You Decide

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U.S. flag with medical symbol in place of stars and dollar bill as stripes, stethoscope resting atopShould the United States adopt a single-payer, universal health care plan?

  • Yes? But have you considered...
  • No? But have you considered...

…that some experts assert that universal health plans have not been successful in other countries and could lead to increased bureaucracy?

Many opponents of single-payer health care view the plan as too similar to socialized medicine, a model they fear has unfortunate consequences. “Probably the first country to have universal health care provided by the government was the Soviet Union,” wrote Thomas Sowell in“After decades of socialized medicine, what was the end result? In its last years, the Soviet Union was one of the few countries in the world with a declining life span and a rising rate of infant mortality.”

Sowell continues that in countries with government-provided health care — like Canada, Japan, the Soviet Union and Britain — office visits are often cut short and becoming a doctor is a “less attractive occupation for some, leading to such things as earlier retirement or fewer young people going into medicine.” Opponents like Sowell worry that without the system of financial rewards associated with private-sector health care, motivation for people to enter medical careers will dwindle.

Some opponents use Canada as a real-world example of why a universal health care system will not work in the United States. In his editorial “Health Care Demagogues,” Doug Bandow argues that the health care system in Canada is breaking down and leaving patients behind.

“The Vancouver-based Fraser Institute estimates that the average wait between general practitioner referral and specialty consultation is 16.5 weeks; the time between the latter and actual treatment is another 9.2 weeks,” he writes. “Delays for cancer patients run a month or two. The wait is almost seven months for eye care and eight months for orthopedic surgery.”

…that some experts argue a universal health care plan would be more economical than the current system?

According to some estimates, the administrative costs of universal health care plans — insurance overhead, employers’ costs to manage benefits, and the administrative costs of hospitals, practitioners’ offices, nursing homes and home care — are much lower than private-sector plans. In 1999, according to a report published by the Massachusetts Medical Society, administration costs in the United States totaled at least 294.3 billion — $1,059 per capita — compared with $307 per capita in Canada. Administrative costs accounted for 31 percent of health care expenditures after exclusions (conditions not covered by insurance policies). The authors of the report concluded that the United States could significantly trim administrative costs by adopting a health care system based on Canada’s model.

In 2005, the National Coalition on Health Care, a nonpartisan alliance of health care organizations, conducted an investigation of four potential health care reform scenarios, including a universal health care plan. Their results were published in the report “Impacts of Health Care Reform: Projections of Costs and Savings.”

The report’s author, Kenneth E. Thorpe, Ph.D., wrote, “Systemwide health care reforms, along the lines that the Coalition’s specifications envision, would produce substantial reductions in national health care spending — reductions that would begin soon after reforms were phased in and that would increase over time.”

Thorpe reported that the Centers for Medicare and Medicaid Services projected that if the United States continued with its current system of health care, national health care spending would rise from $2.1 trillion in 2006 to more than $3.8 trillion by 2015.

“Under the [universal health care scenario], savings would begin in the first year of implementation and would be about $182 billion in 2015; total savings in the first decade of implementation would exceed $1.1 trillion,” Thorpe wrote.


Considering this, should the United States adopt a single-payer, universal health care plan?

Nothing about the issues facing the candidates and American voters in 2008 is black and white. With these You Decide activities, you can explore both sides of an issue, put your own critical thinking to work, and discuss the pros and cons with others. In the end, perhaps you will ask different — and better — questions than those presented here.


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