Steel-Man Series: Universal Healthcare (Part 1)
[Writer’s Note: This was originally posted on my website on 3/20/2020 and is the first part of a 3-part piece. There is no podcast covering this article yet, but I do plan on recording one eventually.]
We all see the push for universal healthcare coming from the Left in the U.S. But lately it seems, if you are in enough social media groups, that there is a push from the Right to provide some sort of universal healthcare coverage as well. Even President Trump mentioned his favorability towards a single-payer system during the 2016 campaign, but this may have been to earn some of the independent or moderate-progressive vote. As a conservative, it is scary to hear more and more people okay with changing our healthcare system this radically. I used to mark this up to poor public education, but that is a very narrow-minded way to approach this growing movement. There is obviously a good reason as to why people are pushing for this change that has more to do with just the economics behind healthcare. This leads me to believe this is a cultural movement, and as I have explained in previous articles, conservatives, including myself, tend to have a blind spot when it comes to behavior driven by culture. I will attempt to steel-man the pro-universal healthcare position in this article to make the best affirmative case possible and see how it measures up to the arguments for free market healthcare and health insurance. This will be an article in a series of articles that will take this steel-man approach.
While writing this article, I decided to split it into multiple parts (3 parts total). The reason I did this is because healthcare is a large topic and there are several points to go over if I am to properly steel-man the pro-universal healthcare position. After completing the first few sections, I found this article going over the 4,000-word mark. I do not know about you, but I do not often have the time to read an article of that size. So, for the sake of not turning people away from this article, I will split it into multiple sections and release those sections a few days apart. Part 1 of the universal healthcare topic will include mostly the introduction to this topic.
Another quick point I want to bring up is the strategy I will use for this steel-man series. I will select different poplar positions used by the affirmative party, in this case it would be pro-universal healthcare advocates, and list out sources and data that support their argument. The sources I will use for their position will be as objective as possible, or at least lean in their direction so I do not set up a straw-man. An example of sources I will use frequently in this article is the Organisation for Economic Co-Operation and Development (OECD) and the Commonwealth Fund. Both organizations lean Left (the Commonwealth Fund more so than the OECD), but are often the primary data source for other articles. I did spend hours vetting these sources, including looking into their methodology and bias rating, because I want to make a watertight argument. The pro-universal healthcare steel-man position will be at the beginning of each positional argument. After the steel-man position is laid out, I will follow with the pro-free market healthcare critique. The pro-free market healthcare critique will often be longer than the steel-man position because I will attempt to bridge each argument showing where pro-free market healthcare proponents might agree with the steel-man position and give credit where credit is due. It may seem like I do not give a full argument for some of these positions, but that is because I do not want to bring in or repeat material that will be used in other arguments for different points. My goal here is not to lay out a “point-counterpoint” tutorial to be used as a weapon against the affirmative case, but to show how an honest debate on an idea should be given. I hope this series helps all readers see both sides of the argument in an authentic way.
First, we must get our definitions correct so we are talking about the same thing. There are many terms thrown around that seem like they are interchangeable, but there are small details in these terms that make it important to use them in the correct context. The first term is socialized medicine. Socialized medicine, also known as nationalized healthcare, is a healthcare system in which the government owns and operates healthcare facilities, employs the healthcare professionals, and pays for all healthcare costs. Socialized medicine is a term thrown around in places it does not often belong. There is a push for government healthcare in the U.S., but socialized medicine is closer to the hard socialist, or even communist, view on healthcare because it is the ownership of the whole healthcare industry, including the healthcare facilities themselves, not solely as an insurer who pays for the healthcare costs. There really are not many fully socialized healthcare systems in the world today, for good reason. If you want an example of a completely socialized medicine program in the U.S., the Veterans Health Administration (VHA) is government healthcare using government owned facilities. The VHA, and Veterans Affairs (VA) in general, has had a long list of issues as of late so, pro-universal healthcare advocates in the U.S. tend not to bring them up as an example of what they want to achieve.
Another important term is universal healthcare. Universal healthcare, also known as universal healthcare coverage, is what pro-government healthcare advocates are really pushing for. Universal healthcare is the guaranteed healthcare coverage of all citizens of a country. As advocates for universal healthcare like to point out, most developed countries have some form of universal healthcare, and this is correct. The terms that people mix up when talking about universal healthcare is healthcare and insurance. Healthcare is the actual care and prescriptions one receives when going to a healthcare facility, and insurance is the entity who pays or covers the healthcare costs. This is an important distinction because universal healthcare is not actually healthcare at all, but the universal insurance for healthcare which is why “universal healthcare coverage” is a more accurate term. But just as I did in the opening paragraph, I will be using universal healthcare as a shorthand way to describe coverage, as most people do.
The next terms are Medicare and Medicaid. These are common terms used in the U.S. and are often lumped together, but they do refer to different programs. Medicare, as it currently stands, is a single-payer federal health insurance program to provide healthcare coverage for Americans over the age of 65 and people with permanent disabilities. If you are in America, you often hear the term “Medicare-For-All” which is just this same coverage for all Americans. Medicaid is a health insurance program for low-income and disabled Americans. There is a push to expand Medicaid to cover more people, especially from healthcare reform policies by the Obama administration. President Obama helped push the Affordable Care Act (ACA). The ACA, also more popularly known as Obamacare, is a health reform legislation that allows uninsured Americans to gain subsidies for their healthcare costs. The original ACA legislation had an “individual mandate” that would penalize (with a few exemptions) individuals who choose not to carry health insurance in the form of a tax penalty. This mandate was later repealed because of pressure from Republicans who argued an individual mandate is unconstitutional. That argument was confirmed by a federal appeals court.
Another important term is single-payer system which is the system used for Medicare. A single-payer system is a healthcare system in which one entity, also known as a single-payer, collects all healthcare fees and pays for all healthcare costs, the idea being a single-payer, being the government, would reduce the administrative work and lower costs. Programs like universal healthcare or Medicare-for-all can use a single-payer system, but some of the cost reduction will be mitigated by using private insurance since that increases administrative work by having more “payers.” This is why many advocates for universal healthcare, like Bernie Sanders, would try to eliminate private health insurance to ensure prices can be controlled by government run plans.
Now that the terms are defined, I hope in a way government healthcare advocates would agree with, let the steel-manning begin. Please go to Part 2 for the following arguments: (1) Most of the developed countries in the world have some form of universal healthcare coverage, (2) waiting in line for healthcare is not as bad as not being able to afford healthcare, and (3) people in countries with universal healthcare have better health outcomes. You can also jump to Part 3 for the following arguments: (4) the cost of healthcare is much lower in countries with universal healthcare, (5) we have the technology and the systems setup that will make universal healthcare easy to administer to everyone efficiently, and (6) healthcare is a human right, period. I hope this exercise will help bring more honest debate and expose the damaging effects of straw-manning arguments that result in weak positions and ideas. Thank you for reading.
P.S. If you are still reading, and I hope you are, I will be republishing my writing from my website on Medium so there may be some older stories I cover, although I do not often cover current events. I shut down my website because I have changed my main resource of communication and content hosting to Locals.com. Although I will be publishing my long-form written content on Medium, you can find my more regular content, podcasts, and interactive community at engineeringpolitics.locals.com. Please feel free to join this growing community if you want to stay up to date and/or support this content. Thank you for your consideration!
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