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 socialized medicine, which essentially puts every person in a country on the same level of access.

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. The United Nations' Universal Declaration of Human Rights enumerates medical care as a right of all people.

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.

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.

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. 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.

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.

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.
 * 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.
 * Death rates are lower under socialized systems.

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.
 * Free healthcare can lead to overuse of medical services, and hence raise overall cost.
 * Socialized medicine leads to greater inefficiencies and inequalities.
 * 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.

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.

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. In fact, medical insurance companies will all but cease to exist, as is the case in many countries, if universal health care is adopted.

Impact on Medical Research
Those in favor of socialized medicine posit that removing profit as a motive will increase the rate of medical innovation by removing profit as a motive. 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 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. For example, it might only take one government agent to do the job of two health insurance agents.

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.

Government agencies are less efficient due to bureaucracy. 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. 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.


 * Profit motives, competition, and individual ingenuity lead to greater cost control and effectiveness.


 * Healthy people who take care of themselves have to pay for the burden of those who smoke, are obese, etc.


 * Empirical evidence on single payer insurance programs demonstrates that the cost exceeds the expectations of advocates.

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.

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 is a policy that affordable health care is available to everyone in a country, either through providing a minimal level of government-funded health care insurance to everyone or through another system. Socialized medicine is a policy whereby the government centralizes control over the healthcare system, allocating services to all citizens in an equal manner.

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."

Examples

 * Medicare (Australia)
 * Medicare (Canada)
 * National Health Service (United Kingdom)
 * Journal of Health Care for the Poor and Underserved

Related topics

 * Universal health care
 * Medicare (United States)
 * Two-tier health care
 * Massachusetts 2006 Health Reform Statute

Supporting universal health care

 * American Medical Student Association (AMSA)
 * Connecticut Coalition for Universal Health Care
 * Physicians for a National Health Program (PNHP)
 * Universal Health Care Action Network (UHCAN)
 * Universal Health Care / National Health Insurance

Opposing universal health care

 * Heritage Foundation's health care research site
 * Health Care Issues The Heartland Institute
 * Americans for Free Choice in Medicine (AFCM)
 * Capitalism Magazine
 * The Problems with Socialized Health Care from Mark Valenti's Liberty Page

Neutral

 * BalancedPolitics.org - "Should the Government Provide Free Universal Health Care for All Americans?"
 * Health Action by People India (HAP)