Talk:Universal health care/Archive 2

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Archive 2

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Archive 4

Opposition to Universal Health Care

"Not dying from an easily treated disease because a person cannot afford health insurance is not a right." I don't think even the Nation would phrase things in this manner if it were asked to list criticisms its opponents have to universal health care, hence I edited this. Furthermore, is it really appropriate to have unsourced rebuttals to the criticisms?

There are some serious NPOV problems with this section, but I'll leave it to a more experienced Wikipedian to fix it.—The preceding unsigned comment was added by Tin Man (talk • contribs) 15:32, 6 September 2006 (UTC).

Regarding: "[I]s it really appropriate to have unsourced rebuttals to the criticisms?" Rebuttal to criticism is OK, but Wikipedia policy is that content must be published by verifiable sources. -AED 18:25, 6 September 2006 (UTC)

pro and con lists

The lists have some serious problems, and should probably just be summary sections that point to a full article on the topic. For example, it is misleading to state "health care is a right" without explanation, and it is also embarrassing because the artics] 18:51, 4 January 2007 (UTC)

UHC is not always SP, but SP is a type of UHC, so I thought it would be better incorporated into that article. Kborer 19:38, 4 January 2007 (UTC)

It's not true that SP is a form of UHC. Contray to what many people think, including many single-payer advocates, the two are distinct concepts. Single-payer is a economic model for financing health care. UHC is a concept that all people are guaranteed access to needed medical care; that there is universal coverage, such as under a private and/or public health insurance system. That's it. Single-payer is, in it's literal meaning--which is what's most relevant--simply an economic model for financing medical services delivered to patients. Single-payer also denotes--for nearly all of its advocates--a way of setting up a fee negotiation structure between the payer and providers (this can be referenced by leading SP advocacy organizations such as Physicians for a National Health Program). The payer of single-payer can be either a private or public payer. Single-payer does not imply UHC; they address distinct concepts; respectively, a financing model and access model. Some of the confusion comes from that fact that virtually all single-payer systems also utilize universal coverage, and most single-payer advocates--in the US and elsewhere, also advocate for universal coverage. But they are distinct. UHC is not a type of single-payer, and single-payer is not a type of UHC. I wrote a fair amount of the entry for single-payer and addressed these issues in a slightly more expanded manner there. Single-payer advocates also call for a number of other health system elements, but those, too, are not literally "single-payer." I'm new to this, so I have more to comment about in the article--not having made any edits yet, most saliently the misstatements regarding UHC and socialism and the inapt inclusion of this entry in the Socialism category. If anything is to be done, rather than repeating the info from other entries, like single-payer, or merging, is to hyperlink to the more expanded commentary elsewhere and to strip it out of here, allowing the focus on UHC itself, and secondarily referring to the related issues such as financing mechanisms. ---- my sigg isn't showing up, so by JackWikiSTP

You're right. I removed the suggested merge tags awhile ago, but I guess there's no harm in continuing to talk about it. There is a lot of misunderstanding with this and related health care topics. Originally I had thought that bringing together the ideas that were being miss used would help clarify the situation, but currently it seems best to have separate pages which specify what is what, and what is not what. Kborer 22:30, 23 January 2007 (UTC)

Leads to make this a better site:

Two important details to research on this topic.

The top two systems Italy and France, (Canada way back, because it is controlled by the Doctors Union, and most services are privately supplied, with no quality control.)

France. You pay the doctor first, and then the government re-imburses you, so that you are the audit system.

Italy. Doctors receive a per capita annual salary, so the system, the payment system rewards health.

Canadian system rewards visits.

I will try to do the research...asap...

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 00:10, 24 January 2007 (UTC)

These are arguments in favor of public universal health care, to be added, but a reference is needed

• In countries in Western Europe with public universal health care, the private health care in also allowed and anyone can decide to pay and get the private health care: most of the advantages of private health care continue to be present, see Universal_health_care#Europe.
• Universal health care and public doctors would protect the right to privacy between insurance companies and patients.
• Health care is increasingly unaffordable for businesses and individuals.
• Providing access to medical treatment to those who cannot afford it reduces the severity of epidemics by reducing the number of disease carriers.
• Patients would be encouraged to seek preventive care, enabling problems to be detected and treated earlier.
• A centralized national database would make diagnosis and treatment easier for doctors.
• The profit motive adversely affects the motives of healthcare. Because of medical underwriting, which is designed to mitigate risk for insurance providers, applicants with pre-existing conditions, some of them minor, are denied coverage or prevented from obtaining health insurance at a reasonable cost. Health insurance companies have greater profits if fewer medical procedures are actually performed, so agents are pressured to deny necessary and sometimes life-saving procedures to help the bottom line.

The first paragraph

User:Caesarjbsquitti's edit of the 24th January[1] leaves the first paragraph making no sense:

This type of socialized medicine is practiced in many countries, especially first world nations such as Canada, the United Kingdom, and France and Italy ranked in the top three in the world

How can four countries rank in the top three in the world? (And the top three for what?)

As a separate matter (which long predates that edit), I'm not sure it's NPOV to use the loaded term "socialized medicine" without qualification in the first paragraph (at least in the US, it's a term used primarily by opponents of such a system, as noted on the Socialized medicine page). The Wednesday Island 14:46, 26 January 2007 (UTC)

Regardless of whether you feel socialized medicine is a loaded term, it just doesn't apply to universal health care and should be removed. Kborer 00:00, 27 January 2007 (UTC)

Of the countries listed, only the UK practices true socilaized medicine (although it is also a system of universal healthcare), because physicians are government employees and most of the healthcare system is run by the public sector. In France, Italy, Germany, Canada, etc., physicians are not salaried by the government and the private sector still has a presence, thus they are simply countries practicing universal healthcare, not socialized medicine. Refer to "International Healthcare Systems Primer," by Hohman & Chua, published by the AMSA.

This Article Is Not Neutral

It has a pro big buisness insurance company slant as if written primarily by the sellers of Health Insurance and without much consideration towards the 40million plus people in the United States who have no more access to health care above what they might get in an impoverished country like Mexico. The article needs to defend the rights of all citizens to Health Care, rather than having a bias and implying that its as good for the rich in a country to have superior health care than for most people to have access to it. This writer feels it would be best for modernized countries to make laws that make it illegal for companies to make money off the misery, pain and suffering of others. Companies who often refuse to pay claims as things are. This article needs a rewrite or side article relating what it feels like to be uninsured person in a rich country. --merlinus 21:05, 26 January 2007 (UTC)

What you are suggesting is that the article be rewritten to push your personal political agenda. That is not what wikipedia articles are for. Kborer 00:10, 27 January 2007 (UTC)

Those 41.2 million people "without healthcare" in the U.S. are only 14.2 % of the population, so what's the problem? Looks like we're doing great to me. Note that that number is actually people who were without healthcare for at least part of the year surveyed (meaning many of those may actually have healthcare but were in between jobs or something). Also, approximately one-third of that 14.2 million people live in households with an income over $50,000, with half of these having an income of over $75,000 [2] That means these are people who can afford to buy healthcare but are choosing not to for their own reasons (many of these are young and healthy and choose to put off purchasing it). Another third of that 14.2 million are people who are eligible for public health insurance programs but have not signed up for them. That leaves only 4.5 million people out of a nation of 300,000,000 people that don't have access to healthcare. That's only about 2% of the population. That's so small that half of that may even be an accounting error. The solution is not a welfare state. Find these people who make up that 2% of the population, put them on a list, and let bleeding hearts like you give them charity. All Male Action 07:21, 27 January 2007 (UTC)

These are all interesting points -- why don't you add a section to health care politics about these ideas? Also, if anyone knows a forum for arguing about health care topics, that would be a great link for these pages, judging from how the talk pages keep getting off topic. Kborer 13:02, 27 January 2007 (UTC)

"Those 41.2 million people "without healthcare" in the U.S. are only 14.2 % of the population, so what's the problem? Looks like we're doing great to me." Doing great if you're a white male living in the suburbs with $50,000+ a year coming in. 40 million people getting left behind isn't "doing great." It's never those on the bottom who comment that everything's great, seems like there's a telling pattern there, right? —The preceding unsigned comment was added by 149.31.51.59 (talk) 15:24, 10 April 2007 (UTC).

Wow, did you really need to bring racism into it? You socialists tend to fight dirty. Try using logic instead of emotion. Likwidshoe 05:22, 12 October 2007 (UTC)

It really boggles my mind to see how someone can sit on a high horse and act like 41+ MILLION PEOPLE don't matter because they fall into a "percentage" of only 14+ percent so therefore, THEY DON'T MATTER, SO WHAT'S THE PROBLEM? <Let the bleeding hearts pay for them> This statement alone makes me sick. If our country would have used this same formula when electing a president, we wouldn't be in the situation we're in now. Who will ever know if it could be better but it's a certain, it couldn't possibly be worse. Someone needs to stop and think about individuals instead of percentages. If we used HALF of the money we've spent on this revenge "war" on health care, that 41 million people could have health care. Why are the citizens of Iraq more important than the citizens of The USA? Oh, right, the oil. I forgot. I must be a bleeding heart. My concerns are more for my fellow man than a barrel of oil. And don't forget about those FAT contracts Halliburton gets out of the deal for rebuilding everything we spent ALL of our Defense Funds BLOWING UP ! < shock and awe > I'm definitely in shock and in awe of the "percentage" of people who support this tactic of greed. But don't forget, KARMA is a MOFO!!! Big Johnson By the way, when I say "revenge war" I'm NOT refering to 9/11 because that would be a war against Osama Binladen. This war is just revenge for the first president Bush against Sadam Hussein and now that he's dead, the present president Bush doesn't know WHAT to do from this point forward so all he can do now is attack his own country with propaganda. Again, KARMA is going to be rough on him.

---

My family and I are part of the 41 million without healthcare. My mom, who is recently divorced and raising my two sisters on her own, cannot afford the monthly cost of healthcare for the entire family. Yesterday night, my youngest sister took too much of her medicine because she didn't know any better. While we sat on the phone with poison control, we all worried about the costs of taking her to the emergency room - without health insurance, the cost would be astronomical. Fortunately, it did not come down to that, but even after that emergency, we still know that we cannot afford the monthly cost of health insurance for the entire family, unless we wanted to give up our electricity, something we struggle to pay every month. If there were some form of universal health care, it would be far easier for us, but there is not, so we continue to live without healthcare and hope that an emergency does not arise. (May 14, 2007)

What are you even ranting about? Far out Iraq conspiracies? This subject was supposed to be about socialist health care. Likwidshoe 05:22, 12 October 2007 (UTC)

I'm skeptical of All Male Action's numbers. In the source he cites, Table 8. People With or Without Health Insurance Coverage by Selected Characteristics: 2004 and 2005, in Income, Poverty, and Health Insurance Coverage in the United States: 2005 U.S. CENSUS BUREAU, 30,000 of the uninsured had income under $50,000.

I would like further proof of his claim, "Another third of that 14.2 million are people who are eligible for public health insurance programs but have not signed up for them." According to several reports, some people are technically eligible for public health programs, but the federal and state governments have made it so difficult for them to establish eligibility that they can't do it, like Nikki White, for example. Some federal rules require a birth certificate, and many elderly people never got one. The New York Times reported that infant mortality rates were going up in Mississippi, because among other things it was too difficult for pregnant women to establish eligibility.

I'd like to see All Male Action make a good argument based on solid numbers from reliable sources. Can you do it, All Male Action? Nbauman 19:52, 14 May 2007 (UTC)

"According to several reports, some people are technically eligible for public health programs, but the federal and state governments have made it so difficult for them to establish eligibility that they can't do it, like Nikki White, for example. Some federal rules require a birth certificate, and many elderly people never got one. The New York Times reported that infant mortality rates were going up in Mississippi, because among other things it was too difficult for pregnant women to establish eligibility. "

This paragraph makes no sense. First of all, elderly people would be automatically eligible for Medicare and/or Medicaid. As for the idea that they "can't establish eligibility" because they don't have a birth certificate - as it turns out, my father was born in Pennsylvania coal mining country. He was born at home, and never had a birth certificate registered. When it came time for him to get Social Security, he needed a birth certificate. it took about two weeks, but he got a certified copy by telephone. It wasn't at all difficult if you can establish you were actually BORN here (surely most people know where they were BORN.)

My father is over 65, so I can see why he had that problem. I find it very hard to believe that anyone born in the US who is younger than him has a problem getting a birth certificate.

Unless the New York Times has some other reason why women in Mississippi have problems establishing that they're American citizens via a birth certificate, it's ludicrous to say that it's some kind of major problem. It simply is not - not unless your mother delivered you in an alley and you were raised by wolves - or unless you're trying to pull a scam on the govt and that's why it's impossible for you to get the paperwork.Simplemines 09:45, 13 August 2007 (UTC)

Read the Wall Street Journal story about Nikki White and the New York Times story about Haley_Barbour#Infant_mortality and then tell me what you think. Nbauman 16:21, 13 August 2007 (UTC)

I read the Nikki White article. From the timeline: "2001-October 2003: Uninsured. Ms. White leaves her job because of illness and loses coverage. Unable to obtain individual private insurance, she eventually submits to mother's entreaties to apply for Medicaid."

When you leave a job, your employer HAS to offer you COBRA. She must've been offered it. She apparently rejected it, let her coverage lapse, THEN tried to get a private policy. For someone with a pre-existing condition, that is incredibly stupid.

COBRA can be expensive, but not nearly expensive as letting your coverage lapse and then try to get insurance.

I'm sorry the woman died. I'm also sorry she made such stupid mistakes.

Let's assume, though, that socialized medicine is passed. For all the things she went through, she would've been put on a waiting list for anything from a CAT scan to surgery, and may very well have died in the wait. This is something that happens in countries with socialized medicine, and sadly it's not rare or unusual. Socialized care is RATIONED, meaning there's only so much to go around, so even if you need a test ASAP, it makes no difference. You will be made to wait your turn.

The situation now is bad. State control will only be worse. Simplemines 10:21, 19 August 2007 (UTC)

Infant mortality? That's a stretch. The difference is no more than three per 1,000. Can you show that socialized health care accounts for lower rates? A more accurate measure of the care would be something like breast cancer survival rates. You don't even want to look at the cancer survival rates if you're a socialist supporter. It's not a difference of two out of a thousand. They are differences of up to 30 and 50% higher deaths in the socialized health care countries. If you don't believe that source, go ahead and do some research. The socialist picture is not pretty. Likwidshoe 05:22, 12 October 2007 (UTC)

Simplemines, watch out for that word "apparently." COBRA wouldn't have kept Nikki White alive.

COBRA only lasts 18 months, with an 11-month extension, or a total of 29 months. See [3] "Can individuals qualify for longer periods of COBRA continuation coverage?"

Nikki White quit her last job, with benefits, in 2001. Her COBRA coverage would have ended in 2003 or April 2004 at the latest. The WSJ story said, "She couldn't get private health insurance at any cost." She was accepted into TennCare in 2003. TennCare informed her that they were dropping her in 2005, and she did everything she could to appeal. In August 2005, they stopped paying for the MRI scans that she needed to stay alive. The article also says that she applied for SSI and was rejected because she didn't meet Tennessee's definition of "disabled".

WP:Talk is not the place to debate universal health care, it's the place to discuss improvements to the article. You shouldn't give your own opinions about universal health care, you should cite reliable sources.

If you believe that under socialized medicine, Nikki White would have been put on a waiting list for a CAT scan and died anyway, then find a reliable source to document it. In Canada, for example, according to articles in Health Affairs and elsewhere, urgent patients are given CAT scans immediately -- that's why there are waiting lists for non-urgent patients. But I'd like to see evidence to the contrary. Nbauman 18:16, 19 August 2007 (UTC)

Nbauman, I'm aware of the limitations of COBRA. I also know if you transfer from COBRA to a Blue Cross plan, your preexisting conditions CANNOT be held against you if you do not let there be any lapse in coverage from COBRA to Blue Cross.

Since you're so interested in Canada, a new article in City Journal would seem to shred some of your notions about Canadian healthcare. Here is the intro graph: "Mountain-bike enthusiast Suzanne Aucoin had to fight more than her Stage IV colon cancer. Her doctor suggested Erbitux—a proven cancer drug that targets cancer cells exclusively, unlike conventional chemotherapies that more crudely kill all fast-growing cells in the body—and Aucoin went to a clinic to begin treatment. But if Erbitux offered hope, Aucoin’s insurance didn’t: she received one inscrutable form letter after another, rejecting her claim for reimbursement. Yet another example of the callous hand of managed care, depriving someone of needed medical help, right? Guess again. Erbitux is standard treatment, covered by insurance companies—in the United States. Aucoin lives in Ontario, Canada."

The link is http://www.city-journal.org/html/17_3_canadian_healthcare.html

Just as Canadians, fed up with the severe problems of their system, are moving toward a market solution, unschooled, ignorant, or leftwing Americans move toward socialism.

Read the article and see if it makes a dent.Simplemines 09:51, 21 August 2007 (UTC)

First, on Nikki White -- are you saying that in Tennessee she could have transferred to Blue Cross when her COBRA ran out, without increased charges for pre-existing conditions? Can you document that? In the WSJ article, her mother said that she couldn't get insurance at any price. Do you have any evidence to the contrary? I know people in some states, including one person whose COBRA is running out, who have pre-existing conditions and either can't get insurance at all, or would have to pay a premium of $10,000 a month.

Second, on the City Journal article -- I've read David Gratzer's articles and I've heard him debate. Thanks for pointing this one out. I also read the New England Journal of Medicine, which is where they published the studies of cetuximab (Erbitux). When they published the studies, they also published an editorial commenting on the unusual, extraordinary cost of cetuximab, and its disappointing effectiveness. (The Price Tag on Progress — Chemotherapy for Colorectal Cancer, Deborah Schrag) The cetuximab treatment would cost $160,000, and extend life an average of 1.7 months (the most expensive treatment in medicine). The government health care systems in Canada, England, and the U.S., and most American insurance companies, calculate the years of life saved by a treatment. The British and Canadians pay something like $70-100,000 to gain a year of life. Cetuximab would gain a month of life for $100,000, the equivalent of $1.2 million a year. Many Americans can't afford that with their private insurance coverage (NYT, Costly cancer drugs bring hard decisions). Realize Gratzer isn't talking about saving Suzanne Aucoin's life. She has stage IV colon cancer, with a 10% chance of surviving 5 years with the best treatment. The issue is whether the Canadian health system should spend $160,000 on a drug that would extend her life by 1.7 months, a drug that many Americans don't get because they can't afford it. Do you think the Canadian health system should be forced to spend $160,000 for cetuximab to get 1.7 months survival?

And back to the original point -- do you have any evidence that patients with lupus who are taking immunosuppressive drugs like azathioprine don't get CAT scans to monitor their treatment? Nbauman 18:19, 21 August 2007 (UTC)

Single Payer Health Care merge.

It seems to be that single payer and Universal health care are very seperate things and should not be merge.

It is posible to have a Single payer system that is not universal and it is possible to have a Universal system that has multiple payers.

I think that merging these two topics whould only make it harder to seperate the two different ideas and might make it harder for readers to tell the difference between these two ideas. 72.228.90.129 19:04, 5 February 2007 (UTC)

Neutrality of this article needs to be examined!

I have added a neutrality icon to this page - the section on universal coverage in the United States cites examples in other countries that are not backed up with sources, true examples or figures. I also added links to tables dealing with life expectancy and infannt mortality rates among nations, as published by the CIA World Factbook online, found here.Dmodlin71 11:02, 11 February 2007 (UTC)

Also, the statements pertaining to states enforcing monopolies on state-funded healthcare services should be deleted, unless they can be backed up with verifiable references. Dmodlin71 11:06, 11 February 2007 (UTC)

I removed this, first because there are a few references and second because I'm helping out in changing the page, and weeding out the POVs. Please help too!Wikidea 15:42, 22 May 2007 (UTC)

Definition

Does anybody have a source for a definition of "Universal health care"? As far as I could tell, the source cited, Massachusetts Nursing Association. "Single Payer Health Care: A Nurses Guide to Single Payer Reform.", does not have a definition. Nbauman 20:05, 17 February 2007 (UTC)

For a definition of Universal health Care please visit http://www.euro.who.int/observatory/Glossary/TopPage?phrase=U

which states in summary, that Universal Health Insurance provides health care coverage to the entire population (100%)

"Universal Health Insurance Core definition: A national plan providing health insurance or services to all citizens, or to all residents. Source: Getzen, 1997 Example/s: Ninety-five percent of the population was covered in 1997, but it was not until a law was passed in 1999 providing universal health insurance that the entire population was covered. "

204.174.219.3 19:57, 7 March 2007 (UTC)

I erased the the part that stipulated a requirement to pay. Although the definition cited above refers to Universal health Insurance and not care, I think it is more than obvious that the concept of universal coverage requires everyone to be covered and not everyone to pay. Of course, universal coverage is often implemented with an obligation to insure (and pay) for those who can, but for universal coverage inability to pay cannot be a reason for exclusion. Jonas78 23:35, 24 July 2007 (UTC)

My objection to the definition is that it doesn't distinguish between the universal right to be treated for necessary healthcare and a system that provides universal a universal system of paying for healthcare that is a system, rather than a patchwork of mandates that apply to doctors, hospitals, and so on, to shift the costs of required care to them so they will force the government and charities to pay for required coverage.

In the US, doctors and hospitals are required to provide all necessary care to preserve life regardess of ability to pay. And public hospitals are required to treat all patients who show up and need care. So, while the US doesn't have a system of universal healthcare payment, it does have a requirement for universal healthcare if you can get through the rationing that not having the means to pay erect. Mulp 18:52, 23 September 2007 (UTC)

Article quality

This article is really bad right now. It provides no good information, has many unsourced and POV statements, and it glances over the topic in favor of playing up emotions. It needs to have less emotion and more information. As it stands, it reads like something off a short website instead of an encyclopedic article. Topics that should be included could include things like how countries implement care, what restrictions there are, and possibly political or social response to the topic if done so in a neutral manner that documents support and dissent. It should also not be presented as a list of opinions as the last two sections are, because they run into the same problem of merely glancing at the topic and offering no information beyond talking points. Rebochan 13:00, 6 March 2007 (UTC)

One Heck of a Mess

I began work to correct this mess but gave up in favor of commenting here. I comment not only as a dual citizen of the USA and Canada [more than 30 years lived in each nation] but also as a provider of healthcare services in hospitals on BOTH sides of the border.

My attention to the need for HEALTHCARE REFORM began back in 1991 with the fascinating Walter Cronkite TV Documentary entitled "Borderline Medicine". Walter followed 2 cases of normal pregnancy, 2 of cancer, and 2 of cardiac bypass surgery, one on each side of the border. The subsequent effect upon American cries for UHC surpassed Cronkite's 1968 aposty concerning the winabiity of the Vietnam War, a statement that convinced LBJ not to run again. Most advocacy for UHC in the USA is tracable back to Walter's nifty film.

The worst mess on the article page is the misunderstanding that Canada has national UHC. It does not. Canada is not a republic. It is a federation of ten provinces. Each province has its own government-regulated HC insurance plan. Services covered in Manitoba [which has universal state-operated automobile insurance!] are not the same as services covered in Newfoundland, and so forth. The federal government now provides only Guidelines for the provincial systems. Two decades ago it had purse string power over them by Federal Grants, but those days are now over.

Second, Americans presume that UHC in Canada was implemented under the reign of Left Wing governments. This holds true ONLY for the system implemented in Saskatchewan back in 1949 -and man is THAT a story to be told some day in Wikipedia! But it was the late 50s to early 60s federal CONSERVATIVES that brought UHC from sea to sea. But not a single, national scheme, such as Britain has.

Universal Health care is barely understood by persons who already have it, and dreadfully misunderstood by those who don't have it but either WANT IT or DON'T WANT IT. The former group tend to idealize UHC irationally and misunderstand what can actually be achieved. The latter group defame UHC irationally and misunderstand that it has nothing to do with Karl Marx.

The name of the game is the label one succeeds in imposing upon the facts. Canada does not have a single-payer heathcare system. That term was never used in the lively debate before adopting this kind of healthcare delivery. Canadians did not WANT a nation where the rich would live and the poor would die. The ethical aim of UHC is to ameliorate the biological connection between health and wealth, also between health and social class or rank. The most impressive researcher into this human condition remains British professor of epidemiology and public health, Sir Michael Marmot. Dr. Marmot was also the 2002 winner of the Nobel Prize in Economics. Look him up on the I'net.

Across six decades, a conclusion I have reached is as follows. The system used by a nation or society to distribute health care among its members is that society's answer to the question: Why have a society in the first place? At bottom, different HC delivery systems provide varying degrees of opportunity not to individuals, but to DNA units in our H. sapien gene pool.

Trylon 04:24, 7 March 2007 (UTC)

Can you cite a reliable online source to say that? Nbauman 12:59, 6 April 2007 (UTC)

I doubt anyone can; only in the US is Socialized Medicine used as a strawman for a rational system of paying for healthcare. In Canada, the debate, as I think Trylon is trying to point out, is how to pay for Socialized Medicine and how to ration care, because no matter what, care must be rationed - no health insurance plan says "we pay for anything you want that is related to health." The stigma attached to Socialize Medicine caused those wanting a rational system of payment to relabel it Universal Healthcare, but the issue continues to be framed by those who attack the strawman Socialized Medicine Mulp 19:08, 23 September 2007 (UTC)

Good points, Trylon. If you write you comments up, get them published even as an op ed, then I or someone can cite it. As the article is covering a term of art in political framing, I don't think any article can be anything but a hash. I think the article should be reduced significantly to focus on the political use of the political slogans, like "Universal Healthcare" because the words are intentionally vague and shifting meanings. Mulp 19:08, 23 September 2007 (UTC)

US-centric

Apart from the list of countries with UHC, this article bearly mentions any actual UHC systems.

Also, the primary focus of the article should not be a debate on the *worth* of UHC, taking place in a country that doesnt have it. surely the article should focus on UHC as it actually exists in countries where it actually exits?! The article should define what is it, the historical development of the concept and historical attempts at implementing it, describe where and how it is implemented in specific terms in the contempory context, philosophical underpinnings, etc, etc. There is lots that could be discussed other than its good, no its evil, ad infinitum. After that is done then you could have a section on particular pros and cons, etc. But as usual on wikipedia, you come to find out dome iformation and yo just get an argument. aussietiger 05:47, 6 April 2007 (UTC)

Economics of Medical Insurance

It's a false statement to claim that medical insurance is subject to market failure in an article about Universal Health Care. Health care is the market failure, single payer and hybrid models are responses to that market failure. Medical insurance is consumption smoothing. Milton Friedman opening and often asserted that one of the biggest issues with the current system in the US is that without medical insurance and without access to medical care is synonymous. Medical insurance is subject to adverse selection, medical care isn't. When you're sick, you want medical care. Access to medical care likewise is something everyone wants. —The preceding unsigned comment was added by DJFLuFFKiNS (talk • contribs) 12:51, 25 April 2007 (UTC).

This section needs to be reworked by someone with access to Economic literature and not educated guessing. As an example, there are four standard market failures put forward in relation to the workings of private health care markets (Following Arrow: externalities, returns to scale, supply-side restrictions and asymetric information (-> adverse selection, moral hazard). They cause ressources in health care to be allocated inefficiently. Thats is the rationale for state intervention and regulation. Universal health care addresses these issues, but it does not magically solve them, it produces problems of its own. Thats why most European countries actually have neither socialized medicine nor private health care markets, but in very different ways have tried to achieve "quasi-markets"... A good overview is given by Ch.17: Healthcare, in Connolly and Munro, Economics of the Public Sector, 1999. I am not a native English speaker, so I will abstain from making any major edits. Jonas78 00:01, 25 July 2007 (UTC)

Knowledge and the interest to add good content are far more important than phrasing. In other words, your English sounds fine, please edit away.--Gregalton 04:20, 25 July 2007 (UTC)

Userbox?

Is there a userbox to indicate a user's support for universal health care? Wooyi^{Talk, Editor review} 04:28, 5 May 2007 (UTC)

PRC

I know the text included the woolly phrase '....are among many countries that have various types of universal health care systems.', but the map actually shows more than are listed. Why are other countries, notably the PRC, not listed? If it is because no reference can be found, why is it still on the map? Is it OK to have something on an image without references, but not OK to have text without references?
Davidmaxwaterman 05:11, 14 May 2007 (UTC)

I agree - it's a nice map, but I'm a bit sceptical about some of the countries there too. Wikidea 08:18, 22 May 2007 (UTC)

Structure

This is a good page, mainly because it's got anything on it at all. I've made changes to the structure, however, to simplify it. Here are the main ones:

• Separate title for Funding of health care has been removed, and put with economics
• Separate title for Health care in times of disaster has been removed, and put with the US section
• Deleted the section on Private Universal health care - this idea pops up on a few pages - it's fiction, because every system of health care (universal or not) has some form of regulation, and none of it's private. There will always be drug standard regulation, price regulation, subsidies, or something. It makes little sense to talk about something that doesn't exist.
• Inserted table (from Canada page) on costs by country in the economics section.

Can I also have thoughts on whether the arguments for/against should be slashed a bit, possibly removed? It's pretty mundane when the first "argument" for health care is "health care is a right" and the first argument against health care is "health care is not a right". Arguments usually require the word "because", and I'm afraid it rather sounds like something you might see on Fox news at the moment. There is also a distinct lack of facts, and the opinions of right wing think tanks, like the Cato Institute certainly don't count. It's also a "debate" so far as I know, that only exists in the United States, so I'm not sure how relevant it is. As I say, what does everyone think? Wikidea 08:17, 22 May 2007 (UTC)

When about half of the references in the article are from Cato (better described as a Libertarian think tank that is far right on spending/tax issues) you certainly have a point. At the very least, opponents of universal healthcare would benefit from having a larger variety of sources rather than most coming from a fringe source. There are many other sources that argue against universal health coverage.Gmb92 05:49, 17 July 2007 (UTC)

Regarding costs by country, here's a good link on this, which measures it on a per capita basis and as a share of GDP. [[4]]

One of the arguments for (mentioned in one form in this article) is that universal coverage will improve early detection and thus survival rates. This is backed up by the American Cancer Society (page 7):

A lack of health insurance is associated with lower survival among breast cancer patients. Moreover, breast cancer patients with lower incomes are more likely to be diagnosed with advanced stage of the disease and to have lower 5-year relative survival rates than higher-income patients. [[5]]

Gmb92 05:59, 17 July 2007 (UTC)

Merging

I've been looking at all the pages around these topics and I want to propose a merger between this page and the general Health care page. This one is better, but the other has a more appropriate name. This page is quite details, covers economics and politics, plus references to other countries. So I suggest the content there be added in the appropriate place here, and that Universal health care redirects to the Health care title. Wikidea 09:10, 22 May 2007 (UTC)

I oppose merger. I don't understand your reason for merging. Health care, and universal health care, are both enormously complicated topics. If universal health care were merged into health care, it would have to be condensed to a paragraph, and it would be impossible for people pro and con to present their views in enough detail to satisfy them. Furthermore, universal health care is an important policy debate. Nbauman 00:05, 16 July 2007 (UTC)

Yes, you're right, thanks for reversing it. Now the page content is about the UHC debate specifically, without the extra things that belonged on the Health care page, so cheers.Wikidea 00:20, 16 July 2007 (UTC)

Map of countries with universal health care

It would be helpful to know on which reference this map bases. Personally, I think the classification of some countries are disputable, especially for Switzerland. In my opinion Switzerland has universal health care at least with respect to the definition in the first sentence. Hermes Agathos 16:19, 25 May 2007 (UTC)

Also, why is China colored on the map? The article gives no indication that China has a universal healthcare system.

Format problems and de-marging

The current format is strange and clearly an artefact of the merger/demerger. Could we perhaps simply go back to the last version before the merge, and then clean up? The 31 May version seemed pretty good.--Gregalton 10:13, 17 July 2007 (UTC)

The information that was taken out was more appropriate on the Health Care page, so information needs to be added to this article specifically about Universal health care.--Jorfer 16:37, 17 July 2007 (UTC)

Yes, that's right. The problem is that the concept of universal health care is a pretty specific term, used only in the U.S. In the rest of the world, nobody gives a second thought to whether health care is universal or not, because it's taken for granted that it is. So what you end up with, if you're talking about UHS is a specifically American political debate - for all the stuff on the article before, it really belongs better in the Health care page itself. I was tempted to delete the "debate" points that exist on the page now, because it's all very specious - I mean the first points are "health care is/is not a right" - what a spectacularly inane entry for an encyclopedia (oh no it isn't!) Wikidea 11:51, 22 July 2007 (UTC)

Keep in mind that this is not a typical encyclopedia. We are trying to build the most complete encyclopedia ever created, so to that we need to take on all well sourced relevant material which often means going where traditional encyclopedias shy away from. A written encyclopedia cannot be continuously updated and adapt so it is limited in the material it can cover.--Jorfer 21:20, 24 July 2007 (UTC)

Content merge

We now have most of this document already included in health care so we might as well erase that part from this article as we should follow DRY. I am in favor of keeping a seperate article for universal health care, but I also feel that much of the previous content is more appropriate for the Health care article. The lack of consensus is for a complete merge, but I think there is a consensus for the merger of much of the material. If there are any major objections to this then speak now.--Jorfer 05:43, 25 July 2007 (UTC)

I object. Removing 90% of the content of this article as was done turns it into a list. I'm all for editing selectively so that there is less overlap (although some overlap is not necessarily bad). It must be done, however, in such a way that it doesn't gut the content or context of this article. One of the principles under DRY is 'Imposing standards aimed at strict adherence to DRY could stifle community involvement in contexts where it is highly valued, such as wikis.' To me, this is a clear example of this instance. If there is a broader effort to organise all of the content about countries, etc., then in that context. This is a separate and distinct concept and issue, and arguably much clearer in meaning than "health care" alone. So yes, major objection registered.--Gregalton 05:58, 25 July 2007 (UTC)

There is no doubt that this article needs major work (thus the tag), but the content that was here was distracting from what is supposed to be the purpose of the article and that is to explain the universal health care system and not health care around the world.--Jorfer 06:03, 25 July 2007 (UTC)

As for some overlap being good, this is true especially per WP:Summary, but the amount of overlap here is unproductive as it means that we will essentially have two different copies of the same article. Merging two similar articles is the most annoying merge to do (I am speaking from experience).--Jorfer 06:07, 25 July 2007 (UTC)

I understand your point, but there is quite a bit of content that is specific to universal health care that would be lost (and in the interim, the article would essentially be gutted). The consensus seemed to be against merging (or more specifically, there was no consensus to merge), so discussion of how to merge them may not be relevant. Parts of this could be removed, but given the back and forth and objections to the merge, I would suggest this needs a light hand for deletions until a better sense/consensus emerges of what each article needs (to minimize overlap, among other issues). Best,--Gregalton 07:00, 25 July 2007 (UTC)

On the Neutrality of "BalancedPolitics.org"

I'm opposed to BalancedPolitics.org being listed as a neutral source on this issue (or any issue, for that matter). The name of the website gives the impression that it's neutral, but every article on the website is written by the same person, a person named Joe Messerli, who admits to having a conservative or libertarian perspective on most issues. Not surprisingly, most of the statements he makes about UHC are from that perspective. Many of the statements he makes are also unsupported opinions, such as: "There isn't a single government agency or division that runs efficiently", "Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness", "Government-controlled health care would lead to a decrease in patient flexibility", "Patients aren't likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.", and "Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care." In his explanations of these statements he cites no studies or statistics. Anyway, I think the link to this website should either be removed from the page or at the very least it should be labeled as a conservative/libertarian-leaning site, as opposed to a site that's "neutral". AnomyBC 02:03, 26 July 2007 (UTC)

Thank you for your suggestion! When you feel an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the Edit this page link at the top. You don't even need to log in (although there are many reasons why you might want to). The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes — they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. ⟳ausa کui ^× 19:27, 29 July 2007 (UTC)

Graphic

Kborer, I challenge the text in that graphic.

Where is your reliable source WP:RS to support your claim that "The availability of health care to a population is independent of the system used"?

Where is there a system with private financing, and universal care? Nbauman 19:32, 1 August 2007 (UTC)

The point is that universal health care is not a health care system or something you can implement. Rather, it is something that can be achieved. The graphic does not make any claims about what percentage of the population is covered by different systems, it merely illustrates that you could plot different health care systems along those three axes. If that is unclear, we should rewrite the image caption. Kborer 20:39, 1 August 2007 (UTC)

That's an interesting point. I think that's a personal opinion and a matter of controversy. I don't believe that universal health care can be achieved in a free market system. Personal opinion doesn't belong in a WP article. If you can find a reliable source to say that, you can include it by attributing it to a reliable source. Nbauman 22:24, 1 August 2007 (UTC)

It is by definition that universal health care is independent of health care systems. The matter of opinion is whether certain systems do lead to universal health care. My intention was not to claim that all systems do lead to universal health care, and so I have changed the caption text to clarify that. Kborer 22:52, 1 August 2007 (UTC)

I do tend to agree that universality is unlikely to emerge in a free market system. The graphic would make sense as a means of scaling a particular type of system. But they are unlikely to be independent factors. I certainly think the heading is wrong and should be changed.--Tom 23:15, 1 August 2007 (UTC)

I propose to delete the graphic. Are there any other editors other than Kborer who are strongly of the opinion that it should stay?--Tom 10:43, 5 August 2007 (UTC)

I agree it should go; the claim that it is 'independent' is not supported (or original research). I don't know that this was intended, but 'independent' on a graph clearly evokes the statistics meaning (no causal relationship); in certain political systems it clearly does have a causal relationship.--Gregalton 12:06, 5 August 2007 (UTC)

If you were to plot the locations of currently implemented systems on those three axes, you might certainly see a causal relationship. However, the graphic is not plotting anything, it is merely showing some dimensions along which health care systems could be plotted. Kborer 15:42, 5 August 2007 (UTC)

The text reads "The availability of health care to a population is independent of the system used. With any health care system you might have universal health care, no health care or anything in between." The use of the word independent, as noted, implies that there is no causal relationship, whereas there may well be. Since there is effectively no support on the talk page for retaining this graphic, please leave it off for now.--Gregalton 16:04, 5 August 2007 (UTC)

I can see how the caption could be confusing, since it refers to "systems" instead of "types of systems". How does this sound? "With any type of health care system you might have universal health care, no health care or anything in between." Kborer 16:19, 5 August 2007 (UTC)

That is definitely better, but I still don't think the graphic adds much to understanding (part of my objection). My other objection is content: even the revised statement is questionable, since (as others noted) there are in fact no examples of universal health care (or even non-universal health care) without significant government financing. I appreciate the effort, I'm just not sold that it appreciably makes things easier to understand. Perhaps if you simply removed the government/private financing axis? Looking at this, I can see that by government financing/private financing you may be referring to single-payer vs compulsory insurance (for example), but that's not clear either. Another thought is to split the graph into two: one that includes the universal health care axis, one that includes the financing axis. To me, this would be more instructive.

Dang, I've written that para and I'm not sure I'm being clear. Are you trying to classify systems of universal health care? It may be more feasible to classify types of universal health care systems separately from the non-universal, and not raise the issue of causality. On the other hand, if you're trying to classify systems by their universality, the question of causality becomes very important and it may be better to leave it off.--Gregalton 16:33, 5 August 2007 (UTC)

In a different graphic I try to classify types of health care systems. [6]. However, in this graphic I am only trying to explain that the opposite of universal health care is no health care, and that different health care systems can have different levels of universality. The graphic is helpful because it shows that universal health care is not a type of health care system, but a way of measuring health care systems. Maybe the two should be combined into one graphic.

Your other concern is that there are no implementations of universal health care without public financing. Even if this were true [7], it would still make sense to include them in the graphic for people to think about. Kborer 17:40, 5 August 2007 (UTC)

Kborer said above that "in this graphic I am only trying to explain that the opposite of universal health care is no health care", but it is obvious that the opposite of "universal health care" (heath care for everybody) is "no health care at all" (no health care for anybody). We do not need a graph for that. This article already establishes that this is not a matter of "public versus private funding" or "public versus private provision" because as the article already makes clear, the various univeral health systems in existence have a mix of all of these. So the other axes of the graph are completely irrelevant.

I disagree with the notion that the information is obvious to everyone and that the graphic is not helpful. The graphic illustrates basic concepts, which is especially useful for people who are new to the subject. For example, some people think that universal health care is a type of health care system. Kborer 19:30, 5 August 2007 (UTC)

With respect to the point above "even if this were true...", the WaPo article does not seem to support the comment. Even without mentioning federal funding, the article directly refers to (state) government funding: "Next, the plan aims to cover 300,000 more residents by expanding Medicaid eligibility for lower-income residents and by creating a new subsidized state insurance program." I also don't see the point about "different levels of universality"; it is commonly accepted and in the article's lead sentence that universal health care refers to coverage of substantially all of a given population. Would it be meaningful to refer to universal health care for 20% of the population? (Everybody but the unhealthy, for example?).--Gregalton 19:11, 5 August 2007 (UTC)

Different levels of universality was a bad way to put it. I only meant different levels of coverage. The point of the WaPo article was that most people under the MA plan would have private insurance. It is not completely private, but then again, the Canadian and UK systems are not completely public either. Kborer 19:30, 5 August 2007 (UTC)

I made the point that there were no universal systems w/o government funding (not many non-universal, either); the WaPo article does not support that point. I appreciate the effort on the graphic, but still don't think it contributes substantially to understanding. Given the discussion on this talk page, it doesn't seem to have clarified much, and incited much more discussion on what it means. I don't mind the two-axis graph, although it's not really specific to universal health care.--Gregalton 20:13, 5 August 2007 (UTC)

Single Payer /Hybrid sections

These sections seem to very overly concerned with the US health system which ís not universal and therefore does not really have a place in this article. For example the term "single payer" is mentioned in both sections, but it is a term entirely born out of that current debate in the US.

Surely this article should describe what is meant by Universal Health Care and how it has been implemented in different places around the world. The rest of the article seems to do that very well but these two sections seem out of place with that. For this reason I am proposing the deletion of these two sections. I am sure the information in them can be obtained via the section on United States and related articles with about US health care such as Health care in the United States and single-payer health care.--Tom 10:18, 5 August 2007 (UTC)

Single payer sand hybrid systems aren't just part of the American health care debate. They are two different types of universal systems; Germany is an example of a hybrid while Canada is an example of a single payer. I am restoring these sections as it is an important difference between universal systems.--Jorfer 02:49, 6 August 2007 (UTC)

It sure is important to point out that there are other systems than "single payer" ones, but the division made here seems indeed very US oriented(the only important characteristic seems to be whether the government "pays" or not). No mentioning of social insurance, income related vs risk related insurance premiums, legal obligations to be insured, non-profit (not state run!)insurance companies vs. profit oriented insurers, the extent and regulation of competition between insurers, binding legal definitions of insurance packages...

I think an appropriate synonym for hybrid would be "everything else". And it is noteworthy that the article does not describe a single so called "hybrid system", it only describes the UK and Canada in some detail. And I don`t want to say its wrong, but stating that Germany moved from private insurance to a hybrid sytem kind of leaves me clueless. When? What is meant by that? What do you define as private insurance? What literally translates as the "private insurance system" in Germany is not a free market system. Jonas78 11:56, 6 August 2007 (UTC)

It is a basic differentiation between universal health care systems; anything more would overwhelm the article. Germany's system has basic universal health care coverage, but people can pick up any extra insurance from the private market. This is what is meant by a hybrid system.--Jorfer 22:43, 6 August 2007 (UTC)

You say its a basic differentiation, but I would insist it is not a very clear one. In the single payer article you will find this definition for single payer: "An approach to health care financing with only one source of money for paying health care providers. The scope may be national (the Canadian System), state-wide, or community-based. The payer may be a governmental unit or other entity such as an insurance company." by the National Medical Library. First, the term refers to the financing of health care. A logical opposition should then also be defined in terms of the financing of a system. I guess thats why 'multi-payer' system is often used as an opposition, and that would only say that those sytems have not a single centralized source of finance. What you refer to in the German case is more a Two-tier health care system, according to the article Canada is the only Western country not to have one, and its not an opposition to single-payer. When you insist that Germany is a hybrid system, because you can pick up extra insurance from the private market, I would ask you, isn´t that the case in Britain, too? Jonas78 01:15, 8 August 2007 (UTC)

The two sections seem to imply that there are two different funding models for UHC. The two models being either "Single Payer" insurance or a "hybrid" system being some mix of "Single Payer" legislated compulsory insurance plus a "free market system" (paid for either by private medical insurance or pay-as-you-go private purchase). But all over the world, UHC has been been achieved with a hybrid model. There seem to me to be two main exceptions to the hybrid model. One being UK, which does not have a compulsory insurance scheme, and the other being Canada, which has legislated against private practice in areas where there is Single Payer coverage.

And here comes the confusions.

• According to some definitions, Canada's is a pure Single Payer system whereas the UK's system has been dubbed in the US with a POV name "Socialized medicine". This is confusing because it is not a term that is used outside of North America.

• According to some, the UK does not have a Single Payer system, even though in reality it is more single payer than most insurance based schemes because taxation pays for virtually everything.

• The Canadian system is somehow seen as more "free market" than the UK's because the NHS institution is run by the government and the Canadian institutional providers are independent from government. But in reality there is more freedom in the UK as there is a flourishing private sector and anyone can choose to pay for or insure themselves for service in the private health care sector and unlike Canada there are no bars to doing so.

• The media and pressure groups, and sadly too some medical people who ought to know better, falsly imply that people in the UK have no choice of doctor, surgeon, and have to wait for medical service and suffer great pain. The NHS system is often dubbed in the media as "socialized", "socialistic", "dirty", with "no choice". This is not how the people in the UK see their NHS. Sure, you can always find some exceptions. There will be a miniscule minority of people who would argue that the NHS is a bad thing. And there will be sensational stories in the press from time to time. These often prove to be exceptional and sometimes downright misleading. Good news does not sell newspapers and hardly ever hits the press whereas sensational stories always will. The media therefore paints an unrepresentative picture.

• The press similarly dub the Canadian system as beset by queues and people in pain with people fleeing over the border. I have no direct experience of the Canadian system, but I suspect this is a very small part of the total picture and just as sensation as the stories about the UK's NHS.

• People in the US, for largely historical reasons going right back to the founding of their nation, have a great distrust of government and taxation. They argue, almost as though it was axiomatic, that involving the government in medicine will cause costs to rise. This in spite of the fact that their nation spends more than twice as much per capita on health care as the next highest country, has an almost totally private system of provision, and yet has worse heath outcomes and still has many uninsured people and people who go bankrupt and even die for lack of care or the affordability of medicines ot attendant care.

• Because of the way the US debate has been shaped (deliberately in my view) this tends to mean that the world of UHC is represented by Canada at one extreme and the UK at the other with every other country having UHC somewhere in between, but largely ignored. But as I and I think Jonas too would point out, if one looks at the world as a whole, the UK and Canadian models are not representative of UHC as a whole.

• Putting the UK at one extreme and Canada at the other is an entirely misleading way of looking at it. From a funding perspective the UK and Canadian systems would be very similar if, say, Canada adopted to allow private medicine, the only difference being that in Canada, the health institutions are mostly privately owned whereas in the UK they are partly publicly owned and partly privately owned and maybe in part sub-contracted directly to the public system. In the UK, the public and private systems compete with each other. People in the UK mostly do not choose to pay for private medicine because the NHS is really quite effective. These realities are not conveyed in the article or in the media.

Many of the external links and references in this article discuss the US and Canadian models, partly one suspects because of the predominance of the English language and the strong cultural and historical links between the US on one side where the debate is raging, and the UK and Canada on the other. But the UK and Canadian sysyems are not representative systems and they are often misrepresented.

I have strayed a bit from the intended focus on the removal of the sections. But my main point is that if the sections on Single Payer and Hybrid (and potentially that horrid word "socialized medicine") are to remain in the article, they should be seen from a proper global perspective. Can I suggest we now discuss the issues I have raised and how they can be incorprated to improve the article--Tom 09:20, 8 August 2007 (UTC)

OK on the premise that it is best to be brave, I have re-arranged the article slightly and moved discussion of these topics into Economics and a new sub section called Funding. I have tried not to delete anything but some of the discussion about the reasons for hybridity has been dropped, primarily because it seemed to me to be gibberish and not relating to anything I know about in the real world. As for Single payer, the meaning is still clear and I have deliberately put it as a sub-heading so that it can be seen in the index at the top. Some of the details have been cut because they can be obtained from the relevant article. I have moved the US down a bit because its not a Universal system yet and put it under politics because the issue for the US is one of political change. I have explained a bit more about insurance.

The lack of European examples trouble me. Either we should have more examples of implementations (probably with smaller sections for the UK and Canada) or we should drop the examples altogether. I prefer to keep them in myself. --Tom 12:00, 8 August 2007 (UTC)

Tom, thanks to your edit things look improved to me. I agree on the lack of European examples, but at least there is now an idea that health care systems are not to be distinguished along one single dimension.... Jonas78 16:58, 10 August 2007 (UTC)

Right, because nobody ever generalizes or sensationalizes the US health care system. Nobody ever says horror stories are typical. Uh huh.--Rotten 04:19, 20 August 2007 (UTC)

And incidentally, while the polls I've seen do indicate that US voters want change (and it needs big changes indeed), they usually rate their own personal health care very high. And single payer initiatives failed in the two most pinko kooky moonbat states (my state of MA and Oregon). You've been swallowing too much "Guardian" bullshit, my friend. --Rotten 04:23, 20 August 2007 (UTC)

To Rotten. I presume that barbed attack was on me. One again you are resorting to personal attacks. My knowledge of the health care system in the UK comes as a user not from the press. As an example, when my then 74 year old mother fell and broke her hip 5 years ago the emergency room doctor told us she would be operated on the very next day to receive a new hip joint. She was admitted to the hospital. When I went to visit her the next day she had not had the operation. It had been cancelled because an emergency patient with a severe heart problem took the theater slot that had been allocated. But she got the new hip joint the following day instead. I don't know if someone else's operation had to be cancelled for Mum to get hers, but if it was, that would be 2 cancelled operations contributing to the so called "horrifying" statistics about cancelled operations in the UK. Mum was only too pleased to lose her slot to someone who was in greater need. She was in bed and not suffering in any way. There was no hospital bill to be paid. I just wish people in the US could get more balanced information about universal health care as it operates in other countries.--Tom 15:55, 2 September 2007 (UTC)

I thought Rotten's attack was on me. I would like to see Rotten supply facts rather than sarcasm. And I'd like to see Rotten cite reliable sources that we can use in the article, rather than his own opinions.

Your story, Tom, makes a good point, but of course we can't use personal experience in WP. However, I have a story from the Wall Street Journal that made exactly the same point about the Canadian system -- a man's scheduled surgery (coronary bypass, I think) was delayed by a couple of days, because he was bumped by more urgent cases. The reporter asked him about it and he said, he didn't mind, the other cases were more important than his.

So Rotten is wrong on one point -- I don't just read The Guardian, I also read the Wall Street Journal, including their right-wing editorial page (along with several medical journals, including Health Affairs). Nbauman 17:51, 2 September 2007 (UTC)

There is nothing newsworthy about my mother's case... its an everyday reality and people are sensible enough to accept it and trust the doctors' judgements about these things. Its a bit weird that, as you say, news items might be quotable in WP, but individual personal experience is not. News items about the NHS are nearly always sensational and negative and therefore overall, press reports are totally distorting of the true picture. The good stories are not newsworthy. The exceptions that hit the headlines do not make the rule but they are very often quoted by certain editors here and in the articles of pressure groups and so called think tanks that these editors reference.--Tom 19:10, 3 September 2007 (UTC)

I think that the way the health care treats ordinary people is newsworthy -- especially for us in the U.S. where the question of whether government-run systems can deliver good health care is important in the health care debate. That's why the Wall Street Journal (pre-Murdoch) was such a good newspaper. Since I read the UK science and medical magazines, I have a perhaps overly-favorable view of UK journalism.

The reason you can't use personal experience on WP is that there is no way to verify it. People often exaggerate. For example, one flaw in Michael Moore's Sicko is that a woman complained that her husband would have survived kidney cancer if the insurance company had paid for a bone marrow transplant. Bone marrow transplants actually can't cure kidney cancer. The WSJ has published stories very similar to the ones in Sicko, but they checked them out carefully. I'm sure you're telling the truth, but I have no way to verify it. Nbauman 01:55, 4 September 2007 (UTC)

Criticisms?

Theres no section about criticisms of this type of system, other than the pages as external links? I've been known to not notice things in front of me, so please dont flame me if I'm just not seeing the section lol.

Sicewa 02:02, 16 September 2007 (UTC)

It was taken out by an anonymous IP a long while ago. Thanks for noticing. If you see something strange on a Wikipedia page, then it is a good thing to back a month and check if it due to unnoticed vandalism.--Jorfer 19:41, 16 September 2007 (UTC)

Canadian System Consistently Better?

There's a contradiction between two wikipedia articles I thought I'd point out.

In this article, it says "According to Dr. Stephen Bezruchka, a senior lecturer in the School of Public Health at the University of Washington in Seattle, Canadians do better by every health care measure. According to a World Health Organization report published in 2003, life expectancy at birth in Canada is 79.8 years, versus 77.3 in the U.S[19]."

However, the article "Canadian and American Health Care Systems Compared" states "n 2007, Gordon H. Guyatt et al. conducted a meta-analysis, or systematic review, of all studies that compared health outcomes for similar conditions in Canada and the U.S., in Open Medicine, an open-access peer-reviewed Canadian medical journal. They concluded, "Available studies suggest that health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent." Guyatt identified 38 studies addressing conditions including cancer, coronary artery disease, chronic medical illnesses and surgical procedures. Of 10 studies with the strongest statistical validity, 5 favoured Canada, 2 favoured the United States, and 3 were equivalent or mixed. Of 28 weaker studies, 9 favoured Canada, 3 favoured the United States, and 16 were equivalent or mixed. Overall, results for mortality favoured Canada with a 5% advantage, but the results were weak and varied. The only consistent pattern was that Canadian patients fared better in kidney failure"

I'm far from an expert of either the topic of health care or encyclopedia articles, so I leave it to the jury to decide.

-Dev —Preceding unsigned comment added by 142.104.167.64 (talk) 03:55, 21 September 2007 (UTC)

Does every human have the right to health care?

A topic that should be discussed.

No, just like a car, it has to be provided to you by someone with the expertise to build them. I would assert that one does not have a right to health care, but a right to the health they already possess. Although it is sad when someone can't afford medical care, why should I force someone else to pay for it? I'll offer up my own money for charity, but how do you justify forcing people to hand over their own money to pay for something they won't get? 70.134.57.120 03:51, 28 September 2007 (UTC)

You could say the same thing about education, or police services, or clean water. Why should you pay? Because you spend less if you pay for preventative care up front than if you wait until they end up in the emergency room. Acct4 04:30, 28 September 2007 (UTC)

If I don't pay at all I don't pay for either preventative care OR emergency services, that argument will not convince many people to pay for the care of others. Its a great way to convince people they should get their own preventatice care, however. Its much cheaper and painless to brush your teeth regularly than to have your cavities filled and dental diseases treated. This analogy also brings up a startling issue: I'd be willing to give someone a toothbrush and a lifetime supply of toothpaste, but not money to pay for injuries that could have been prevented. When I'm am providing something out of charity, I, not the receiver, gets to decide what is administered. If healthcare is the concern of everybody else, everybody else gets to decide exactly which treatments you are allowed to receive and which ones you aren't. You no longer have a choice, because you are no longer spending your own money. -- 76.25.76.181 22:47, 2 October 2007 (UTC)

The right to health care originates in age old human compassion which leads to moral obligation. This is often reflected in religious texts of all types which promote an obligation the wealthy and the well to care for the poor and the sick. In today's society these rights are usually codified in law. I find your drawing of a parallel between health and material posessions difficult to comprehend. ---Tom 09:54, 28 September 2007 (UTC)

I completely agree that this is moral obligation for all people. However, I don't get that fuzzy feeling volunteering public resources - other people's time, efforts, and money - instead of my own. Its much easier if I have IRS agents take other people's money, but its not very charitable of me. The parellel between health and material posessions is impossible to draw. I drew a parellel between health CARE and material needs. After all, I can give health care, but I can't give health. I can give cars, I can't give the ability to move from point A to point B. -- 76.25.76.181 22:47, 2 October 2007 (UTC)

"Rights" aren't derived from other people. Rights are innate. You have the right to seek out health care. You have no right to demand it from others. I find your equivalence of rights and government force difficult to reconcile. They aren't the same things. Likwidshoe 05:45, 12 October 2007 (UTC)

This talk page is for discussing improvements to the article. The question of whether health care is a human right is already included in the article, with cited sources on both sides, and should not be debated here. If there are specific improvement in how this topic should be handled in the article, please share them here. The only improvement I suggest is that the United Nations Universal Declaration of Human Rights be cited as well. It states in article 25: "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control." An idealistic statement to be sure, but it's another way of looking at the question. -- Sfmammamia 15:00, 28 September 2007 (UTC)

So its preferred that such a debate take place in the actual article, and then the information be organized later? And aren't you allowed to add that citation yourself? -- 76.25.76.181 22:47, 2 October 2007 (UTC)

I will add the citation. I was doing other editors the courtesy of suggesting the addition here first, and seeing if there was comment, before going ahead with it. With regard to your other question, and at the risk of repeating myself, the article already cites sources who assert both sides of the question: "Is health care a human right?". If you feel that the existing treatment of the question is inadequate, please be bold and add material to the article, so long as it meets Wikipedia standards of verifiability and neutral point of view. As it says at the top of this page, the talk page is not a forum for general discussion of the issue. -- Sfmammamia 02:05, 3 October 2007 (UTC)

Bulgaria

Bulgaria is indicated on the map as a country with no universal health care system, while the article says

Most of Europe has publicly sponsored and regulated health care. Countries include Austria, Belgium, Bosnia, Bulgaria

which is right? 62.123.127.15 15:08, 8 October 2007 (UTC)

South Africa

Universal health care contrasts to the systems like health care in the United States or South Africa, though South Africa is one of the many countries attempting health care reform.[1]

The last part of this sentence is misleading and must be removed. South Africa is not "attempting health care reform." It has been a reality since 1995. --Formeat 07:34, 13 October 2007 (UTC)

Fair use rationale for Image:Medicare-brand.png

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Please go to the image description page and edit it to include a fair use rationale. Using one of the templates at Wikipedia:Fair use rationale guideline is an easy way to insure that your image is in compliance with Wikipedia policy, but remember that you must complete the template. Do not simply insert a blank template on an image page.

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BetacommandBot 01:43, 7 November 2007 (UTC)

Serbia

Serbia also has a publicly funded health care system similar to other European countries. It is also not coloured on the map. --142.201.5.100 22:11, 7 November 2007 (UTC)

A few changes

I've made a few edits to clean up this article a bit - I'll explain each.

1 - I've started the article with a definition of Universal healthcare. Call me crazy, but it's probably good practice to begin an encyclopedia article with a definition of what you're talking about. Hack and slash away, but the keys of universal healthcare is government control and subsidy, (either of finances or finances and services) and guarenteed access. Can anyone show me a uhc system that doesn't have government subsidy?

2 - The opening paragraph in implementation is really weak - It says that universal health care is guaranteed access at a reasonable cost (that's part of the definition). Most countries implement uhc thru taxation and legislation (actually, all of them do, and again part of the definition). I've cut that paragraph in order to get the meat of this section, how uhc is implemented in different countries. Maybe we could say something about the history of implementation, how long they take, which types of countries attempt uhc, etc.

3 - in the US implementation section, changed a few things - the US is not the only country w/o uhc (as per the definition). A few other miscellenous things. There is some clean up necessary in the Canada section, but I'm no expert on the canadian system.

4 - Austrialia commentary is pretty unsourced. I'm really no expert on Australia, so I have to defer. Can someone help source that?

5 - The financial outcomes compared section is unsourced and misleading and it's time that that goes. There is no research cited showing a causative link between healthcare system and lifespan, infant mortality rate, etc. Look up causation vs. association. Don't you think that exercise, diet, and genetics have more to do with life span than who payed your doctor bill? A financial outcomes section should be how much healthcare services were received vs. how much those services cost and the quality of those services.

6 - The US debate at the end probably doesn't belongs in the 'Healthcare in the United States' article. I won't change it, but it should probably go. Nmcclana 06:01, 7 November 2007 (UTC)

Nmcclana, in future, please follow Wikipedia etiquette for talk pages: please do not edit existing talk page sections, and please add new comments at the bottom. I reverted some of your changes in the article today and made further changes trying to meld your approach with the earlier version of the article. Per WP:LEAD, the lead should function as a summary of the article, so major points raised in the lead should also appear in the article, with expansion, references, etc. Inserting the term "socialized medicine" into the lead was POV, as that term was not in the article itself, and, as noted in the article on that term, is used frequently (in the U.S. particularly) as a pejorative. (Also, the way you defined socialized medicine in the lead was inconsistent with the definition included in that term's article, so only serves to confuse things here). I restored sections of the article that you had deleted without explanation -- they were sourced and relevant, and the only reason I could see for your deletions was that you felt they were already stated in the lead. --Sfmammamia 01:24, 8 November 2007 (UTC)

Yeah - you cleaned up the intro, looks nicer than my first attempt. In the intro I wanted to define Universal healthcare. I think there are two basic types, 1 - where governments manage the finances, but private enterprise manage the services. 2 - where government does both. It's a moot point, but what's the NPOV description for each of those systems? And, yes, I deleted the into on implementation because I felt it was stated in the lead.

The lead needs some love - it is not a concise overview, nor does it provide context, or summarize points. I'll take a stab at trying to clean that up.

Also, I do disagree with one edit - in universal health care systems - Administrators & legislators DO determine coverage terms. Generally, the legislation only provides the framework, it doesn't define every drug in the formulary, how much each procedure will cost, etc. I'll pull up citations on that. Nmcclana 02:44, 8 November 2007 (UTC)

I deleted the disputed sentence. It didn't really say much -- we've already established that universal health care programs arise out of government mandate. Instead, I added a sentence in the third paragraph that reflects what the article actually says -- that these programs vary widely in their structure, payment mechanisms, and nature of government involvement. The article itself never states there are only two types of universal health care programs, it says that there are many structures under which universal health care is delivered worldwide. In my view, simplifying it down to two types is debatable and distorts the purpose of the lead. --Sfmammamia 03:30, 8 November 2007 (UTC)

Debate in the USA - reduced patient flexibility?

In the section on "Debate in the United States" it says that Government-controlled health care would lead to a decrease in patient flexibility. The cited article does indeed say that. But the argument put forward in the cited article says that some treatments may fall outside the universal system and that people may have to pay for treatments not covered by the national program. I do not see how that is "reduced flexibility". If the universal system does not cover certain treatment, then people will have the same choice they had before the introduction of the universal system. That is, they can insure themselves for the potential need for such treatments or they can pay for the treatment out of pocket. It does not look inflexible to me. --Tom (talk) 13:08, 21 November 2007 (UTC)

Except if you're in Canada where you can't get treatment outside of the state run system.Freedomwarrior (talk) 15:34, 21 November 2007 (UTC)

Agreed. But Canada is quite an exception in this regard and it is not per se a reason for saying UHC reduces patient flexibilty.--Tom (talk) 18:31, 21 November 2007 (UTC)

Debate in the US - common arguments for and against...should they be based on fact and logic???

Rightly or wrongly, we have a section called Debate in the US. At the moment this is subbed with "arguments of proponents" and "arguments of opponents".

IMHO an argument is based on facts and logic. Is it right to include arguments that are not supported by objective facts and logic? I see many arguments based on prejudices rather than facts and a lot of false logic. For instance, it is claimed that government is always less efficient than the private sector and that government involvement in health would therefore be inefficient. But where is the evidence that government is always inefficient? It seems to me to be a prejudicial claim. And citations based on one event are extrapolated to all potential futures quite unfairly. Because at one time there were detected failings in privacy maintenance of Medicare records, ergo, it is claimed UHC in the USA will lead to loss of patient privacy. It is like arguing that because the brakes failed on my car, all cars should have their brakes removed because brakes don't work. These are nonesense arguments and IMHO should have no place in WP.--Tom (talk) 13:17, 21 November 2007 (UTC)

Well, if you want an example of how a centralized system is less efficient then the private sector then compare Cuba in 1959 with modern communist Cuba or the "economic" performance of the countries of Eastern and Central Europe under communism with their performance since the fall of the Berlin Wall. Notwithstanding, we don't add criticisms here based on your notions of fairness. Stop eliminating sourced material and POV pushing.Freedomwarrior (talk) 15:43, 21 November 2007 (UTC)

I get my information from Science magazine, the New England Journal of Medicine, and the Wall Street Journal.

Science said that the Soviet health care system collapsed after the fall of the Soviet Union, that the Moscow Institute of Cardiology, which developed treatments that are used today in every U.S. hospital, was turned into a clinic for rich Russians and foreigners, and the life expectancy in the former USSR has declined by about 10 years.

The NEJM said that the Cuban health care system today has outcomes, with life expectancy, that are not significantly different from outcomes in the US, despite their lack of resources.

The WSJ said that the Chinese health care system has shifted to the private sector, and now, for example, a child with leukemia, a curable disease, was kicked out of a hospital because his parents couldn't afford to pay. During the SARS epidemic, people who got symptoms of SARS could't go to the hospital and be quarantined, because the hospitals wouldn't take them without payment.

A good comparison of the efficiency of the free market and government in health care is Medicare Advantage. According to Paul Krugman and others, Medicare Advantage, the privately-administered Republican program, costs 15% more than the government-administered program, with outcomes that are no better.

I don't think that BalancedPolitics.org meets Wikipedia standards for reliability. It's just a personal web site set up by some guy named Joe Messerli, who doesn't otherwise identify himself and has no particular credentials. Worst of all, it just consists of personal assertions by Messerli, without citing specific sources. I wouldn't delete it now, because it may provide a useful template, but I think it should be replaced by more reliable and authoritative sources. As you know, my idea of a reliable source advocating free-market health care is the Wall Street Journal editorial page, the Manhattan Institute, or the equivalent. Can't you come up with something better than BalancedPolitics.org? Nbauman (talk) 18:13, 21 November 2007 (UTC)

But even the Manhattan Institute at times has used some rather dodgy statistics to argue its cases. But then so may have others on the side of the argument. I only try to verify some of the facts I hear from those that oppose the introduction of Universal Health Care,single payer health insurance or Socialized medicine in the United States (or rather not so much facts but horror stories about what might happen, because that is often how it is often couched). A lot of the information or logic used to make the case against these concepts are of dubious origin, twisted or distorted logic (and so far, a rather surprising amount of it has been) then it is right and proper to bring that out and challenge it. --Tom (talk) 19:31, 21 November 2007 (UTC)

Re "Communism"... I didn't say anything about communism. In England, the government forced the hospitals to put the cleaning of public hospitals out to private contractors and the result is widely recognized to have been a disaster as the contractors just cut peoples salaries, the quality of cleaning is widely felt to have declined (despite what was written in the contracts) and hospital infections rose. It may be cheaper in money terms but the cost in human misery was surely was not worth it. It's expensive to sue and the problem has been there was no way measure taken of quality before so the chances of winning a case could be slim. --Tom (talk) 19:07, 21 November 2007 (UTC)

Re: "Fairness". I said "unfairly" in relation to extrapolation of one case to another. So you would perhaps argue that all cars SHOULD have their brakes removed because mine failed, because I used unfair in the sense of it being a unreasonable extrapolation. Please keep to the point!

Re "Sourced material"....the point I make is that anyone can say anything and one can say "it is argued" even if the "argument" is based neither on fact or reason. The Cato article you added back is "reasoned" on the same basis as the argument that all cars should have their brakes removed! —Preceding unsigned comment added by Hauskalainen (talk • contribs) 19:09, 21 November 2007 (UTC)

Re "POV pushing". Actually I only started my critical review by looking at the arguments against. I will in time apply the same test to the arguments for. If an argument can be made on facts and reason then it is right and proper that it should be in WP. But if an argument is made on a false premise or unreliable (non-independent) data then it should be challenged and probably removed. WP is a place to get factual information. Which is why I queried whether we should be repeating unsubstantiated claims. --Tom (talk) 19:14, 21 November 2007 (UTC)

Re: Effect of regulation on costs in "for profit" and "not for profit". I deleted an edit by Freedomwarrior because the inference cannot be made. Regulation may or may not affect "for profit" and "not for profit" institutions differently but the answer is I suspect we do not know because the article you cite (not peer reviewed I assume) actually does not examine this issue. You may think that regulation is synonomous with UHC but it does not have to be. Regulation is a different thing altogether. On the other hand, I do not agree with the implicit assumption in the original text you edited that UHC is equated only with "not for profit" hospitals. The findings seem to me to be an argument for turning "for profit" hospitals into "not for profit" ones.--Tom (talk) 13:23, 22 November 2007 (UTC)

Tom, I don't know whether you've studied economics or not, but here's a very basic proposition for you: regulation tends to increase the costs of providing a service in "for profit" (free market or semi-free market) and "not for profit" (socialized) institutions, since it tends to add to the overhead costs and even the cost of treatment itself.

I understand that regulation is not necessarily synonymous with universal health care; you are mistaken, however, if you think that the two things are not at all related, since regulation can be one of the means to arrive at so-called universal health care--i.e. the current incarnation of Hillarycare relies almost exclusively on regulation to arrive at socialized medicine.

As for the rest, I don't understand what your problem/concern is. The blurb on behalf of socialized medicine attacks so-called "for-profit" medicine and the costs that are associated with it. As in other articles, I am modifying the text to reflect the fact that the United States has a substantial regulatory system (that increases costs). This is a statement of fact. Unless you don't think that the United States' system is sufficiently regulated...Freedomwarrior (talk) 16:57, 22 November 2007 (UTC)

This seems a rather strange and false dichotomy. There is (at least as far as I am aware) no health care system anywhere in the world that is not regulated, and fairly heavily regulated. Is your argument that health care in the US is so heavily regulated that it is akin to the costs borne by a system of universal health care, but without the benefits?

And, it is not at all a given in economics that regulation increases costs - some would say it is a gross distortion. The convention to drive on the right side of the road (or the left, depending on location) is a form of regulation, but I don't know that anyone would argue that this regulation increases costs (or, conversely, the costs are outweighed by the benefits).--Gregalton (talk) 17:14, 22 November 2007 (UTC)

I said that regulations tend to increase the costs of providing a service, not that they always increase costs. Indeed, there are some regulations that can be beneficial, as your example suggests. Nonetheless, as the Cato Institute paper can attest, the regulations that health care providers in the United States face, increase costs without delivering the benefits of so-called universal health care. That is not, however, why I am insisting that we add the short comment on the level of regulation in the United States. While I don't dispute the contention that nearly all health care systems in the world are fairly heavily regulated, neither the United States nor any country with a substantial level of regulation can be used as a stand in for "for profit," because of the substantial level of regulation which undermines the profit motive. If health care in the United States--or any country with a similar level of regulation--is to be used as a stand in for anything, it should be used to reflect the horrors of having a mixed, semi-socialized system. Freedomwarrior (talk) 17:50, 22 November 2007 (UTC)

So, your argument is that the most efficient way to have universal health care is a government-run system? (And what is it you're trying to imply by saying "so-called" universal health care?)--Gregalton (talk) 18:48, 22 November 2007 (UTC)

I reinstated the original text and added a bit to reinstate the original meaningwhich was that for-profit hospitals have higher costs and worse outcomes than not-for-profit ones. I have not examined the claim in detail but that is what it says. The Cato article was about the cost and benefits of regulation and comes to the conclusion that a lot of regulation costs more to implement than the benefit. But the claim made in Freedomwarrior's edit changes the meaning completely. The edit loses the original meaning (which I have added back) and made it say that in states with higher regulation, for profit health care has higher cost and worse outcomes. So I added back the original edit to reinstate the original editor's intent. In the US today there are many not-for-profit hospitals as well as for-profit hospitals. Actually the same is true in the UK, as many non-NHS hospitals are actually run by charitable foundations. External regulation by government presumably applies to both types of institutions. And as you seem to accept, it may increase costs in both equally. If you can demonstrate the proposition that you added, that states with more regulation cause for profit hospitals to have higher costs than not for profit hospitals, then provide one. The Cato article does not claim that. If you just want to make a claim about regulation in isolation, make it elsewhere, not in the claim about the relative outcomes in different types of institutions.

In the UK, NHS hospitals have to comply with the same regulations as other hospitals. They also have to work within internal, NHS set regulations. Whether the external for-profit and not-for profit hospitals have internal regulations that are more or less onerous than the NHS's own, I have no idea. I suspect not. But judging by the amount of NHS work that is subcontracted to the private sector, I doubt very much that the costs in the private sector are very much less because so little work is actually sub-contracted out.

I did not see any "blurb about socialized medicine" as you put it. Not-for-profit does not necessarily mean run-by-the-government. And yes I did study economics (twice in fact, though on each occasion it was not not my major) but I do have a degree in Banking and Finance, a monthly subscription to "The Economist" magazine and a keen interest in all matters financial, social, scientific and international. Regulation is usually there to protect the public. If the US has enacted overly expensive health care regulation (and I doubt that it has to as great an extent as is claimed by Cato) then that is an argument for re-examining the regulations and their implementation/affects (which is one of the main recommendations in the article you cited). It is not necessarily a reason to go completely laissez faire.

Having worked for British, European and US companies, I have a good insight into the mind sets of different nationalities with regard to business ethics. I can understand why legislators in the US feel the need to regulate. I am not saying that US ethics are any worse than those in the UK, but I think people in the UK would want more regulation of health care if it was fully for-profit. Anecdotally, I managed to prove that my private dentist in the UK had started drilling my teeth for profit. If the dentist drilled, she got paid more than if she did not. Sure I could have gone to the regulator and tried to prove the point. It might have gone to court and I would have been asked to to give evidence of fraud. Or she could have been called before a disciplinary hearing by her professionals. Chances are she would have got let off (drilling for profit is not that unusual). But I have better things to do with my time. I would rather the dentist got paid for keeping my teeth in good repair and got a salary regardless of the amount of drilling done (thus removing her incentive to drill and fill for profit). One wonders whether the exceptionally high rate of coronary by-pass operations in the US or those MRI scans is really something to be proud of....are they are needed or do they just keeps heart surgeons and MRI units in profit?--Tom (talk) 18:43, 22 November 2007 (UTC)

Gregalton, I have not said that socialized medicine is the solution. While I wasn't arguing that "health care in the US is so heavily regulated that it is akin to the costs borne by a system of universal health care, but without the benefits," I did agree with that contention because a semi-socialized system offers few of the benefits of a socialized system (for instance, the supposed universal coverage, etc.)--which is what you stated--and few of the benefits of a free market system--which I should've mentioned earlier--, while generating unnecessary costs. My personal preference would be for the United States to adopt a fully laissez-faire health care system.

By using "so-called" to describe most universal health care systems, I am simply emphasizing that they do not provide the supposed benefit of universal coverage, because there are individuals who have to resort to coverage outside of the national health service to obtain treatment. Freedomwarrior (talk) 19:36, 22 November 2007 (UTC)

Tom, this is the version I am proposing:

"For-profit healthcare in states with significant levels of regulation has been shown to have higher expenses and worse results than not for profit care in such countries."

My edit does not change the meaning of the original text, it simply makes it clear to readers that we are talking about "for profit" health care providers in countries with significant levels of regulation. All that I am doing is making sure that readers know full well what the nature of the system that is being criticized. As far as I'm know, there's nothing inappropriate with that--i.e. my edit does not violate wikipedia regulations.

By the way, if you want to blame the "high rate of coronary by-pass operations in the US or those MRI scans" on someone, you'd do well to blame it on frivolous malpractice suits--i.e. regulations--, not the market. Freedomwarrior (talk) 20:24, 22 November 2007 (UTC)

This whole regulation/no-regulation argument, according to this logic, has almost nothing to do with the universal health care article. What places with light regulation / fully laissez-faire health care systems are you referring to?--Gregalton (talk) 20:23, 22 November 2007 (UTC)

One of the claims made on behalf of universal health care is that it is superior to "for profit" medicine. I read that as a claim that "universal health care" is superior to the kind of health care that would be available in a country with a laissez-faire system, which is non-sense because there are no (or few) countries with such a system. All that I am doing is amending the claim to reflect the fact that it is criticizing "for profit" medicine in a country with a semi-socialized system. Freedomwarrior (talk) 20:38, 22 November 2007 (UTC)

But if you say that you would be changing the meaning. The original text had the clear and simple message that not-for-profit hospitals have lower overheads and better health outcomes than the for-profit medicine (irrespective of regulation). Now you are tying that claim to regulation is somehow influential in this. But there is no evidence for it.

Also many universal systems DO have for-profit providers and they are still universal. I am not sure what your problem is with understanding these simple matters. Your answers seems to be saying either "universal systems are not universal" and that "for "profit medicine" in the US is actually "socialized medicine" or even worse. All those positions seem to be POV to me and not mainstream. --Tom (talk) 20:55, 22 November 2007 (UTC)

Now I see that you have reinstated the disputed edit. You seem to be taking two independent pieces of data (at least one of which is not peer reviewed) and independently drawing a conclusion and obscuring a previous editor's edit. That is WP:OR and it is clearly based on POV. I personally will not revert this now for fear of being blocked under the 3 reverts rule. But I suspect and hope that someone else will revert your edit. If not, then tomorrow is another day.--Tom (talk) 21:14, 22 November 2007 (UTC)

Tom, you are straying from the text. Here it is the proposed text:

"For-profit healthcare *in states with significant levels of regulation* has been shown to have higher expenses and worse results than *not for profit care in such countries*."

Here is the original: "For-profit healthcare has been shown to have higher expenses and worse results"

The sole difference between the two versions is that the modified text reflects the fact that the studies were conducted in a country with a significant level of regulation (something that you are not disputing) while the original text ignores this. Your claim that I am somehow engaging in original research is non-sense. My addition is a statement of fact, nothing more. Whether or not regulations in the United States affects costs (which I think it does), is irrelevant and besides the point (I've only discussed it on this page because you raised it, not because I care). The addition of "in states with significant levels of regulation" does not amount to a claim that "regulation is somehow influential in [increasing costs]," as you seem to believe. Indeed, it doesn't amount to anything more than a clarification on the nature of the United States' system. How this "obscures" the previous editor's edit is incomprehensible to me.

Your countless attempts to distort and fudge the facts on free medicine, while indicative of how weak the argument for socialized medicine is, are unacceptable. Stop making inane objections to the inclusion of sourced material, which does not alter the meaning of the text. Freedomwarrior (talk) 21:17, 22 November 2007 (UTC)

Freedomwarrior and Tom, I have deleted the argument in the pro column that you have been debating, for the following reasons: 1) there are already two other arguments in the pro column that address the profit motive in medicine 2) studies comparing for-profit and not-for-proft medicine (both of which already exist in the U.S.) are only tangentially related to the arguments for or against implementing universal care. Also, may I suggest/request that you both review the suggestions for conciseness under "Good practice" on WP:TALK? Thanks,--Sfmammamia (talk) 08:43, 23 November 2007 (UTC)

Sfmammmia: I have removed the text below:

"Implementing universal health care in the U.S. would require increased regulation. Regulation should be viewed as the problem in the U.S., not the solution. One study by the free-market think tank Cato Institute estimated that health care regulation provides benefits in the amount of $170 billion but costs the public up to $340 billion.[79] "

I looked at the source and could not find any reference to universal health care at all. Hence, the statement that universal health care would require increased regulation is not supported by the text (one could easily make an argument that universal health care would reduce the amount of regulation). The link between regulation and universal health care (whether as problem or solution) is ambiguous. Hence, the only part of this that is left (after removing editorial statements not supported by the source is a discussion of the cost of regulation, which is really for another article (health care in the United States, perhaps?).

Please note I looked at the article quickly; if I have inadvertently missed the link to universal health care, I'll be happy to reconsider. Best regards,--Gregalton (talk) 13:54, 23 November 2007 (UTC)

Gregalton, I think you are right. In an attempt at compromise, I strayed into OR as well. What is needed is a reliable source that argues quite specifically and clearly that government-based, regulatory solutions to extending universal health care would be more costly than their benefits. Or that countries who have universal health care systems have greater regulatory costs than countries without. The Cato report, such as it is, is already mentioned in the article on Health care in the United States --Sfmammamia (talk) 15:18, 23 November 2007 (UTC)

Thank you for your gracious response. Quite honestly, I'm not at all certain that the answer will be one way or the other, nor that a cost/benefit analysis is sufficient or entirely credible. The regulatory waste identified by Cato is a bit more than 1% of GDP (1.25% roughly). Since the US spends more of its GDP on health than most other countries, and for example more than 50% more than the UK (on a GDP basis), the bar for regulatory costs is set rather high.--Gregalton (talk) 02:26, 24 November 2007 (UTC)

Germany and Austria do NOT have universal health care systems

I have lived in those countries, and from my own experience, I know that they don't have universal health care. This is how it works: If you are an employee, your employer is required by law to pay for your health insurance. This contribution is a percentage of your income, but the insurance cover is the same for everybody. If you are not employed, and claim unemployment benefit or a pension from the state, the authority that pays your unemployment benefit (the employment center) is required to pay for your health insurance.

HOWEVER: Health insurance is not provided by the state, but by the "Krankenkassen" (semi-private insurance companies). If you are neither employed by a company nor claiming unemployment benefit nor a state pension, you are NOT automatically insured. You must either pay for insurance out of your own pocket (around €350 /month) or go without insurance - ie. pay the FULL cost of your medical treatment out of your own pocket. The problem is that NOT everybody has the right to claim unemployment benefits and pensions. Self-employed people, unemployed university graduates, young people who have worked for less than a year, formerly self-employed pensioners, the long-term unemployed, immigrants, expats and a number of other groups are not eligible for them. In principle, this system resembles the USA (where only certain groups are eligible for insurance by government) more than the UK (where every citizen is automatically insured by the NHS). In practice, the number of people without health insurance in Germany and Austria is lower than in the US, but ONLY because millions of Germans and Austrians (who are more risk averse than Americans) choose to spend those €350, not because the state is providing insurance for them. The number of uninsured is still significant. In Germany alone 300,000-400,000 people are estimated to be uninsured [8]. That is about 0.4% of the population.

In other words, health care is not a right in Austria and Germany, and "universal health care" does not exist in the way defined in this article: "government mandated programs intended to ensure that all citizens, and sometimes permanent residents, of a governmental region have access to most types of health care". How is this relevant to this article? Firstly, I would like to remove the claim that "The United States is the only wealthy, industrialized nation that does not have a universal health care system". If America can be considered to be lacking universal health care, then so can Germany. Even in a practical sense: The American government spends just as much on healthcare as the German government, namely 7% of the GPD (source: WHO). And when 0.4% of Germans are uninsured, we can hardly speak of anything even approaching "universal". Secondly, I would like to remove Germany and Austria from the map of countries that have universal health care. Cambrasa (talk) 13:25, 24 November 2007 (UTC) Cambrasa (talk) 13:25, 24 November 2007 (UTC)

I disagree with this interpretation. The lead states "intended to ensure that...". Perfection is not specified or implied (i.e. would one person w/o insurance disqualify a system?). And, [reliable sources in English] usually classify Germany as providing universal health care. Contrast this with the numbers cited in the article of 15% of the population in the US without, or almost forty times higher than the German level. In other words, one could reasonably state that Germany's system is not achieving its intended goal, but it is overstating the case to say that the goal does not exist because less than 1% of the population is not covered.

And, since a precise definition (percent of the population w/o insurance) does not exist, the article should stick to generally-accepted usage, which consistently refers to Germany as a jurisdiction with universal health care/insurance. I expect the situation is the same for Austria, but if you have better sources, look forward to seeing them.

Question: I don't understand your point about the proportion of spending on GDP. Yes, German and US governments both spend about 7% of GDP on healthcare, but in Germany this represents about 75% of healthcare expenditures, compared to less than half in the US (about 45%). As a country, Germany spends substantially less (about 10% compared to 13% of GDP), insures 99.6% of the population, and has health results not notably worse than most other OECD countries.--Gregalton (talk) 15:19, 24 November 2007 (UTC)

I've restored the statement that the U.S. is the only wealthy, industrialized nation that does not have universal health care. It has a reliable source, and as Gregalton says, reliable sources categorize Germany and Austria (and Japan, also mentioned in the edit summary as justifying the statement's deletion) as having implemented universal health care systems. By the way, total U.S. healthcare spending is 15% of GDP, not 13%, so the contrast is even greater than Gregalton's characterization. --Sfmammamia (talk) 16:56, 24 November 2007 (UTC)

I too think the 99.6% is as universal as it practically can be. Even in the UK not everyone is covered by the NHS. There are many people in the country who are living in the UK but do not have formal residential status and therefore are not covered except for emergency treatment. A person from another EU country is expected to be insured from his home country unless he or she has been working for more than 3 months and has applied for and has been accepted to have residential status. Many recent Polish immigrants to the UK will be in this position. British people who have paid taxes to the UK state all their lives but then live outside the UK are not entitled to return for treatment. Even as temporary visitors, these people can only receive emergency room treatment for free. The German system shows that it is perfectly possible to have private medicine, funded by insurance, and achieve a universal system, even for 7 per cent of GDP. But it probably has to be regulated. I was curious about the statement in the article that [User:Gregalton|Gregalton]] referred to which says that "Total out-of-pocket payments (in Germany) are not permitted to exceed 2% of an individual’s annual income". Do you Cambrasa know how that is achieved? There would be many in the US without insurance that would be amazed at that! Is it really true???--Tom (talk) 17:05, 24 November 2007 (UTC)

Ah, but the German government does not cover 99.6% of the population. There are millions of Germans, mostly self-employed and underemployed people, who are forced pay for their own health insurance. I don't know what the exact number is, but I estimate that about 5% of the population is not covered by government. The fact that most of those 5% are still insured is mainly a consequence of culture and not of the health care system. Contrary to the US, having no health insurance is considered socially unacceptable in Germany, so people will make any conceivable sacrifice to pay those €350. They will give up their car, sell their house, take their children out of private school, and even starve rather than go without health insurance. Yes, the fact that the self-insurance contribution is fixed at €350 with almost zero deductibles and co-payments, irrespective of age and medical history helps to make the system more inclusive. But it's still a voluntary contribution, and if you can't (or won't) afford it, you don't get treated. If the German system was applied 1:1 to the US, the number of uninsured would be a lot higher (probably around 5%). As a system it is therefore no more universal than the American system. Cambrasa (talk) 13:02, 26 November 2007 (UTC)

You are changing the terms of the discussion: the 0.4% was your own figure. No-one claimed that universal health insurance required that the government provide/finance all of the care, nor that the German government financed 99.6%. The German government has created a health care system (as in the intro to the article, mandated a system) whereby 99.6% have insurance. In fact, most universal health care systems do not actually have all of the provision of either insurance or health care accomplished by government directly. Your hypothetical comparison does not therefore apply: the German system does cover 99.6% (according to your source); the actual U.S. system does not (and does not attempt to). If you'd like, we could compare imaginary sports cars too, but it wouldn't be very meaningful (my imaginary sports car travels at the speed of light, beat that. Unless of course, your's goes faster).--Gregalton (talk) 13:17, 26 November 2007 (UTC)

Balanced politics.org reference

I believe the balancedpolitics.org site link [9] does not meet the standards for a reference. I can see the other side of the argument, that this section is about the debate, but this does not appear to meet even minimal standards for notability. (In general, the links in this section need to be cleaned up). Any objection to my removing them (with reasons)?--Gregalton (talk) 05:23, 27 November 2007 (UTC)

Agreed. BalancedPolitics.org appears to be the work of a single, non-notable author, Joe Messerli, essentially a platform for his own views, similar to a blog. --Sfmammamia (talk) 18:20, 27 November 2007 (UTC)

I've left most of the quotes with citation requests, save a few that were just ridiculous.--Gregalton (talk) 19:44, 27 November 2007 (UTC)

It presents both sides of the issue and explains them fairly. In fact, being a college student, my professor told us that we could only use BalancedPolitics.org to argue political points (and what a surpise, she is left-leaning). I know what you are trying to do and I see it happening with many articles not just this one. You're looking for loop holes in the system to have an excuse to silence the opposing voice, yet you just happen to over-look those that you agree with. However you must learn to tolerate opposing view points and not shut them out just because you disagree with them. I can guarantee you that I could find problems with the supporting arguments if I was as willing as y'all are to find something wrong with the supporting evidence against my opinion. Though I don't expect you to admit that any of this is correct, it is quite apparent that this is the case.--Lucky Mitch (talk) 01:25, 28 November 2007 (UTC)

Oh yeah, and where do you get off deleting something just because you think it is "just ridiculous" Gregalton, what makes you think you are any more of a reliable source?--Lucky Mitch (talk) 01:32, 28 November 2007 (UTC)

Lucky Mitch, it's not about suppressing argument, it's about improving the encyclopedia. Wikipedia has guidelines for reliable sources. What your professor says is not relevant here. BalancedPolitics.org is a self-published website, and for that reason is not an acceptable source. May I suggest that the best way to strengthen the argumentation portion in the article is to find other reliable sources that support the points where cites are requested? --Sfmammamia (talk) 01:55, 28 November 2007 (UTC)

I left almost all of the arguments with a request for citation, that is hardly suppressing an opposing voice (and please note I did this for arguments both for and against). Provide a reliable source and any of these can stay. And perhaps I should not have characterised any of these as ridiculous - perhaps "poorly formulated and unsourced" would be better.--Gregalton (talk) 04:41, 28 November 2007 (UTC)

Mandates or compulsory?

These are politically charged words and neither is part of the essential definition of "Universal Health Care." As far as I can tell there is no 'universally' accepted definition of 'Universal Health Care.' Perhaps this article should be retitled, "Universal Health Care According To John Edwards." Many would say that it isn't really 'Universal Health Care' unless it's a single payer system payed for out of tax revenues which automatically covers every citizen. Other than that, though, what we're talking about is 'universally available' health care.

This is a weird topic. If "universal" means every single person is covered (the more standard definition) then much of this article isn't about Universal Health Care. Neither 'mandates' nor 'compulsory insurance' accomplishes that. The only sensible interpretation of "Universal" in the context of this article is 'universally available,' but even that is weird.

We have laws today that mandate emergency room services for anyone who walks in the door--it's just a matter of who pays. Maybe the article title should be changed to "Universal Health Insurance?"

But let's keep the politics out of it. We can't be defining UHC as requiring mandates or compulsory insurance--those definitions are both incorrect and way too politically biased.Mystylplx (talk) 00:27, 12 December 2007 (UTC)

There are many countries that have achieved universal health care (according to objective evaluations, such as that done by the World Health Organization) accomplished in part by government mandates for compulsory health insurance. Examples include Germany, Japan and Singapore. So insisting that the article avoid mention of compulsory insurance is certainly coming from a very specific, U.S.-centric, political POV. I'm reverting the mention. --Sfmammamia (talk) 01:22, 12 December 2007 (UTC)

You're right. It's fine the way it is--I was just in a mood ;) Sorry.Mystylplx (talk) 18:51, 12 December 2007 (UTC)

Refusal to treat and duty of care

A key point of UHC in most (all?) countries is that patients cannot be refused emergency care (or indeed almost any care, once they have the resources), even if it is extremely expensive; a good example being a liver transplant. Duty of care in the US requires docs to treat in all viable cases, but financial restrictions don't allow it. My experience with transplant surgery in the US meant I saw patients regularly turned away due to lack of insurance - these patients sometimes died as a result. Transplants can cost hundreds of thousands of dollars, and so patients could not reasonably be expected to pay for them if their insurance fails. This could not occur in Ireland, UK, France etc. While it would have been original research to add this to the article, yesterday CNN reported on an interesting story (http://edition.cnn.com/2007/HEALTH/conditions/12/21/teen.liver.transplant.ap/index.html?imw=Y&iref=mpstoryemail) which documented such a refusal by a US insurance company.

My question is: can this now be added as a proposition point in the Yea vs. Nay debate on UHC?

Perhaps it could be used as a source for the second-last point on the prop side:

The profit motive adversely affects the motives of healthcare. Because of medical underwriting, which is designed to mitigate risk for insurance providers, applicants with pre-existing conditions, some of them minor, are denied coverage or prevented from obtaining health insurance at a reasonable cost. Health insurance companies have greater profits if fewer medical procedures are actually performed, so agents are pressured to deny necessary and sometimes life-saving procedures to help the bottom line.[citation needed]

Also, it would be great to get more sources for the opposition side too - still a lot of citations needed.

Cheers! Conor (talk) 12:50, 22 December 2007 (UTC)

Characterizing the U.S. System

We've had some back and forth edits on the language describing the U.S. system, based on the IOM report. The website says that it's the "only wealthy, industrialized nation" to lack universal health care, but the body of the report qualifies it a bit differently. It says that the U.S. is "one of the few industrialized nations" to lack universal health care [10]. It isn't clear to me what the criteria is for "wealthy" in this context. It strikes me that the second characterization is better sourced, and makes the critical point adequately. —Preceding unsigned comment added by 146.145.79.247 (talk) 17:47, 2 January 2008 (UTC)

I disagree. The website characterization -- the U.S. as the only wealthy industrialized nation lacking universal health care -- is equally valid as a source statement and is supported by other comparisons which do account for comparability in wealth, such as the Commonwealth Fund's comparisons, the OECD's comparisons, and the World Health Organization's comparisons. I feel that stating the uniqueness of the U.S. in this regard is important and notable. "One of the few" does not capture this uniqueness. --Sfmammamia (talk) 17:58, 2 January 2008 (UTC)

I'm not so sure - the formal written report signed by the committee strikes me as a stronger source than the blurb at the top of the website. There's another subtle difference between the website and the body of the report - the report talks in terms of guaranteeing access, rather than universal coverage, which is real technical issue involved. Overall, the report itself appears to me to be more careful and nuanced than the website summary. Having said all that, I'm not going to arm wrestle you over it, though  ;-) —Preceding unsigned comment added by 146.145.79.247 (talk) 14:40, 3 January 2008 (UTC)

"Debate in the United States" - with italian sources??

i'm afraid i'm unclear on how this is legitimate. the section 'debate in the united states' has three arguments in favor of UHC that are referenced to italian language sources. this makes no sense at all. the debate in the united states isn't put forth by italian language sites. this strikes me as little more than POV pushing under the guise of being additions to the pro/con section on the US debate. Anastrophe (talk) 16:47, 22 January 2008 (UTC)

The 'debate in the united states' is also done using comparison with countries with different systems: you can check this for most of the points raised. Unfortunately, the references to prove what happens in other countries may be more easily available in other countries' languages.

Of course we all are encouraged to find and add better references for each topic cited in the article.

The debate about Universal health care is not limited to US, so we should also consider to change the section title.

An other problem with references: the arguments used in the debate are listed as "common arguments forwarded by the ...", however, for no argument is given a reference that it is common forwarded indeed, and not used by a few people only. The references are about the argument itself, and not about being common.

Laurusnobilis (talk) 17:21, 22 January 2008 (UTC)

the article makes the pointed contention that there is no notable debate about UHC in the rest of the world; that the US is the only developed nation where there is a debate. changing the title of the section would be inappropriate. the european union encompasses english language nations; since this is the english language wikipedia, english language references should be used exclusively, although i acknowledge i was wrong that english language references are required. regarding the last point, it could be used as a rationale for removing the entire section, since there is no reliable source provided that codifies that these are common arguments at all. final point, please do not edit another user's comments. it is inappropriate. Anastrophe (talk) 17:26, 22 January 2008 (UTC)

I agree that this section, about a debate in the United States, should rely on English sources. Surely these points have been made in English in a reliable source somewhere. --Sfmammamia (talk) 18:40, 22 January 2008 (UTC)

There is a debate about UHC in the rest of the world (some quick found references: [11][12]); let's omit the discussion about whether it is "notable" or not, however it is less prominent than in US.

Most of the argument used are not specific to US, for instance, whether health is a right, and "Unequal access and health disparities still exist in universal health care systems".

My proposal is to change the section name from "Debate in the United States" to something without reference to US, and "common arguments ..." into "arguments ...". Of course, only relevant (in the sense of the wikipedia policy) argument should be listed.

Each country in European union has a different health care system, hence is possible that you don't find English references for most of the Europen union health care systems.

Laurusnobilis (talk) 19:04, 22 January 2008 (UTC)

I'm not really clear why there is a section in this article about the specific debate in the United States at all. If discussion about that debate belongs anywhere in WP it belongs in the article Health care in the United States with a simple cross reference to that additional material in the United States section of the current article. This article is about Universal health care and the US does not have Universal health care. End of story. Its not the only country without UHC and it would be very dull to represent every country's issues here.--Tom (talk) 21:20, 22 January 2008 (UTC)

US does not have Universal health care, yes, but in US there is a debate about adopting it.

The debate about advantages or disadvantages of UHC is general and not specific to US, so it makes sense to have this section, and to have it here Laurusnobilis (talk) 23:04, 22 January 2008 (UTC)

i generally agree, however, by all appearances this section has become somewhat of a 'dumping ground' for random arguments on the pro and con, rather than a reliable list of the most critical issues. it really should be trimmed extensively. Anastrophe (talk) 23:21, 22 January 2008 (UTC)

Quite honestly, the main article Health care in the United States is already long enough, and some of the points of debate are more gracefully interwoven into subtopics within that article, so tacking this debate section on there seems inadvisable to me. That points to the need either for a separate article on the US health care debate (and what an editing nightmare that would be, especially with regard to concerns of neutrality of structure and undue weight!) or just deleting the US debate section altogether. There is a more abbreviated form of this debate at Publicly funded health care, perhaps material from both debate sections could be merged into a separate article? I have no good answers here. Others' thoughts? --Sfmammamia (talk) 02:01, 23 January 2008 (UTC)

canada UHC

the following quote from the NEJM was added recently: "Although there are laws prohibiting or curtailing private health care in some provinces, they can be changed". while an accurate quote, it tends to misrepresent the reality. the legislative process is long, slow, and laborious. the fact that this sentence attempts to soften is this reality: There are laws prohibiting or curtailing private healthcare in some canadian provinces. it would be better to cite the reality, not NEJM's speculations. Anastrophe (talk) 18:11, 27 January 2008 (UTC)

Nbauman: I corrected the error in the heading that I accidently introduced earlier today having misread the requirement in the Canada Health Act requiring provincial health insurance to be publicly managed, not for profit, and accountable to parliament. I took that to mean that private health insurers cannot operate, but of course that is not so. I thank you for the clarification in the section that you added. --Tom (talk) 18:23, 27 January 2008 (UTC)

Anastrophe: Regarding provincial curtailments, so you mean privately funded heath care? Or privately insured health care? Or do you mean that private providers cannot do both state funded work AND privately funded work? Or is any health care not funded by the state banned? I am quite unclear about the restrictions that the provinces and territories may have laid down.--Tom (talk) 18:23, 27 January 2008 (UTC)

i have no idea. i'm going strictly by the NEJM quote, which 'softens' the reality - whatever that reality is - by speculating about how laws can be changed. Anastrophe (talk) 18:38, 27 January 2008 (UTC)

Anastrophe, the NEJM does not engage in "speculations." They have doctors from Canada on their editorial board, they have many articles by doctors from Canada, they have experts who review their articles before they're printed, and they publish letters with dissenting views. And they travel to Canada for medical conferences all the time, just as they meet Canadian doctors who travel here. They are very familiar with the reality. I'd like to know what you know about reality that they don't know, that is not speculation. If you can find a WP:RS who knows as much about the "reality" as they do, you are free to add it to the article. Nbauman (talk) 01:45, 28 January 2008 (UTC)

read the plain text of the sentence. of course laws can be changed, but it's a meaningless suffix to the sentence. it's as meaningful as saying "there are laws which prohibit people from committing murder, but they can be changed". the accurate and true statement is "There are laws prohibiting or curtailing private health care in some provinces". all laws can be changed. it's meaningless to the reality today. Anastrophe (talk) 03:23, 28 January 2008 (UTC)

List of Countries with "Universal Health Care" is Deceptive

This reads like it was written by advocates or activists for universal health care in the United States, with the intention of making the rest of the world look like nirvana, for the purpose of promoting a particular kind of universal health care in the United States, a kind perhaps not available in the countries listed as having universal health care in the article.

I live in Japan, which is listed, without qualification, as having universal health care. Here's what Japan actually has: Either your employer administers a health care plan, or you buy it from the city. Only larger employers have their own plans. They cost maybe $350 per month. Cities charge maybe $500 per month. These costs will vary with location. You get a health insurance card when you join. With that card 70 percent of your costs are covered. If you don't work for a large employer who deducts the payments and you don't pay the city's fee, you don't get health care. If you don't have the 30 percent co-payment, you don't get health care and you don't get medicine.

Is this what most Americans understand to be universal health care? In the U.S. if you don't buy health insurance, you don't get health care. In Japan if you don't buy the city's health insurance, you don't get health care. (There is some free health care: most cities offer a free annual exam (blood and urine, chest X-ray, electrocardiogram, weight and height), and there is some 100 percent care for the disabled in some cities.)

I wonder how many of the other countries "with universal health care" in the list don't really have universal health care when examined in detail.

Japan's system basically works because the population is mostly homogeneous, there is a large middle class and fewer poor than in the U.S., and people just pay for health insurance. They put priority on paying for the insurance, over buying a car or eating out or having another kid or whatever. Those who don't pay are in the same boat as the U.S.

Don't get me wrong: I love the Japanese system. I get to choose my doctors, mostly showing up without an appointment. I can just go to another doctor for the same problem if one doctor's treatment doesn't satisfy me. There are no records or cross-checking to prevent that.

You seem to imply that health insurance in Japan is optional and that there are uninsured persons. But from what I have read, it is not. It is compulsory. In other words it's just like a tax except the money goes into an insurance Fund and virtually the whole population is covered. So in that sense it is quite unlike the US system and IS universal.

• ...every government jurisdiction, whether city, town or village, was required to provide health insurance to every uncovered resident by 1961. Since 1961, virtually all Japanese have been covered by either employers or the government. (From an academic web site http://www.nyu.edu/projects/rodwin/lessons.html#II.)
• In 1961, health insurance was established for all, enabling anyone to afford necessary medical care. To make this possible, everyone was (and still is) required to join some kind of a health insurance plan (From a Japanese government web site http://www.sg.emb-japan.go.jp/JapanAccess/health.htm). Can I ask you to double check your information? --Tom 17:28, 4 September 2007 (UTC)

Me again. Those sources are not correct.

Practically speaking, most employers will deduct your health insurance payment, and you don't have a lot of choice about it, I suppose. But I know expats working for Japanese employers who have talked them into not deducting the payment when they told them they had purchased their own insurance from overseas providers.

If you are self employed, unemployed, or work for a small company (I have experienced all three of those states), you simply do not have to pay for health insurance, and nobody tracks you down and asks you about it. The only way to get insurance is to hop on the subway to the ward office and apply for it and pay for it, about 50,000 yen a month (it varies by city, this was Nerima Ward in Tokyo circa 2004). If you don't pay for insurance, you don't get a card. If you don't have a card, one of two things happens (I have personal experience with both): (1) The doctor refuses to treat you, or (2) they ask for 100 percent payment in cash, rather than the normal 30 percent copayment. If you have a card an forget it, same thing. They either ask you to go get the card, or they take a deposit of 100 percent of the cost pending your return with the card, at which point they refund 70 percent. And, by the way, if you have a card and don't have the 30 percent copayment? No treatment.

Now mind you, practically speaking, a very large percentage of the Japanese population has insurance compared to the United States. Your statement "virtually the whole population is covered" is probably true. It's true because virtually the whole population pays insurance premiums, monthly, with "cash-money," not because it's just magically there from the government.

And those who don't and who get sick, usually get their bills paid by relatives (who may be pissed off at them, but this is kept within the family and dealt with outside the public system).

As for the statement on the Japanese Web site to the effect that "everybody is required to join," I suspect that is similar to the "requirement" that you pay for public television. Since there is no sanction, many people don't pay their NHK bill. Even if you may be in some sense "required" to buy insurance, there is no followup, audit, investigation, census, central record keeping or whatever by the city to check on this. And if you don't have it, you don't get care.

So in summation, there is a single nationwide system to which doctors bill for medical care (actually, two parallel systems, as I explained in my first post), but it's not a universal entitlement, but rather a monthly premium billed, cost controlled insurance plan that is the same for everybody, without the requirement of medical checks and the like to qualify. But still, you need to pay your 30,000 to 45,000 yen monthly premium.

My problem is that Japan is being used here as implicit support for the idea that there should be a zero-premium entitlement style universal health plan in the United States ("because _everyone else has it_"). That is not what Japan has, and I suspect if a country-by-country, ground-level check by informed expats living in other countries in the list here were made, there may be similar discrepancies.

The acid test: does a homeless person living in a cardboard box on the west exit of Shinjuku station get health care? No. He gets nothing. In a Canadian style system would that person get health care? My understanding is yes. So you can call these two systems universal health care, but they are different. If you apply Canada to the U.S., everybody gets care, but if you applied Japan, you'd get a huge number of people not paying their three or four hundred dollars, and things might not be so different than now. The cost differences between a Canadian and a Japanese style health care system would be pretty massively different in the U.S., I'd reckon. —Preceding unsigned comment added by 203.216.99.100 (talk) 11:20, 17 September 2007 (UTC)

"particularly since you are not disputing the fact that you are simply trying to bully your opinion onto this and other articles" "However, if you insist on foisting your particular opinion on readers, then you are engaging in a violation of the rules." "They do not justify your efforts to transform this article into a US bashing session."

You might want to see Wikipedia:Assume good faith

"I have so far refused to play the little game of finding citations, because I've thought it contemptible to have to do such a thing" "Very simply, there is no reason why your opinion should get to trump mine." "I am not going to argue about which of the different possible tests for determining whether a country is "wealthy" and "industrialized" is best, because 1) I don't have the time to do so and 2) I don't need to."

You might want to see Wikipedia:Verifiability specifically where it says "The threshold for inclusion in Wikipedia is verifiability, not truth." on the top of the page. You should also see WP:Undue.

--Jorfer (talk) 17:51, 9 February 2008 (UTC)

population insuring itself...

Freedomwarrior: I have reinstated this. I see this as the intent of the schemes that are implemented. Tax and subsidy are POV. I don't think anyone in the UK thinks their health care is subsidized, except to the extend that some people get out more than they pay in and vice versa... but that happens in insurance. You don't talk about motor insurance being subsidized. Its insurance. It just happens that the government is the insurer. You will not find a UK official web site referring to health taxes or health subsidies... its your POV.--Tom (talk) 20:03, 9 February 2008 (UTC)

DoopDoop: I see you have a strikingly common view of things with Freedomwarrior. Would you by any chance be related? You have again deleted the phrase population insures itself. I know that you may think that this is just semantics, but most UHC is based on a form of National Health Insurance passed by legislation in which the population collective insures itself against paying medical costs at the point of need. The 1948 British system was set up under a scheme known as "National Insurance", and the 2006 Dutch law Zorgverzekeringwet translates as "Health Insurance Law". The Canada Health Act begins with a preamble "An Act relating to cash contributions by Canada and relating to criteria and conditions in respect of insured health services' and extended health care services". They are not called health tax and health subsidy laws. As I say above in another section, no Briton thinks that health care is subsidized because they know it is collectively paid for by contributions paid for by contributions over a lifetime and neither do Finns where I live now. And I suspect Canadians think they are insured too. What gives you the right to declare that this isn't a form of collective insurance? --Tom (talk) 02:30, 10 February 2008 (UTC)

It is obvious that universal health care systems have a strong insurance component (not because of the names of the laws, but because benefits of the schemes depend on the unpredictable ilnesses). However it is just a matter of emphasis. Here in the lead section leftwingers generally would be comfortable with the "collectively insuring itself" part, but some rightwingers will think that these words are POV for various reasons, so I think that consensus about these words is not likely in the lead, and I think that insurance theme could be developed more in a separate section (including moral hazard, asymmetric information and cost control topics). --Doopdoop (talk) 21:32, 10 February 2008 (UTC)

Its not a matter of emphasis. It is the intent! You seem to accept that compulsory health insurance is a form of collective insurance for the protection of the community, but in effect state that we must not call it that because it might upset some on the right (in the USA I presume) who might think otherwise. What would they call it? Robbery? An infringement on civil liberties? Do they think the same about compulsory auto insurance? Or paying tax to have a national defence system? People on the right in other countries do not think like this. This is such a minority view. Even it was as high as 20% in the U.S. (which I greatly doubt) it would amount to just 60 million people in a world of 6 billion? I don't think that 1 per cent should have a veto on what the other 99% can hear.--Tom (talk) 22:58, 12 February 2008 (UTC)

Bizarre reliance on docs from the Cato Institute

Is there a reason that every single anti-UHC point in the For/Against section is derived from documents from the Cato Institute? I know they have different contributors, but it seems a bit limiting... What's the WP view? Is one Institute's POV on a subject enough to cite it? I don't believe so.

--Conor 22:56, 30 July 2007 (UTC)

WP:NPOV requires that we represent all significant points of view. The Cato Institute is a significant point of view. Politicians and lobbyists bring out their reports to justify their positions.

Their positions are ridiculous. They believe that if people can't afford to buy health care in the free market should do without it. Ridiculous positions are a significant part of the debate, and they belong in an encyclopedic article. If you disagree with them, you can find a reliable source with good response to their ridiculous positions, and let readers see how ridiculous they are. That should be easy enough. A debate is often a good way to explain these ideas. Nbauman 02:00, 31 July 2007 (UTC)

The problem isn't that their views are silly - that's a matter of opinion - rather the difficulty is that an entire section of the page is supported only by reports from this one institute. The heading says "Common arguments forwarded by opponents of universal health care systems" but lists only those found in Cato documents. One would expect "common arguments" to be sourced from multiple credible reports. What we have here is essentially a list of reasons why Cato think UHC is a bad idea. Surely that's not conducive to a good Wikipedia page? --Conor 00:19, 6 August 2007 (UTC)

Conor is correct. The issue is whether citing only one source is valid under wiki guidelines or not for referencening data. A position is silly or ridiculous or not is merely opinion based. The content (in my opinion) of this entire article would better serve the public if it controlled the opinionated material. This is suppose to be a ENCYCLOPEDIA article, not a debate forum. There are other cites and links, even within wikipedia, for that, such as here. Not in the main article. —Preceding unsigned comment added by 64.107.246.50 (talk) 18:45, 14 February 2008 (UTC)

Publicly-funded health care is the main article for this page

It seems that Publicly-funded health care covers nothing except universal health care. --Doopdoop (talk) 22:22, 11 February 2008 (UTC)

I disagree. As is true in the U.S. you can have publicly funded health care for specific segments of a population, hence not universal, so while there's an ample overlap in the topics, they are distinct concepts. --Sfmammamia (talk) 01:18, 12 February 2008 (UTC)

current state of publicly-funded health care does not reflect this distinction (except in very few places). --Doopdoop (talk) 22:11, 12 February 2008 (UTC)

Publicly-funded health care does not necessitate universal health care. This is like claiming that Health care is the main article for Publicly-funded health care, this can go on ad infinitum. For example, U.S. Medicare, Medicaid, the Veterans Administration, the U.S. military, in fact ALL U.S. versions of publicly funded health care are not universal. --Historian 1000 (talk) 22:43, 12 February 2008 (UTC)

Doopdoop, if the current state of the article on publicly funded health care does not reflect the distinction both Historian 1000 and I have pointed out here, how about taking your concerns to that article and/or making bold edits there? --Sfmammamia (talk) 22:50, 12 February 2008 (UTC)

Even after bold edits there would be 95% overlap. --Doopdoop (talk) 23:02, 12 February 2008 (UTC)

This article, on universal health care, is twice the length of the article on publicly funded health care. So, unless my understanding of math is very messed up, 95% overlap between the two articles is impossible. So far, you have not gained consensus on your assertion in the topic header, so continuing to revert the hatnote seems less-than-constructive to me. --Sfmammamia (talk) 23:39, 12 February 2008 (UTC)

Regardless of what is or isn't currently in the Publicly-funded health care article (and this can obviously change at any moment with editing), the fact remains is that the two are distinct issues. This is really just POV pushing by Doopdoop and nothing more. --Historian 1000 (talk) 23:43, 12 February 2008 (UTC)

So far the only difference presented is in the details of USA health care system. But those details are covered in both articles. Also please explain why there is no Universal vehicle insurance page (only vehicle insurance page). --Doopdoop (talk) 23:56, 12 February 2008 (UTC)

Doopdoop, as this article states quite clearly, there are several funding models for universal health care, including ones that rely primarily on compulsory insurance. Have you read the description of Singapore's system within this article??? How about the multilayered funding of Germany's system???? That is why this hatnote has no consensus. Slow-motion efforts to re-insert it are not a method of achieving consensus. --Sfmammamia (talk) 00:29, 15 February 2008 (UTC)

Compulsory insurance is just a tax with a different name. --Doopdoop (talk) 07:03, 15 February 2008 (UTC)

Great sound bite. Got a reliable source for that? Because otherwise, it's just your POV. --Sfmammamia (talk) 17:22, 15 February 2008 (UTC)

Many sources, including Taxation_in_Germany, include healthcare insurance in the overall tax burden. --Doopdoop (talk) 22:04, 19 February 2008 (UTC)

It's my understanding that internal references are not useful as reliable sources, and I see that that section in the Taxation in Germany article is entirely unsourced. --Sfmammamia (talk) 23:06, 19 February 2008 (UTC)

Another great example that's described in this article is The Netherlands. With a universal system that is 55% government funded and 45% privately funded. In other words, only somewhat more "publicly funded" than the US system, which is 45% publicly funded and leaves 1 in 7 uninsured. --Sfmammamia (talk) 17:46, 20 February 2008 (UTC)

This article () discusses German insurance contributions as a taxation issue. --Doopdoop (talk) 21:45, 20 February 2008 (UTC)

Thanks for the reference. I think it would be good to check and update the Germany section of this article against the reference, even though it is 2 years old. The referenced article states: "A central health-care fund will be introduced to pool contributions made by workers and employees as well as the tax money. The fund will pass on money to insurance companies, who -- should they require additional funding -- can also raise cash directly from their members through a levy." I would argue that this paragaph is an indicator that Germany's system still is a mixed-funding system.

Please note that the source covers future plans so do not use it for updating the article unless you verify that there were no last minute changes. --Doopdoop (talk) 21:22, 21 February 2008 (UTC)

WHO statistics back me up and may be helpful to this discussion. According to the WHOSIS database, Germany's system is 77% publicly funded; 23% privately funded. The Netherlands: 62% public, 38% private. Singapore: 34% public, 66% private. And yet, all of these systems are universal. That is why I think it is a gross oversimplification, POV, and inaccurate, to say that Publicly funded health care should be the main article for this topic. --Sfmammamia (talk) 22:30, 20 February 2008 (UTC)

Publicly funded healthcare article also covers Germany, so there is no POV. --Doopdoop (talk) 21:22, 21 February 2008 (UTC)

(undenting) I've made an attempt to meld the two different versions of the lead into something of a compromise version. I think the WHO statistics bear out the point that public funding is not the only mechanism used to achieve universal health care, and that mixed public-private funding is fairly typical. I will add references to the WHO statistics in each of the country areas cited in this article as a way of illustrating the blend of funding (and varied degrees of "public") that go into universal health care systems around the world. --Sfmammamia (talk) 22:19, 21 February 2008 (UTC)

Auto-archiver proposal (and be bold)

I'm going to be bold and put an auto-archiver to work here. Any objections welcome...--Gregalton (talk) 12:03, 22 February 2008 (UTC)

Unfair benefits...

The article currently states that "Universal healthcare is unfair to healthy tax payers because it gives people who smoke, drink, do drugs, and eat unhealthily unfair benefits"

This is not entirely true. Across most of Europe, tobacco and alchohol are taxed heavily to both discourage behavior that leads to ill-health and to ensure that users (who do indeed add to the burden of health care costs) meet a fairer share of the cost. In the UK, a general agreement between the NHS and the motor insurance industry ensures that the NHS receives a sum of money each year from all motor insurers to meet the health care costs caused by motor accidents. This agreement avoids the need for every claim to be contested, keeps the lawyers out and costs down. It does however mean that motorists are making extra contributions towards heath care through their insurance premiums. There has even been talk of taxing "junk food" but politicians are wary to do so because there are rather too many value judgements that would never reach consensus.--Tom (talk) 23:38, 1 March 2008 (UTC)

Remove this paragraph if you think it NPOV problems. --Doopdoop (talk) 23:41, 1 March 2008 (UTC)

Glaring omissions

Why are there virtually no mentions of the healthcare systems in Europe?

England is about the worst funded and lowest quality health care n Europe. Some countries like Germany have a system on mandatory private insurance. Some countries like France has a completely private care part of the system but with fixed payouts by a single payer stabilizing the system. Why is non of this explained?

Do we even have articles on these systems? If no, just ask someone to translate them from the French and German wikipedia's, then summarize them here.

What have you people been doing?!? JeffBurdges (talk) 12:52, 20 January 2008 (UTC)

This comment is completely stupid, and ill informed. The UK's (not England's, get your countries right) health care is neither the worst funded (it's now one of the best) or the lowest quality (try going to Greece) in Europe. It's a fantastic system, it's universally accepted as the right thing by all political parties, and we look to America with horror about how inhumane a country can treat its poorest citizens. We also have very low opinions about Americans who can't spell, have no knowledge of geography and make idiotic assertions. Wikidea 23:39, 22 January 2008 (UTC)

the article talk page is not for general discussion of the issues, it is for discussing article improvement. your commentary is interesting, but belongs elsewhere. see WP:FORUM. your comments are also quite uncivil. Anastrophe (talk) 01:10, 23 January 2008 (UTC)

Anastrophe: I think you are taking this remark too literally. Look at the substance, not the form; Wikidea is voicing (in personal and non-encylopedia-like language), a viewpoint that is rightly included in the discussion, on which we need not all agree. However, as an adherent to his viewpoint, the author of the comment probably thinks the article is well-served by having his comment on the record. Civility issues aside, is there anything wrong with wanting to add some emphasis on the user page to an issue in (or about) an article's subject, that you consider important? Non Curat Lex (talk) 23:29, 1 April 2008 (UTC)

• Thank you for your suggestion. When you feel an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the edit this page link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes — they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to). ⟳ausa کui ^× 15:47, 20 January 2008 (UTC)

Jeff: You say that England has about the lowest quality care in Europe. An interesting claim. I'd be interested to know where you get that information from because if its true it represents a big change since the last major assessment was done by the WHO. Perhaps you can tell us here or at National Health Service or Healthcare in the United Kingdom. Its even more remarkable because the UK has increased spending from about 6.7 per cent of GDP on health in 1997 (the date of the stats below) to about 8.1 per cent today, so other countries must have been doing phenomenally well too.

The WHO in 1997 ranked the UK in 18th place out of 191 in a World league table of performance attainment ahead of 21 other European countries. These include Ireland(19th), Switzerland(20th), Belgium(21st), Sweden(23rd), Cyrpus(24th), Germany(25th), Finland(31st), Denmark(34th), Solvenia(38th), Croatia (43rd), Poland(50th), Slovakia(62nd), Hungary(66th), Lithuania(73rd), Ukraine,(79th),FYR Macedonia(89th), Romania(99th), Bulgaria(102nd), Latvia(105th), Yugoslavia(106th), and finally Russia at (130th). All of which are European countries. And as far as I recall, the UK health service has improved greatly since these stats were taken with huge capital and people investment and grealty decreased wait times.

In overall attainment the UK was, in 1997 ranked 9th out of 191 countries, with an index score of 91.6 and only 6 European countries bettered that. France managed 91.9. The worst country scored 35.7. The USA scored a very respectable 91.1 and was placed 15th, just behind Germany. --Tom (talk) 18:50, 20 January 2008 (UTC)

Tom, where's the link for those WHO data?

That would be a good table -- WHO ranking in one column, and the type of system (universal, private, otherwise) in another column. (I don't think the WHO rankings are quite as accurate as some of the peer-reviewed journals, but for a lot of countries that's all we've got.) Nbauman (talk) 19:07, 20 January 2008 (UTC)

Its from the The World Health Report 2000 Health Systems: Improving performance. I have the PDF on my PC but I downloaded it from the internet so you must be able to Google it and find it. --Tom (talk) 19:53, 20 January 2008 (UTC)

_Actually, the UK really did much better than 9th because ahead of it were Monaco, San Marino, Andorra, Malta and Luxembourg most of which are European microstates) with tiny populations relative to Europe as a whole (together less than one fifth of one percent of the total European population). Many of these are also tax havens for the rich so its not surprising they come out at the top of the table. I also accidentally omitted several other European states below the UK including Slovenia(38th) which came out just ahead of the US (at 37th). We can raise the US by 5 places too (maybe more) if we exclude those very small countries :) --Tom (talk) 20:18, 20 January 2008 (UTC)

Criticism of Canadian healthcare

I deleted the following paragraph recently added, because almost all of it is outdated, poorly or unsourced, or contradicts reliable sources:

Universal health care in Canada has caused some problems for the country's funding. On December 24, 1999 the Toronto Star reported "The Ontario government is bailing out deficit ridden hospitals to the tune of $196 million." In the same report the paper also stated a shortage in the number of doctors. Canada's health care has also been seen as inferior to private health care, such as in the United States. The British Columbia Medical Association released a paper criticizing this and calling for "the establishment of maximum wait times or 'care guarantees' for various medical procedures" and saying "patients not helped within the guaranteed time frame should be able to seek care out of province - at no cost to themselves." This is because it's criminal for citizens to pay out of pocket for private health care. The only other two countries with these laws are North Korea and Cuba.

Here are the problems I see with the paragraph:

• The 1999 quote from the Toronto Star is uncited and almost 10 years old.
• The statement about doctor shortage is fairly accurate, but also poorly sourced; there's a much better statistic cited in the Health care in Canada article.
• The statement about inferiority to U.S. is unsourced and contradicts the well-sourced and more neutral comparison in Canadian and American health care systems compared.
• The BC Medical Association quote is undated and unsourced.
• The statement that includes the phrase "it's criminal" is totally inaccurate -- about 30% of Canadian healthcare is privately funded. Again, a much more accurate portrayal of this is in Health care in Canada.
• The comparison statement about North Korea and Cuba is pure rhetoric and highly inaccurate.
• The only source cited for the entire paragraph is Human Events Online, which bills itself as the Conservative Voice, so fails on neutrality and is of dubious reliability.

A more balanced and better sourced critique of Canadian healthcare might fit in this article. But those are contained in the other articles I noted. --Sfmammamia (talk) 15:16, 6 March 2008 (UTC)

Quality of Cites in the "Debate in the United States" section

I just thought I ought to point out that quality of cites given on the "left" side supporting universal health appear to be of much higher quality than those on the right, which ironically enough depends more on nonscientific, right wing/libertarian sources like the CATO Institute. (This somehow seems to be a familiar pattern....)

Also I came across this detailed, pro-universal health care "position paper" paper by the American College of Physicians titled Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries (PDF shortcut). This appears to be a good ref to add for multiple cites in the article. FYI. -BC aka Callmebc (talk) 14:48, 1 March 2008 (UTC)

Callmebc, that ACP article is a good cite. Here's another one: [http://tcf.org/list.asp?type=PB&pubid=636 The Basics: National Health Insurance: Lessons From Abroad

The Century Foundation, Century Foundation Press, 2/7/2008]

I agree with you that there is an absence in this entry of cites to high-quality studies opposing universal health care. What can be done about that? Nbauman (talk) 01:34, 2 March 2008 (UTC)

Well, it's probably not easily fixable because you're getting into politics not too different from the topic of Global Warming -- you are apparently finding most of the experts and researchers lined up on one side, while on the other you are getting mostly politically driven conservatives and free marketeers. If you try to give equal room for both, you then short change the experts and violate WP:WEIGHT. If you try to structure the article by giving weight based on merit, you'll then likely end up having to constantly contend with frustrated conservatives alleging that the article is biased. But merit is merit: I think the best refs and arguments should be found for both sides and presented sectionally rather than side by side. If this means the pro-universal health care section becomes larger, so be it. -BC aka Callmebc (talk) 07:37, 2 March 2008 (UTC)

I think it is better to integrate pro and contra arguments by grouping them by topic they discuss (quality of care, cost, social justice etc.) --Doopdoop (talk) 13:28, 2 March 2008 (UTC)

I would caution us all to be very careful about evaluating the "quality" of citations and studies offered to support positions we disagree with. It's very difficult to objectively evaluate evidence for the "other side" - whatever that evidence or position may be. Cato has a point of view - but so does any other think tank you may want to mention, whether it be Public Citizen, the Urban Institute, the Economic Policy Institute, Kaiser Family Foundation, Brookings, Aspen, Heritage, etc. Frankly, I've seen some pretty shoddy work from some of these institutions that are generally considered liberal or moderate. (Of course, in some cases my biases may have kept me from seeing that it really was solid, persuasive research; in other cases, it probably really was schlock work - the problem is that it's hard for me to tell.) None of these organizations, Cato included, are fly-by-night operations. They're well known, and their philosophic affiliations are generally well recognized.

If we are concerned that someone may be misled because they think Cato is something other than it is, I'd suggest that we wikilink to the the article on Cato. If we have concerns about a particular Cato work product that's being referenced, we should clearly describe what it is or how the work was done (e.g., "based on an internet opinion survey with 23 participants," "in an opinion piece published in their monthly newsletter," "in an op-ed . . .," "in a position paper . . ." etc.) I'd suggest the same rules for organizations all across the political spectrum. For every Cato Institute that one person thinks of as controlled by politically-driven free-marketers, there's a Center for American Progress that someone else thinks of as controlled by politically-driven anti-market tax-and-spend liberals.EastTN (talk) 16:49, 5 March 2008 (UTC)

As an aside, I just noticed that the sentence starting this discussion has a link for the Cato Institute that takes you to the website for People For the American Way, rather than to either the website or the wikipedia article for the Cato Institute. Indicting an group because it shows up on a list of "Right Wing Groups" compiled by self-described progressive advocacy organization probably isn't the best way to create the appearance of maintaining a NPOV.EastTN (talk) 18:49, 5 March 2008 (UTC)

That was deliberate -- CATO is a politically based advocacy group and not a scientific organization by any means, and is quite typical of the groups against universal health care, the "right side". Whereas the pro universal heath care advocates are far, far more likely to include organizations in good scientific and/or medical standing like the American College of Physicians. -BC aka Callmebc (talk) 02:29, 8 March 2008 (UTC)

I thought it might be. Again, I'd simply urge caution in evaluating and characterizing groups that we disagree with - especially blanket evaluations of entire organizations. It's also important to be careful about the sources we use to support our own positions. People for the American Way is also "a politically based advocacy group." Whether they agree with us or not, it doesn't strengthen the claim that Cato isn't credible because they're an advocacy group when we appeal to another advocacy group to make our case. (And for those of us with long memories, it might be useful to remember that American Medical Association fought vigorously against the enactment of the Medicare program - just because a group has solid medical or scientific credentials does not necessarily mean that it will be on the "progressive" side of any particular public policy debate.)

If the Cato materials really are that weak, there's no need to arm-wrestle with other editors. Just go to the source, add factual information to correctly characterize that source, and let readers judge. "Quality" is subjective and in the eyes of the beholder. Survey methodology and sample size are factual and objective. If one group's source is a peer reviewed study, that should be clear. If another group's source is an opinion survey of 150 physicians, that should also be clear. If a third group's source is a policy paper written by committee, say so. We can fight forever over "Public Citizen is good, Cato is bad . . . no, Cato is good, Public Citizen is bad . . . , no no, you just don't get it, Public Citizen . . ." There's nothing to fight over when you add "in an undated press release Cato claimed . . . ," or "the study considered A, B, and C, but did not address X, Y, or Z, which Brookings suggests . . .," or "based on a survey of 12 leading conservative thinkers . . ." If we play it straight and get all the facts on the table, we don't have to worry about the consequences. We just have to remember that people who disagree with us will be (or, at least, should be) adding exactly the same kind of qualifications to our sources - and we need to be not just o.k. with it, but helping them to get our sources correctly characterized. EastTN (talk) 14:01, 10 March 2008 (UTC)

I agree with most of what EastTN is saying -- attribution and detail about sources and their methodologies are generally a good thing. However, I think a "tit for tat" approach to neutrality can easily get us into WP:UNDUE. This is especially true with sloppy sourcing. One editor posts a peer-reviewed, soundly researched article; then to counter its conclusions, another editor goes out and finds an opinion piece from a highly biased source that doesn't even meet WP:SOURCES: "reliable, third-party published sources with a reputation for fact-checking and accuracy", as if this was a way to reach neutrality. It isn't, and every editor should take responsibility both for posting only reliable sources, and removing material that comes from questionable sources. Some of what Cato publishes is labeled as opinion, some of what it publishes is based on research, and I think there's a qualitative difference between those two in terms of reliability. --Sfmammamia (talk) 14:38, 10 March 2008 (UTC)

That's absolutely right. My only point is that we need to be careful in how we handle the citations of people we disagree with. We can easily misjudge them, and even when we don't, reacting too quickly can lead to an unproductive fight. If a source really is bad, it will quickly become evident if we characterize it correctly. Working through the details first encourages us to debate the merits of the evidence, rather than fighting over who's wearing a white hat and who's hiding under the black stetson. If the facts on a source are bad enough, multiple editors are going to start asking "now, just how large was that survey, and how did they select the participants?" - then we can delete it based on how it was done rather than our opinion of the author or publisher. I also agree that Cato publishes a mix of opinion pieces and research. But, the particular section we're discussing is focused on "Common arguments forwarded by supporters/opponents of universal health care systems" - for that, even if they're completely wrong and misguided, even a pure opinion piece by Cato is a valid example of arguments advanced by opponents of universal health care.EastTN (talk) 17:58, 10 March 2008 (UTC)

Just for kicks - here's a totally research free think-tank piece (no peer-reviewed studies were harmed it its writing) that made me smile. Why link to something with no numbers? It reminded me to keep my sense of humor.EastTN (talk) 21:41, 10 March 2008 (UTC)

I just wanted to point out that perhaps the reason it sounds unbalanced is because it IS. I have added numerous references (from respected sources, not just CATO) on the con side, and they have been removed. There was no discussion about why they were removed, only that someone felt they didn't do a good job. Seeing as how they have been items that include the economics of health care issues in private vs universal models, they are strong arguments against universal healthcare that contributed in a NPOV manner. But not everyone wants NPOV now, do they? —Preceding unsigned comment added by 141.214.17.17 (talk) 23:59, 28 April 2008 (UTC)

JaaJoe.com Just Another Average Joe spam

I've removed the external link to JaaJoe.com Just Another Average Joe twice. According to Whois, the domain was just registered 3 months ago. It's not a notable source. The main page has a Google page rank of 0. The article is not professionally written and the author does not even use a full name, just "Cisco." It's also been spammed by the same IP 24.243.31.156 (talk) on the Cardiopulmonary resuscitation page. --Lifeguard Emeritus (talk) 09:50, 20 April 2008 (UTC)

The IP 24.243.31.156 (talk) has reinserted the link twice more (4 times total) despite being reverted by another editor. The IP has been issued a spam warning. --Lifeguard Emeritus (talk) 05:31, 21 April 2008 (UTC)

It is wrong to claim most care is subsidised by taxpayers'

I think the claim that "most care is subsidized by taxpayers" is inherently wrong.

Most health care in universal systems is in fact paid for the users of the system. In a big pot kind of way the government ensures that the very healthy subsidize the needs of the very sick, the very wealthy subidize the health care costs of the very poor, and the economically active subsidize the economically inactive (e.g. children, retired people and the unemployed). But the vast majority of users are not permanently in those extremes and will pay in over time broadly what they get out (either through tax or compulsory insurance). Indeed, most people pass through all of these phases at some point in their lifetime so subsidy is probably not the right word. For most of us, its a way to even out the burden of these factors over a lifetime.

Health care in The Netherlands is only 5% funded by government and is a universal system. So it is mosly not subsidized by taxpayers. I think most Britons do not think their health care is subidized either, even though they get it for free when they need it. The NHS is not government charity. In the long run we pay for it through taxes. At the extremes, if we are lucky, we pay our taxes and never fall ill. But we don't begrudge that because because we know we could just as easily have been very seriously ill. Britons (and I presume the Dutch) vitually never have to worry about health care costs whatever their health or financial status. --Tom (talk) 10:20, 8 February 2008 (UTC)

Question, Tom: if it is only 5% funded by government, who funds the other 95%? Non Curat Lex (talk) 23:31, 1 April 2008 (UTC)

5%? No way. It's been more like 60%, with an increasing shift to more private insurance under recent reforms. England has 85% public funding, Germany about 75%, Canada is 70%,the US has about 45%....Netherlands is far less a market-oriented system than the US, until recent reforms the extent to which the private/public funding split will need to wash-out after the changes are fully in effect. Numerous OECD sources and Holland's government documents clear this up, but I don't have the figures right at hand.JackWikiSTP (talk) 17:17, 12 May 2008 (UTC)

Again with the normative claims

Here we go again. Let me repeat what I said on the talk page on socialized medicine:

There is no such thing as an objective definition for the terms "industrialized" or "wealthy." The questions that one would ask to determine whether a country is either of those two things is open to individual interpretation. For instance, you might say that measuring GDP per capita is a more effective approach to determine whether a country is wealthy, while I might argue that looking at the aggregate GDP is better. Who's right? Well, that's a question of opinion. Another example, what's the appropriate level of "industrialization" for a country to be considered "industrialized?" Indeed, what does it mean for a country to be "industrialized"? Is it possible for a country to be "un-industrialzied"? Again, those are all matters of opinion. At what point is a country objectively "wealthy"? Finally, explain why some "industrialized" countries with high GDPs (i.e. wealthy by some people's standards) that don't have universal health care, like China or India, shouldn't be counted alongside the US. It is a matter of opinion, and it should be reflected as such. Freedomwarrior (talk) 05:16, 9 February 2008 (UTC)

China and India are not industrialized countries. Un-industrialized countries exhibit high GDP growth (which China and India do), have a majority of there population in rural areas (which China and India do), have a lack of the rule of law (which China and India do), and have significantly lower GDP per capita then industrialized nations (which China and India do). Aggregate GDP is really affects wealth at the national level. It really only affects foreign relations and the amount of power and influence the very top have. You are not more wealthy if your country has twice the aggregate GDP of another country, but you have to distribute it between 6 times as many people. By your reasoning, we could argue that Zimbabwe is more wealthy than Monaco. Also, current GDP does not reflect GDP accumulated from previous generations. China and India are just now emerging economically after government mismanagement pretty much erased their nations' wealth, while the United States has been able to accumulate wealth from previous generations. Numbers and number taking methods are not perfect gauges which is why there is no absolute standard for the word industrialized. For example, GDP is not a perfect number as it does not reflect the informal economy which makes up a large part of less developed nations' economies and is expressed using an absolute currency standard (dollars for example), which often does not reflect the cost and quality of living in a country. For more on the problems with GDP alone see Gross domestic product#Criticisms and limitations. The reason why we don't include China and India is because America was developed based on European tradition and not Eastern tradition. We share a long established Democratic tradition unlike the East, so it is a better comparision to compare ourselves against Europe.--Jorfer (talk) 06:12, 9 February 2008 (UTC)

I am not going to argue about which of the different possible tests for determining whether a country is "wealthy" and "industrialized" is best, because 1) I don't have the time to do so and 2) I don't need to. By conceding that "there is no absolute standard for the word industrialized," you made my point for me. My changes simply reflect that there are some who believe that the United States it not the only country without some form of universal health care and others who do. All that you're saying is that you (and other editors) have a right to pass on your opinions as facts to this article's readers, which constitutes a violation of Wikipedia rules. Therefore, I once again insist that we edit the text to reflect an impartial statement of the facts in the form of the compromise put forth by Gregalton on the Socialized Medicine talk page. Freedomwarrior (talk) 07:13, 9 February 2008 (UTC)

Nonsense. There are quite standardized definitions, and references provided on that talk page. If you were even attempting to be serious on this issue, you would recognize that every definition of "wealthy" countries corrects for per capita GDP. You don't wish to argue about which definition is best, but refuse to recognize even the most widely accepted part of the definition. If you refuse to recognize any outside sources, other editors can rightly refuse to countenance your edits.

And there is no requirement that any listing of wealthy, industrialized nations be absolute: even the most biased editor would note that wealth and levels of industrialization will and have changed over time. And even using lists with slightly different compositions does not disprove the (cited) reference.--Gregalton (talk) 07:38, 9 February 2008 (UTC)

These "standardized" definitions are normative in nature. I have so far refused to play the little game of finding citations, because I've thought it contemptible to have to do such a thing (particularly since you are not disputing the fact that you are simply trying to bully your opinion onto this and other articles). But if you need a source for the very obvious claim that there is not an objective definition of wealth, you can turn to Van den Bossche's treatise on WTO law or a random journal on economics.

There is no requirement that you provide an objective definition of what constitutes an "industrialized" or "wealthy" country, if you recognize that those claims are not factual, but rather normative. That does not violate Wikipedia rules. (And that is why I did not press the issue on the socialized medicine page further) However, if you insist on foisting your particular opinion on readers, then you are engaging in a violation of the rules. Very simply, there is no reason why your opinion should get to trump mine. As I've said before, an opinion is an opinion is an opinion. Your sources are worthless (other than to demonstrate that there are some who are of the opinion that the US is the only wealthy country without some form or universal health care). They do not justify your efforts to transform this article into a US bashing session.

Ohh, by the way....not "every" definition of "wealthy" countries relies on per capita levels of GDP as you seem to proclaim from on high. Broadly speaking, those in the security studies field are prone to looking at a country's aggregate wealth alongside per capita GDP, etc.Freedomwarrior (talk) 08:07, 9 February 2008 (UTC)

The point is not whether there is a consistent or absolute definition of "wealth" but of the phrase "wealthy, industrialized nations". Which there is. You may be right that in some other contexts, "wealthy" may be used differently, but this is not in the context of security studies. In the relevant field, wealth is not used in the way you're referring to.

The rest of your point above appears to consist of accusing me of foisting a point of view or bashing a particular country. As a general point, that's not worth responding to, although I will note that you seem to insist on pushing points of view like definitions of socialism, etc., that appear to correspond only to your own conception thereof.

If you think I am breaking "the rules", by all means complain or start a formal process rather than just maligning me.--Gregalton (talk) 09:39, 9 February 2008 (UTC)

As I understand WP's core policies, the cited statement meets them. I can find no distinction made in the core policies between how WP edtors should handle "normative" claims and factual ones. Is there one? To dilute the statement as Freedomwarrior wishes to do, he is welcome to add a cited statement from a reliable source that counters it. But adding weasel words to dilute the cited statement based on an editor's individual and unique evaluation of the validity of the statement seems to me to violate WP:OR --Sfmammamia (talk) 17:47, 9 February 2008 (UTC)

• "particularly since you are not disputing the fact that you are simply trying to bully your opinion onto this and other articles"
• "However, if you insist on foisting your particular opinion on readers, then you are engaging in a violation of the rules."
• "They do not justify your efforts to transform this article into a US bashing session."

You might want to see Wikipedia:Assume good faith

• "I have so far refused to play the little game of finding citations, because I've thought it contemptible to have to do such a thing"
• "Very simply, there is no reason why your opinion should get to trump mine."
• "I am not going to argue about which of the different possible tests for determining whether a country is "wealthy" and "industrialized" is best, because 1) I don't have the time to do so and 2) I don't need to."

You might want to see Wikipedia:Verifiability specifically where it says "The threshold for inclusion in Wikipedia is verifiability, not truth." on the top of the page. You should also see WP:Undue.

--Jorfer (talk) 17:52, 9 February 2008 (UTC)

Let's try this Sfmammamia: WP:ASF. According to wikipedia rules, "Assert facts, including facts about opinions—but do not assert the opinions themselves." Therefore, [[User:Sfmammamia|Sfmammamia], Wikpiedia does have a rule against including normative statements (i.e. opinions) as factual statements, because such comments tend to amount to nothing more than blatant POV pushing (as is the case with the comment in dispute). Sfmammamia, there's a reason that editors are not allowed to list their own particular opinions as facts, as Gregalton insists. For instance, (this may sound familiar since it's what Gregalton is doing) I could go to any number of websites that share my own particular bias and just find links with whatever biased claim I want to insert, and foist it on editors. Ultimately, the article would become nothing more than a blog on behalf of a certain position (which is what some editors seem to insist on). If you are allowed to pass of your normative claims as fact, you have no justification for excluding me from including something as fact provided I have a source that makes the same claim (no matter how inane it happens to be). I could even include things like, "the proletarian revolution is inevitable" in the article on communism (since Marx makes that claim). See the problem? A source that reflects a normative opinion cannot transform that opinion into facts (or else, you're going to have a massive edit war on your hands when other editors decide to turn their opinions into facts).

Sfmammamia, I provided a source at the top of the thread, which undermines Gregalton's claim to having some form of an absolute standard for. I do not have an on-line version (since it's a treatist on WTO law), however, I can provide page number, etc. if you insist on it. If there is an absolute standard Gregalton, you've demurred on demonstrating it; therefore, I would invite you to either "enlighten" me or refrain from wasting my time with your silly claims about non-existent "objective" standards. The claim must be modified to demonstrate that it is not a factual (positive claim) but rather a normative claim (an opinion). Failure to do so means that this article is violating wikipedia rules.

By the way, Gregalton, unless you have a Masters or a PhD in the relevant field you should be a bit more modest and stop making enormous categorical claims about what is and isn't said in a field...Freedomwarrior (talk) 18:18, 9 February 2008 (UTC) a The term industrialized is recognized as a mostly objective term with subjectivity only really near the cutoff mark due to the lack of numerical guidelines, but there are recognized taxonomical guidelines (some of which I outlined above) that all indicate China and India do not fall into this category. A limited amount of subjectivity does not make a term subjective. You may want to look at the article Developed country. You will notice that there is a high level of consistency among the lists. You will see that by any standard China and India are not industrialized countries.--Jorfer (talk) 18:47, 9 February 2008 (UTC)

Freedomwarrior, I do not see the source you say you provided at the top of the thread, perhaps it has been buried in the lengthy discussion? If you'd like to quote it here and provide cite information, perhaps that would be a valuable contribution to the discussion. With regard to WP:ASF, perhaps a compromise would be to attribute the statement to the source, such as: According to the Institute of Medicine of the National Academies of Science, the U.S. is the only wealthy, industrialized nation that does not provide universal health care. I'd have no objection to that change. Would that satisfy your concern? Also, with regard to the top part of your post, you seem to misunderstand the definition of reliable sources. Let's see, the policy says "reliable, third-party published sources with a reputation for fact-checking and accuracy." I would say that the Institute of Medicine meets that standard. As you put it, going to "any number of websites that share my own particular bias and just find links with whatever biased claim I want to insert" does not appear to meet the same standard.--Sfmammamia (talk) 18:50, 9 February 2008 (UTC)

Jorfer, I have to laugh at your claim that "A limited amount of subjectivity does not make a term subjective." What does it make it then? Objective? That most editors are consistent in their opinions here and elsewhere reflects their willingness to accept opinions on the basis of authority, it does not reflect a set of objective facts. If a statement is subjective, as the one that you are defending, I don't understand why there is such strong opposition to reflecting the fact that it is the opinion of a group of like-minded individuals. Can someone please explain this to me? Are you scared that readers will suddenly realize that it's just a cheap shot at the US?

In describing the WTO process for determining whether a country is "developed" or "not developed," Peter Van de Bossche says that countries are left to determine in what categories their level of development puts them in (this is in the 2005 version of his case book on The Law and Policy of the World Trade Organization, the exact text is found at page 101). The determination is based on a subjective self-assessment on the part of the state. Very simply, the organization has recognized what I've been arguing: there is no objective means for categorizing a country into any of these groups. These are all subjective valuations, which vary from group-to-group and academic-to-academic.

Having said that, I have not objection to the change that you are proposing Sfmammamia, since it would reflect that it is a claim being made by the Institute of Medicine of the National Academies of Science and not an objective pronouncement.Freedomwarrior (talk) 19:13, 9 February 2008 (UTC)

Done. --Sfmammamia (talk) 19:18, 9 February 2008 (UTC)

And this is what the Dutch health minstry video says about the role of the "market referee" in the Dutch system

Martin van Rijn: lf you want people to have more responsibility and more choice to get better care, and not have a top-down decision-making process you need two very important rules. One is: guarantee good quality care. The Health lnspection ensures that quality is guaranteed in the Netherlands. And you need a market referee who ensures that negotiations between insurers and care providers are honest. To avoid creating monopolies and power blocks.

And this from http://www.europeanvoice.com/downloads/NL_New_Health_Insurance_System.pdf about the insurance regulator and the Netherlands Care Authority...

Registration with the Supervisory Board for Health Care Insurance (CTZ) Health care insurance companies must additionally be registered with the CTZ to allow supervision of the services they provide under the Health Insurance Act and to qualify for payments from the equalisation fund.

The choice for private insurance that assigns greater responsibilities to insurers who are allowed to make a profit makes it inappropriate for the government to supervise the effectiveness of the way health insurance is operated. Therefore, the main objective in overseeing lawful performance of the new-style health insurance is for the government to ascertain whether the care insurer is fulfilling its obligation to provided insured persons with the services to which they are entitled under the Health Insurance Act. The regulator that exercises this supervision, the Supervisory Board for Health Care Insurance, CTZ, has various duties and powers under which it:

• reports to the minister on whether the Health Insurance Act is being carried out in accordance

with the law;

• reports on the practicability, effectiveness and efficiency of proposed policy concerning

performance of its regulatory role;

• investigates care insurers at the request of the Health Care Insurance Board;
• has a possibility to impose rules for audits by care insurers and for the content and structure of auditors’ reports.

Tasks of the Netherlands Care Authority The Netherlands Care Authority exists to: · regulate the markets for providing, insuring and procuring care. This task extends to making and monitoring markets as well as regulating them. The authority regulates tariffs and services. It also promotes the transparency of markets and the availability of information about choices available to consumers; · oversee lawful implementation by care insurers of the provisions of the Health Insurance Act, including the care and acceptance obligations and the prohibition of premium differentiations; · oversee lawful and effective performance of the provisions of the Exceptional Medical Expenses Act by care insurers, care offices and the central office that administers the Exceptional Medical Expenses Act.

Principal new powers of the authority

The most important new power held by the Netherlands Care Authority is to impose specific obligations on parties with significant market power. It has been given the power to do this in order to cultivate the care procurement market in fields where free pricing exists. The authority further has powers to lay down general rules for care providers and care insurers to increase the transparency of the market for consumers. The authority will also be given the power to publish transparency information if care providers and care insurers fail to do so.

Essentially it is all about transparency.--Tom (talk) 19:49, 9 February 2008 (UTC)

"That most editors are consistent in their opinions here and elsewhere reflects their willingness to accept opinions on the basis of authority, it does not reflect a set of objective facts."

It is not most editors being consistent with their opinions. It is all government agencies being consistent with their opinions if you actually took a look at the article on developed countries which I am assuming you haven't due to your response.

"I don't understand why there is such strong opposition to reflecting the fact that it is the opinion of a group of like-minded individuals. Can someone please explain this to me? Are you scared that readers will suddenly realize that it's just a cheap shot at the US?"

No, it is not a cheap shot at the United States. It is realistic assesment that the United States is the only country without universal health care among similar countries. The opposition is because your edit the article reflects a level of uncertainty about what constitutes an industrialized country where virtually non exists which fails WP:Undue.

"Very simply, the organization has recognized what I've been arguing: there is no objective means for categorizing a country into any of these groups. These are all subjective valuations, which vary from group-to-group and academic-to-academic."

It would be very easy to say this, but this could represent an unwillingness on the behalf the WTO to put into place a set of objective rules. The process also likely reflects the danger involved in making a conclusion on this due to its complexity; if they created a standard it would likely be incomplete and they would rather avoid that entirely, but that does not mean that there is a lack of an objective definition. It could easily be due to individual governments access to information, which the WTO does not have access to. Your source therefore does not necessarily indicate your position. There are always difficult to classify objects in taxonomical systems, but taxonomy is generally objective. The classification of organisms into familia, genus, and species is much more subjective than what constitutes a developed country, but the classifications are well established where there is only on classification per organism. If you attempted to name it something else no one would recognize your name for it. Likewise, despite some subjectivity be involved, there are countries that are classified as industrialized and countries classified as un-industrialized.--Jorfer (talk) 19:50, 9 February 2008 (UTC)

This debate about the meaning of “industrialized" and "wealthy" is pointless and off-the-mark for this topic.

What people mean--and what is said in most quarters--is a reference to the OECD nations, often referred to as the “Western democracies” and also "industrialized democracies." The point is that the reference is to the OECD nations, all (most? to avoid that debate) of which meet the standard of industrial and wealthy. Referring to the OECD nations is an objective standard. Though there are now some OECD nations that aren’t considered under the traditional "Western Democracy" label. I'll --or some else can--try to work out appropriate language, which would include the link to OECD's page, but I think everyone is referring to the same thing--including most readers who generally understand the given labels--OECD exempted. I see “wealthy" and 'industrialized" as more subjective and less normative, but this topic isn't the place to get into those debates. JackWikiSTP (talk) 17:34, 12 May 2008 (UTC)

How to expand the "Debate" section

I have added examples to the debate section numerous times. They have been sourced. The sources are reputable sources (not just CATO-like think tanks.) They complied with NPOV. They were relevant to the topic at hand. They did not erase any other entries on the article. They have been removed shortly after (ie less than 5 minutes.) Why are they being removed? I know I am supposed to assume good faith, but the fact that they are consistently removed from the "con" side of the argument makes me wonder if not everyone is willing to have this article contain all relevant information. —Preceding unsigned comment added by 141.214.17.17 (talk) 00:41, 29 April 2008 (UTC)

Your most recent additions did not cite any sources. You are welcome to add them back when you have sources to cite for them. Please read WP:V and WP:CITE if you are unfamiliar with how to cite your sources.--Sfmammamia (talk) 01:41, 29 April 2008 (UTC)

My last edits, yes. In fact, I put those in as a test just to see how long they would survive (about 2 minutes.) However, my additions earlier that WERE sourced have also been deleted, each time I put them in, as I said in my original point. I want to know how to get them added in without them being deleted 2 minutes later. —Preceding unsigned comment added by 141.214.17.17 (talk) 06:36, 11 May 2008 (UTC)

Please cite the specific diffs where you added reliably sourced material that was removed, and perhaps we can address and discuss your question. ----Sfmammamia (talk) 18:51, 11 May 2008 (UTC)

Proposed merge

I am proposing that the article Socialized medicine be merged into Universal health care. I see these two articles as being broadly about the exact same issue, where socialized medicine only focuses on the more negative political connotations in the American political landscape. However, Wikipedia is not US-centric. Rather, it should represent a worldwide view of the subject. The purpose of providing the reader with the most accurate, verifiable, and neutral exposition of health care programs is not best achieved by the division of this subject into two separate articles. ⟳ausa کui ^× 02:55, 6 May 2008 (UTC)

Oppose: the term itself is US-specific, and should remain documented as a political term. Likewise, universal health care is a political term in the US, and mostly non-controversial elsewhere. The subject of this article should remain universal health care; the subject of socialized medicine should be the use of the term and its political connotations (esp pejorative); most of the "analysis" content in the socialized medicine article could be moved/integrated with this, publicly-funded health care, or health care economics, etc.

So I agree there should be some rejigging, but there is no way the socialized medicine article can be removed - it will get searched for. It should be cut down tremendously, however, with links to other appropriate articles.--Gregalton (talk) 05:04, 6 May 2008 (UTC)

Oppose. One can have universal health care without full-blown public funding or public provision of health services (which is what socialized medicine refers to). UHC is a broad concept with many ways of achieving it or aiming to achieve it. Socialized medicine is a politicized term used only in the U.S. whereas UHC is mostly an internationally used term with no particular political bias (at least not outside the U.S.) I agree with Gregalton that people will search for socialized medicine and it would be wholly inappropriate for people to believe that that this equates in any way to UHC. --Tom (talk) 09:05, 6 May 2008 (UTC)

Oppose. User: Ryan Delaney argues that a WP article shouldn't deal with an American issue, but should be merged with an international article. That doesn't make any sense. Lots of WP articles are national articles -- U.S. health care, U.K. health care, etc. By that logic, we should merge all our national health care articles into one big health care article.

Health care is too complicated. The articles tend to be, if anything, awkwardly long. It has to be broken into separate topics. Socialized medicine is a distinct, separate topic, and it's complicated enough to require its own treatment.

Furthermore, as editors above point out, socialized medicine is not the same as universal health care. Many national systems, such as Switzerland, Japan, and Canada are universal but not socialist.

User: Ryan Delaney hasn't been working on this article. Among those of us who have been, there is consensus not to change.

But thanks for bringing up a provocative idea. Nbauman (talk) 15:31, 6 May 2008 (UTC)

Oppose. Issues of length and focus as raised by other editors above. --Sfmammamia (talk) 17:55, 6 May 2008 (UTC)

Weak support. There are too many articles about the same topic (POV forking). Not 100% sure universal health care is the best name for this topic. --Doopdoop (talk) 21:31, 10 May 2008 (UTC)

Oppose. For purposes of this debate and future debates about the various labels to define central concepts, I want to add some commentary; also to address the comment directly above by Doopdoop.

The traditional meaning of Socialism as practice and ideology--based on Marx's definition--is when the means of production (land, labor, capital) are in public hands. (There are other definitions of socialism dating back to the 19th century, but the means of production issue is always key). A component of that is public funding. However, I want to point out to an above comment, mere public funding does not constitute being "socialist" (to refer to a specific sector rather than an overall system or philosophy) when it is not accompanied by public ownership of the means of production. Were the “socialist" label to be applied as a definition to any publicly-funded activity, then the entirety of government spending would be defined as socialist. While some (e.g. some libertarians) might hold that position, it is only an infinitesimal number in the US--or elsewhere in the West. The public provision of health care services--with publicly owned facilities--is the mark of “socialist,” e.g. Britain, though they do have some private services and spending. No Western nation has either 100% private or public funding.

More generally, "universal" refers to access, not to an economic model, e.g. socialist, capitalist. The access and economic model concepts are distinct, as previously noted. Hence, discussing "universal" as a separate topic is appropriate. I think the major details of other nations is too much baggage and takes up too much real estate to the detriment of clarity on the "universal" concept; the level of emphasis on practices diminishes the value of explicating the concept. —Preceding unsigned comment added by JackWikiSTP (talk • contribs) 18:12, 12 May 2008 (UTC)

Are the US-Specific External Links Really Needed Anymore

The US specific external links were recently deleted, and then that deletion was reverted. I'd like to suggest that they should go. Two arguments were put forward for keeping them: 1) that the US is part of the world, and 2) that they lead to useful information. Both of these comments are absolutely true. but the section of this article on the US links to the more detailed article on Health care reform in the United States, which would seem a much more appropriate place for links dealing specifically with the debate in the US. Moving a lot of the US-specific clutter out of the more general world articles on health care, health reform and heal care systems was one of the primary motivations for creating that article in the first place. Segregating them there still allows people to find the information, while making articles like this one less US-centric. EastTN (talk) 13:55, 11 June 2008 (UTC)

I will answer this and the charge of being too U.S.-centric. Remember, I agree that there are too many unimportant links -- I objected to the wholesale deletion. We should delete the links selectively, and leave in the best ones, but that's a lot more work than arbitrary wholesale deletion.

It does seem as if the external links are a result of a linking war between the free market advocates and their adversaries. Again, we should delete them selectively and leave just the best ones.

As to U.S.-centric -- I agree that the links are too U.S.-centric. The solution to that is to trim the unimportant links and add European and other non-U.S. links. I'd like to see some of the international reports on their own health care systems.

But the U.S. is one legitimate topic of many. If you had an article on structural steel engineering, would you delete the Eiffel Tower on the grounds that it was too Franco-centric and belonged in the section on France?

The entire article shouldn't be focused on the U.S. system and its debates, but a significant portion should be. The U.S. is an important health system, and the lack of universal coverage is egregious.

The debate over universal health care is much more timely in the U.S. because of the lack of universal care, and the ongoing policy debate. In the U.S., there is a whole industry devoted to advocating the advantages of privatizing health care, and they are trying to export their ideas worldwide, so European and Canadian doctors are understandably concerned about whether it works as well as its promoters claim.

So there is disproportionately more available data, and more peer-reviewed articles, on the U.S. situation. There are many articles in U.K medical journals comparing the U.S. system to the U.K. system. So even a legitimate article on universal health care worldwide is going to be weighted towards the U.S. situation, because that's where the loudest debate is. The solution is to expand the other countries.

Second, linking to Health care reform in the United States. The external links list in that entry is just as bad and should also be trimmed. But the question is, what external links should we have in this article? I think we do need a few useful external links here, about the U.S. system and other systems.

I'm not passionate enough about it to get into a revert war, and I agree it could use some deletions, but I don't think it needs wholesale deletions. Nbauman (talk) 18:05, 11 June 2008 (UTC)

I don't want to get into a war over it either, and I'm not all that exercised about any particular link. I have been concerned about the overall relationship between the various articles on health care systems, health care financing and health care reform. They seem redundant and confusing, and ideological battles seem to get played out across multiple articles in a way that probably doesn't benefit the typical reader. It would be good if we could have one article that dealt with the US debate, and could keep it from spilling out across all the various global articles.

I don't actually think this article is all that US-centric any more. A lot of non-US material has been added. The two exceptions seem to be the "Politics" section, which is almost all US-material, and the "External links" section.

I do agree that we need a section discussing the US, and the Structural Engineering/Eiffel Tower analogy may be a good way to discuss this. An article on structural engineering probably should reference the Eiffel Tower, among other structures. It might even have a couple of paragraphs on it, but you'd expect it to link to a specific article on the Eiffel Tower that would have a lot more detail. (Actually, as it turns out, Structural engineering doesn't mention it, but History of structural engineering does. The reference is pretty brief, and it links to an extensive article on the Eiffel Tower.)

That seems to me a good model for this article. Under "Implementation" we have a section on "Americas" with a section on "United States. That section is six paragraphs long - roughly comparable to some of the more substantial sections for other countries - and includes both a sidebar template and "see also" links to the articles on Health care in the United States and Health care reform in the United States. It doesn't seem to me that the US is at all de-emphasized here.

You're right that we need to do some link pruning in all of these articles. Coming to agreement on which links are "best" may be difficult - there are serious philosophical disagreements between free-market advocates and advocates of more collective solutions. I'm a bit uncomfortable grouping links by "support," "oppose," and "neutral." I understand the motivation - it helps readers understand what they're linking to - but it almost seems to beg for a linking war by encouraging people to get more links on "their" side.

Again, this isn't worth fighting about, but I would encourage you to think about the benefits of moving the US political stuff out of this article. The debate in the United States section, for instance - we could might be able to reduce some of the edit wars here by cutting it down to a couple of paragraphs that say there's an ongoing, vigorous political debate in the US and that it centers around issues such as whether health care is a right and whether the free market or government is a better mechanism for providing health care - and then link to a US-centric article that has the whole ball of wax. EastTN (talk) 20:58, 11 June 2008 (UTC)

Image copyright problem with Image:Medicare-brand.png

The image Image:Medicare-brand.png is used in this article under a claim of fair use, but it does not have an adequate explanation for why it meets the requirements for such images when used here. In particular, for each page the image is used on, it must have an explanation linking to that page which explains why it needs to be used on that page. Please check

• That there is a non-free use rationale on the image's description page for the use in this article.
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This is an automated notice by FairuseBot. For assistance on the image use policy, see Wikipedia:Media copyright questions. --04:27, 20 September 2008 (UTC)

this article is censored

http://www.businessweek.com/magazine/content/07_28/b4042072.htm Removing this is blatant censorship and bias at it's worst.YVNP (talk) 20:27, 8 October 2008 (UTC)

Unconstitutional

Second paragraph: "Universal health care systems require government involvement, typically in the forms of enacting legislation, mandates and regulation."

Shouldn't it be pointed out that the United States Constitution does not grant the Federal Government the authority, or the power, to regulate, mandate or legislate this issue. A Constitutional Amendment would be required before enacting Universal Health Care in the United States. —Preceding unsigned comment added by 134.205.71.86 (talk) 15:34, 17 October 2008 (UTC)

Given the US federal government's already heavy involvement in health care, the assertion that a constitutional amendment would be required to enact universal health care in the US is dubious. A reliable source would need to be cited for such an assertion to be added to the article. --Sfmammamia (talk) 01:00, 18 October 2008 (UTC)

The Constitution is an extremely vague document in parts which is why strict constructionist ideology is not widely accepted anymore. The enumerated powers in the United States Constitution which can be found here give Congress the authority to "...provide for the common Defence and general Welfare of the United States...". It thus boils down to whether you feel Universal Health Care supports the general welfare whether it is constitutional or not.--Jorfer (talk) 03:26, 18 October 2008 (UTC)

Also, the Ninth Amendment to the United States Constitution is extremely vague. It thus can be used to argue for federal protection of anything perceived as a right. This argument succeeded in Roe v. Wade with the "right to privacy" being argued in favor of abortion. Thus if health care can be argued to be a right (as many believe), it would have further protection from being declared unconstitutional.--Jorfer (talk) 03:52, 18 October 2008 (UTC)

That is original research. Unless someone who we can trust gave that arguement it is irrevalentYVNP (talk) 06:56, 22 October 2008 (UTC)

Well, more likely that not, there is some strict constructionist scholar out there that can be sourced (i.e. A Cato institute publication), but if the anonymous IP could find one, it would still fail WP:UNDUE.--Jorfer (talk) 13:11, 22 October 2008 (UTC)

Renaming Universal health care to Socialized health care

User: Matamoros moved "Universal health care" to "Socialized health care" without any discussion in Talk that I can find -- in fact, Matamoros hasn't done anything else on this article or discussed anything in Talk.

We had a long discussion about a proposal that Socialized medicine be merged into Universal health care, and the consensus was against it, because we decided that socialized health care was not the same as universal health care.

I think it is incorrect to rename this article to "Socialized health care" because there are many universal health care systems that are not socialist. I think the change should be reversed.

What is Matamoros' reason for changing it? What do others think? Nbauman (talk) 17:27, 13 June 2008 (UTC)

I am undoing it. Too much confusion with Socialized Medicine. Socialised health care should redirect to that article, which is what I will be doing momentarily. --Sfmammamia (talk) 17:31, 13 June 2008 (UTC)

Definitely the correct move. As far as I (British) can tell, the use of "socialised" in this context is primarily an American thing. It's very, very rare indeed for us to refer to the National Health Service as "socialised health care" or the like unless an American has previously introduced the term. 86.136.250.154 (talk) 00:06, 24 September 2008 (UTC)

A rose by any other name... Rjljr2 (talk) 16:55, 29 October 2008 (UTC)

Vandalism

Why would someone replace this whole article with the word "penis"? Dumaka (talk) 17:17, 20 November 2008 (UTC)

Prescriptions / U.K.

The article states "All treatment is free with the exception of charges for prescriptions". This is correct but may not be completely clear. What this means in affect is that, irrespective of the cost of the drug needed, the dosage (or, for example, the number of pills dispensed), the cost of the prescription is the same. —Preceding unsigned comment added by 86.143.70.28 (talk) 10:07, 5 January 2009 (UTC)

The statement is accurate, we dont need to get into huge detail about the UKs health care system on this article, especially as Scotland, Wales, NI and England have different policies on this. BritishWatcher (talk) 10:11, 5 January 2009 (UTC)

Image of Hospital in Scotland

here's some images of an NHS hospitals in Scotland that could be used (New Beatson, Glasgow):

http://www.hbs.org.uk/hospitals/pictures/Beatson%20-%20new.jpg

http://www.nhsgg.org.uk/content/mediaassets/locations/beatson300.jpg —Preceding unsigned comment added by Alpha-ZX (talk • contribs) 20:35, 19 January 2009 (UTC)

Why is this article a map of the world?

Read the article on the police. Is this article about how the police are 'implemented' in every country in the world and which countries don't have police? I'm no expert on state run/mandated healthcare, but I'd love to know about the different types of implementation, history of implementation, a link to an article 'arguements for state healthcare' and 'arguements against state healthcare'. But 3/4'th's of this article is dedicated to a checklist of countries. Another big chunk is dedicated to the argument around implementation of universal health care in the united states.

Though the templates are a step forward! If we could only get more encyclopedic content in there.--70.143.64.199 (talk) 06:30, 29 January 2009 (UTC)

Blocking request for User:LincolnSt

Editors may wish to be aware that I have today placed a blocking request on User:LincolnStfor perisitently vilolating the spirit of editorial co-operation, for demonstrating bias in his edits, for depleting the usefulness of WP articles on health care to its readers and for making changes so rapidly that they seem to be planned aforethought and dumped on the editing community. See http://en.wikipedia.org/wiki/Wikipedia:Administrators%27_noticeboard/Incidents#Blocking_request__User:LincolnSt for examples and to express your thoughts if you have any.--Hauskalainen (talk) 08:32, 29 January 2009 (UTC)

Strong Bias in the United States Section

Someone obviously vandalized this site. Under US section, vulgar words have been inserted. Unsure of how to fix, but seeing this adds to the notion that this site is too biased to use as a reference source. —Preceding unsigned comment added by 71.115.57.83 (talk) 17:27, 18 February 2009 (UTC)

In the section on the United States, there is strong Bias towards a pro- Universal Healthcare. The article is practically glorifying it. I dispute the neutrality of this section. Statistics for the other side are provided but not for the negative side. And the cons of the pro-con section are the most general arguments I have heard against universal health care, not to mention the number of pros out weigh the cons. 69.145.140.178 (talk) 05:33, 30 May 2008 (UTC)

That's fine. Why don't you pull up some statistics that defend the notion that privatized health care, as it exists in the U.S. right now, is more efficient than universal healthcare as applied in Sweden, or France? I wish you luck finding them. Let the Republicans rant and rave about the inefficiency of European health care; there are no facts to back them up, as those of us with experience in both systems can tell you. 147.9.177.90 (talk) 06:28, 6 September 2008 (UTC)

Straw man. Health care in the US right now sucks (IMHO), but it is not "privatized health care". It is very much a 'mixed system' (~ 45% public!), and suffers from that mixture. What is needed is a totally free (as in free speech) system. Where can those wishing to make these kinds of arguments add them? Where can one talk about how the current crippled insane employer linked system evolved? Rjljr2 (talk) 16:54, 29 October 2008 (UTC)

The purpose of this article is not to provide a forum for "those wishing to make these kinds of arguments". There are several other articles in Wikipedia specific to the US health care system. You may want to have a look at Health care in the United States and Health care reform in the United States. If you have other reliable sources to contribute there, please feel free to make bold edits or add to the discussions on their related talk pages about how to handle the US-specific debate in a neutral way in keeping with Wikipedia's core policies on reliable sourcing and no original research.--Sfmammamia (talk) 22:14, 29 October 2008 (UTC)

Point taken and understood... I am glad my initial reaction was to post here in the talk thread:) Nevertheless, the article as is seems to lack references to stronger criticism of "Universal Health Care". If I find time I will try to add something (in accordance with the core policies, i.e. not debate). Rjljr2 (talk) 13:11, 30 October 2008 (UTC)

I agree with what Sfmammamia says. The article should be confined to factual information rather that claims made by proponents or opponents which often cannot be demonstrated to be true one way or the other. Otherwise you get claims and counter claims and their respective supporting information, which may give food for thought but makes the article somewhat longer and therefore tedious to read.--Tom (talk) 19:28, 31 October 2008 (UTC)

The argument is certainly made in this article for universal health care in the US, most blatantly in the section where it is mentioned that "conservatives can support this because..." then mentions the lower cost spent per person by the government. People disregard the facts that American private health care dollars fund the lion's share of the R&D in the world health care system, and that American companies that shelter income in European countries for a lower tax burden provide much of the funding for health care overseas. I'm not against the idea, but I think if you want to make an argument on a page like this, you need to present legitimate arguments, not impassioned rants. My vote is for removing the "pro-con" approach to the writing and just present facts. Bradbutler01 (talk) 13:55, 29 January 2009 (UTC)

History of universal health care

Bismarck's "Sozialgetzgebung" created universial health care in Germany in 1883. So the NHS part is revisionist crap. —Preceding unsigned comment added by 89.246.223.47 (talk) 10:49, 1 March 2009 (UTC)

Hauskalainen, you have not argued anything in the talk page. An editor associated with you, Cosmic Cowboy (talk · contribs), has already received last warning from administrators.LincolnSt (talk) 11:55, 29 January 2009 (UTC)

European Union

http://fadelibrary.wordpress.com/2009/02/24/healthcare-across-eu-borders-a-safe-framework/ http://www.publications.parliament.uk/pa/ld200809/ldselect/ldeucom/30/3004.htm http://news.bbc.co.uk/1/hi/world/europe/7484198.stm

Please add a chapter called European Union, this is very important, this will totally change the concept of Universal Health Care in the European Union countries.

• • • • • The initiative follows a series of judgements in the European Court of Justice which established the right of European citizens to seek treatment abroad if they are entitled to it in their own country but have suffered an unreasonable delay.

http://www.independent.co.uk/news/world/europe/the-international-health-service-plan-to-give-british-patients-the-right-to-treatment-abroad-414809.html ********

Please say it in the way you want, but basically, if you are a European you can go any country you want in the European Union and use the health care system of the other country, your government has to pay the bill. All the information is on the website. Lets say that I am Italian and the hospital in my region do not provide the care I need, I can fly to France or Spain get the help I need there and pay 0 zero cero, THE iTALIAN GOVERMENT HAS TO SEND THE CHECK TO THE SPANISH GOVERNMENT. This was a rule by the European Court of Justice, —Preceding unsigned comment added by 70.179.104.87 (talk) 23:23, 2 March 2009 (UTC)

Lacking info on Universal Health Care in Taiwan

It is a known fact that Universal Health Care is implemented in Taiwan. This article lacks information relating to such. http://www.nhi.gov.tw/english/index.asp

—Preceding unsigned comment added by 163.15.178.13 (talk) 10:52, 5 March 2009 (UTC) 

China

China to provide universal health care by 2020

http://www.google.com/hostednews/ap/article/ALeqM5iZ2J6GxXq5H15q6GophdmYSPrCPQD97CVB0O1 —Preceding unsigned comment added by 70.179.104.87 (talk) 20:38, 18 April 2009 (UTC)

Peru

Could you guys please write an article regarding this issue:

In Peru the Universal health Care access become a right, the government will merge the 3 Peruvian health institutions(military, Social Security and Emergency for the poor(kinda medicaid)). Peru will be the 4th real Universal Health Care provider in the Americas, after Canada, Brazil and Cuba. Just to let you guys know, Peru is pro Free trade and business, we have free trade with US, Canada, China, Japan, Australia, South Korea Chile, Indonesia , European Union, EFTA, and looking for one with Australia and Russia. So Peru is not what you will call a closed economy or socialist(US way of naming communists).

Law on Health Insurance published today http://www.andina.com.pe/Ingles/Noticia.aspx?id=mSOVQJu0hxY=

Law on Health Insurance marks major reform http://www.andina.com.pe/Ingles/Noticia.aspx?id=rsbFfAZYpMU=

I hope this information works, I am pro Universal health care provided by the US government modeling Canada's. Say bye bye to the greedy private providers. —Preceding unsigned comment added by 164.106.14.170 (talk) 16:57, 17 April 2009 (UTC)

More Concept Differentiation Needed between Nationalized Health Insurance versus Nationalized Health Care

Since conecepts of Universal Healthcare include such VASTLY different methodologies as:

1) Universal Health INSURANCE, where the medical system is basically privatized, but everyone in the country/region has health Insurance supervised by the national govt. (example: Canada)

2) Universal Health CARE, where most of the medical staff and facilities are government-run, with privatized services available within the government system if the government subcontracts to them, and where those desiring more specialized/luxurious services can still go through private doctors and facilities if they pay separately for them supplementally (example: England)

3) Other variations of the above where the goverment is involved in assuring that everyone has health insurance AND/OR healthcare services available to them fully or to to some degree via their government

4) Variations in inclusion or exclusion of prescriptions and how they are handled is also a major distinguishing issue

I would sincerely like to see a better introductory paragraph written to help people understand the MAJOR conceptual differences! It is very upsetting that the American public, especially, constantly equates Universal Health Insurance PROPOSALS as being the equivalent of Universal government-hired/run health CARE practitioners/facilities, simply because noone is pointing out THAT THESE ARE 2 ENTIRELY DIFFERENT CONCEPTS involved under the topic of Universal Healthcare!

Under nationalized health CARE, your physician works for the government, while under nationalized health INSURANCE, those who fall under that system are usually seeing doctors or going to hospitals that are still in the private business sector - it is their insurance policy that is nationalized.

Could whoever is working on making this section a worthwhile reference for the public on this highly controversial topic - and someone who can write more knowledgably and briefly than myself (sorry about my wordiness) please itemize (as I did in the first paragraph) or in some other way highlight these distinctions, modifying the current first paragraph which presently just casually covers these MAJOR difference in a sort of run-on sentence that minimalizes the importance of recognizing the varying concepts involved in Nationalized Care versus Nationalized Insurance.

Thanks to all who've contributed so far with a goal of making this section useful to all. CentristViewpoint (talk) 02:18, 13 April 2009 (UTC)CentristViewpoint

But the paragraph quite rightly says that UHC is about ensuring everyone has access to their healthcare needs. This has nothing to do with the issues that you are mentioning. All people in Canada or England have access to health care regardless of their financial status. That is the important thing. The issue you seem to want to make seems to imply an assessment that health care provided by government is somehow different from that provided by doctors working for themselves or some privare corporation. That issue is described in some depth in the article socialized medicine. This article is about universality of access to medicine and not the effect of the profit motive in medicine. --Hauskalainen (talk) 07:53, 13 April 2009 (UTC)

Most countries that have UHC have a mix of public and private delivery. In Canada, many hospitals are publicly owned. In England, nearly all family doctors are in fact private business that bill the government in much the same way as they do in Canada. So even the understanding you have of what is and what is not in one category or the other is not exactly representative of reality. In Canada and England, doctors and patients together make medical decisions based on evidence and cost effectiveness. Doctors do not have to constantly refer to either an insurance company or the government to determine how to prevent or treat illness. The same rules apply to everyone and the rules are under democratic supervision. Its why politicians in the UK and Canada cannot be paid off by the health insurance industry or the pharmaceutical industry as they are in the United States. The loss of the profit motive and the focus on common sense is the big difference. The only major role of government in both systems is to come up with the money to fund the public health care system. If people want more than the universal public health care system can provide then they pay for it themselves (out of their own pocket) or bully the politicans to provide more for everyone (by raising taxes). It's simple. And it's fair. --Hauskalainen (talk) 08:34, 13 April 2009 (UTC)

I think those of you who are commenting are getting too much into the analysis of the usage of these systems - my point is that there should be some type of highlighting/education of the public via Wikipedia so that they EASILY learn from the article that, in fact, there is a MAJOR difference between nationalized health CARE versus nationalized health INSURANCE, and it is not REQUIRED that a government have nationalized health services at the same time if it has nationalized health insurance - example: Medicare is a nationalized INSURANCE plan where patients see doctors/hospitals in the private sector. I just think that since national health insurance (like Medicare) does NOT require one to also have government-run hospitals/physicians, READERS SHOULD BE HELPED TO UNDERSTAND THIS DISTINCTION - any analysis of whether or not either system works totally aside. CentristViewpoint (talk) 16:39, 14 April 2009 (UTC)CentristViewpoint

As someone who supports Universal Health Insurance yet is at least undecided about Universal Health Care, I would like to agree heartily with CentristViewpoint. well, first, I will agree with some others and say that YES, the philosophy behind the two is similar. Both programs assert that healthcare is a basic human right. So, you are right in that respect. But the execution is very different. To put it this way, Cuba is a country with Universal Health Care; that is, the government is entirely in charge of health care, which is indeed more typical of a heavily socialist/communist type of option. On the other hand, Universal Health Insurance is an option that basically fits any ideology to the right of communism and to the left of libertarianism. I think the difference is absolutely critical and should be delineated. Please, someone with the knowledge/time to do so, go ahead and inform us.

This article is about UHC which is different from UHI or socialized medicine though both may be routes to achieving UHC. On the issue of insurance, UHI does not really fit the libertarian view as I think libertarians would argue that they should have the right NOT to have health insurance if they don't want it. The opposing view is that a right to life can depend on the right to access to funding for that care (medical or otherwise) that could be very very expensive and the best way to guarantee that right is thru insurance. A child born without limbs for example will need care for the rest of its life. All forms of insurance are about pooling risk.

The argument then becomes what is the best form of insurance. The best pools are large ones where the risks of the high costs of the few are borne by the many. The largest possible pool for a given nation is the pool of the national population where everyone is IN. That is what UHI is.

The problem with sub-optimal sized pools (as in private insurance models) is that low risk people seek to be outside and high risk people seek to be inside making the risk sharing uneven. Worse still, if the insurance is not mutual, there is a further group to consider and that is the people seeking to profit from the managing of the insurance pools. This makes insurers try to keep healthy people in the pool and kick the unhealthy ones out. It is the behavior of the insurers in doing this which is totally against the whole concept of insurance (which is to pool risk by having everyone pay in when they are well so that if they get sick if and when they fall ill and can have access to funding regardless of how much they have paid in). This has led to the private health insurers finding themselves as the most despised element in America's health care system.

UHI avoids this whole problem of picking and choosing to gain the system (whether by the insured or the insurer) by ensuring through law that everyone is IN the scheme from the point of their conception until the day they die. The downside of a national insurance plan is that coverage is the same for everyone. The child of the gas station attendant gets the same access to care as the child of an investment banker or even the president. Some find that an attractive proposition and others may not. There is no right or wrong way and the best solution is for the people to use democratic action to determine how to proceed (whether by government activity as insurance pool manager or by regulating the insurance market or by some combination of the two). In the UK it is possible for the investment banker to buy better care if he is prepared to pay much more. But the investment banker cannot opt out of the national funding pool. This relieves the state of the cost of his expensive treatment even though it breaks the rule on equity of access. In fact though, fewer than one percent of people in the UK actively insure themselves in the private market though a higher number do also have private options thru their employer (about 6 or 7 per cent I believe). I hope that helps to explain it better.--Hauskalainen (talk) 08:31, 23 June 2009 (UTC)