Resolved: The United States ought to implement a single-payer universal healthcare system

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Definitions

What is single payer?

“Medicare for All is a proposed single-payer plan that would restrict or abolish private insurance and expand Medicare benefits to most of the population.” Single Payer Health Care

Single Payer Health Care vs. Universal Coverage

Debate sharpens over single payer system, but what is it?

Single payer explained (vide0)

General

Single-Payer, Multiple-Payer, and State-Based Financing of Health Care: Introduction to the Special Section

The Pros. and Cons of a Single Payer Health System

Virtues and Vices of a single payer system

What single payer would mean to doctors

The Sanders single payer health care plan

Access and cost: What the US can learn from other countries (hearing)

General Morality and Health Care

Debate: Is the government morally obligated to provide health care?

Health care for the poor: For whom, what care, and whose responsibility?

Justice, health, and health care

Moral obligations and the social rationality of government

Is health care a right or a “moral obligation” ?

Universal health care: A moral obligation?

Health care and justice: A Moral obligation? Using John Rawls’ veil of ignorance, this paper makes the argument that there is a moral obligation to provide health care but that the obligation can be fulfilled through universal access to private managed care, employer mandates, the current Obamacare, and a single payer system.

Is there a moral obligation to provide health care to all children?

Pro — General

Adopting a Single-Payer Health System

Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care

Envisioning a Better U.S. Health Care System for All: A Call to Action by the American College of Physicians

Doctor group pushes single payer

Docs single payer prescription

Health care needs a single payer

Road map to a single payer

Funding a single payer system

How a single payer system improves quality

Affirmative — Private Insurance Bad

The Cost of Employer Insurance Is a Growing Burden for Middle-Income Families

It’s Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt

Affirmative — Women

Vulnerable And Less Vulnerable Women In High-Deductible Health Plans Experienced Delayed Breast Cancer Care

Affirmative — Morality

Values-Based Foundation for a U.S. Single Payer Health System Model

Health care as a basic human right

The right to health

Funding health care as a basic human right

The missing moral dimension in the health care debate

Health care for all: A moral obligation

Health care as a moral crisis

We have a moral obligation to provide health care for all

Heath care as a basic human right

Is it the moral obligation of the state to provide basic health care for its citizens? This paper makes a strong argument that there is a moral obligation on the part of the government to provide basic health care through a single payer system. The author makes the argument that this care can be supplemented by a private system.

Negative — Morality

The moral and practical superiority of free market reforms

The moral obligation argument

Moral health care vs. universal health care

Negative — General

Single-Payer is Not the Solution to America’s Health Care Problems

Single Payer is Not the Answer for New York

What liberals get wrong about single payer

Larger problems of Sanders’ single payer plan

False lure of Sanders’ single payer plan

Single payer doesn’t work well

A single payer plan would still be expensive

The grass is not always greener — a look at health care systems around the world

How Medicare for All Will Wreck America’s Health Care System  (b00k)

Disastrous Reality of Medicare for all (book)

National Health Spending Estimates Under Medicaid for All  We estimate that total health expenditures under a Medicare for All plan that provides comprehensive coverage and long-term care benefits would be $3.89 trillion in 2019 (assuming such a plan was in place for all of the year), or a 1.8 percent increase relative to expenditures under current law. This estimate accounts for a variety of factors including increased demand for health services, changes in payment and prices, and lower administrative costs. We also include a supply constraint that results in unmet demand equal to 50 percent of the new demand. If there were no supply constraint, we estimate that total health expenditures would increase by 9.8 percent to $4.20 trillion.
While the 1.8 percent increase is a relatively small change in national spending, the federal government’s health care spending would increase substantially, rising from $1.09 trillion to $3.50 trillion, an increase of 221 percent.

The Sanders Single-Payer Health Care Plan. Our central findings of the effects of the Sanders approach are shown in table 1 and include the following:
 All American residents would be automatically enrolled in acute care coverage, increasing insurance coverage by an estimated 28.3 million people in 2017, from an uninsurance rate for nonelderly adults of 10.4 percent under current law in 2017. In 2026, the Sanders plan would decrease the number of nonelderly uninsured by 30.9 million, or 11.0 percent of the population, relative to current law. (The uninsurance rate under current law in 2026 is projected to be larger than the rate in 2017 as a result of demographic changes and a slight decrease in the rate of employer-sponsored insurance.) Although the intent is unspecified in the campaign’s materials, this finding assumes that the plan would cover the undocumented population as well as citizens and other legal residents.
 National health expenditures for acute care for the nonelderly would increase by $412.0 billion (22.9 percent) in 2017. Aggregate spending on acute care services for those otherwise enrolled in Medicare would increase by $38.5 billion (3.8 percent) in 2017. Long-term service and support expenditures would increase by $68.4 billion (28.6 percent) in 2017.  Together, national health expenditures would increase by a total of $518.9 billion (16.9 percent) in 2017, and by 6.6 trillion (16.6 percent) between 2017 and 2026.
 The increase in federal expenditures would be considerably larger than the increase in national health expenditures because substantial spending borne by states, employers, and households under current law would shift to the federal government under the Sanders plan. Federal expenditures in 2017 would increase by $1.9 trillion for acute care for the nonelderly, by $465.9 billion for those otherwise enrolled in Medicare, and by $212.1 billion for long-term services and supports.
 In total, federal spending would increase by about $2.5 trillion (257.6 percent) in 2017. Federal expenditures would increase by about $32.0 trillion (232.7 percent) between 2017 and 2026. The increase in federal spending is so large because the federal government would absorb a substantial amount of current spending by state and local governments, employers, and households. In addition, federal spending would be needed for newly covered individuals, expanded benefits and the elimination of cost sharing for those insured under current law, and the new long-term support and services program.

Analysis of Sanders’ Single Payer Plan 

Medicare for All Would Make Looming Doctor Shortages Worse

Negative — Alternatives/Counterplans

Reforming American’s Health Care System Through Choice and Competition 

Chris Jacobs, “Democrats’ New Single Payer Bill Will Destroy Everything Good about Your Health Care,” Federalist, March 1, 2019, h.

Negative — Medicare for All Doesn’t Save Lives

Roy A. Beveridge, et al., “Mortality Differences Between Traditional Medicare and Medicare Advantage,” Inquiry, June 2017, .

John Z. Ayanian, “Medicare Beneficiaries More Likely to Receive Appropriate Ambulatory Services in HMOs than in Traditional Medicare,” Health Affairs, July 2013,.
Costs

Charles Blahous, “The Costs of a National Single Payer Health Care System,” Mercatus Center, July 30, 2018,

Chris Jacobs, “The CBO Report on Single Payer Isn’t the One We Deserve to See,” The Federalist May 3, 2019,

John Holahan and Linda Blumberg, “Estimating the Cost of a Single Payer Plan” Urban Institute, October 9, 2018,

Jodi Liu and Christine Eibner, “National Health Spending Estimates Under Medicare for All,” Rand Corporation, April 2019, https://www.rand.org/pubs/research_reports/RR3106.html.

Josh Katz, Kevin Quealy, and Margot Sanger-Katz, “Would ‘Medicare for All’ Save Billions or Cost Billions?” New York Times, April 10, 2019,

Negative — Cost/Spending

Can Taxing the Rich Pay for Sanders Medicare for All Plan?

Tax Hikes on the Wealthy Alone Can’t Pay for ‘Medicare for All’

Sanders’ Single Payer is Almost Twice as Expensive as He Says 

The Extremely Bad Economics of Medicare for All 

 

Sanders says Medicare for All Would Reduce Health Care Spending. Would it?

Choices for Financing Medicare for All 

Sanders’ Single Payer is Almost Twice as Expensive as He Says 

Negative — Economy

Choices for Financing Medicare for All 

Negative — Collapse of Private Insurance

Kamala Harris Reveals That Medicare for All Involves Ending All Private Insurance,” The Federalist, January 31, 2019
Medicare for All Would Abolish Private Insurance 

Negative — General Solvency Answers

Medicare for None
Why Vermont’s single-payer effort failed and what Democrats can learn from it
Why Bernie Sanders Plan Won’t Get us More Health Care 

Negative — Medicare Advantage Good/Better to Keep it than replace with Medicare for All

Enhancing Medicare Advantage 

Mortality Differences Between Traditional Medicare and Medicare Advantage 

A dozen facts about Medicare Advantage

Negative — Rationing

Sanders Admits His Plan Would Ration Care

Negative — Health Care Stocks

Health Care Stock Route Amidst Political Pressure

Negative — Hospital Collapse

Hospitals Stand to Lose Billions Under Medicare for All 
The Implications for Medicare for All for US Hospitals 

Negative — Surveillance Bad

How Electronic Records Became an Absolute Fiasco
Death by a Thousand Clicks: Where Electronic Health Records Went Wrong

Negative — Wait Times

Waiting Your Turn: Wait Times for Health Care in Canada 
Private Costs of Public Cues for Medically Necessary Care

Negative — Hospital Collapse

Hospitals Stand to Lose Billions Under Medicare for All 
The Implications for Medicare for All for US Hospitals 

Negative — Doctor Shortages

Medicare for All Would Make Looming Doctor Shortages Worse

Negative — States Counterplan

Could States Do Single-Payer Health Care?

More States Are Proposing Single-Payer Health Care. Why Aren’t They Succeeding?

Gated articles

Books/Book Chapters

Daniels, Norman. “Justice, Health, and Healthcare”. Contemporary Bioethics: A Reader With Cases. Ed. Jessica Pierce, Ed. George Randels. New York, NY: Oxford University Press, 2010.

Key Theoretical Approaches

Nozick argues that a distributive state such as the one Rawls presents cannot be justified. He also offers a direct counter to Rawls’ arguments which I will attempt to answer.

Nussbaum, Martha. Frontiers of Justice. Cambridge, MA: Belknap Press, 2006.
This present’s Nussbaum’s capability approach. I will contrast her account with the Rawlsian account of justice.

Rawls, John. A Theory of Justice. Cambridge, MA: Belknap Press. 1971
I use Rawls’ justice as fairness account to justify my thesis that we are morally obligated to provide universal healthcare.