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Novice Tournament R1: The United States should implement a system of Single Payer health care.

A brief outline of my case – my first point upholds that a free market system is better than a universal one, showing that a better system exists to a single-payer system; my second point critiques the Canadian health care system, illustrating that even if a universal health care system is deemed better in general, the resolution ought to be negated because the model system for this debate is undesirable for the United States to implement. A Free Market System is Superior a) it better values autonomy It is important to adopt a system that respects autonomy. Autonomy is often compromised in health care setting because illness increases individuals’ dependency on others: “it [illness] reduces patients’ power to exercise autonomy and it also makes them vulnerable to manipulation and even to outright coercion by those who provide them with needed health services … Without a strong principle of respect for patient autonomy, patients are vulnerable to abuse or exploitation, when their weak and dependent position makes them easy targets to serve the interest (e.g. financial, academic or social influence) of others.”1 (pg. 14) ­What’s preferable about a free market system is that it gives individuals direct control of their money by eliminating third party interference: “unlike price controls and other tools of government rationing, markets allocate resources according to consumer preferences, rather than the preferences of politicians, government bureaucrats, or special-interest lobbyist.”2 (pg. 4) When evaluating the protection of autonomy, a free market system is preferable because it allows individuals to better align their care with their interests. b) it encourages growth A free market health care system promotes growth in two key areas – entrepreneurship and the number of doctors. While many entrepreneurs exist in the health care field, they are discouraged by third-party payers (insurance companies, employers, and government) which, “With respect to healthcare, they tend to be bureaucratic, wedded to tradition, and resistant to change. They are, in a word, the entrepreneur’s nemesis.”3 Under a free market system these same hindrances don’t exist, as giving individuals more control over spending is incredibly beneficial to entrepreneurship. The bureaucracies of government involvement also affect job satisfaction in the medical field. Looking at the Great American Physician Survey of 2013, 31.7% of respondents list third-party interference as the primary reason to not be a physician4 (slide 13). America is already facing a doctor shortage, with the American Medical College estimating that by 2015 there will be 62,900 fewer doctors than needed, and the idea of universal health care does not sufficiently add to this pool, even with government attempts to incentivize it5. It is clear that a free market is preferable for growth because it frees the system from the burdens caused by third-party intrusion. Canadian System is Flawed for the U.S. a) costs of the system are too high The current health care system in America is very costly, with 17% of the GDP going to health care6; while this is cited as one of the number one concerns for why America ought to adopt a new system, what needs to be seen is in the increasing instability of the Canadian system. The Fraser Institute published a report in 2011 looking at Canadian health care spending concluding, “that Canada’s health system produces rates of growth in health spending that are not sustainable solely through redistributive public financing”7. This report found that Ontario and Quebec were spending 50% of their revenue on health care in 2011, and that by 2017 four more provinces would reach this high level of spending. While Canadian spending is on the rise (“Total federal, provincial and territorial government health spending has grown by 8.1 percent annually”7) current U.S. per capita spending is slowed down to a record 1.3% growth rate over the past three years, “That is the lowest rate on record for any three-year period and less than one-third the long-term historical average stretching back to 1965.”8 This decreased rate is credited to both economic recovery, and implementation of ACA. Given these current settings, it is clear that the U.S. ought not adopt a Canadian system of universal health care, because it encourages unsustainable spending growths that cannot be justified onto the U.S. b) quality of care is low Quality of care in Canada is seen as low due to two factors – inaccessibility and placement of people in improper care. Canadian care has become increasingly inaccessible over the past couple of decades. Whereas 20 years ago, people had to wait on average 9.3 weeks to receive treatment, another report from the Fraser Institute found that it is currently up to 18.2 weeks9. Furthermore, this rate shows that waiting time increased a total of 3 days from 2012. The report goes on to state that looking at the number of procedures Canadians are waiting for across the 10 provinces, in 2013 it was up to 928,120, an increase of 57,658 from the previous year. A Senior Healthy Policy Analyst from the Fraser Institute sums up the impact of these numbers in his statement, “Canada is effectively reneging on its promise of universal healthcare for those citizens forced to endure these long waits … These lengthy delays have real and important effects on Canadians’ health and wellbeing, imposing pain and suffering, mental anguish, lost productivity at work and leisure, and possibly even disability and death.”9 Unfortunately inaccessibility isn’t the only negative quality to the care that’s being delivered -- often people are placed in improper care under this system. Dr. Jeffrey Turnbull, a Canadian doctor in the Ottawa Hospital, is largely dissatisfied with how the Canadian system is implemented. The main problem he sees with the system is how it doesn’t put alternative level of care patients (ALC’s) in the proper location. While they should be quickly moved to nursing homes or other long-term care facilities, they are kept in the hospital too long due to the poorly organized system. Turnbull explained, “There are maybe 160 people in the hospital at $1,100 a day waiting for long-term care. So we’re spending maybe $180,000 a day for care that is crappy, not in their best interests. In a nursing home, it would be about $200 a day.”10 An actual evaluation of the statistics of patients in the Ottawa Hospital on one day showed that, “Thirteen percent of the beds, therefore, are occupied by people who, under ideal circumstances, should not be in the hospital.”10 Given that this is a largely inefficient system that leaves too many people waiting for proper care too long, and displaces a considerable amount of patients in improper facilities, it is clear that the Canadian system has strong costs and its implementation is not desirable system for the United States. Sources 1 -http://books.google.com... 2 – http://www.cato.org... 3 – http://www.ncpa.org... 4 - http://www.slideshare.net... 5 - http://www.nytimes.com... 6 - http://assets.opencrs.com... 7 – http://dailycaller.com... 8 - http://www.whitehouse.gov... 9 – http://www.ctvnews.ca... 10 – http://fullcomment.nationalpost.com...