Affirmative Brief Introduction I. Attention step – Susan and Bob Druss are self-employed. He suffers from chronic back pain and she is recovering from pneumonia. When asked about health insurance Susan Druss quoted, ”We have none. We have absolutely none. Our child is covered but at far as we are concerned we can live or die – but we cannot get sick. There is nothing we can do about it.” According to Mr. Druss, “We look at is as a luxury item.” Health insurance is not a luxury but a necessity. When two people who both work cannot afford it along with the millions of others, we know it is time for a change. From cnn.com October 4, 1999. II. Background A. Importance 1. All Americans have the right to health insurance. 2. Millions of people lack health insurance and go without necessary medical care. B. Definition of Terms 1. National health insurance – a government operated system of insurance that provides financial benefits and medical services to persons disabled by sickness or accident. (Encarta 2000) 2. HMO – or health maintenance organization is an organization that provides health care to voluntarily enrolled individuals and families in a particular geographic area by member physicians with limited referral to outside specialists and that is financed by fixed periodic payments determined in advance. (Encarta 2000) III. Resolved: That the U.S. should have a nationwide health insurance plan. Sign Post – To further support this preposition, I will offer A. Too many Americans do not have health insurance and current programs are unreliable and provide insufficient care. B. The affirmative plan will make health insurance, available to all Americans while offering better services and resources. Body I. These problems with the status quo are clearly evident. A. Harms exist 1. Current programs such as HMO’s are unreliable. a) To support this argument, I offer evidence from . . . b) Dallas News - December 9,1999 - from an article titled “Dwindling HMO choices leave senior citizens with tough decisions.” c) About 327,000 senior citizens will have to switch carriers by January 1 because 99 HMO plans have dropped out of medical care – many seniors will have little or no choice in their next plan. 41 percent of HMO’s are less than 5 years old. Tom Slack, CEO of Health First quoted, “when you do something like a managed care program and its not well received, and your physicians scream and belly ache . . . its time to change strategies.” d) These facts and quote prove how unreliable health maintenance organizations can be. When HMO’s go out of business, as they often do, they leave all of their patients without care. Joining a new plan is time consuming and often expensive. Unreliable systems like this hurt Americans when they cannot find new programs to obtain health insurance from. 2. HMO’s provide poor care and employ cost cutting therefore benefit cutting methods that decrease the quality of services you receive. a) To support this argument, I offer evidence from . . . b) Newsweek – March 18, 2000 – from an article titled “Curing Health Care.” c) HMO’s use lists of drugs that are frequently used; if the prescription you need isn’t on the list, you are not covered and you must pay for it yourself, which is extremely costly and unaffordable to many. HMO’s use cost cutting techniques which endanger patients and hinder possibility of survival is some cases. HMO’s also promote certain procedures that gain them large amounts of money but are totally unnecessary and can be risky. d) This evidence proves that current programs are immoral and do not provide adequate care. As mentioned they do not cover all expenses and in many cases surgery or medicine that could easily save peoples lives are out of reach because of cost. The status quo does not provide sufficient care and uses cost cutting techniques, which are wrong. B. The harms are significant and widespread. 1. Huge amounts of Americans are uninsured. a) To support this argument, I offer evidence from . . . b) CNN – October 4, 1999 – from an article titled “Who are the Uninsured.” c) More than 44 million people in the United States are uninsured, that’s about one sixth of the population. It has increased more than a million per year for several years. d) This startling statistic exemplifies the serious and growing problem of uninsured Americans. This statistic shows that one sixth of the population may not be getting any or some of the medical attention they need. 2. Low income workers, women, and children suffer the greatest in the status quo. a) To support this argument, I offer evidence from . . . b) Dallas News - December 9,1999 - from an article titled “Dwindling HMO choices leave senior citizens with tough decisions.” c) Low-income homes have worst percentages of no health insurance with about one half of the people lacking insurance. Women and kids suffer worst with over ten million children currently uninsured and more than 11 million women. d) These numbers clearly shows harms in the status quo. Women and children are put last in society. The majority of the millions of uninsured are near or below poverty level. They can not afford health insurance and in most cases do not receive care because of it. 3. Current legislation will further burden the low-income uninsured. a) To support this argument, I offer evidence from . . . b) Dallas News - December 9,1999 - from an article titled “Dwindling HMO choices leave senior citizens with tough decisions.” c) A current legislation to try and increase the number of people insured gives tax benefits to those who own health insurance. This legislation will only further burden the main source of the uninsured – the low-income working class. By giving benefits to those who can afford insurance and punishing others because they cannot worsens the situation of the uninsured when the are unable to afford to pay the premiums. d) This example proves that current legislation in the form of tax benefits and credits will not work in society and only increase the harms of the status quo. C. Inherent barriers exist in the harms. 1. Ways of expanding insurance to low-income citizens such as tax credits don’t work a) First of all, many low-income citizens may not even find out that they can receive a tax credit. Secondly, tax credits are not available to all. A credit for children is being pushed by the Clinton campaign, but it will only help to cover a few million out of over 44 million. Without national insurance, there is no way that we can be sure that everyone is going to get the insurance and care they need to live. 2. Society does not want a purely socialistic program. a) To refute this argument, I offer evidence from . . . b) Encarta – 2000 – From an article titled “National Health Insurance.” c) The British national health insurance program is one of the most comprehensive systems in operation. All people employed or unemployed receive benefits covering all medical needs such as hospital services, specialist service, general medical service, dentists, maternity, and child welfare to name a few. Citizens may use any of facilities run by the government. Also, physicians are not required to be a part of national service and may operate private practices in conjunction with the national plan. d) This example proves that other national plans work just as they are meant to, without decreasing the quality or availability of service. Also a national health plan is not socialistic by any means. National programs such as Medicare for the elderly already exist. This plan would only expand coverage to all people. If this plan is socialistic, programs like Medicare and social security are also yet no one speaks out against those programs. In addition, privatization, which is still available in systems like in Britain, will distinguish the national program from socialism. 3. Price of insurance premiums are too high to create a national plan. a) Prices are rising because of two reasons that will be solved by the national plan. One, people without insurance that receive care pass on the cost of service to people with insurance raising their premiums. If all people have insurance this can not happen. Secondly, the cost of prescriptions is rising steeply because drug companies control the market. In a national plan, the government could set prices and stop the rapid price increase. II. The affirmative plan. A. Administration – Because it is a national plan it will be under the jurisdiction of the National Government, while they may subsidize state governments to handle processing. B. Mandates 1. An affordable health plan will be offered to all Americans. 2. Insurance will include access to all government run facilities and cover all necessary services. C. Funding 1. Large tax breaks for insurance, Medicare, and Medicaid services already consume huge amounts of tax dollars. 2. By incorporating these systems into the nationalized plan it will keep the funding required low. D. Enforcement 1. The new policy could not be enforced like a law; rather it would be voluntarily open to all Americans. 2. As in other countries private business would also be allowed to those who would rather purchase it. III. The affirmative plan will result in advantages as it solves the significant harms within the status quo. A. It will eradicate the millions of uninsured Americans. 1. By offering affordable insurance, the people that could not formerly afford insurance would obtain the insurance they need. B. Government program is more organized, cost efficient, and reliable. 1. A government program will not turn over like the hundreds of HMO’s and will not leave people without insurance 2. The government can organize cost spending more effectively than small companies and will therefore save money. C. Government program will standardize care so all will receive quality and available care. 1. Because the government own majority of hospital facilities, it makes numerous resources open to people all over the country rather than being subjected to a single specific practice or hospital. 2. The government program works for citizens, rather than to earn a profit. This will eliminate cost cutting measures that are utilized in the current system. 3. Care will not be limited as many programs are and all people will receive the care that they need to live a healthy life. This is possible because the government can standardize the facilities and equipment in hospitals. Conclusion I. Summary - Resolved: That the U.S. should have a nationwide health insurance plan. HMO’s and similar systems are unreliable, use cost cutting methods, and do not provide the essential care to Americans. Over one sixth of the nation currently have no form of health insurance and are in no position to do so. Low-income working families are suffering the greatest.