Stickman Warning: Private VS Government-owned Healthcare

Arjun Kapur
6 min readSep 15, 2020

It’s very easy for politicians to say “Healthcare is a right!”, “Medicare for all!”, “Free healthcare!”. Before we monolithically nod our heads this distorted utopia, why don’t we first ask ourselves, what is healthcare? If you get sick, really really sick, you don’t just want healthcare, you want QUALITY healthcare. Where do you find that? In healthcare systems like the US where patients are treated by skilled doctors, cutting edge technology, and TIMELY care. Sure, the private healthcare system has its cons, but do we want to just ignore the plethora of advantages and potential benefits that are stacked against the minority of costs?

Photo by Kendal on Unsplash

Government-run healthcare systems take decisions away from patients and put them in the hands of bureaucrats.these choose the conditions for obtaining operations(whether you qualify for a bypass of cancer treatment), what equipment and how many you are allowed to use. In the UK with NHS, because the system is single-payer and publicly managed, they sharply restrict access to treatments. Some examples include knee and hip surgery, cataract surgery, treatment for diabetes, and arthritis.

They’re expensive too. A study showed that a Bernie sanders style single-payer system would cost the government 32.6 trillion dollars over 10 years. So, if you are going in the direction of medicare for all, there will be enormous tax increases. Not just for the rich and elite class, but also for working Americans and poor too. Even a doubling for all projected individual and corporate costs would still be insufficient to finance these federal costs. The assumption that anything can be free is foolish, and should not be the perspective of anybody. The healthcare’s devil in disguise is our classic example of Canada. Healthcare costs took up 46% of the federal budget in 2010. that is projected to be 80% in 2030.

“UK healthcare isn’t free. It’s deducted out of our wages every month and you pay according to what you earn. It’s free at the point of service but you still have to pay.”- Resident of London

Furthermore, government-run systems are implied to depress research and development for new cures. Us outpaces countries like France and Germany in Biomedical research spending. that’s why medical breakthroughs rarely come from countries where the government controls healthcare. 70 billion dollars of biomedical investment comes from the private sector in the US.

Medical care is a commodity, and often, we are faced with commodities we cannot afford. The idea that one recognizes medical care as a commodity rather than a right deems you soulless. This is foolish both morally and practically. Morally, you have no right to man medical care of me. I may recognize your necessity and offer charity. My friends may band together to fund your medical care. But your necessity does not change the basic math. your necessity is a basic service and a good provided by a third party. No matter how much I need bread, I have no right to steal your wallet or rob the local bakery to obtain it.

To present the health care debate as one between public and private is to misrepresent the real issues. There will always be public involvement in health care and there should be; it is a hallmark of a civilized people that everyone has access to health care, both out of compassion for our fellow human beings and to enable everyone to participate fully in society. The real question is how health care is then provided. In the U.K., with the NHS, we have opted for a monopolistic course. It’s one where the state, by and large, controls funding, resource allocation, and provision. The government thus directs services through targets with the result that, for all the good intentions of clinicians and managers, satisfying central whims too often comes before caring for the patient. The NHS is not a body that thrives through being customer-focused.

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But then turning the whole lot over to the private sector (even with a guarantee of universal coverage) is no catch-all solution. There are plenty of private hospitals and insurers in the U.K. that have fought long and hard to create a profitable monopoly for themselves. And, looking at the privatization of other U.K. industries in the 1980s, the economists’ John Vickers and George Yarrow concluded privatization did not always reap the rewards anticipated because it often simply turned public sector monopolies into private-sector ones.

The key, instead, is to nurture competition in a system that provides for universal coverage and equitable access. In the Netherlands, for example, providers are under diverse ownership and people can choose between them. People (not the state in the case of the U.K., or employers in the case of the U.S.) can also opt for a health insurer of their choice, the provisions being that: every insurer must provide a minimum package of care, no insurer can refuse to insure anyone, and the state pays for those who cannot afford it, while topping-up for those with excessive health risks. On measures developed by the Health Consumer Powerhouse, Dutch people recently rated their health system more highly than any other European population.

Oof, too harsh? Well, its a stickman article so don’t get too triggered. Let’s evaluate the pros of public healthcare can bring. While I will almost always advocate for a market based economic approach to allocating resources, health care is not an area where the profit motive should dominate decision making. Simply put, the end product is a patient’s health. Private health insurance has a conflict of interest between the insurance company and the insured which will be resolved in favor of the insurance company a majority of the time.

Photo by Ashkan Forouzani on Unsplash

There are numerous stories about an insured making a routine claim only to be inundated with paperwork, or being told the policy doesn’t cover that procedure or being told the insurance company has to look into the claim to see if the insurance company can make a payment. In any of these situations the central idea of insurance — to provide some safety for the insured at a specific cost — is compromised.

I live in Australia. 20 years ago my dad was walking up a hill one day and had a very significant pain in his chest. He went to the doctor, they did the relevant tests and within less than a week he was booked into hospital to have a quadruple bypass on his heart. A very skilled surgeon performed the surgery. My dad is a piano teacher, never made much money. Luckily the entire process didn’t cost a cent. In America I wouldn’t have a dad anymore. In Australia, my dad is now over 80 years old and still going strong 20 years on. I love having my dad around, and love living in Australia.- Resident in Australia

Also, insurance companies will seek to minimize the amount of money they would have to pay to the insured. Again, remember the product here is the patient’s health. Supposed the insured has a disease where the cure is expensive but a cheaper alternative exists. However, the cheaper alternative would moderately or seriously compromise the insured’s quality of life. Because the insurance company is profit-driven, it will probably opt for the cheaper treatment that compromises the insured’s quality of life.

So what do you think? Is healthcare a commodity or something we are subjected to have, no matter our financial background?

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