Health care politics

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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. 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

[edit] 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. Just like any other industry, one way that a person gains access to these goods and services is by paying for them. The high cost of certain advanced or prolonged treatments led to the creation of health insurance, so that many people could share the risk of an expensive procedure. Now, many governments around the world have established socialized medicine, which essentially puts every person in a country on the same health insurance plan.

It is important to learn from health care in Canada and their experience with socializing its health care system. Under Tommy Douglas, Douglas's number one concern was the creation of Medicare. In the summer of 1962, Saskatchewan became the centre of a hard-fought struggle between the provincial government, the North American medical establishment, and the province's physicians, who brought things to a halt with a doctors' strike. The problem is that while the system became publically funded, most services remained privately owned; half-public, and half-private. It never became a truly public system, with the doctors union, theCanadian Medical Association and the College of Physicians and Surgeons maintaining control over the system. [1] Other concerns by even some physicians is that the College discourages alternative, complimentary health care treatments. [2] The inability of consultants to critically view the system and make recommendations was based on the deceptive nature of this system.

[edit] Philosophy

[edit] Right to Health Care

One question is whether every person has a fundamental right to have health care provided to them by their government.

Those who feel that health care is a right believe that societies which are able to provide health care have a duty to do so equally for all of their citizens.[3] The United Nations' Universal Declaration of Human Rights enumerates medical care as a right of all people.[4]

The opposing school of thought is that health care can become an entitlement if government specify it as a right of citizenship, but that it is not a fundamental right of all people. Furthermore, that it violates fundamental individual rights because it is a non-essential wealth redistribution. [5]

[edit] Government Involvement

Health care can exist without government involvement. That said, most governments choose to get involved in two ways: regulating the industry or socializing the industry.

[edit] Government Regulation

A second question concerns the effect government involvement would have. One concern is that the right to privacy between doctors and patients would erode as governments demand power to oversee health of citizens.[6] Another concern is that governments might attempt to control costs by gaining or enforcing monopsony power. For example, governments, such as Canada, have outlawed medical care if the service is paid for by private individual funds. [7]

[edit] 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.

Socialized medicine requires government involvement and oversight which leads to two questions. The first is whether governments actually have the authority to socialize health care. This question varies from government to government, and is usually resolved through the passage of legislation. Providing health care is not the responsibility of government unless laws are enacted to create such a responsibility.[8]

[edit] Economics

[edit] Impact on quality of health care

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

Arguments which see socialized health care as improving the quality of health care:

  • For those people who would otherwise go without care, any quality care is an improvement.[9]
  • 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.[10]
  • Death rates are lower under socialized systems.[11]

Arguments which see socialized 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.[citation needed]
  • Free healthcare can lead to overuse of medical services, and hence raise overall cost.
  • Socialized medicine leads to shortages, which force governments to decrease the availability of health care through rationing. This unnecessarily prolongs suffering, and can lead to preventable deaths.[12] [13] For example, in countries that have socialized medicine, people often must be on a waiting list for years before they can see a doctor. Even when someone does get to see a medical professional, the quality of care that the medical professional is able to provide is lower, as evidenced by the poor quality of care provided by in countries that have adopted universal health care, such as Canada and the United Kingdom.[14] [15]
  • Socialized medicine leads to greater inefficiencies and inequalities. [12][16]
  • David Kelley writes that individuals no more have a right to be protected from natural phenomena as the government has the power to levitate individuals in defiance of gravity, which itself is an act of nature like old age and disease.[17]
  • 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.[9]

[edit] Impact on medical professionals

The effect of socializing medicine has a dramatic impact on the various medical professions. Proponents of socialized medicine 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.[9]

[edit] Impact on Insurers

Socializing medicine has implications for the existing insurance industry. Socialized health care causes the loss of insurance industry jobs and other business closures in the private sector.[9]

[edit] Impact on Medical Research

In a recent televised CBC report, research scientist Evangelos Michelakis of the University of Alberta Department of Medicine, has shown that dichloroacetate (DCA) causes regression in several cancers, including lung, breast and brain tumors.[18]. What the CBC written report fails mention, is that 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 ironic 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. The search for cancer cures obviously shows that the current drives to find a cancer cure, are highly motivated by corporate profit cures. [19]

This highlights a significant problem with Canada's half public, half private system, often mistakenly referred to as a 'public system' and that is that because it is not a true public system, and profit is a prime motivational factor, simple treatments, simple cures, simple preventative measures are not at the core of the system's motivations.

[edit] Economic Impact

Universal health care affects economies differently than private health care.

Those in favor of socialized medicine 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.[9] For example, it might only take one government agent to do the job of two health insurance agents.[20]

One of the biggest criticisms of socialized medicine is that it suffers from the same financial problems as any other government planned economy. Not only does it require governments to greatly increase taxes, it requires more and more money each year. Essentially, universal health care tries to do the economically impossible.[21]

Government agencies are less efficient due to bureaucracy.[9][12] Administrative duties, by doctors, are the result of medical centralization and over-regulation, and are not natural to the profession. In fact, 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 was common; governments regulated this form of charity out of existence.[22] Universal health care plans will add more inefficiency to the medical system because of more bureaucratic oversight and more paperwork, which will lead to less doctor patient visits.[23]

  • Profit motives, competition, and individual ingenuity lead to greater cost control and effectiveness.[9]
  • Healthy people who take care of themselves have to pay for the burden of those who smoke, are obese, etc. [9]
  • Empirical evidence on single payer insurance programs demonstrates that the cost exceeds the expectations of advocates.[24]


[edit] Influence on Voting

Universal health care has an effect on elections. Like many wealth redistribution systems, those who stand to benefit the most from the system are often its greatest supporters. Conversely, those who experience poor outcomes within the system and suffer incapacity or death due to poor or inadequate care, by definition, do not participate in the electoral system. of course the exact same can be said of private health care. Industries that profit from it the most will and do spend money lobbying lawmakers to keep the profitable (for them) system in place.

[edit] Alternatives

Many alternatives to universal health care have been proposed. These include mandatory health insurance requirements, complete capitalization of health care, and single payer systems among others.[25]

[edit] Common Confusion

[edit] Socialized medicine and universal health care

The terms socialized medicine and universal health care are often used interchangeably by those debating health care policies, but they are distinct ideas. Universal health care means that everyone has access to health care, while socialized medicine means that the government controls the health care industry.

The confusion occurs when people are talking about a health care system that implements both socialized medicine and universal health care. The person who wants to emphasis the benefits will call it universal health care, and the person who wants to emphasis the economic flaws will call it socialized medicine.

Another reason for the intentional misuse of these terms is to avoid or emphasize the association of socialized medicine with socialism. Again, when people are talking about a health care system that implements both socialized medicine and universal health care, detractors will use the term "socialized medicine," and supporters will use "universal health care."

[edit] See also

[edit] Examples

[edit] Related topics

[edit] External links

[edit] Supporting universal health care

[edit] Opposing universal health care

[edit] Neutral

[edit] References

  1. ^ Toronto Star
  2. ^ Holistic Therapies Threatened by the College
  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. ^ National Health Care for the Homeless Council. [1] "Human Rights, Homelessness and Health Care".
  5. ^ [2]
  6. ^ http://www.cato.org/pub_display.php?pub_id=3057
  7. ^ http://www.cato-at-liberty.org/2006/08/23/revolt-against-canadian-health-care-system-continues/
  8. ^ http://www.cato.org/pubs/pas/pa565.pdf
  9. ^ a b c d e f g h Messerli, Joe. "Should the Government Provide Free Universal Health Care for All Americans?" BalancedPolitics.org. March 1, 2006.
  10. ^ "The Best Care Anywhere" by Phillip Longman, Washington Monthly, January 2005.
  11. ^ 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.
  12. ^ a b c Goodman, John. "Five Myths of Socialized Medicine." Cato Institute: Cato's Letter. Winter, 2005.
  13. ^ http://www.cato-at-liberty.org/2006/05/02/depends-on-what-the-meaning-of-universal-is/
  14. ^ Heritage Foundation Report [3]
  15. ^ The Cure: How Capitalism Can Save American Health Care [4]
  16. ^ 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.")
  17. ^ Kelley, David E. 2003. A Life of One's Own. Cato Institute
  18. ^ [http://www.cbc.ca/canada/edmonton/story/2007/01/17/cancer-chemo.html Alberta scientists test chemotherapy alternative Last Updated: Wednesday, January 17, 2007 ]
  19. ^ University of Alberta - Small molecule offers big hope against cancer. January 16, 2007
  20. ^ 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.
  21. ^ [5] Universal Health Coverage --- Call It Socialized Medicine
  22. ^ Kelley, David E. 2003. A Life of One's Own. Cato Institute
  23. ^ http://www.cato.org/pubs/handbook/hb109/hb_109-7.pdf
  24. ^ http://www.cato.org/pub_display.php?pub_id=3057
  25. ^ Kereiakes DJ, Willerson JT. "US health care: entitlement or privilege?." Circulation. 2004 Mar 30;109(12):1460-2.