# Why is socially provided universal healthcare 'better'? **URL:** \ **Category:** Great Debates\ **Created:** [February 8, 2012, 12:09pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181 "2012-02-08T12:09:40Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [February 8, 2012, 5:08pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/21 "2012-02-08T17:08:26Z")
> [@msmith537](#): > > The downside of universal health care is, of course, the “free rider” effect and “moral hazard”. That is to say, some people wll always require more out of health services than they put in. People will also use health services more often instead of taking preventative measures that would reduce their need for them in the first place. While these are theoretically true in economic terms, really neither is significant. 1. In terms of the free rider problem, health insurance is, after all, insurance. An insurance scheme will pays some people more than they put in, by definition. That’s the point of insurance. I have paid far more in insurance premiums than I have ever gotten out of them, but insurance isn’t an investment; it’s a payment made to avoid catastrophic risk. I’m paying for cost certainty. Yes, I’ve paid way more in car insurance than I’ve gotten out, but I pay for peace of mind knowing I won’t be screwed if my car gets totaled. And with \*\*universal \*\*health insurance you pay less because you avoid adverse selection, which is a far bigger economic deal in this case than the free rider problem. 1. The notion that people will use more health care just isn’t supported by a great deal of evidence. Canadians do not spend all their time rushing to the emergency room or booking appointments with their doctors, for some rather obvious reasons: - It costs to go to the hospital. While you might not pay money, it costs time and bother and effort. The hospital isn’t fun. I don’t go to the hospital unless it is absolutely and obviously the only option, because why on earth would I want to go there, even if it’s free? Furthermore, people have other things to do. The demand curve stops climbing at some point because people can only be so unhealthy before they die, and time spent in a hospital is not something people are clamoring for. - The system is self-rationing. If everyone goes to the ER for sniffles, then the ER doctors will be overwhelmed and the wait will become intolerably long, making people learn to stop going there for minor problems. - Family doctors and specialists are generally pretty good at managing patient demand. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 8, 2012, 5:56pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/22 "2012-02-08T17:56:37Z")
> [@bldysabba](#): > > Just to set the context for the debate. I’m not American, and have no interest in getting pigeonholed into one side or the other of the crazy ideological divide y’all have going on over there. This is not springing from any interest in what’s happening in the US(with which I have only passing familiarity). > > Where it _is_ coming from is that I often see people in debates automatically assuming that a spreading out of healthcare\* costs, whether through insurance or a public system, is a good thing. I’d like to find out why this is. Up to here you seem to be questioning the value of insurance in general. Some of your responses make me think this also. There are lots of economics around insurance, but insurance makes sense when dealing with events which are probabilistic, but expensive. In a smoothly functioning system you can say that on average you are not being paid for by other people, but by your premiums when you are healthy. In insurance you also pay after the event. In reality some people pay more than they get and some pay less, but more or less you pay the expected cost of an illness over a year, plus insurance company overhead. And the reason is that it smooths out spiky risks to a more regular yearly cost. > [@](#): > > There are two aspects that I see in this. One is the subjective interpretation of morality. That it is wrong to let other people suffer. This isn’t really up for debate in as much as how you feel is pretty much all there is to it. However, I’d be interested in knowing how much of your opinion on the issue is influenced by whether you think it is morally superior to provide universal healthcare. I, for one, don’t think there is anything inherently moral in making sure someone has healthcare even if they personally can’t afford it. The bigger the risk pool, the cheaper insurance is because the statistics become better and predictions are more accurate. The real question about UHC is whether each person has a right to be treated when ill. If I understand you, you think it is perfectly moral to let someone die because they don’t happen to have enough money for treatment. I won’t react until you confirm it. > [@](#): > > The other aspect is the actual benefit/loss to society. I think this offers slightly more productive ground for debate, if one leaves sentiment behind. For instance, an argument can be made that universal health insurance frees people up from having to worry about potentially catastrophic medical costs, and makes them more productive. An example of the other side of the argument is that it prevents properly functioning markets from forming(which would be regulated. I’m not libertarian either) and thus causes a net drag. > > This sort of actual benefit/loss to humankind of universal healthcare is what I’d like to understand. Which side do you come down on? Why? Do you have an example of markets working properly? Properly working markets would exclude people with high expected costs and only cover people with low expected costs. Users work the opposite way - the reason for mandates is that it makes perfect economic sense for a healthy 25 year old to not get insurance, and wait until he becomes a not so healthy 50 year old. We can go into this further, but the high cost of US healthcare compared to European plans shows UHC works. As far as I can tell, much of the opposition here comes from people with money not wanting to spend any of it on those losers who need help with medical costs. ---
**Author:** ![BrainGlutton](https://avatars.discourse-cdn.com/v4/letter/b/82dd89/32.png) [@BrainGlutton](https://boards.straightdope.com/u/BrainGlutton)\ **Post date:** [February 8, 2012, 6:30pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/23 "2012-02-08T18:30:54Z")
> [@Hentor\_the\_Barbarian](#): > > From an empirical and objective standpoint, the system we have in the US achieves poorer outcomes at grreater costs when compared to other systems in place around the world. And we have a lot more rent-seeking behavior, too. From the insurance companies, not the doctors. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [February 8, 2012, 6:32pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/24 "2012-02-08T18:32:55Z")
> [@Lemur866](#): > > OK, I’ll say it. A lot of people would vote for universal health care in a second, if it could be limited to white people. Could you be more specific about what you mean by “a lot”, and how you came to this conclusion? ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 8, 2012, 7:27pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/25 "2012-02-08T19:27:57Z")
Because it is universal and socially provided, the clue is in the name. The UHC/insurance debate is a red herring. Everyone in the UK is, in effect _purchasing_ insurance with their tax input. It just so happens that the policy is not written down, it covers everyone equally, prioritises according to needs rather than means, covers all treatments that can show efficacy to a given standard, cannot refuse coverage due to existing conditions, is infinitely transferable, demands no input at all from non tax-payers, waives prescription costs for the vulnerable and chronically ill, it is cheaper that the USA system and should you wish to pay a little extra you can still go private and jump any queues (and for less than an equivalent US healthcare policy), it bankrupts no-one and doesn’t ask for credit cards. Apart from that, no…not better at all. ---
**Author:** ![KneeSid](https://avatars.discourse-cdn.com/v4/letter/k/dec6dc/32.png) [@KneeSid](https://boards.straightdope.com/u/KneeSid)\ **Post date:** [February 8, 2012, 7:32pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/26 "2012-02-08T19:32:46Z")
A huge problem with America today is without insurance you wait to get treated. It’s obviously much cheaper to treat a heart attack about to happen, than to wait till after it’s done, but that is what happens. I had a workmate who went to Cook County two days in a row for what he said was a heart attack. They sent him home twice, saying to come back if it’s worse. On the third day he went to the ER, raced up and down the stairs and tried his best to elevate his heart. He was then seen, THEN they did the test, found he was 90% blocked in his neck and did emergency surgery to unclog it. This is not that uncommon, for people hovering on a major problem to have to wait till it explodes ---
**Author:** ![The\_Hamster\_King](https://avatars.discourse-cdn.com/v4/letter/t/8edcca/32.png) [@The\_Hamster\_King](https://boards.straightdope.com/u/The_Hamster_King)\ **Post date:** [February 8, 2012, 7:40pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/27 "2012-02-08T19:40:00Z")
> [@Novelty\_Bobble](#): > > It just so happens that the policy is not written down, it covers everyone equally, prioritises according to needs rather than means, covers all treatments that can show efficacy to a given standard, cannot refuse coverage due to existing conditions, is infinitely transferable, demands no input at all from non tax-payers, waives prescription costs for the vulnerable and chronically ill, it is cheaper that the USA system and should you wish to pay a little extra you can still go private and jump any queues (and for less than an equivalent US healthcare policy), it bankrupts no-one and doesn’t ask for credit cards. But, what about the effect on insurance company profits? Surely it’s not fair that people can to go to the doctor without someone getting rich off it. That’s a BIG negative right there! ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 8, 2012, 7:40pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/28 "2012-02-08T19:40:16Z")
> [@Lemur866](#): > > OK, I’ll say it. A lot of people would vote for universal health care in a second, if it could be limited to white people. I oppose universal health care, and I’m not white. Just a data point for you to add to your no doubt exhaustive analytical data set. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 8, 2012, 7:44pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/29 "2012-02-08T19:44:52Z")
> [@The\_Hamster\_King](#): > > But, what about the effect on insurance company profits? > > Surely it’s not fair that people can to go to the doctor without someone getting rich off it. > > That’s a BIG negative right there! :smack: bugger, I knew there was something critical I’d overlooked. It breaks my heart to think of the insurance company executives having to downgrade to a 45’ cabin cruiser. It’ll take them _ages_ to get to their Bahamas Villa now. Thoughtless, that’s what I am! ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [February 8, 2012, 7:48pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/30 "2012-02-08T19:48:44Z")
> [@Bricker](#): > > I oppose universal health care, and I’m not white. For this purpose, Cubans without accents count as white. 😃 \*\*But in any case: \*\*He said, roughly: _A lot of people would vote for universal health care if it were limited to white people._ You said, roughly: _I’m not white and I’m against it!_ How are those two comments meaningful together? \*\*As to what he said: \*\*I’m certain that some level of Republican disdain for UHC is because they think some people are _freeloaders_. The same reason some Republicans (wrongly) dislike Mexicans and Blacks (under the assumption that they get great lives on the dole). Many Republicans think that minorities are getting a free ride, while they, the Republicans, have to work for a living. So, I assume that since many Republicans think minorities are _freeloaders_, at least some Republicans would be for UHC where \*freeloaders \*get nothing. I, of course, have no numbers on this. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [February 8, 2012, 8:00pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/31 "2012-02-08T20:00:18Z")
Yeah, but characterizing opposition to universal healthcare as a race thing just turns the debate into a waste of time. Even if that _is_ what it’s about, the way you get universal healthcare through Congress is convincing everyone it’s in their own interest so they stop worrying about whether it’s also in the interest of people they dislike. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 8, 2012, 8:03pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/32 "2012-02-08T20:03:39Z")
> [@Lobohan](#): > > For this purpose, Cubans without accents count as white. 😃 Ha! Ha! I don’t get it. I’m not Cuban. I’m Salvadoran. > [@](#): > > \*\*But in any case: > \*\*He said, roughly: _A lot of people would vote for universal health care if it were limited to white people._ > > You said, roughly: _I’m not white and I’m against it!_ > > How are those two comments meaningful together? I assumed, since he was so confident about his conclusion, that another data point might be helpful for his analysis. I also assumed the obvious corollary would be drawn: that since I am not white, I don’t favor UHC even if it were limited to white people. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [February 8, 2012, 8:09pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/33 "2012-02-08T20:09:16Z")
> [@Bricker](#): > > Ha! Ha! > > I don’t get it. > > I’m not Cuban. > > I’m Salvadoran. My bad, I thought I remembered Cuban. Since we’re sharing, I’m half Filipino. 😃 > [@](#): > > I assumed, since he was so confident about his conclusion, that another data point might be helpful for his analysis. I also assumed the obvious corollary would be drawn: that since I am not white, I don’t favor UHC even if it were limited to white people. Ah. Very kind of you to aid his data collection. ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [February 8, 2012, 8:31pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/34 "2012-02-08T20:31:53Z")
> [@Lemur866](#): > > OK, I’ll say it. A lot of people would vote for universal health care in a second, if it could be limited to white people. Lemme call this out more clearly: nonsense. Being explicitly racist is definitely taboo in this country. Define it otherwise, however, and you’d be likely to get some buy-in: give UHC to citizens-only, not to undocumented immigrants, and I think there’d be takers. Give it only to the elderly, and you’re good to go. Give it to children only, and people are okay with it. Not exactly U, but who’s counting? ---
**Author:** ![tim314](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tim314/32/3468_2.png) [@tim314](https://boards.straightdope.com/u/tim314)\ **Post date:** [February 8, 2012, 8:38pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/35 "2012-02-08T20:38:42Z")
> [@Bricker](#): > > I oppose universal health care, and I’m not white. So, why do you oppose it? ---
**Author:** ![Paranoid\_Randroid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/paranoid_randroid/32/18_2.png) [@Paranoid\_Randroid](https://boards.straightdope.com/u/Paranoid_Randroid)\ **Post date:** [February 8, 2012, 9:29pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/36 "2012-02-08T21:29:25Z")
I don’t have much desire to hash out the finer points of universal v. private health insurance, except to note that — although by historical accident the US did encourage through incentive the employer provision of health insurance — it’s nevertheless an unavoidable side issue in this debate. By purchasing insurance through one’s employer, a worker can avail herself of its increased market power and risk pool. Thus even in absence of tax incentives I think _something_ like the current system would’ve arisen, because without it health insurance would be largely unaffordable. [TLDR: it won’t do to avoid commenting on employer-provided health insurance by claiming it’s merely some US idiosyncrasy.] And for the record, because I hear it a lot around here … > [@RickJay](#): > > The notion that people will use more health care just isn’t supported by a great deal of evidence. Strictly speaking this is untrue. The effects may not be overwhelmingly, system-crushingly significant, but the provision of health insurance undoubtedly carries some amount of moral hazard. The empirical literature backs this up. And this shouldn’t be too hard to believe — lowering the monetary cost lowers the cost overall even if there remain costs along other vectors (time, comfort). ---
**Author:** ![msmith537](https://avatars.discourse-cdn.com/v4/letter/m/d9b06d/32.png) [@msmith537](https://boards.straightdope.com/u/msmith537)\ **Post date:** [February 8, 2012, 9:34pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/37 "2012-02-08T21:34:22Z")
> [@RickJay](#): > > - The system is self-rationing. If everyone goes to the ER for sniffles, then the ER doctors will be overwhelmed and the wait will become intolerably long, making people learn to stop going there for minor problems. Except it doesn’t actually work like that. That’s why emergency rooms often have long waits. > [@The Hamster King](#): > > But, what about the effect on insurance company profits? > > Surely it’s not fair that people can to go to the doctor without someone getting rich off it. I’d rather doctors and pharma companies and people who actually provide the products and services get rich off it, rather than some middle-man insurance company. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 8, 2012, 10:04pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/38 "2012-02-08T22:04:03Z")
> [@tim314](#): > > So, why do you oppose it? Presumably because his employer pays for great insurance. ---
**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\ **Post date:** [February 8, 2012, 10:07pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/39 "2012-02-08T22:07:19Z")
nm ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 8, 2012, 10:08pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/40 "2012-02-08T22:08:14Z")
> [@RickJay](#): > > 1. The notion that people will use more health care just isn’t supported by a great deal of evidence. Canadians do not spend all their time rushing to the emergency room or booking appointments with their doctors, for some rather obvious reasons: But a nice mechanism of universal healthcare is it’s cheaper to prevent or to intervene earlier - as I understand it, the US system (in its entirity) doesn’t and cannot encourage _prevention_ on anything like the scale UHC does [Previous page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=1) [Next page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=3)