://www.aapsonline.org/brochures/sademcr.htm "The Political Fallacy that Medical Care is a Right."] )] They (laissez-faire capitalists for example) 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. They assert that doctors should not be servants of their patients but rather they should be regarded as traders, like everyone else in a free society." Leonard Peikoff, [http://afcm.org/hcinar2.html "Health Care Is Not a Right,"] December 11, 1993]

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. [ [http://www.cato.org/pub_display.php?pub_id=3057 Universal Health Care Won't Work - Witness Medicare ] ] In practice, this does not happen to any significant extent.

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 fair allocation of national resources irrespective of personal wealth. Laissez-faire supporters argue that this blocks a fundamental freedom to use one's own purchasing power at will. [ [http://www.cato-at-liberty.org/2006/08/23/revolt-against-canadian-health-care-system-continues/ Cato-at-liberty » Revolt Against Canadian Health Care System Continues ] ]

Controlling the Industry

When a government controls the health care industry, they essentially mandate what health care everyone will get and use wealth redistribution to finance it, as with any tax. Critics would argue that HMOs and medical insurance companies (which are not under the democratic control of health care users) also determine what health care a person might get.

Universal health care requires government involvement 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.Fact|date=November 2007
* 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. [ [http://www.washingtonmonthly.com/features/2005/0501.longman.html "The Best Care Anywhere"] by Phillip Longman, Washington Monthly, January 2005.]
* A study of hospitals in Canada found that death rates are lower in private not-for-profit hospitals than in private for-profit hospitals. [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. [http://www.cmaj.ca/cgi/content/full/166/11/1399 Free Full Text] .]

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. [Miller, Roger Leroy, Daniel K. Benjamin, and Douglass Cecil North. "The Economics of Public Issues". 13th Ed.th ed. Boston: Addison-Wesley, 2003.]
* Free healthcare can lead to overuse of medical services, and hence raise overall cost. [Heritage Foundation News Release, [http://www.heritage.org/Press/NewsReleases/NR092900.cfm "British, Canadian Experience Shows Folly of Socialized Medicine, Analyst Says,"] Sept. 29, 2000] The Cure: How Capitalism Can Save American Health Care [http://www.heritage.org/Research/HealthCare/hl982.cfm] ]
* Publicly-funded medicine leads to greater inefficiencies and inequalities. Goodman, John. [http://www.cato.org/pubs/catosletter/catosletterv3n1.pdf "Five Myths of Socialized Medicine."] Cato Institute: "Cato's Letter". Winter, 2005.] Sade RM. "Medical care as a right: a refutation." "N Engl J Med." 1971 Dec 2;285(23):1288-92. PMID 5113728. (Reprinted as [http://www.aapsonline.org/brochures/sademcr.htm "The Political Fallacy that Medical Care is a Right."] )] Friedmen, David. "The Machinery of Freedom." Arlington House Publishers: New York, 1978. p 65-69.]
* 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.Fact|date=November 2007 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.

Opponents argue that government-mandated procedures reduce doctor flexibility. This, along with the loss of private practice options and possible reduced pay dissuades many would-be doctors from pursuing the profession.Fact|date=November 2007

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. [For example, the recent discovery that dichloroacetate (DCA) can causes regression in several cancers, including lung, breast and brain tumors. [http://www.cbc.ca/canada/edmonton/story/2007/01/17/cancer-chemo.html 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. [http://www.expressnews.ualberta.ca/article.cfm?id=8153 University of Alberta - Small molecule offers big hope against cancer. January 16, 2007] ] Those opposed argue that it will do the opposite, for the same reason.

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 adding a middle man, the government, to regulate the supply of health care.Fact|date=November 2007 For example, it might only take one government agent to do the job of two health insurance agents. [William F. May. [http://www.religion-online.org/showarticle.asp?title=106 "The Ethical Foundations of Health Care Reform,"] "The Christian Century", June 1-8, 1994, pp. 572-576.]

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.Lawrence R. Huntoon, [http://www.jpands.org/hacienda/article49.html "Universal Health Coverage --- Call It Socialized Medicine"] ] Opponents of universal health care argue that government agencies are less efficient due to bureaucracy. However, supporters note that modern industrial countries with socialized medicine tend to spend much less on health care than similar countries lacking such systems, and their health outcomes are often significantly better.Fact|date=March 2008

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.David E. Kelley, A Life of One's Own:Individual Rights and the Welfare State, Cato Institute, October 1998, ISBN 1-882577-70-1] 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. [Cato Handbook on Policy, [http://www.cato.org/pubs/handbook/hb109/hb_109-7.pdf "Chapter 7: Health Care,"] Cato Institute 6th Edition (2005)] . However, in the UK for example, which has universal health care under a socialized medicine arrangement, free home visits are common for the elderly and infirm that cannot visit a doctor's office and such visits are part of the service and are not offered as charity.Fact|date=March 2008

*Healthy people who take care of themselves have to pay for the burden of those who smoke, are obese, etc.Fact|date=November 2007 However, several countries tax alcohol and tobacco highly in order to recoup the costs that excessive use of these products has on national health expenditures. Some have even considered taxing more heavily foodstuffs that are considered less healthy Fact|date=March 2008.

*Opponents of single payer insurance programs claim that empirical evidence demonstrates that the cost exceeds the expectations of advocates. [Sue Blevins, [http://www.cato.org/pub_display.php?pub_id=3057 "Universal Health Care Won't Work -- Witness Medicare,"] Cato Institute, April 11, 2003.]

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. [Kereiakes DJ, Willerson JT. [http://circ.ahajournals.org/cgi/content/full/109/12/1460 "US health care: entitlement or privilege?."] "Circulation." 2004 Mar 30;109(12):1460-2.]

ee also

*Globalization and Health
*Health care reform in the United States
*Journal of Health Care for the Poor and Underserved
*Kaiser Family Foundation
*Massachusetts 2006 Health Reform Statute
*Medicare (Australia)
*Medicare (Canada)
*Medicare (United States)
*National health insurance
*National Health Service (United Kingdom)
*Two-tier health care
*Universal health care

External links

upporting universal health care

* [http://www.amsa.org/uhc/ American Medical Student Association (AMSA)]
* [http://cthealth.server101.com/ Connecticut Coalition for Universal Health Care]
* [http://npalliance.org/ National Physicians Alliance (NPA)]
* [http://www.pnhp.org/ Physicians for a National Health Program (PNHP)]
* [http://www.uhcan.org/ Universal Health Care Action Network (UHCAN)]
* [http://www2.umdnj.edu/omcweb/1999/universalhealthcare.htm Universal Health Care / National Health Insurance]

Opposing universal health care

* [http://www.heritage.org/research/healthcare/ Heritage Foundation's health care research site]
* [http://www.heartland.org/Article.cfm?artId=10333 Health Care Issues] The Heartland Institute
* [http://www.afcm.org/ Americans for Free Choice in Medicine (AFCM)]
* [http://www.capmag.com/article.asp?ID=4511 Capitalism Magazine]
* [http://www.liberty-page.com/issues/healthcare/socialized.html/ The Problems with Socialized Health Care] from Mark Valenti's Liberty Page

Neutral

* [http://www.balancedpolitics.org/universal_health_care.htm BalancedPolitics.org - "Should the Government Provide Free Universal Health Care for All Americans?"]
* [http://www.hapindia.org Health Action by People India (HAP)]

References