The United States Senate Committee on Finance approved a proposal to reform health care on Tuesday, clearing it to move forward. The bill passed by a 14-9 vote, gaining support from the committee’s thirteen Democrats, and one Republican.

Senator Olympia Snowe was the only senator from the Republican party to back the bill. However, she said this might change as the bill moves through Congress.

“There are many, many miles to go in this legislative journey. My vote today is my vote today. It doesn’t forecast what my vote will be tomorrow,” Snowe said.

President Barack Obama, who supports the bill as part of his effort to overhaul the country’s health care system, welcomed the committee’s vote. “We are closer than ever before to passing healthcare reform but we are not there yet. Now is not the time to pat ourselves on the back – now is the time to dig in further and get this done. In this final phase we should engage with each other with civility and seriousness that has brought us this far and that this subject deserves.”

The bill, which contains a ten-year plan with an estimated cost of US$829 billion, is aimed at lowering healthcare costs and increasing the affordability of insurance. Proponents will now seek to merge it with another bill from the Senate Committee on Health, Education, Labor and Pensions. Senate Finance Chairman Max Baucus emphasized, “Americans want us to craft a package that will get the 60 votes needed to pass.” He argued that the Finance bill was the best candidate to attract needed the centrist support.

Critics, however, have said that the proposed plan is too costly, and will cause the government to interfere too much into the private healthcare sector.

“We can now see clearly that the bill continues its march leftward,” said the senior Republican on the committee, Senator Charles Grassley. “This bill is already moving on a slippery slope to more government control of healthcare.”

 

From supporters:

* In most cases, people have little influence on whether or not they will contract an illness. Consequently, illness may be viewed as a fundamental part of what it means to be human and, as such, access to treatment for illness should be based on acknowledgement of the human condition, not the ability to pay[11][145][146][147] or entitlement.[148] Therefore, health care may be viewed as a fundamental human right itself or as an extension of the right to life. [149]

* Since people perceive universal health care as free, they are more likely to seek preventative care which, in the long run, lowers their overall health care expenditure by focusing treatment on small, less expensive problems before they become large and costly.[150]

* A universal health care system allows for a larger capital base than can be offered by free market insurers (without violating antitrust laws). A larger capital base “spreads out” the cost of a payout among more people, lowering the cost to the individual.

* Universal health care would provide for uninsured adults who may forgo treatment needed for chronic health conditions.[151]

* In most free-market situations, the consumer of health care is entirely in the hands of a third party who has a direct personal interest in persuading the consumer to spend money on health care in his or her practice. The consumer is not able to make value judgments about the services judged to be necessary because he or she may not have sufficient expertise to do so.[152] This, it is claimed, leads to a tendency to over produce. In socialized medicine, hospitals are not run for profit and doctors work directly for the community and are assured of their salary. They have no direct financial interest in whether the patient is treated or not, so there is no incentive to over provide. When insurance interests are involved this furthers the disconnect between consumption and utility and the ability to make value judgments. [153] Others argue that the reason for over production is less cynically driven but that the end result is much the same.[154].

* The profit motive in medicine values money above public benefit.[155] For example, pharmaceutical companies have reduced or dropped their research into developing new antibiotics, even as antibiotic-resistant strains of bacteria are increasing, because there’s less profit to be gained there than in other drug research.[156] Those in favor of universal health care posit that removing profit as a motive will increase the rate of medical innovation.[157]

* Paul Krugman and Robin Wells say that in response to new medical technology, the American health care system spends more on state-of-the-art treatment for people who have good insurance, and spending is reduced on those lacking it.[158]

* The profit motive adversely affects the cost and quality of health care. If managed care programs and their concomitant provider networks are abolished, then doctors would no longer be guaranteed patients solely on the basis of their membership in a provider group and regardless of the quality of care they provide. Theoretically, quality of care would increase as true competition for patients is restored.[159]

* Wastefulness and inefficiency in the delivery of health care would be reduced.[160] A single payer system could save $286 billion a year in overhead and paperwork.[161] Administrative costs in the U.S. health care system are substantially higher than those in other countries and than in the public sector in the U.S.: one estimate put the total administrative costs at 24 percent of U.S. health care spending.[162] It might only take one government agent to do the job of two health insurance agents.[163] According to one estimate roughly 50% of health care dollars are spent on health care, the rest go to various middlemen and intermediaries. A streamlined, non-profit, universal system would increase the efficiency with which money is spent on health care.[164]

* About 60% of the U.S. health care system is already publicly financed with federal and state taxes, property taxes, and tax subsidies – a universal health care system would merely replace private/employer spending with taxes. Total spending would go down for individuals and employers.[165]

* Several studies have shown a majority of taxpayers and citizens across the political divide would prefer a universal health care system over the current U.S. system[166][167][168]

* America spends a far higher percentage of GDP on health care than any other country but has worse ratings on such criteria as quality of care, efficiency of care, access to care, safe care, equity, and wait times, according to the Commonwealth Fund.[169]

* A universal system would align incentives for investment in long term health-care productivity, preventive care, and better management of chronic conditions.[150]

* The Big Three of U.S. car manufacturers have cited health-care provision as a financial disadvantage. The cost of health insurance to U.S. car manufacturers adds between $900 and $1,400 to each car made in the U.S.A.[170]

* In countries in Western Europe with public universal health care, private health care is also available, and one may choose to use it if desired. Most of the advantages of private health care continue to be present, see also Two-tier health care.[171]

* Universal health care and public doctors would protect the right to privacy between insurance companies and patients.[172]

* Public health care system can be used as independent third party in disputes between employer and employee.[173]

* A universal single-payer system would significantly lower administrative costs. Multiple peer-reviewed studies estimate the administrative savings alone from such a switch to be over $200 billion.[174] Medicare has a 4% overhead compared to a 14% administrative overhead in private insurance.[175]

* In a private system, insurance companies may be motivated by moral hazard to cancel the insurance policies of the sick, which is called rescission. Thus, unlike the situation under national coverage, individuals find out that they have no health coverage when it is too late to do anything about it.[176]

From opponents:

* Health care is not a right. [12][177] Thus, it is not the responsibility of government to provide health care.[178]

* Free health care can lead to overuse of medical services, and hence raise overall cost.[179][180]

* Universal health coverage does not in practice guarantee universal access to care. Many countries offer universal coverage but have long wait times or ration care.[51]

* Access to necessary emergency care is already guaranteed. The federal Emergency Medical Treatment and Active Labor Act requires hospitals and ambulance services to provide emergency care to anyone regardless of citizenship, legal status or ability to pay.[181][182][183][184]

* Eliminating the profit motive will decrease the rate of medical innovation and inhibit new technologies from being developed and utilized.[185][186]

* Publicly-funded medicine leads to greater inefficiencies and inequalities. [12][185][187] Opponents of universal health care argue that government agencies are less efficient due to bureaucracy.[187] Universal health care would reduce efficiency because of more bureaucratic oversight and more paperwork, which could lead to fewer doctor-patient visits. [188] Advocates of this argument claim that the performance of administrative duties by doctors results from medical centralization and over-regulation, and may reduce charitable provision of medical services by doctors.[177]

* Converting to a single-payer system could be a radical change, creating administrative chaos.[189]

* Unequal access and health disparities still exist in universal health care systems.[190]

* Steven Burd, CEO of Safeway Inc. has stated that 70% of health care costs are a direct result from behavior and are therefore preventable. He believes that individualized rational actions and market methods can create healthy behavior, which could reduce United States health-care costs by 40%. [191]

* The problem of rising health care costs is occurring all over the world; this is not a unique problem created by the structure of the U.S. system.[51]

* According to the Association of American Physicians and Surgeons universal health care is a planned economy and therefore causes turmoil; causing governments to greatly increase taxes as costs rise year over year, as universal health care is economically impossible.[192] Acc As an open-ended entitlement, Medicare does not weigh the benefits of technologies against their costs. Paying physicians on a fee-for-service basis also leads to spending increases. As a result, it is difficult to predict or control Medicare’s spending.[190] The Washington Post reported in July 2008 that Medicare had “paid as much as $92 million since 2000” for medical equipment that had been ordered in the name of doctors who were dead at the time.[193][194][195][196][197] According to Centrists.Org large market-based public program such as the Federal Employees Health Benefits Program and CalPERS can provide better coverage than Medicare while still controlling costs as well.[198][199]

* Some commentators have opposed publicly-funded health systems on ideological grounds, arguing that public health care is a step towards socialism and involves extension of state power and reduction of individual freedom.[200] Representative Anthony Weiner introduced an amendment that would allow Republicans with an ideological opposition to single-payer health care to vote to eliminate the Medicare Act.[201] Every representative on the House Energy and Commerce Committee voted to keep the government-run, government-administered, single-payer Medicare system.[202]

* Universal health care systems, in an effort to control costs by gaining or enforcing monopsony power, sometimes outlaw medical care paid for by private, individual funds.[203][204]

* Some supporters of American health care reform oppose capping the ability of Americans to seek monetary damages and redress (“tort reform”).[205]

* Much of the opposition to current proposals stems from the concern that they will lead to mandated abortion coverage or otherwise increase the number of abortions performed in the U.S. [206]