Talk:Universal health care

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

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

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

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

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

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

Again with the normative claims

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

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

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

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

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

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

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

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

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

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

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

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

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

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

You might want to see Wikipedia:Assume good faith

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

with the law;

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

performance of its regulatory role;

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

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

Principal new powers of the authority

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

JaaJoe.com Just Another Average Joe spam

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

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

How to expand the "Debate" section

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

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

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

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

Proposed merge

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Strong Bias in the United States Scetion

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

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

Are the US-Specific External Links Really Needed Anymore

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Renaming Universal health care to Socialized health care

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

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

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

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

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

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

Proposed text on Mexico

I've deleted the following text from the "Americas" section:

????? Mexico has Universal Health care for the children who were born since January 5th, 2007...please do not delete this information, just edit it. read the info here http://www.esmas.com/noticierostelevisa/mexico/593939.html

The tone is non-encyclopedic, and since the source isn't in English, it's impossible for a non-Spanish speaker to verify. If this information is correct (and I have no reason to believe that it is not), we need someone who can verify it and (ideally) find an English-language source, and then we need to rework the text to make it more encyclopedic. Depending on how much information is available, it may be appropriate to create a new subsection for Mexico.

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