Replace Private Insurance With Medicare For All / HealthChoice

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a while back we held a debate in which the resolution was the US healthcare system is terminally broken and guess what that resolution was actually defeated and yet the idea that the system is broken is certainly the presumption of another idea that more Americans are telling pollsters that they are now in favor of and that Democratic candidates for president are endorsing and promoting and that is the idea of a single-payer system where the government picks up the bill for

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everyone's health care coverage and private insurance more or less goes away at least for most people once seen as an outlier concept single-payer is definitely getting a rhetorical try out for this period in time and it's so controversial still that we think it has the makings of a debate so let's have it yes or no to this statement replace private insurance with Medicare for all I'm John Donvan I stand between two teams of two who are experts in this

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topic who have thought about it long and hard they will be arguing for this resolution and against the resolution which again is replace private insurance with Medicare for all as always our debate will go in three rounds and then our live audience here at the Cape Playhouse at Hunter College in New York City will choose the winner and as always if all goes well civil discourse will also win one more reminder to the audience if you haven't done it yet or just arrived please cast your pre debate vote IQ to us org forward slash vote is the URL you'll be prompted to cast a

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vote for the motion against the motion or to declare yourself undecided it's going to be the difference between the first and the second vote that determines our winner our resolution is replace private insurance with Medicare for all let's meet our debaters first a team arguing for the resolution please welcome dr. Adam Gaffney Adam welcome to intelligence squared us you are a pulmonary specialist you're the doctor on the stage at Harvard's Cambridge Health Alliance you're also president of physicians for a National

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Health Program Adam it's great to have you on the stage thanks so much thank you for having me and let's meet your partner please ladies and gentlemen welcome Joe Sandberg hi Joe you are a progressive entrepreneur you're co-founder of aspiration com you're also co-founder of the advocacy group working hero action you are one of the nation's top activists for the Earned Income Tax Credit which helps low-income families it's great to have you on the stage thanks so much thanks for having me

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and we have two debaters arguing against the resolution replace private insurance with Medicare for all please first welcome Nick Gillespie hi Nick welcome back you have debated with us twice before you're undefeated by the way so a lot at stake here for tonight for you tonight your editor at large have Reason magazine your co-author of the Declaration of Independance ent s how libertarian politics can fix what's wrong with America you're gonna extend that winning record tonight I you

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know it's no secret that I have a glass jaw John so we'll see I'll keep my guard up thanks for having me sure it's great to have you back and let's please welcome another returning debater ladies and gentlemen Sally pipes as I said Sally you're an IQ to us alum you are president and CEO of the Pacific Research Institute you're a prolific writer on health care including your column piping up for Forbes calm that comes from your name yes yeah I figured that out your forthcoming book is called false premise false promise the

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disastrous reality of Medicare for all Sally pipes welcome back to until the latest be here so ladies in lemon art our teams arguing for and against the resolution [Applause] so let's move on to the debate proper our debate goes in three rounds round one opening statements by each of the four debaters in turn the first to speak in support of the resolution replace private insurance with Medicare for all is president of the physicians for a National Health Program please ladies

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and gentlemen welcome for his opening statement Adam Gaffney thank you so let's be clear on one issue there is no debate the United States has the costliest health care system in the world and despite that we're Evenor Leath irty million people uninsured and many more with insurance that is so skimpy it's basically junk as an intensive care unit physician I have seen the harm that our

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system imposes on patients care delayed care for gone because of cost with catastrophic results these are the facts and we're here to discuss tonight how do we deal with them our side is going to argue that a single-payer improved Medicare for All system is not only the best way forward it is actually the only way if we are going to solve three of the gravest problems of the American

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healthcare system so what are those problems and how will single-payer solve them number one we have to cover everybody as I mentioned nearly 30 million people are uninsured in this country and that problem is getting worse now you may hear sometimes that it doesn't matter very much because hospitals can't turn you away if you show up so what's the big deal believe me it is a giant deal if you're uninsured and you go to the

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hospital and they're admitted you may accrue tens of thousands of dollars of medical debt bankrupting you but for the uninsured the cost of physician care is often too high the cost of prescription drugs are too high so what do the uninsured do they go without the care they need in the ICU I have seen patients with common conditions like diabetes like high blood pressure not get the care they need for years because they were uninsured and wind up with

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life-threatening complications into the intensive care unit I do not want to see that anymore and we don't have to it's a choice we make Medicare for all would solve that problem by covering everyone the day it is implemented everyone in no one out problem solved let's move on to problem number two we also have to improve coverage for everyone else now you're gonna hear from the other side tonight I think that Americans love their private health insurance they don't want to give it up

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but the reality is private health insurance is failing Americans from coast to coast and they know it insurance deductibles the amount of money you pay out of pocket before insurance kicks in or rising insurers greed keeps Americans from the health care they need and what is the consequence of those high deductibles people don't get care children with asthma don't get their inhalers failed seniors don't go to the physician and whine of potentially in the hospital and standing with complications of chronic

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illnesses a recent study found that women with high deductible healthcare plans which are becoming the new normal or very likely to put off diagnosis and treatment of their condition it means that people are using GoFundMe to raise money for their medical care even though they have health insurance so Medicare FERS all would solve these problems very quickly and very simply everyone would get a public insurance plan that would cover your healthcare needs without co-pays or deductibles does that sound

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like fantasy no it's how it works in many countries in Europe it's how it works in Canada we can do it here in the richest country in the world all right that brings me to the final goal controlling costs so you may hear from the other side tonight that while that all sounds good but how are we gonna pay for it well I'll tell you how we're gonna pay for it we're gonna pay for it because our current system is far more costly that it needs to be let me give one example private health insurance

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company take 12% of every premium dollar you give them in their overhead for their profits for their administration for their marketing in order to fight with doctors in order to fight with patients that is six-fold higher than traditional Medicare which only takes 2% for its overhead that is enormous waste meanwhile on the other side hospitals are employing armies of billers and coders to fight with the insurance companies we spend $80,000 per physician

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in this country just to cover the cost of their interactions with insurers that's fourfold higher than Canada so that waste time that physicians should be spending with their patients and a waste time that patients should be spending recovering from their illnesses we don't need to do it this way and the simple fact is that a Medicare for All system could save hundreds of billions of dollars in administrative waste money

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that could cover everyone we could use to cover everyone so in closing the profound suffering imposed by our ailing health care system deserves strong medicine there's a reason why a majority of Americans support Medicare for all there's a reason why so many physicians think this is the best reform both for themselves and for their patients it is the only reform that can actually deliver universal health care while delivering the cost savings to pay for

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it for all of those reasons I ask you tonight to vote YES on the motion that we replace private health insurance with an improved Medicare for All system for everyone in the country thank you thank you I'm Ghazni the resolution replaced private insurance with medicare for all here's our first speaker to argue against the resolution editor-at-large at Reason magazine Nicol sp hi thank you everyone and you know what I want to start with

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is I want to start with the things I think that we agree on all four of us on the stage I won't speak for John but I suspect he's in on this too which is that we want we want a country where people can pursue life liberty and happiness as they define it and we want a country where people who want health insurance and who have medical care that they get it that it's universal and accessible to all the question is how best do we get there and then let me lay out quickly the reasons why I'm against the idea of

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Medicare for all particularly the way that it's talked about by Bernie Sanders who is really the the impetus for this conversation and he talks about it as Medicare for all it means no premiums no co-pays no deductibles and no more time wasted arguing with profit-driven insurance companies does anybody yeah that all sounds great doesn't it okay now how exactly do we get there the what because we don't want we don't just want

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a system that is available for everybody we also want one that is constantly improving and innovating and one of the things that's interesting in Adams statements he didn't talk about improvements in health care he didn't talk about innovation he didn't talk about growing the ability of people to get more health care even as plainly we would be increasing the demand and what I want to talk about because Sally is the real expert on our side in terms of the details and the nitty-gritty of what the Canadian system is like which is the only pure single-payer plan out there in the planet and she's going to talk about

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the deficits that that produces but think about it in terms of general economics in terms of general general economic system markets deliver more stuff to more people in more ways than controlled systems then single then a single-payer system is going to do so the question is how do we deal with that it is true according to Gallup the most recent Gallup polls 80 percent of people in America say that the quality of their personal health care is

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excellent or good 70 percent say their cut health care coverage is excellent or good so most of us are happy with the system as it is so that means if you're arguing for Medicare at all you're telling 80 percent of Americans you guys you're all wet you're you're wrong about things one of the reasons for that is because in order to do Medicare for all and this is according to the proponents of the plan the cost is going to be between 3 trillion - for Chilean dollars a year in new taxes that the government

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will be raising that's that's double what the federal government already is raising in taxes so we're gonna be doubling taxes some of that will be offset because as private people we about 50 cents of every health care dollar is spent by the government about 50 cents by insurance companies employers and people like that so we're still looking at at least to two trillion dollars a year in new taxes that you're going to be paying the cost of health care for all is what has killed these plans in states like

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California New York which have seriously entertained it or in Bernie Sanders own home state of Vermont which actually passed a single-payer plan without talking about the cost that it was going to be the governor who was in favor of it when it came to be it turned out that they were gonna have to increase put in an eleven and a half percent payroll tax on top of everything and a nine percent increase in the state income tax they Scotch the system in a state that has fewer than a million people they decided they could not afford Medicare for all

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that's an object lesson Bernie Sanders home state now Medicare for all if you go back to this idea that you know supply and demand is not different when we're talking about medical care than it is say when we're talking about groceries we're about the production of books or movies or clothing when you increase the demand for something and you do not increase the supply you are going to get limited you know you're gonna get Waits you're going to get waiting list you're gonna get questioning by a bureaucrat not by what

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you can do there's no place outside of the system in order to go gets up because it's all been public it's all been made public finally and this is the other reason to be against Medicare for all it's gonna kill innovation in the healthcare field and everything that is good about healthcare is better now than it was 50 years ago because of innovation it's gonna stymie things in two ways first off do you really expect a centralized bureaucracy to decide okay this is a good cutting-edge way of

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treating illness we're gonna go ahead with that the government and bureaucrats in the government in particular when they have when you have no recourse outside of that system which is the whole point of Medicare for all there is no outside they're not going to be responsive their net could be forward-looking they're not going to be avant-garde when it comes to new types of health care the other thing and this goes to Bernie's idea about profit driven insurance companies how many of you work for a living and how many of you work for a wage you know talking

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about stuff is profit driven is just mere ideological can't if you take away a drug company if you take away a doctor's incentive to make money and to come up with new ways of doing things which is what will happen under Medicare for all because there will be strident price controls on all sorts of activities in the health care space you're going to hurt the ability to try new things and to make money from doing them there's nothing wrong with that so what can we do and this I'm going to have to give up my time here in a second

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what we can do is do things to make markets function more clearly ask yourself when is the last time like do you know how much your blood test cost you even out of pocket it's unclear the health care system will be fixed if we bring more market signals in so that things are working better and also we can subsidize people the twenty eight million people without insurance we can give them money to help them buy insurance on the private market and I'll stop there thank you very much for your

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time please vote against Medicare for all if you care about cost okay our about Kinnear stretch in there you've heard the first two opening statements and now on to the third debating for the resolution once again replaced private insurance with Medicare for all is aspiration coms co-founder Joe Sandberg thank you I grew up in poverty my mom raised me by herself and when I was a teenager we

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lost our home to foreclosure I saw my mom wake up in the middle of the night in cold sweats agonizing over how she was gonna help her parents in their final years get health care how she was gonna make sure my brother and I were able to go to the doctor and get the care we needed I saw her struggle working multiple jobs to pay for her private health insurance because she often worked as a freelancer the experience I had growing up and the

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experience my mom had raised me by herself doesn't make me unique in fact it puts me in common with almost 8 out of 10 Americans who live paycheck to paycheck this debate is much bigger than the question of single-payer health insurance this debate is about the number one reason that America has a poverty crisis poverty isn't what the statisticians have told us that if you live below some arbitrary mathematical

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line you're poor and if you earn $5,000 above that line you're middle-class poverty is whether you have the peace of mind that when your kid is sick you'll be able to take her or him to the doctor poverty is the 8 out of 10 Americans who live paycheck to paycheck when 8 out of 10 Americans live paycheck to paycheck we don't have the middle class we have a massive poverty crisis and it's a reflection of a changing economy where more and more people don't

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work for an employer but work in unstable unpredictable freelancing jobs you know of these jobs there what's called the gig economy for an economy where people work for one employer maybe employer-based health insurance was suitable but a lot of the arguments you're gonna hear tonight against Medicare for all our arguments that are outdated 25 years it's true that people used to be reasonably happy with their employer-based health

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insurance when they had employers but as we increasingly move into an economy where people are reliant on freelancing work the idea of employer-based health insurance seems antiquated and it is the number one way we can solve America's poverty crisis is by ensuring that no one is of want or worried for health care and the surest way we can do that is through a single-payer system that

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isn't motivated by profit you're gonna hear a lot of statistics tonight about innovation and the profit motive and how it'll stifle innovation if we don't have private health insurance but ultimately your vote has to be a question of what kind of society we want to live it do we want a society where the God we worship is that of efficiency and productivity and the profitability of a particular

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industry or do we want a society where we make sure that not everyone can pursue happiness but that everyone is happy we're not everyone has access to health care but has health care where people don't have the right to live they live instead of being too poor to die now I bring a unique perspective as an entrepreneur and a business person I operate in the private sector and let me tell you the current system is broken

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left right center upside down every which way to Sunday and it's not just broken for the 40 million people who don't have insurance and the 40 million people who are underinsured who are disproportionately women in people of color but it's also broken for entrepreneurs for employers and for workers and let me give you a couple of examples the United States is the only developed economy in the world whose businesses have to compete globally without government

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health insurance so where our companies are operating in a global marketplace against companies from Germany or Japan or England they're competing against companies that aren't responsible for health insurance and therefore can direct more private-sector dollars to real innovation that's productive inventing new products and research and development second of all think about the effect on entrepreneurs you know at the top level people think this is a golden era of entrepreneurship but it's actually untrue this is a golden era of people

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starting companies but they can't survive more than a couple of years and the biggest reason is those new companies are crippled by health insurance costs and third of all is let's talk about the gender and racial wealth gap the gender and racial wealth gap grows and grows with every passing decade and the reason primarily is that women and people of color lack the kind of collective bargaining power in our economy that they once had in an era of stronger unions but there's something else that suppresses the bargaining

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power of low-income workers imagine your hesitation to ask the person who controls whether your kid can go to the doctor for a raise aren't you going to think twice about going to that person and asking for more money knowing that if you pissed that person off he or she can control whether you take your kid to the doctor in conclusion as you hear us expound on the merits of single-payer health insurance and you hear statistics

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from this side and from our side remember that this is fundamentally about a question of we want a country where people make money off of those who die and don't have access or a country that prioritizes ensuring that no one is too poor to live Thank You Jo Sandberg our resolution again replaced private insurance with Medicare for all and here to make her opening statement against the resolution CEO and president of the Pacific Research Institute

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Sally pipes thank you Medicare for all is more popular today than ever senator Bernie Sanders 2019 bill has 14 co-sponsors congressman from Illinois Paul's single-payer bill has a hundred and eighteen co-sponsors 50% of Americans being polled today support the idea of Medicare for all but in spite of that I am confident that I can make the case against Medicare for all and but by

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the end of the evening that you will decide with Nick and myself that you should vote against the proposition support for Medicare for all resides on rests on several misconceptions the most important being met the idea of Medicare for all Medicare for all would simply enroll everyone in a government health insurance plan Medicare as we know it along with Medicaid would be eliminated private health insurance would be banned and 1 million people in the insurance

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industry would lose their jobs all Americans would be in a single-payer health care system the only thing that this program would borrow from the Medicare program is the payment structure and that's a problem doctors would be paid Medicare rates which are 40 percent below what they get paid for treating private patients private patients subsidize doctors for treating Medicare and Medicaid patients if we eliminate private insurance doctors and

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hospitals will lose significant amounts of income many doctors will decide they want to reduce the size of their practice they want to quit medicine or they want to go into another profession that will exacerbate our nation's doctors shortage already the American Association of medical colleges has predicted that by 2030 and America will have a doctor shortage of 120,000 doctors of course these are all hypotheticals so let's look at two

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countries that have Medicare for all or a version of Medicare for all systems after more than 70 years in operation the National Health Service the UK's socialized health system hasn't found a way to treat an unlimited stream of patients and with the limited resources they have in England today more than 4 million Brits are waiting for medical treatment some are waiting for an appointment with the with because of the dwindling number of doctors in the UK

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others are the victims of rationing they've been told they're not sick enough to get treatment they're not skinny enough to be treated for anorexia or they're not blind enough to have their cataracts removed recently the National Health Service said in a way to reduce waiting times they should conduct group appointments where one general practitioner we call primary care would see up to 15 patients with the same condition at the same time but even the UK allows private insurance that's not

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the case in Canada the country where I grew up encounter today there are over 1 million people on a waiting list waiting for a procedure or a treatment the cost of lost wages for these people who cannot work according to the Fraser Institute is 2.1 billion dollars Canadians are not facing short waits in 2018 the median wait time from seeing a primary care doc to getting treatment by a specialist was just under 20 weeks

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Canadian patients may face further waiting times doctors frequently prohibit patients when they book an appointment to discuss more than one to discuss only one issue if you need to talk a second or third issue you have to book a second or third appointment it's no wonder that Canadians 323,000 Canadians in 2017 left Canada and went abroad to seek treatment for conditions that they thought they needed care immediately there are countless stories

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my friend dr. Brian Day who runs the illegal Camby clinic in Vancouver Canada he's an orthopedic surgeon he says 60,000 surgeries a year at his clinic and the government of BC has been challenging him saying it's illegal and they wants the government wants to shut him down in Great Britain the stories are the same brett king and his wife their son needed cancer treatment he was age six they couldn't get it in the UK they said it wasn't worth it he went to Spain and had the

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treatment but he the couple the parents were sent to jail for taking their son abroad Mick Jagger The Rolling Stone frontman when he was diagnosed with needing a heart valve replacement he came to New York's Presbyterian Hospital and had the surgery when he was in recovery his younger brother in the UK said thank goodness that nick has not got to wait in line for the National Health Service Canadians and Brits pay a lot for the care that they wait the average it's not free Bernie Sanders will tell you

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single-payer health care is free the average Canadian family last year paid 13,000 330 dollars in hidden taxes for a health care system that rationed care and had long waits that it taxes that Americans would face under Medicare for all would undoubtedly be higher as Nick has said since it would cover everything under the Sun a dental vision long-term care drugs the Canadian system doesn't even cover those things long waits high

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costs poor outcomes this is a harsh reality for millions of people around the world who are living under versions of Medicare for all Americas largely private health insurance system does merit reform I grant you that but Medicare for all is not the solution I hope you will realize this and join me in voting against the motion thank you Thank You Sally pipes and that concludes round one of this intelligent square us debate where our resolution is replace private insurance with Medicare for all

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I want to move on to round two round two is where the debaters address one another directly and they take questions from me and also from you our live audience here at the Cape Playhouse in New York City our Lucian is replace private insurance with Medicare for all the team arguing for that resolution Adam Gaffney and Joe Sandberg have said yes Medicare for all indeed is strong medicine but they say it's the medicine that is needed now that we're in a country which is the richest in the world but also produces

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the costliest health care costs in the world yet with many millions of people still uncovered that Medicare for all is a way to make a system that would be universal that would eliminate the things that wear down people who are poor of meager means such as high deductibles and also that it would be a system that because of by unifying all of the operations under one payer would reduce a lot of the bureaucracy and the bloat which they say is a major problem

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in working with multiple insurance companies where administration they think goes into the hundreds of billions of dollars with eight out of ten Americans living paycheck to paycheck they also point out that going to you're looking to your job for your insurance is an outmoded idea we're not in that world anymore because the way that people work has also changed the team arguing against the resolution sali pipes and Nick Gillespie first of all as we just heard Sally say they're not saying the system doesn't need reform

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they are saying that Medicare for all is the wrong way to reform it Nicholas B has argued that going to Medicare for all puts us in a controlled system and the controlled systems never work as well at delivering what needs to be delivered as markets do that going to Medicare for all would squash innovation would squash improvements that it would require three point three to four trillion dollars in new taxes that it hasn't work the team says it hasn't worked in places like Vermont they very

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vividly described problems in countries that have such systems as Canada and the United Kingdom they basically don't believe that bureaucrats will have the vision to make the kinds of decisions that lead to innovation and improvements in health care of the kind that we've all experienced over the last 50 years or so basically they're saying that it's two that would have to radical and impact on our system throwing a million people who work in the insurance industry out of work causing doctors to give up the field because the way that

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they get paid would become very very full of disincentives for them so those are those are there's a lot there there's a I also want to say that among all of our debates this is maybe the best set of opening for opening arguments I've ever heard because you you all took different cracks at this from different positions and I'd like to try to dig into as many of them as we can as we move forward but I noticed that there's a difference on understanding and interpretation of the facts there's also a base of philosophical difference I think between the two sides I want to explore that

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very very briefly just a little bit this notion that I think right now is certainly motivating the Democratic candidates that health care is a human right it's one that we are increasingly hearing as part of the rhetoric it's it's not a new idea the World Health Organization signed on to it back in 1946 and we signed those treaties but it hasn't really been part of the conversation until I would say the recent past I want to start with I'll go to the side arguing against the resolution this question do you think health care is a right and how does that

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inform the position you're taking on the resolution Sally pipes right well health care to me is neither a right or a privilege as it's being talked about it is a good health care is a good and service and like all goods and services health care is necessarily scarce declaring a right to health care that is green lighting essentially unlimited demand for health care will not miraculously engender unlimited supply in in to meet the demand for health care

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it's also unclear what a right in health care really is doesn't mean the right to the very best doctors the very best care or simply a right to equal care if the latter would the government have to ban people from paying for better care and does the right to health care come with any corresponding duties if I have a right to health care does the government have the right to tell me myself that I am NOT healthy and that I can't have health care do I waive that right if I'm a smoker or if I'm a opiez as in the UK

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British people that are obese or smokers are having a hard time because doctors are told not to treat them so I believe healthcare is not a right let me bring the same question to nm calf knee healthcare absolutely should be a right it's not a right in this country because we care more about the interests of the private insurance industry and their shareholders and we care about the rights of American patients so yes it should be around umm it's not some you know complicated philosophical question we consider a lot of basic social

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services rights in this country we think children have a right to an education is our teachers a scarce resource in some sense of the word I suppose does that mean we pay kids we force kids to pay for their education and the ones who don't have enough money don't get to go to school what kind of society treats these fundamental social services that we all require as no different than luxury commodities so absolutely yes health care should be a right Nicholas I I think Adams you know response there shows the kind of paucity of this

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argument of to call something a right or not let's talk about food for instance because what what I wanted people to keep thinking about is the idea that medicine the delivery of medicine is no different say than the delivery of food we have to say people have a right to food what does that mean exactly it doesn't get us very far but if we look at the food system in America we we create massive amounts of food you Joe you became a millionaire by creating blue apron right a new way of selling

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food to people yes just a millionaire multi-millionaire no and and your press materials but what what I'm getting at is that we don't say because some people don't have enough food the government should then dictate the prices and the offerings throughout all of the food in the world what we do as a society and again we don't need to talk about rights what we decide as a society is to say look we don't want people to go starving so we're gonna create subsidies we're gonna create programs by which they can get the food that they need we can do

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that better or worse but it's the same thing with health care I think to talk about it as a right or not a right doesn't get us very far and mostly what it does is it takes away from this idea if 80% of us are happy with our health care I'm not sure I'm in that 80% by the way but if 80% of us are what did we do to help the 28 million not the 40 even before you move on to that I want to stay in the right question for Joe Sandberg yeah I want to make three points first of all if 8 out of 10 Americans are living paycheck to paycheck do you think 8 out of 10

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Americans are happy with their health insurance probably not which one is lying the second of all second of all the question about whether health care is a right ultimately is your decision to make in this vote if you believe health care is right and should be a right and should be secured as a right by our government then you should vote for this resolution if you believe that health care is a scarce asset that's monetized for profitability then you should vote against this

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resolution third health insurance and health care are different questions one of the failings of this whole debate here and at large is the conflation of the question of insurance and health care Medicare for all versus private insurance is simply a question of who pays the doctor in the present system we're all paying health insurance companies that take 20% or so of what we pay them to spend on administrative

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costs and profitability for shareholders and then use the other 80% to pay the doctors in this program called Medicare which serves 60 million Americans 60 million Americans who most need health care the highest acuity Americans only 2% of dollars paid to Medicare go to administrative costs Medicare is one of the greatest organizational tramps in the history of humankind and they don't know exactly let me let me break in there I want to take two - your

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opponent's one of the points that was made in the opening ticket to you Nicholas B is that Medicare for all has the virtue of by definition being universal that and and I want to I want you to respond to that that that's a worthy goal it's a necessary goal I think they're saying and medicare-for-all by definition addresses that issue I think that it is a fair point and a good question to say why why doesn't everybody have access to health care and again I I take Joe's point you

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know that health care and health insurance are two separate things and what we really ultimately care about is when you need to see a doctor can you see a doctor our treatments being developed that really solve problems that we need to have solved it's not about insurance per se and things like that having said all of that it's one thing to say you know something like Medicaid which is a federal program that split with the states that deals with poor people poor people have access to Medicaid and they get in the system and then they can't see doctors because

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there aren't any doctors who will take the payment schedule that Medicaid puts forward same thing with Medicare increasingly doctors are saying you know what I can i if I take a Medicare patient I've got to take 40 percent less money that I'm gonna get from a private company that's a problem again the main thing to think about here is how do you deal not with the mass of people who are doing okay in a system how do you deal with the hard cases the poor people people with pre-existing conditions that

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we can deal with not by destroying the system and blowing it up and turning it into Medicare for all but rather by directly addressing people who need help let's say that in response some of that several things I mean first of all many of the people you're talking about who are doing okay are doing okay until they get sick that's the fact your insurance may seem fine until you were really sick until you need chemotherapy until you are diagnosed with cancer until you were struck by a motor vehicle it reality is

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is that that's when you real you see the flaws in the current system that's when you experience deductibles that have thousands of dollars that's when you realize that your networks keep you from going to certain doctors are certain in the hospital so I want to rewind briefly and respond to some of the comments that Sally made in her opening statement because I think those are really critical she painted a pretty scary picture of what health care is like in countries that have universe tax finance systems like UK France Canada sounds like really scary stuff um

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in Canada it's funny because the man who's regarded as founding the Canadian of universal system Tommy Douglas is regarded as a hero in that country in the UK the NHS is commonly referred to as the national religion of that country it's funny that if these systems are so bad that people really actually seem to like them very much not only that they are petrified of taking the US as Daman that's unquestionably true um you know you heard a lot about waiting times in those nations pretty scary stuff what

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about all of the people in the United States who are on waiting lines that are infinite in length because they have no health coverage at all how about all of them who never get to see a doctor or never get to take the medication they need there is no waiting list they just don't get it um you know the final point I want to make is this idea that there are cords of Canadian medical refugees heading south of the border for health care that comment has been made for decades and it's easy to make it but once you actually look at the facts you

42:24

realize it's false and the medical health policy journal Health Affairs there was a scientific study of this issue that found no systematic evidence for Canadians fleeing south of the border to get health care all right yes some do but it is not a systematic problem charlie pipes 323,000 Canadians leave Canada and go abroad for getting an MRI a CT scan or a hip replacement or whatever because the waiting lists are too long those numbers are not false I am Canadian I have doctors in my family I know this Tommy Douglas was named the

42:55

greatest Canadian by the Canadian Broadcasting Corporation the government monopolies radio and television station so just you have to think about where that came from so we do have long waits I will I have many many stories but I just want people to know that when the government is fully in charge my cousin's a doctor my other cousins a doctor doctors are paid they're basically union members they're paid rates set by your provincial government nick may be the very best cardiac surgeon I may be the very worst were paid the same amount of money

43:26

there's a global budget set so my cousin in late November his global budget for doing cataract surgery is used up and he can't do any more treatments unless he does them illegally or under dr. Brian day's illegal Camby clinic so we have the Canadian health care system is a disaster it's what Bernie Sanders and privileged I apart for our country but it is going to be a disaster my mom used to say before she died I hope you're not becoming one of those impatient Americans Americans are impatient they want to see the doctor right away they

43:58

want to get their treatment right away and we're a wealthy country and that's one of the reasons why health care is expensive here Adam and Joe I want to take two I want you to talk for a bit about a point that your opponents made which is that Medicare for all will ultimately start to lower costs for people in the health care profession particularly doctors there are a lot of numbers floating around a lot of studies some say that they would be cut 40 percent I know Adam you said you think that's nonsense

44:27

but they do they do make a case that ultimately the way costs are going to be saved will be to reduce the amount of money that goes to hospitals and doctors and then that will be a disincentive for innovation and actually for participation in the workforce leading to a doctor shortage so coherent argument I'd like to get your response to it whichever of you would like to take it so and this is the fact of the matter about 10% of our health care spending goes towards physician salaries now a lot of people would like to see that lowered but the reality is is you can

44:59

move to a Medicare for All system and keep that the same that's not where the savings come from the savings come from the fact as I said earlier that private insurance companies take 12% of their overhead of their premium dollars for overhead versus two percent in traditional Medicare our hospitals use 25% of their revenue just for billers and coders and administration twice the proportion of hospitals in Scotland for instance so and finally there's big savings to be made on pharmaceutical companies which

45:29

are getting away with murder by basically charging whatever price they meet they want if you say have monopolies not a very free market oriented system so that's where the savings come from you have hundreds of billions of dollars in savings and administration and drugs and and drug prices and you can transition to a Medicare for All system and hospitals and doctors will be okay we're not going to suddenly get into boats and ship you know ship off to okay let's point out that we don't really actually know neither side really knows we're both working with hypotheticals I think that's okay because we're looking for the ideas behind the hypotheticals Nick

46:00

why don't you take that on so your opponents are saying it the money doesn't have to come from doctors it will come from the bureaucracy of the private insurance companies which now cover roughly 60% of the population yeah it's actually higher than that the number of people who are covered through private insurances it's closer to 80% I believe but in any case this this discussion of Medicare is great because it only charges 2% or only spends 2% in administrative costs that is because Medicare is geared towards retirees who

46:31

are politically the most connected and you know powerful constituency in America anytime the government goes to say you know what we're gonna cut down on Medicare fraud and billing abuse or just mistakes people go bananas old people go bananas they call their congressmen and it gets stopped immediately in Obama's counts chief economic adviser Christina Romer did a study and in you know during Obama's years in office and found that 30% of

47:03

Medicare's budget could be cut without affecting medical care there is a huge amount of waste in Medicare right now as we know it which is already bankrupting the country there's no incentive to look for fraud and bad billing and things like that December for private insurance for private insurance yeah they go after waste fraud and abuse because they have to whether or not we can cut 30% of Medicare's budget without affecting medical benefits I can tell you we can cut 100% of private health insurance and we didn't prove Medical Outcomes

47:35

because the essence of private insurance is about making profit for their shareholders and the question that you have to ask is a philosophical one it isn't solely one about numbers and cents it is a question of do we want a society or the profit motive informs who lives and dies I'm a capitalist I'm a business person I'm an entrepreneur I think many things are totally suitable to the profit motive but some things aren't we've tried this system of a

48:05

profit oriented health insurance industry and it's left 80 million people disproportionately women and people of color either uninsured or underinsured Joe I mean in terms of the profit that you're talking about the insurance companies are making in a recent year was last year the year before they made something like 22 million dollars which sounds like a lot of money right but the the proportion of money of the proportion of health care costs covered by private insurers was about a trillion point one that that means their profit as a percentage of all of the money

48:37

being spent by them on health care it's not even 2 percent its point zero two percent it sounds like that's not money that would move the needle in any significant mind that 22 billion that 22 billion is the profit for shareholders that doesn't count the tens of billions that go to executives the tens of billions that go to unnecessary administrative work all of which is ultimately attacks on low-income Americans who are disproportionately women and people of color so it's a much

49:09

bigger pie than just the 22 billion dollars of profitability you know and I just quickly say insurance has been around as an economic instrument for you know for centuries it is not based on cheating people it is based on figuring out how you can pull risks and make a profit off of it there's nothing wrong with that and and again I want to stress this idea we keep saying yeah I mean I think you guys are claiming that medicine somehow is a totally different it functions totally different than

49:40

other parts of the economy or it is a good that should be held in a balance of all laws of supply and demand I mean you you know why isn't food treated the same way as medicine by your lights and again I would just argue we can deal with people who don't have enough food we can deal with people who don't have enough healthcare without blowing up the entire system in a way that is going to create a place where we're all waiting for old-style medical trees I have a sense in the last

50:10

10 minutes we have not heard very much from Sally I want to give you a shot to get into this conversation that's all nobody has ever said that oh well I mean I have talked about the UK and about Canada and about doctors how they're paid the fact that my cousin graduated four years ago as a orthopedic surgeon after two years not one of her friends who are orthopedic surgeons was able to get a job in in the province of Ontario

50:40

why do you think that would happen here that has happened because the provincial government has a cap on how many orthopedic surgeons they they have meanwhile you have all these people in Ontario on waiting lists to get hip replacements shoulder replacements knee replacements and there are young dogs waiting to do the work and they can't work because they can't get paid okay because the government is the sole impaired I I want to ask Adam take on that picture that was just of you know caps on health care people on waiting

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lists it's a very very vivid picture rather than walk by it and say it's right etc and it would be better because there are so many people unemployed just deal with that problem so first of all it is true that there are some waiting times in Canada that exceed the United States other single-payer countries including the most recent Commonwealth Fund data on international health systems finds that getting a same day or next day appointment is actually more likely in France in the UK than in the u.s. even if the US is better than Canada so this is these are misleading

51:43

statistics but I want to just go back to one point that Nick dismayed which is that the reason why these you know overhead costs are so low in Medicare is because they're not clamping down on fraud that's a very unfortunate argument to make within one week of Pope Publica releasing a till investigative report saying that private insurers are doing nothing basically to crack down in health care fraud that's not the reason why traditional Medicare has such low administrative costs it's because are not spending all that time wrangling with providers over costs and so that's that's that's simply not correct so are

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you saying that there's no fraud waste fraud abuse or miss miss payments in Medicare of course not as fraud and missed payments and every health care system on earth the question is how do we achieve the savings to cover everyone and I think we've made a very strong case and you need a public insurance system to do that um one other point of this one actually I want to let Nick or Shelley respond to that and then I want to go to audience questions and if I want to give you about 40 seconds if you okay well first of all there are only three countries in the whole world that

52:44

have true single-payer systems ie all private coverage is banned Canada Cuba and North Korea as I mentioned the UK has a private system and about 10 percent of Brits actually have private care and and it's used a lot and companies do help to provide that so it's an important point that Canada is is a true single-payer system in the New World Health Organization study that just came out on cancer survival rates five years out Britain was the worst in five out of seven cancer survival rates

53:16

pancreatic cancer UK in the UK 7.9 percent lung cancer UK 14.7% Canada 21.7% all of these statistics are really scary in the United States we have all the new developments in cancer care Carty stem cell treatments these things are developed in the United States not in these other countries that have price controls and have government taking a major part of our health care okay I want to let you I was invented by

53:47

insurance company none what's that which one of these innovations which one of these discoveries which one of these great new advances and medical science was achieved by Aetna Blue Cross Blue Shield search business cause it's right 611 its cost 2.6 billion dollars from a pharmaceutical biologic idea to bring it to market most don't don't make it only about 1 in 10 make it through the trial I want to live we they take place here you don't go to Canada to get stem-cell

54:18

people come from Canada here Joe on the question of outcome which is ultimately what most matters longevity in the United States is declining did you know that the average life span of someone who is in the bottom 70% of income 7 out of 10 Americans their average lifespan is decreasing I can't think of a more damning statistic about the failure of our health insurance system I want to

54:51

add that there's all these illusions that their side has made about quotas on the number of doctors who can be this that or the other these visions of government-run hospitals none of that has anything to do with Medicare for all Medicare for all is simply a question of who pays the doctor Medicare or private health insurance currently private health insurance takes your money keeps a lot of it for their executives for their profitable profit oriented shareholders and rations care to people

55:23

who most need it okay I'm gonna step in because I think we've covered that ground a little bit I'd like to get some questions so right down the front row for the no team does your argument against Medicare for all extend against Medicare for the elderly as we have it now are the philosophical arguments such that you would postulate let's disband Medicare I think that's a valid question sure I'm happy to you know I am a very late baby boomer I'm in the

55:56

second-to-last year of the baby boom generation which and I'm not going to collect Medicare Medicare will be bankrupt before I'm even there I don't think that any entitlement should be based on age I think all entitlements or all public assets and should be based on need seniors seniors currently get a ton of money from the government both in the form of Social Security and Medicare I think that should go to poor people regardless of age so Nick to the degree that Medicare represents a universal solution

56:27

for a certain cohort you would say no I think I think Medicare as it is currently constituted it covers less than 50% of its costs through various taxes and premiums and things that people pay into it it is a big problem particularly in an aging nation I'm not in favor of Medicare for all what I am in favor of is a free-market health care system that functions like food delivery that fits like housing that functions like buying books and TV and clothing and things like that where we let the

56:57

market work and do its wonders and then we subsidize and help people who are not getting enough sadly I know you want in on this conversation I just want to let to see if your opponent one of your opponents would like to jump in on this question about whether Medicare this program has been around since 1965 and it is enormous ly popular with the people who benefit from it was a good idea or not in the first place would either of you and if you don't really have anything meaningful to say on it if you're just gonna say it's great then I would go back to Sally I'll make a 10 second comment before Medicare most seniors had no health coverage they went

57:29

without care many died as a result that is no longer the case today that is a huge progress the idea that that should be turned back is I don't think Nick was saying turn it back but I'm just gonna say that Medicare and Medicaid under Bernie Sanders plan and privilege I appalled would be eliminated there would be one single payer government health care plan the Indian services plan and the Veterans Administration which is a single-payer health care system and if you want to look at problems look at the VA okay let's go to another question sir

58:01

I think there's questions for the motion in order to fulfill a health care utopia you need to have accessibility it has to be timely and affordable does medicare for all simultaneously improve all three of those aspects and if not which do you think are the most important run through this list again the three things accessible for debility timely and quality thank you yeah one of the underestimated advantages of moving to Medicare for All system is the

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tremendous increase in transparency that it would bring to our health care system and the improved research knowledge and treatments that would come with that transparency presently an atom can speak to this as a clinician the medical community relies largely on information that's gleaned from the Medicare system about treatment outcome quality of care procedure what would happen in a Medicare for All system is the amount of data that we would have would quadruple quintuple and

59:02

likely increase the research and outcomes that are generated from a medical care system that's an underestimated element it also those speaks to one of the weaknesses of the private insurance system which is tremendous opaqueness we don't know really about outcomes we don't know about procedures we don't know about costs in contrast to the Medicare system it's incredibly transparent so I think you definitely see an increase in quality over time from the increase in human knowledge that would be born of a Medicare for All system Nick I won a

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second Joe's request for Less opaqueness or opacity and in the system whether it's Medicare or the private system you know I I can remember a moment this was some years ago for the first time I was on a high deductible plan a doctor purse my doctor prescribed a brand-name prescription drug and I said you know how much is that gonna cost and he was like I don't have any idea and I was like you know in the way in in the examination route I was like could you find out and so he had his nurse go and

01:00:05

they went to my insurance company found out on the pharmacopoeia and I say it was like thirty bucks a month or something he's like you know that's pretty high I can give you a generic that's two dollars a month why not do that we need that kind of system that kind of clarity in every aspect that's exactly what is lacking in today's system it's lacking in Medicare Valley as well and if when Bernie Sanders say you will not have any premiums no co-pays no deductibles those price signals which really matter go totally

01:00:36

out the window so I actually think Medicare for all means nobody's gonna know what anything costs anymore that's a recipe for disaster no that's not how the Medicare system works and we're not proposing quote-unquote single-payer health insurance and we're proposing specifically Medicare for all and the Medicare system is the most transparent health insurance system in the world and we're proposing that we extend it to all that transparency extended to all Sally does Canada have the kind of transparency we're talking

01:01:06

about no because people don't know you have a everyone has a care card and as madam Chief Justice Beverly McLaughlin of the Canadian Supreme Court who just retired in the 2005 case where the court ruled that doctor shallowly should be able to provide health care to people not just in his office but you know at the edits at their home or in their trailer or whatever she in the in the deciding in the decision she said Medicare for all the Canadian system

01:01:36

access to a waiting list is not access to health care nobody knows what anything costs but I do know that doctors are very frustrated and a lot of the best doctors come to the United States because they can practice the kind of medicine they've been trained in they don't have to go to a small rural community when they're a highly trained neurosurgeon to do surgery this is something that Canada tried a few years ago fortunately there was a huge backlash against it but we need to keep the system open and I agree a price transparency is something that we need to promote okay let's go to back to

01:02:07

audience questions ma'am on the aisle there you are talking about market forces and we're not talking about market forces in healthcare so to speak but market forces in insurance and coverage how do you think that we have real market forces now when when we are not decoupled from employment when you can't go out of state when you can't have a little Geico gecko telling you to use their insurance you can't when the users and payers are basically not one

01:02:38

in the same there are no market forces now in private insurance you nailed it all right yep no i i i i i disagree with you only in that there are no market forces there are some market forces but it's all screwed up because insurance companies act as cartels and this is because of government regulation you can't sell insurance across state lines you you know certain people get carve-outs the whole idea that health that health insurance is treated differently as a form of compensation than cash is

01:03:09

one of the original sins of this whole situation we should not be treating health insurance if your employer says you know what here's here's fifteen thousand dollars in health insurance it doesn't get added to your tax bill that's a problem we should all be paid what our employer wants to pay us and then we should be free to buy health care or not with that money I think you know again this goes to the question of price transparency as Sally was saying nobody knows what anything costs as a patient I don't know what it costs i-i've gotten bills recently I moved

01:03:40

here a year ago I went to a doctor and I ended up getting my insurance company you know said you know this seemed to be too much and it was it was an office checkup and it was like $600 I had no idea I paid $35 something is screwy here Adam well one cost we do know is that the US healthcare system is twice as expensive as the healthcare systems of other high-income nations so despite that lack of transparency we're spending a lot more the fact is is that health care cannot be treated as another market good

01:04:10

why why is that because in a market system those who can afford health care get it those who cannot afford it don't and suffer and that is what we have in the United States we already have the most market driven system compared to these other systems I think you agree and as a consequence we have tens of thousands of people dying a year because of lack of access to health care one final point the idea of that why can't healthcare just be like you know beer or cars or luxury TVs there's one good reason why we can actually eliminate co-pays and deductibles for healthcare and not have this explosion and

01:04:42

healthcare demand it's because people don't want to take drugs they don't need they don't want surgical procedures they don't have to have they don't want brain biopsies they don't want to be in the hospital more than they have to so there is a self-limited demand you can in fact eliminate co-pays and deductibles and people will get the care they need when they need it but Sally pipes you you you have argued you have argued that when when people really don't have to pay anything that demands gonna soar rather than and your opponent is saying that it would be self-limiting so take that on well I believe it will soar because as I said

01:05:12

Canada spends about 11% of gross domestic product on healthcare and we spend 18% which is a lot but Canada spends 11% because the government says that's what the government can afford to spend and that's why you have ration care and long waiting lists for care that that that is just a fact and so we we Universal choice will lead to universal coverage you know there are PPO plans or HMO plans there are there's fee-for-service there's Medicare there's Medicaid

01:05:43

there's a chip program there's the VA but you know things like short-term limited duration plans for people who are between jobs I mean it is a disaster that during world war ii when wage and price controls were in the government gave employers the right to write off the cost of health coverage and we as employees would get it tax-free it was a way to attract people when you couldn't pay people more but that distorted the whole system and we should all have our own individual coverage and it should be private and there should be many options

01:06:13

Universal choice will lead to lower cost and better coverage okay we have time for one or two more questions ma'am in the white sweater five rows in hello under the Medicare for all program how would you create encourage patients to be responsible when they're being given the services for free and before you already answered this one sort of but if you look at other systems they have serious problems of abuse by people not

01:06:44

showing up to their appointments scheduling things that they want and and you have to have a system that would allow for it's a great question that's a great question I'm very interesting here the answer which of you would like to take that especially since it's a point that your opponents made in the beginning that people would just would run everything they could out of the system I know that you just said they would be self-correcting but the audience member obviously needs more I mean I fundamentally disagree with the premise of the question I think people miss appointments sometimes because they have difficulties

01:07:14

in life they face other obligations children work it happens I've missed appointments and it's not a problem I don't think as soon as you create a universal health care system people are just gonna book 12 appointments with four neurosurgeons and just show up I just don't think it's gonna happen okay yes I just wanted to at one point in Canada so many of my friends as I said in relatives are doctors the average GP that can see a patient for 15 minutes that's that's it and they're seeing 55 to 60 patients a day a

01:07:45

lot of the patients that are coming because they think it's free they're people who are lonely they're old-age pensioners they are actually booking appointments and taking up the doctors time and there's less time available for patients who really have a situation and they need care and that's why my friend retired at 40 couldn't take it anymore I think we have time for one more question you mentioned and you said that you wanted a free-market health care system but you also mentioned that you wanted transparency within that system so my question for you is how would market forces ensure transparency within a

01:08:15

health care system I suspect that they would ensure transparency in the same way that grocery stores ensure transparency what something costs is right there on the Shelf when you go to the cash register you're asked to pay a certain amount and that's it free markets benefit from transparency I think part of the problem we haven't really talked about it and I have a lot of sympathy and empathy with the idea that insurers here are part of the problem not because they seek profit but

01:08:49

because they're able to mask a lot of behavior and because they're able to structure a lot of regulation that keeps competition out same thing with cartels in general with all due respect to Adam you know the medical cartel like why don't we have more medical schools than we used to then we have you know 25 years ago or 30 years ago why don't we have more doctors and nurses why haven't we changed the way that we certify things and allow medical care to be delivered it's a big deal you know just to get Urgent Care

01:09:19

places put in and around New York which you're becoming a thing now that took forever we don't have a free market in healthcare and that is not something that we should you know double and triple down on that's something we should get rid of and bring in more market forces that concludes round two of this intelligent square us debate where our resolution is replaced private insurance with medicare for all and here's where we are we are about to hear brief closing statements from each debater in turn they will stand up again and address you these statements will be two minutes each it's their last chance

01:09:51

to try to persuade you to vote for their side because immediately after they finish you'll be asked to vote again and then we'll choose the winner right after this so round three closing statements here making his closing statement in support of the resolution replace private insurance with Medicare for all here is Adam Gaffney president of the physicians for a National Health Program thank you and thank you all of you for hearing this debate so I want to close by saying this everyday that I work in

01:10:22

the intensive care units I see some of the sickest patients in the hospital people with kidneys or lungs or hearts that are failing often the last thing I want those patients to be thinking about is how am I going to afford this how am I going to price shop how am i how transparent are these costs I speak in council families at their darkest hours the last thing I want them to be thinking is will this make me go bankrupt but the reality is you don't

01:10:55

need to work in an ICU to know that illness is profoundly trying even in the best of circumstances by putting everyone in one public tax financed health care system we can do two things we can control costs and reduced waste the same way every other high-income nation has done over the previous decades but at the same time we can expand coverage to everyone in the country and improve coverage for

01:11:25

everyone else we're not talking about lowering medical bills we're talking about abolishing medical bills we're talking about ending medical debt ending medical bankruptcies these will be relics of the past so I want to end by not by talking about what's wrong with our system but talking about a better future a future where everyone can get the health care they need when they need it whether they're rich or poor old or

01:11:58

young a health care system where you can go to bed every night knowing that you and your loved ones will always have access to health care no matter what obstacles you face in life if you share that vision of the future I ask you to vote YES on the on the motion Medicare for all and thank you so much thank you Adam Gaffney and that is the resolution replaced private insurance with Medicare for all and here to make his closing statement against that resolution Nick Gillespie editor-at-large of Reason magazine thanks and I want to thank Adam

01:12:30

and Joe I learned a lot this evening and I think we we all whatever side we end up on we we can agree that we learn things and that it's beneficial to talk about this I want to talk real briefly about my experience with an HMO this was in the late 80s I was in grad school and I was I was buying my first health care plan my parents were children of the depression and they said you know get as much health care as you can no matter what because you never know what's gonna happen so I bought an HMO plan that cost $2,000 I was making nine thousand

01:13:01

dollars a year at the time it was great it covered everything the first day that I was eligible I went there I booked an appointment and I got about 30 tests on and as I was walking out I saw a machine in the hallway and I said to the doctor you know what you know what's that do and he's like yeah well it does this do you want it let's hook you up and give you a test it was great everything was free there was no price other than what I had paid already and which would take me over a decade to pay off $2,000 that I put on a credit card check kids never do that

01:13:33

okay it compounds the next time so you know that's great that's Medicare for all you know the bill is paid and then it's free the next time I went to the HMO in order to get treatment because I had a rash or something they were like is it life-threatening is it dangerous you need to go to the emergency room no we'll see you in six months because everything was maxed now that's what happens when you increase demand and you don't do anything about supply that is what will happen with

01:14:03

medicare-for-all and the problem with it is also that it won't be developing new treatments the better thing to do is to allow markets to function much better and more clearly than they do helping to delink health insurance and healthcare from employers that would be awesome in ways we kind of discussed and then subsidize people who cannot afford insurance on the open market that's the way that it works in housing it's the way that works in food in all sorts of other things it'll work great in

01:14:34

healthcare so vote against Medicare for all and vote for a future of better care and new innovative practices thank you very much thank you and here to make his closing statement in support of the resolution here is Joe Sandburg co-founder of aspiration comm two cents that's what this debate comes down to two cents we have a choice between a system that currently serves 60 million senior citizen Americans the Americans

01:15:04

who are most likely to need healthcare serves these Americans in a way that only takes two cents of every $1 for administrative costs is the system preferred frankly by the most powerful group of Americans politically which are senior citizens or we can have a system where 20 cents out of every $1 goes to administrative costs a system that is leaving 80 million people uninsured or underinsured that's it that's what this

01:15:35

debate is about it's not about what's happening in Canada or in Britain it's not about quotas on how many people can become orthopedic surgeons it's not about any of that it's about the proposition that Medicare for all should replace private health insurance Medicare a program that takes just two cents of every one dollar for administrative expenses a program that serves the 60 million Americans who most need health care that we should make

01:16:07

that program two cents that program two cents available to everyone instead of the program that takes 20 cents leaves 80 million people uninsured or underinsured and leaves us with the nation we're 7 out of 10 Americans are experiencing a decrease in expected lifespan in closing the question is two cents or 20 cents if you prefer a system we're only two sets of your dollar goes to administrative

01:16:39

expenses a system that has expanded the longevity of senior citizens an organizational triumph frankly unmatched in the history of our country then I urge you to vote for Medicare for all as a replacement of private health insurance thank you thank you Joe Sandberg and our final speaker of the evening to make her case against the resolution as a closing statement here is Sally pipe CEO and president Pacific Research Institute as we have heard tonight health care is tricky it's one

01:17:11

of the few public policy issues that affects every one of us and often does so when we are at our most vulnerable perhaps tonight's debate convinced you that the American health care system is in need of change I agree with you private insurance is not perfect but I hope that you will vote against the proposition because I believe Medicare for all would leave us all much worse off it may sound morally right to have Medicare for all it may be worth the trade-offs higher taxes ration care long waits whatever in

01:17:43

exchange for a program that is supposedly going to give you security through a government-run program Medicare for all cannot repeal the law of supply and demand good intentions can't fund hospitals pay doctors eliminate waiting times and ration care just ask Canadian crooner Michael Buble who's from Vancouver as I am and you'll find out when his son Noah aged 3 was diagnosed with liver cancer Michael Buble did not stick around in Vancouver

01:18:14

he went to UCLA and took his son where he says he had the best doctors there his son today Noah is cancer-free most Canadian patients aren't so lucky several years ago my own mother died of colon cancer after doctors ordered her as a senior to wait for a colonoscopy because there were too many younger people on the line who are going to have longer lives and so she was denied that she died two weeks later from metastasized colon cancer my family's experience with

01:18:46

single-payer is not unique countless families in Canada and the United Kingdom have stories like mine we can't bring our loved ones back but we can take action to save others from similar faiths we can stop single-payer from taking root in this country we can say no to the false promises offered by politicians about Medicare for all and you can do your part right here right now by joining me in voting against the resolution thank you thank you selling

01:19:18

pipes and that concludes our closing statements where our resolution is replace private insurance with Medicare for all and now it's time to find out which side you found most persuasive I want to ask you again to go to your mobile devices and go to the URL iq2 us dot org forward slash vote you'll be prompted with the same choices you were before yes/no or undecided meaning you became undecided or remained undecided okay I'm gonna let me let me say

01:19:50

something that I really feel compelled to say after this debate I said your opening statements were among the four best I've ever seen I gotta say the same thing about your closing statements they're all different all came from different perspectives we're full of passion really really well-constructed you know when we have future debates I'm going to refer people to your closing statements as for a four in a row that we're really great and on top of that it's so clear that there's a very very profound philosophical divide maybe some very serious disagreements on core values and yet I felt that you all four

01:20:22

of you treated each other with respect and civility and dignity you listened you truly listen to each other and that's the goal of the thing that we do here so I want to thank all four of you for the way that you did and and you know Nick and Sally I think you demonstrated today why we've had you back I want to say to the four team we've got to have you back you were spectacularly good debaters and I want to thank you all right it's all in now I've been given the final results remember it's the difference between the first and the second votes that

01:20:57

determines who is our winner on the resolution replaced private insurance with Medicare for all on the first vote thirty six percent of you agreed with the resolution thirty five percent were against twenty nine percent were undecided again that's the first vote it's going to be the difference between the first and second that determines that on the second vote resolution replaced private insurance with Medicare for all the team arguing for the resolution their first vote was thirty six percent their second vote was forty percent they pulled up four percentage points so that is the number

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to beat the team against the resolution their first vote was thirty five percent their second vote was fifty one percent they pulled up 16 percentage points that is enough the team arguing against the resolution replaced private insurance with Medicare for all declared our winner I want to thank our debaters thank our audience thank you for me John Donvan and intelligence squared us we'll see you next time [Music]

Replace Private Insurance With Medicare For All

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