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That Universal Healthcare is Superior to Multi-Payer Healthcare

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GuitarKirbyGuitarKirby (PRO)
Welcome to Another Exciting Edeb8!
For Clarity:
- Sources will be linked0
 - Direct quotations will be "quoted"
- Noteworthy points will be italicized
- Titled sections of the argument will be bolded
- Full links to sources can be found at the bottom below a horizontal rule

The question on tap today is whether Universal Healthcare is superior to Multi-Payer Healthcare. When it comes to healthcare, there are only two important metrics:

1) The Financial Metric, or what it costs each person to receive adequate healthcare.

2) The Quality Metric, or what the outcome of receiving healthcare is.

These are actually rather challenging to quantify, but Pro will do our best to prove that Universal Healthcare excels at both of these beyond Multi-Payer.

Metric 1: Financial
Healthcare is remarkably expensive under multi-payer systems. In the US, one of the only modernized countries in the world to use a multi-payer system, medical spending per person in 2018 reached USD$11,172 per person, or USD$3.6 trillion total. This money isn't divided among all persons evenly, of course; some shouldered much larger financial burdens than others1.

A study at John Hopkins University found that "Single-payer systems usually have an advantage
over multi-payer systems in the efficiency of
collecting revenues, overall cost control, and the
capacity to subsidize health care for low-income

National health expenditures further show the cost of multi-payer. An analysis of the data available finds that other countries spend half as much per citizen on healthcare as the US does3.

There are a large number of sources that corroborate this data, but in summary, the cost per person for adequate healthcare is lower under a universal/single-payer system than it is under a multi-payer system.

Metric 2: Quality
The quality of care is harder to put into numbers than the financial side of healthcare. However, there is a great deal of data suggesting that outcomes between multi-payer and universal systems are extremely similar in many ways, with the exception of one piece of data which Pro will discuss momentarily.

For some data we will turn again to Peterson-KFF's analysis of the data4. The analyses included here find the following:
- The mortality rate in the US and other wealthy countries has fallen in tandem.
- The US has a poorer rate of Amenable Mortality (the rate at which people die to diseases preventable by adequate healthcare).
- The US has a much worse Years of Life Lost rate than other countries (though it continues to fall in both cases).
- Disease Burden is worse in the US than other countries.
- People us the hospital more in the US than in other countries.
- The US has a higher rate of medical and lab errors than other countries.
- Adults in other wealthy countries have quicker access to doctors and nurses.

Also, remember that predictor mentioned earlier? The one piece of data that predicts better healthcare outcomes in the US is income. Data from a Texas A&M study revealed "Perhaps not surprisingly, babies born to wealthier and better educated parents in the United States tended to fare about as well as infants born in European countries. On the other hand, those babies born to mothers in the United States without these advantages were more likely to die than any other group, even similarly disadvantaged populations in the other countries5." So, if you have less money, your access to healthcare is diminished, a problem in both quantitative categories.

The one wealthy country using a multi-payer healthcare system has poorer outcomes and more expensive care than those using a universal system based on an enormous amount of data.

Pro thanks the judges and looks forward to Con's response.

Works Cited

Return To Top | Posted:
2020-01-15 20:28:02
| Speak Round
adminadmin (CON)
Pro's entire argument is premised on the mistaken notion that everyone should get equal access to healthcare. This is why his financial metric takes an average across the whole population, and why his quality metric likewise relies on nationwide US statistics.

My position in this debate is that I, a relatively healthy individual who spends a lot of time, effort and money to stay healthy, should not have to subsidize the frequent hospital visits of many of my peers who are more careless with their health. While the burden of proof rests with my opponent, I intend to both answer his case and briefly explain my counter-model. First, though, let me address why I win this debate on principle.

The nature of healthcare
Typically, people who affirm this topic argue that healthcare is a human right. Pro, however, has entirely failed to establish that having better healthcare is a good thing for people. The problem with this argument is that because healthcare cannot be (usually) freely provided, every major country has established that labeling healthcare as a human right creates a significant free-rider problem. This is why nations, at their best, only provide healthcare for their own citizens or in their own regions. As a result, no country on Earth has truly universal healthcare. They only have nationalized healthcare.

Pro's arguments don't work on a universal scale. All his points implicitly assume the existence of a plurality of healthcare systems. His statistics all refer to what happens in just one nation. On a universal scale, healthcare would be virtually impossible to co-ordinate even if my opponent did support it, given how difficult it is for doctors to even get on the ground in places like Palestine or Yemen while it is being attacked. Coordinating it would require a one world government, or at least, a global ministry of health. Even the World Health Organisation doesn't have nearly that kind of power.

Politicians have spun the term universal healthcare because it sounds cool. It doesn't really mean coverage throughout the universe, and I think that's a problem. Pro has established, through the sources he has selected, a specific form of coverage that he wants to defend, known as "single payer." In this system, which he failed to explain, everyone pays money to the government (usually via taxes, although pro doesn't specify) and then the government pays doctors, nurses, lobbyists, bureaucrats, researchers, politicians etc. There are normally some exclusions, like cosmetic surgery, although pro hasn't mentioned any so I assume in his preferred system I won't get spam emails about enhancement pills anymore. The government will have already paid for them. It's worth noting that the more lobbying influence there is of pharmaceutical companies on the government in a single-payer system, the greater the degree of corruption preventing normal people from getting coverage while lining the pockets of the political elite. Given how corrupt US healthcare is already, it's interesting that my opponent chose this country as his setting, when he could have chosen to set this debate in any country including those where so-called "universal healthcare" is already working fine. I applaud him for his bravery in defending the merits of corruption.

I think (for the purposes of this debate, anyway!) a more reasonable concept of healthcare than all of the above is that nobody is entitled to it. Modern healthcare systems are a privilege based on the hard work of numerous doctors who deserve compensation for their expertise, much like any other transaction. I also categorically deny that keeping all people alive for a lower cost is a good outcome. Unhealthy people should die young as a natural consequence of their actions. Examples include heavy smokers, addicts, obese people, and many more. This all ties in to my overall principle of fairness. Fairness is more important than health because with fairness, you get a more balanced society with more self-responsibility. With health, you get a lethargic society full of corruption and misery. Of course, pro makes no attempt to prove healthy is always good. If he did want to defend that, he might as well get the guts to defend truly universal healthcare. As an additional benefit, although by no means important to my case, this also deals with human overpopulation by killing off the dumb.

Finances & Quality
Even assuming that you disagree with the above analysis, I do not think pro has demonstrated these benefits well.

Pro's only study that attempted to explain why costs would go down under a single-payer system (which he labelled as coming from John Hopkins University) compared types of health insurance. This is confusing because insurance usually covers specific types of healthcare (in New Zealand, for example, though as the study notes "A challenge for this type of system is to limit the
degree to which the supplementary private system
detracts from the public system" which proves that the public system can often not compete). In fact the study terms this a problem with multi-payer systems in the form of risk selection, meaning people with poor health will just get the types of healthcare that covers their needs. I think that's actually a plus, because it means I don't have to pay for the needs of people with poor health care, and those people will not need to pay for things that are unlikely to affect them (if they DON'T buy insurance, which the study doesn't even consider, then the insurance companies don't need to profit and doctors can get all that sweet cash directly). To counteract adverse selection, unhealthy people will be driven to bankruptcy by insurance companies, which again, I think is a good thing; to quote: "Sicker individuals are
more likely to want to buy health insurance and
health insurers cannot afford to insure only
unhealthy people." So the authors correctly conclude that in multi-payer systems it's more likely that your premiums go up as you get more likely to become sick.

Overall, the study did not find single-payer health insurance systems (and remember, this is health insurance as opposed to healthcare) were superior, despite what pro seemed to think at a cursory glance. It explicitly holds up the example of the Czech Republic doing better under multi-payer, and concludes: "Single-payer and multi-payer systems each have advantages which may meet countries’ priorities for
their health insurance system." There are other points to be made here, but my opponent spent, like, zero effort on this other than a brief quote, so I want to see what he picks up.

The true reason why costs are so high in the US has little to do with it being universal or multi-payer, although some bureaucracy and corruption may shift around. The blue cross identifies three key factors of high healthcare costs in the US - note blue links in this paragraph are clickable and take you to informative infographics with sources. First (of no particular order) there is the cost of chronic diseases, chiefly obesity, cancer and heart disease. All of these are strongly linked to the second, which is that many people in the US have poor lifestyles, especially consuming alcohol and tobacco, and eating fatty foods. The third, currently much smaller (but, crucially, getting worse) factor, is the high cost of prescription drugs (personally, I would add over-medication of prescription drugs because of pharmaceutical lobbying). These causes support my position of paying drug researchers and doctors, not drug companies and insurance bureaucrats, which I will examine below.

I think there is a significant negative effect on health quality when it is not made clear to people that taking up smoking = signing your death warrant. Rather than aggressively fighting poor lifestyle habits, most countries today (but the US in particular) are aggressively legalizing even more proven ways to get sick, such as smoking marijuana for "recreation." Pro broadly agrees that universal healthcare is not higher quality, and I agree the quality is roughly the same, all else being equal. Therefore pro has not demonstrated a benefit in this category, and has not proven his burden.

He did show babies sometimes die younger when parents are poorer in the USA. Two responses. First, this is one correlation. Babies also die younger if exposed to second-hand smoke. Second, this problem could be solved 

But ... what if I still think unhealthy people shouldn't die soon?
Fine. :(

But then you're still going to be paying more in a system that doesn't actually give you better coverage. It just means more people are sick because the system is well-equipped to keep them alive despite their poor choices. In this model, quality and cost of care are no longer your important metrics, but something more like life expectancy. I await pro defending living a long, miserable existence :)

A better model
Let's get rid of all the smoke for a second. How about - when you're sick, you pay to get better? No need for complicated taxes or single-payer health insurance. 

If we want to determine who we fund and how we fund them for healthcare, we currently already do that on websites like give-a-little when people cannot afford it.

To disincentivise rich people from making poor lifestyle choices, denying access to otherwise healthy people of modest means, hospitals should be required to levy an additional tax on wealthy people with poor lifestyles, which subsidizes drug research. And to stop hospitals price gouging, there's a number of options such as a maximum price (which would get regularly adjusted to ensure doctors and nurses are fairly compensated).

Finally, just because healthcare is typically best when it's multi-payer, doesn't mean single-buyer drug systems don't work. They clearly do. Government buys all the drugs, and therefore drug companies cannot keep gouging the price. Simple, and many countries already do this.

The resolution is negated.

Return To Top | Posted:
2020-01-16 03:05:41
| Speak Round
GuitarKirbyGuitarKirby (PRO)
It seems that Con has decided they'd like us all to chase a Red Herring, so let me quickly quash that.

Universal Healthcare is impossible because it isn't really Universal!
The common vernacular of Universal Healthcare is accepted to mean nationalized single-payer, and I'm frankly uninterested in defending a system that neither myself nor anyone else is discussing or in favor of, so let's drop this now, shall we?

I'm going to jump between arguments a bit, so bear with me as we go.

Con has done a lovely job defining single-payer healthcare and the definition provided will brook no argument from Pro. However, they've taken several curious lines of defense, as follows:

1) The Amoral Argument, effectively arguing that equality of access to and quality of care is an unfair burden - numbers with no morality. Theoretically, there's nothing wrong with this approach on paper, but Con has now raised a point that Pro thinks they must defend: Sick people deserve to die if they cannot afford their own care. Pro would also like to point out that many people with physical ailments contribute greatly to society when given access to care. If these people were unable to get this care because of a cost, the human race would be damaged as a whole.

2) You pay more for the same care! Apparently Con has decided to ignore the fundamental argument of Round 1. Your care is at least as good under single-payer as it is under multi-payer. Similarly, many examples were given in which the US - the largest country on Earth to continue to use a multi-payer system - fails compared to other countries, while the cost burden averages much higher than in other countries. Finally...

3) It isn't fair to use the US as the example when the medical industry is so corrupt!
I want to draw special attention to this point because it appears to be the crux of my opponent's argument. My opponent's only statistic to back this claim is one of high drug prices in the US - Pro agrees, and I'll go so far as to say that it doesn't stop at drugs. All types of medical care in the US are higher, and often exceptionally so, than in other countries. Con has decided to dig their own grave with this information, because the reason prices are so much higher is due to the multi-payer system in place. Private insurance demands discounts on healthcare services and products, so the industry increases prices in response, and the cycle continues. Multi-payer systems are controlled by capital and the market, and prone to corruption, and Con has admitted such and tried to use it as a leg up against single-payer systems; I wonder if the judges will be as perplexed as I was on reading that. A research article in HealthAffairs sums this up1: "As private third-party payers consolidated in the early 1990s and their
market clout grew, they moved away from negotiating with hospitals based
on charges and toward contracts based on lower fee schedules or
negotiated rates... Hospitals responded by marking up billed charges
even faster than the costs of care for such patients." Private insurance is driven by multi-payer care, and in turn drives the corruption that my opponent seems so offended by and opposed to. Single-payer eliminates the opportunity for this problem.

While I think the arguments from the first round haven't been reasonably disproven or negated, I have more to add.

Countries with single-payer healthcare have better access to regular doctor visits. This was briefly mentioned in the last round, but let's talk about what it actually means. People with a regularly visited doctor are able to get checkups and health advice for maintaining good health. Smoking, drinking, and other types of recreational drug use are discouraged by doctors. But if you have to go to the hospital when you need care, and you only go in an emergency, you don't have a healthcare authority giving you guidance on a regular basis. This is not only a noteworthy point in Pro's favor, but further refutes Con's point about the use of the US healthcare system as an example.

The resolution is validated, and the negation is refuted.

1) https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.1.45

Return To Top | Posted:
2020-01-16 05:17:27
| Speak Round
adminadmin (CON)
I thank pro for their engaging debate. It's unfortunate and ironic, though, that pro accuses me of dishing out a red herring, when he follows that up by continuing to ignore both the resolution and the majority of my arguments. Luckily for me, this gives me ample opportunity to extend my points and offer more comprehensive rebuttals in this round.

The reason why my principle is important isn't just that universal healthcare is a misnomer; one must assume that all the benefits proponents of single-payer systems call for would be further maximized the bigger the pool is that you're paying into. This is the basic argument of economies of scale that underpins everything around lowering the cost and quality of healthcare in a single-payer model. However, as I pointed out, this creates equity problems that are obvious at this scale for political reasons.

Don't fool yourself into thinking the same things do not apply at smaller scales. If they did, then multi-payer systems would be superior in every way. The truth is that every system is prone to corruption. Socialised medicine in Russia didn't exactly do much for people in gulags, after all. What actually happens is that governments selectively help those whom it is politically expedient for them to support, and again, bear in mind pro has foolishly set this debate in the USA. Pro wants to give the same government which sold poison for drinking water in Flint, near-complete control over their healthcare. This goes far beyond standard government corruption; and even if governments were fairly trustworthy, the very threat of this is an unfair burden on everyday citizens who just want to be healthy. Giving governments more direct control is a bad idea; rather, the control over healthcare expenditure should primarily rest with those responsible for it, that being the people whose poor lifestyle choices led to them needing healthcare.

To put this into a more abstract perspective, multi-payer systems are designed around economic exchanges. Universal systems are designed around affording healthcare to everyone. Rather than paying for fat smokers to lie in hospital for years with chronic conditions, I'd prefer in principle (even if it was more expensive or meant everyone got marginally worse care) to prioritize those who rarely need to go to hospital. Multi-payer systems do, because they allow you to pay doctors for the healthcare you actually need. In universal healthcare, every time, the healthy subsidise the unhealthy. And the more "universal" this care is, the more this happens. I'd prefer this because the alternative is not fair - somebody who is relatively healthy should not bear a larger healthcare burden.

Pro has completely ignored this point. It was the biggest and most crucial point I raised so I'm surprised he missed it.

Pro has also not denied that fairness is more important than healthcare. He has raised no opposition to the idea that the need for equivalent exchange outweighs the need for staying alive. He certainly doesn't seem to think people have a right to life, based on how all his points reduce human lives down to a purely economic analysis. I'd like to extend this idea by suggesting vigilante justice and hit squads would become more popular under my model. This means we can exterminate other people we really don't like, and thereby reduce the global prison population. Seriously, pro hasn't said a word against any of this principle so unless he starts responding I might as well see how far I can take this.

At this point pro is defending only one argument from the first round, costs. He already immediately conceded the quality was roughly the same notwithstanding costs, and ignored all three of my paragraphs analyzing why quality of care in the US was really so low, or cost so high. Just to reiterate, this has nothing to do with the healthcare system, and everything to do with: 1) the poor lifestyle most Americans lead, 2) the resulting chronic diseases placing ridiculous amounts of strain on hospitals, and 3) prescription drug prices rapidly increasing. Pro seems to agree with all three, since he didn't respond to any. Now that we know the true reasons why healthcare costs are so high, it becomes apparent changing the system will have no measurable impact whatsoever. Nonetheless I'm happy to respond to what argument he does raise, which is (broadly speaking) that somehow the incentives would be different in universal healthcare, despite the corrupt medical-industrial complex he agrees has stained the US government's healthcare response quite consistently, and despite his complete lack of any reason why big pharma would not continue to have such influence in his model.

Another point dropped by my opponent is all the good stuff he said his one study shows about universal healthcare, mostly (I assume) because (as I pointed out) that's not what it says. Just throwing quotes around doesn't win arguments.

Pro argues that private insurance demands discounts, and suppliers raise prices. What he has just described there is called supply and demand. It's not really a cycle, because it has a definitely end point that you can calculate. Economists call this the equilibrium price. You can lower the equilibrium price for healthcare through two simple mechanisms - reducing demand (eg not offering so much healthcare to unhealthy people for free) or increasing supply (eg adopting a single-buyer system for prescription drugs). This isn't some wacky theory I've just made up, but literally the first thing in any book about economics. Pro has not explained why a universal healthcare policy would be better than private insurers, but regardless, I'd still like to point out that buying health insurance should not be the only payment option.

All systems are controlled by capital and the market. What we're debating is not whether this happens, despite pro's objection, but rather who should be responsible for paying the capital into the market. Either way costs, in my view here, are roughly equivalent. What I said was a leg-up on single-payer systems wasn't this, but rather that risk selection means that in a multi-payer system, the price you pay for health insurance more accurately reflects your risk profile. This means unhealthy people pay more, which is good.

Pro's HealthAffairs article is saying (to cut through some fluff and jargon) that hospitals set their rates according to the payments made by insurers. It doesn't do a good job of explaining this happened when the government half-heartedly tried to get people onto a public insurance scheme called Medicare, which quickly increased demand for healthcare as everyone who was unhealthy and insurers wouldn't touch could now get healthcare coverage at affordable costs (source). Most hospital costs are not for your regular doctor visits, but serious chronic conditions - and many of those can be traced right back to lifestyle. As the source I just linked states, "the sickest 5% of the population consume 50% of total health care costs." This is a direct result of an attempt to move away from private insurance.

The larger size of some private insurers is not an economic factor in this at all, but a political one in that they are now alongside big pharma lobbying government for reform. Unfortunately the fact that America now has more universalised healthcare than ever in its history, proves that this has been a total dismal failure. Nonetheless, as the healthaffairs article rightly points out through in weird terms, it is competition among smaller insurers that generates the conditions necessary to reach an equilibrium price efficiently. I think the correct and logical response here is to break up insurers. Single payer does not necessarily mean single insurer because the government is not a massive insurance agency, though it means there would be no reasonable public option since for the average Joe healthcare would be free. However even if it did, you only get "competition" in a multi-payer system in this sense. Rather than eliminating the problem, single payer can be responsible for it.

Doctor visits
I would suggest that maybe doctor wait times are bad enough and increasing the number of doctor visits doesn't have to be a good thing. Nor do I think that their advice is often terribly useful, given that 6% of the US adult population abuses prescription drugs, mostly due to ease of access (source). Furthermore, 80% of Americans don't tell their doctors crucial information about their health (source). Public health campaigns are a far more effective way of provoking social change, and that's before you even consider the fact that there are some (although I choose to believe it is a minority) in the medical profession who are corrupt and/or negligent. Pro has no evidence more doctor visits are a preventative factor. If simply telling people to be healthy is sufficient, I would suggest paying for that through advertising rather than hoping all doctors are going to be great.

My model
I never said sick people deserve to die if they cannot afford it. I would say sick people deserve to die if nobody is willing to pay to keep them alive. Why should I subsidise the continued existence of people who are just being a drain on society? If people are willing to pay, then as I have said, they can freely do so. I feel I have already defended this statement in principle, because it is fair, based on a fair exchange of money for health. Pro argued many people with ailments contribute greatly to society when given access to care. That's great, so perhaps they can get better access through offering their contributions. This is why employers often pay for healthcare, and I would argue that in the system I propose, they would be even more inclined to do so, because it would more likely be a means to retaining good workers.

My opponent has failed to pick any other holes in my model. Pretty flawless plan if you ask me.

The resolution is negated.

Return To Top | Posted:
2020-01-16 06:59:54
| Speak Round
GuitarKirbyGuitarKirby (PRO)
Welcome back, and a sincere thanks to my opponent for what, I agree, is a very engaging debate and subject.

Chronic Disease
Con is right in their claim that the US has a higher rate of chronic disease and risky lifestyle behaviors, but their interpretation is that this is a problem that cannot be helped by universal care. A common thread on every study that has been done on the matter of chronic disease in wealthy countries is that all other countries included had universal care. Some examples are here, there, etc. The correlation is staggering and feeds into supporting the resolution, regardless of any gymnastic thought processes my opponent would like to use. As a quick aside, the analysis of data used in Round 1 showed that quick access to a doctor is better in countries with universal care than in the US, another point that my opponent has decided to skip over.

Pharmaceutical Industry
I'd like to now address the question of the Pharmaceutical industry. As Con pointed out (and Pro agrees with this statement), "Big Pharma," as Con calls it, has a stranglehold on the healthcare industry in the United States. The fact that it is an industry is one of the problems, but this angle was already discussed, so we'll go a bit deeper here. We don't have to look far; the study used in the first round, now cited by both my opponent and myself, included the idea that universal systems allow for better price control on prescription drugs and other forms of care - this was in the quote provided. Perhaps Con missed this?

The Idea of Fair
Con has decided to have a fight about what constitutes fairness in healthcare. Multi-payer systems unfairly favor those with additional resources (capital), regardless of their level of health. All I really have to say about this comes out of arguments from the first two rounds, which can be summarized with the idea that people deserve care regardless of access to capital or status. That defines fairness in the eyes of Pro, and leads us to Con's argument...

No Sick People!
It seems that Con is determined to prove that a healthcare system that takes care of less people is better. The statement "I never said sick people deserve to die if they cannot afford it. I would say sick people deserve to die if nobody is willing to pay to keep them alive," is patently outrageous. We are debating healthcare systems, not fairness, and my opponent's repeated attempts to take us down roads other roads is petty and a waste of time and effort. If my opponent believes that it is fair for people in lower socioeconomic circumstances to die of disease amenable to care, then I think they might need to reconsider their definition of the word.

Con's goal at this point appears to be redefining my points to suit their wishes, and at this point has become completely unresponsive to the arguments set forth in Round 1. The judgement of the power of a healthcare system still comes down to the two ideas presented there: Quality and Cost. Con knows that Multi-Payer has no advantages in either, and even admitted such. My opponent made the statement:
"I'd preferin principle (even if it was more expensive or meant everyone got marginally worse care) to prioritize those who rarely need to go to hospital."
My opponent thinks the best possible healthcare system would be one where sick people get worse care or no care, while we prioritize the people who need care the least. Again, a fascinating statement when their entire argument sits on the knife point of what is and is not fair. If I were taking my opponent's side, I'd want to avoid mentioning either the Soviets or the Nazis, Con has shown a worrying approval for allowing the deaths of people based on economic status, intelligence, disability, etc. I sincerely hope that my opponent is being hyperbolic, because if not, they've taken a morally repugnant stance on the subject.

In Summary
Con has failed to refute the arguments made, and instead has attempted to redefine my arguments and twist data like a chunk of silly putty. My original two points stand backed by mountains of studies and data, and one needn't look far to understand this. My opponent's one argumentative pillar, the idea of fairness, has been soundly refuted (even if they say it hasn't). The head-scratching attempts to defend a system that restricts healthcare to rich, healthy people is baseless and completely backwards, especially when combined with an insistence that it is fairer than a system that gives all people, regardless of resources, access to care.

The resolution is validated, the negation is refuted.

Return To Top | Posted:
2020-01-17 01:38:50
| Speak Round
adminadmin (CON)
I thank my opponent for a fun debate. In this last round I'll just offer a few short closing reflections.

In the very last round, pro stated that "people deserve care regardless of access to capital or status" and that I'm being morally repugnant by denying this. I pointed out at the start of round 1 this was the usual argument (that healthcare was some kind of right) and also why it fails. In round 2 pro accused me of red herrings because of this. Now he italicises it for emphasis as a key argument, says I need to reconsider my definitions as a result, and claims that pointing this out amounts to "redefining his points." One word to respond to that: no.

He can't expect to claim anyone deserves healthcare when he spent his first 2 rounds arguing from a purely economic position. The most economically efficient system is the one in which the minimum number of people get healthcare. He doesn't address my argument at all, which I've consistently spent most of my rounds talking about under the heading principle. Simply stating the alternative position, with no logic or evidence behind it, should not carry any weight with judges, especially considering the alternative depth of analysis I have offered. Comparing me personally to a Nazi for offering this up in a debate is a further low blow, especially since historically the Nazis literally supported pro's position.

Pro has offered no clear counter-argument to my model. They haven't even really explained their model. From a technical perspective, pro has already failed in role fulfillment. He has also failed to meet his burden, because he never defined the terms of the resolution in a way that made it clear what exactly he was trying to prove.

Two key questions remain at the end of this debate.

2. Which system is more economically efficient?
Considering my opponent considers this the cornerstone of why he has shown the resolution is always true, he refuses to actually debate any economics with me. He won't talk about supply or demand of healthcare, won't address my argument about insurance risk, and virtually ignored my points about inefficiencies caused by corruption in the last round. He certainly doesn't seem to think his own cornerstone is even that important, since I repeatedly showed that the young death of sickly people as a consequence of poor lifestyle choices leads to greater efficiencies. All he has is a single data point - present-day USA - as though this presents a comprehensive proof. And since that's the hill pro wants to die on, it's clear he isn't looking at a cost metric at all, rather, the subquestion as follows:

Sub-question: Why are healthcare costs so high in the USA?
While pro was light on his model, he sure was insistent on setting this debate in the USA. Pro pointed to a variety of studies showing costs were high, and that the USA was relatively multi-payer compared to most other industrialized countries. I agreed. I've pointed out that not only do none of those studies show (and in fact, several refute) that the USA would be have greater economic efficiency under a more universal system - I've also shown evidence of a causation. This isn't some "mental gymnastics," it's literally how statistics works - I can find correlations between reductions in numbers of pirates and global warming, but that doesn't mean the relationship is causal.

Prefer, then, my analysis which listed 3 specific causes of high healthcare costs. Pro has ignored the biggest 2 causes in terms of health cost consistently - poor lifestyles, and the resulting chronic conditions. No response whatsoever to the fact that having a poor lifestyle increases strain on the health system. No response to the fact that, were it not for these chronic conditions, the US healthcare spending would go down 85% overnight. No response to my round 2 analysis showing that the most sick 5% of Americans, who would never get insurance coverage before Medicare for All, now account for over 50% of their health budget. No response to the fact that America is continuing to encourage poor lifestyles leading to further wait times, stressed doctors, poor care, and above all, high costs.

He does continue to address the cost of prescription drugs. I pointed out in round one that price control was a feature of single-buyer systems, and that single-buyer is entirely compatible with multi-payer; therefore I concluded it wasn't relevant to the debate.

Overall, I have provided a much clearer rationale for high healthcare costs. It's not the system, it's poor lifestyle, chronic conditions, and pharmaceuticals lobbying against bulk buying drugs (not necessarily restricted in either model). Con's single data point is nothing more than a case of confounding variables.

1. Which system is fairer? (The only warrant anyone has provided, which came from me)
Bear in mind that my burden is not to prove multi-payer is cheaper or higher quality. Pro admits neither model can be better quality, and is arguing (wrongly) about aggregate cost. I've added a third criteria, fairness. I've given a consistent narrative that the healthy have no obligation to subsidise the sick, and that this happens under universal healthcare. Pro cannot and does not refute either point. Therefore I win this debate on this question alone, hands-down. If pro wanted to show fairness was not relevant to the debate, in spite of my clear analysis that it was, then maybe pro should have offered analysis to this. As it stands, pro attempted some pretty interesting attacks in the third round, all of which have been answered already.

The burden of proof, in fact, rests entirely on pro. He must show why universal healthcare is not just as good, but superior, in all three criteria that we as debaters have collectively set: fairness, cost and quality. He's ignored fairness, conceded quality, and lost cost.

The resolution is negated.

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2020-01-17 05:29:08
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I hate the medical industry.God put medicine in plants for all disease that exist.Turmeric can reverse brain damage done by schizophrenic medication. And there are DNA repair foods.One of the health video i watch talks about how eating kiwi can repair 5 genes. they added 4 different kinds of berry's with the kiwi and it repaired 25 genes.

Posted 2020-01-18 03:52:09
What a fun one! I hope we get to debate more in the future, I legitimately enjoyed your arguments, @admin.

Unexpected ridiculousness is part of the package, may it never fade.
Posted 2020-01-17 18:36:12
Whew ... feel like I almost completely got away with framing death as a "lifestyle choice" of the poor :D I was seriously expecting cost to be MY argument, and rights to be yours, but then your round 1 just flipped everything in a weird way lol.

I love how ridiculous debates can become sometimes!
Posted 2020-01-17 05:32:47
@admin It's good to be back! Glad you're enjoying the subject matter.

I was on mobile the first round so I'm seeing some of my own formatting issues for the first time right now, no worries.
Posted 2020-01-16 05:20:03
Sorry, the babies paragraph should read "could be solved in other ways." Also sorry my formatting got messed up with the university quotes.

This is a fun one to DA :)
Posted 2020-01-16 03:11:27
The judging period on this debate is over

Previous Judgments

2020-01-18 04:28:46
dpowell3543Judge: dpowell3543    TOP JUDGE
Win awarded to: admin
While both parties had good arguments, I have to give the win to admin. Between the two, they provided more arguments and touched up on all of their opponent's arguments, something GuitarKirby sadly failed to do. They over did a much better job at rebutting their opponent's points and even pointed out the major holes in their opponent's arguments.

Both: Something you both should have done is gone into further details about the costs (actual prices of healthcare and the amount of people pay in taxes for their "universal healthcare") and the difference between each country's health choices. You should also have discussed the difference between each country's populations. All these are major factors in a debate about different healthcare systems. Other than that, good jog guys. It was a good read.
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