Universal healthcare.

I am interested in politics. I am particularly interested in American politics - partly perhaps out of masochism, and partly because I think it is everyone's duty to care about what goes on in this weird, huge country, because for better and for worse, it impacts the rest of the world and has for over a century. One particularly hot topic which, I think, baffles a great number of Europeans (and Canadians) is that of socialized healthcare. Like many others, I'm not sure what the deal is, since it's a system that has been in place for years in many countries and that is undoubtedly functioning. In spite of this, the apocalypse has yet to happen, so why is the Republican party acting like a universal healthcare system will be the world's downfall?

I recently had an exchange about this on Tumblr with someone on the complete opposite side of the political spectrum, and she reiterated with the following list of worries, complaints and issues that I would like to respond to. I will also post my response on Tumblr for her to see, but I like the Blogspot format better, so I wanted to share my viewpoint here as well

1. Any “universal” infrastructure is expensive. We’re talking trillions of dollars to ensure that every individual is provided health-insurance. Considering only about half of the population pays taxes, this unfairly shoulders the tax burden on the few who do pay taxes (the middle class). The poor are often exempt from paying taxes all together, though they would be the ones receiving the benefits from a universal system.

I think this comment suffers from something I just decided to call 'poor-phobia' - the idea that The Poor are somehow the others, not like us, who live in a different city, on a different street, on a different block. Universal healthcare is not a benefit extended by the huge middle-class majority to a small group of 'poor people' who are Too Lazy To Work and Probably On Drugs. From what I have seen in this country, and read about, I am fairly sure these uninsured poor people are not some sort of alien minority. These are very regular people, often from a middle-class background, who are in school, or whose job doesn't provide benefits, or who were laid off because of the recession. I don't like to talk about 'the poor' - because I think that poverty is much more pervasive than that phrase appears to indicate.

2. When the quantity demanded of a good exceeds the quantity supplied, there is a shortage. If every individual in the nation now wants to see a doctor, there is going to be a shortage of doctors. This manifests in to longer waiting times.

I have various issues with this statement. First of all, it seems to believe in sacrificing the needs of the many for the comfort of the few - we can't have universal healthcare, because then everyone would get to see a doctor, and then those people lucky enough to have money or good medical insurance would have to share their doctors with these people! If there's not enough doctors, that's an issue - but the solution can't be to withhold medical care from people who can't afford it.

Also, and I realize this is anecdotal evidence - I've always been able to see a doctor MUCH quicker in Belgium or in the UK than I have over here. And I have a number of US friends who have literally had wait months to see X or Y doctor. So if you're talking about waiting times... how much worse can it really get?

3. The shortage of doctors is exacerbated because there is a lack of an incentive to become a doctor. Doctors typically become doctors in order to make money (as any other rational individual pursues a field). However, if the government is now involved in the health-care industry and can decide how much a doctor must be paid for his services, you will find less people wanting to become doctors.

Well, first of all, not everyone becomes a doctor solely to make money. Like nursing and teaching, I believe one needs a certain calling to become a doctor - I think I'm smart enough to pursue medical studies, but I don't feel the least urge to poke around someone else's body. Some people however find that interesting and find they can help people by pursuing that interest. Monetary gain is not everyone's number one stimulus.

Furthermore, I'm not sure where this even comes from. Doctors are still extremely well-paid in Europe. There is still a certain prestige attached to the profession - only their wages are provided by the government or government-sponsored insurance instead of by individuals or for-profit insurance companies. I assure you, doctors are living more than comfortably, even under this evil socialist system - and last thing I heard, there are still plenty of people who wish to pursue medical studies.

4. The quality of care is reduced in order to fill the shortage of doctors. If everyone is demanding a doctor, and the government “needs” to fulfill the demand, it will inevitably be led to hire underqualified doctors.

Once again, inevitably? I feel like many of these arguments are regurgitated blindly from right-wing propaganda sources, because I honestly believe that there is no marked difference between doctors in Europe and doctors in the United States. I've seen my share of doctors and specialists, and I assure you they are not some gang of plucked-off-the-street drug addicts who had to sign two forms and they're a doctor now. A lot of this just strikes me as pointless fear-mongering.

5. When the demand for a good (health-care) increases, the price of the good also goes up. If everyone now demands health-care, its price will increase exponentially. You hear the term death panels thrown around a lot, but if there are thousands of people on the list who need a kidney, there needs to be a way to decide who actually gets it. This creates corruption.

If you genuinely believe death panels are a real thing, then I truly have no words. Trust me. They're not. Once again, I see you using the 'universal healthcare means more people would be able to get medical attention and that's bad!' argument, which just doesn't fly. Nobody is on a list for a kidney without a good reason. Are you really saying that 'poor' people don't deserve to be on such a list? If the healthcare system cannot handle more patients, then the solution is to reform the system - not to deny care to patients based on income.

6. Any universal system will face corruption. People who are able to afford better health-care are going to demand it. If there is such a shortage of doctors, and long waiting times since everyone in the entire country is going to see the doctor, an extra exchange must be included to make sure you are seen first (if at all) and provided the necessary care. This often leads to a black market in health-care, as people are now willing to dish out a lot of money to make sure they’re given priority.

A black market in healthcare? Does this stuff come from a James Bond novel? Once again - THIS IS NOT SOMETHING THAT IS REALLY GOING ON in countries with socialized healthcare. And also once again - the way to deal with long waiting times if there aren't enough doctors (which for the reasons I explained above, there are... doctors still make plenty of money) is to offer incentives and make sure there are sufficient doctors to deal with everyone... not to cut people off from the healthcare they need. Healthcare is a basic human right. Most countries have figured this out.

7. There is an incentive to abuse the universal health-care system since it is “free”. In America, we see that people who are provided government health-care often abuse the system by going to doctors and emergency rooms for routine colds, headaches, or things that can be easily treated at home. Elderly people on Medicare often go to doctors multiple times a week, even if they do not have any pressing health concerns. Even if there is nothing wrong, people will see that they can get something for “free” and take advantage of it.

I am skeptical about the fact that people would suddenly go see the doctor practically for entertainment purposes if it were free (medications aren't free even in a socialized healthcare system, by the way - though they're cheaper than they are in the US). However, even if this were to be the case, I had rather 10 people go see the doctor for a cold than that one person wouldn't be able to see the doctor if they have cancer. Fix the system, regulate the system, but don't give up on what is essentially a good idea because of a list of hypotheticals.

8. Due to the abuse of the system, there will be a decrease in quality and an increase in waste. This is pretty simple: if doctors are being tied up treating people for ailments that are not significant, there will be longer waiting times, less resources to be allocated towards you, and more money being funneled in to the system.

You keep repeating yourself. Once again - I do not actually think this decrease in quality is borne out by reality in countries where socialized healthcare is a fact. You seem to imagine these countries as though they're all North Korea. I have a serious and incurable visual impairment as well as a blood disorder, and I have received quality healthcare for both - for free, or at least much more cheaply than would have been the case in the US.

9. There is a lack of incentive to actually care about patients; in fact, there is an incentive to treat patients poorly. If you have hundreds of patients every single day, and they are all required by law to only see you, you do not care about the well-being of the patient. Once one leaves or dies, another one will fill their place. You’re getting paid no matter what.

They're all required by law to only see you? In some countries, people are in fact assigned to a certain physician - but in many countries, that's not the case. For example, where I am from, you can basically go see any doctor you want.

As for not caring about the well-being of the patient - where are you getting this information? I suspect it's simply made up. I don't even know how you'd go about measuring that.

10. The government will view you as a number rather than a patient. The relationship between many doctors and patients are unique, in that there is compassion in bedside manners. However, if a doctor sees hundreds of patients every day, there is no ability for a doctor to genuinely care about his patients.

Once again: fear-mongering. Not fact-based. You have implied before that the left isn't using rational arguments, but exploiting people's fears isn't rational either.

11. Any way you slice it, you are putting bureaucrats in charge of a personal decisions that should be made between you and your doctor.

I am not sure how. I can assure you that my doctor does not call the government before prescribing me sinus medication. I always feel as though people talking about the spectre that is 'universal healthcare' believe it instantly turns a country into a communist superpower in which people are but cogs in the great, red wheel turning and turning to the greater glory of the Great Leader. This is not the case. Our countries are not so very different, and Europeans are no less free than Americans. There are no cameras in every room.

Also, I think it would benefit many people who wave these arguments around to actually conduct a poll in a number of European countries and investigate how people really feel. I think you will find that although a number of people will complain about the healthcare system and point out issues, almost none would be willing to trade it in for the American system. Because universal healthcare, for all this talk of 'death panels', works.

I am not saying it would be easy to create such a system for a nation of 300 million people, and I am not saying that there wouldn't be certain abuses to be contended with - but those are no reasons not to at least give this idea a chance.

Healthcare is a basic human right.