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Definitions
“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
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
Doctor group pushes single payer
Docs single payer prescription
Health care needs a single payer
How a single payer system improves quality
Affirmative — Private Insurance Bad
The Cost of Employer Insurance Is a Growing Burden for Middle-Income Families
Affirmative — Women
Affirmative — Morality
Values-Based Foundation for a U.S. Single Payer Health System Model
Health care as a basic human right
Funding health care as a basic human right
The missing moral dimension in the health care debate
Health care for all: A moral obligation
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
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
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
Aaron L. Mackler (2001). Jewish and Roman Catholic Approaches to Access to Health Care and Rationing. Kennedy Institute of Ethics Journal 11 (4):317-336.
Dani Filc (2007). The Liberal Grounding of the Right to Health Care: An Egalitarian Critique. Theoria 54 (112):51-72.
Allen E. Buchanan (1987). The Profit Motive in Medicine. Journal of Medicine and Philosophy 12 (1):1-35.
Nicholas Dixon (2009). Why Mainstream Conservatives Should Support Government-Mandated Universal Health Care. International Journal of Applied Philosophy 23 (1):1-15.
Dan W. Brock (2000). Broadening the Bioethics Agenda. Kennedy Institute of Ethics Journal 10 (1):21-38.
Benjamin Sachs (2008). The Liberty Principle and Universal Health Care. Kennedy Institute of Ethics Journal 18 (2):pp. 149-172.
Dan W. Brock (2001). Children’s Rights to Health Care. Journal of Medicine and Philosophy 26 (2):163 – 177.
Larry R. Churchill (1999). Looking to Hume for Justice: On the Utility of Hume’s View of Justice for American Health Care Reform. Journal of Medicine and Philosophy 24 (4):352 – 364.
Lesley Jacobs (1996). Can An Egalitarian Justify Universal Access to Health Care? Social Theory and Practice 22 (3):315-348.
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.