by Sarah Small
In 1858, Abraham Lincoln and Stephen Douglas met for a series of famous debates as the two vied for a U.S. Senate seat in Illinois. Modern school debates and even the presidential debates trace their roots to the 1858 Lincoln-Douglas debate format, heavily emphasizing logic, ethical values, and philosophy.
The Academy on Capitalism and Limited Government, a not-for-profit corporation in support of the University of Illinois, funded its own debate series that address issues of individual rights and limited government, and, in true Illinois spirit, named it the Lincoln-Douglas Debate Series.
On March 9, 2010, the Center for Business and Public Policy hosted the inaugural debate entitled “Who Controls Your Health Care: a Debate on Free Market vs. Government.”
“The goal today is really to have a rigorous and vigorous debate about an issue that is obviously very important to all of us, that is the nation’s healthcare,” said Jeff Brown, Director of the Center for Business and Public Policy in the College of Business, “and we are very pleased to be chosen to host the first of these debates.”
Two national experts on health care presented positions on a free market health care system and a government run health care system. Arguing for a free market system was Dr. Michael Tanner, a senior fellow at the Cato Institute in Washington D.C. Dr. Steffie Woolhandler is a professor of medicine at Harvard University and co-founder of Physicians for a National Health Program, and she defended the idea of a government run system.
In his presentation, Tanner argued that under a government-run health care system, the common man would be forced to do as told, and that if the nation adopted a free market health care system, it would evolve to operate like any other industry in the country.
“The less government control, the more consumer choice,” Tanner said. “The more the consumers are part of the game the better the outcome. “
He said he agreed with the proponents of a government run health care system the existing system is broken, but he said that instead of having too little government regulation and too large of market, he said there is too much government involvement and the market is too small.
“We have far too many people in this country who are uninsured,” Tanner said. “The biggest reason is because in this country we tie health care to your job. That means that when you lose your job, you lose your health care.”
He argued that policies should not be available through employers, that way if someone lost his or her job, the policy would not also be lost. Much like auto insurance policies or homeowner insurance policies, he advocated for a “personal and portable insurance that belongs to you and goes with you from job to job.”
A lack of competition is another flaw in the health care system, Tanner said. He discussed a system where consumers search their options and are able to purchase the health care policies appropriate for them.
“The president is absolutely right when he talks about how little competition between health insurances there is,” Tanner said. “It’s because government regulations protect the insurance cartels from true competition. You can’t go online and find the cheapest insurance policy anywhere in the nation and buy it.”
Woolhandler addressed the issue of Americans living without health insurance and the lack of affordable health care for the people who are insured.
“It would be a mistake to think that the health care debate is only about the uninsured,” Woolhandler said. “In fact, many people have health insurance, but they still suffer financially if they have a serious illness.”
She presented a concept called the 20-80 Rule, which indicted that the 20 percent of people who are sick each year account for 80 percent of the costs of health care. She said this idea is significant, especially for the health care companies because then they only need to recruit the 80 percent of the population that is healthy and has very low health care expenses.
“You get a nice fat premium and people don’t use much care,” Woolhandler said. “You have to selectively recruit those healthy people, and you have to keep those sick people out. Competition in health insurance is a race to the bottom.”
To provide evidence for her support of government run health care Woolhandler pointed to the systems of other developed nations that have developed forms of national health care that are highly regulated, usually public and always provide universal care.
Especially in the issue of eliminating waste in the health care system, she pointed to Canada, which applies a supply-side control system that has government regulations on the number of different medical facilities and equipment that each city can operate. The doctors in the cities decide which patients will get access to those facilities.
“It’s all centralized in the hospitals and the doctors have to fight it out among themselves,” Woolhandler said. “You want a system that targets the resources to people who need them the most. And that’s what we try to do in a single-payer system.”
After an hour of considered debate between Tanner and Woolhandler, the audience questioned the two presenters vigorously and came away thoughtful and educated.