Free healthcare creates economic productivity

The argument

The case here is made on macroeconomic rather than moral grounds: free healthcare is defended as something that would make the economy more productive, whatever else is said for or against it. The starting observation is a measurable one. Workers with health insurance miss almost five fewer workdays a year than their uninsured counterparts. For any single worker that is a modest difference, but spread across an entire workforce it compounds into a substantial difference to GDP, since the days are lost from production that would otherwise have occurred. The cost of the current arrangement has been estimated directly. The United States economy loses between $65 billion and $130 billion annually in sick days and premature deaths incurred under a for-profit health system. Both halves of that figure matter to the argument. Sick days represent production forgone while a worker recovers; premature deaths represent the permanent removal of a worker from the economy, along with everything they would have produced over the remainder of a working life. The mechanism connecting insurance to the difference is preventative care. A worker who is provided with free health insurance is more likely to see a doctor, and more likely to obtain preventative medicine, because the calculation of whether a symptom is worth paying to investigate no longer arises. Conditions are caught while they are still minor rather than after they have become serious, and workers who are less inclined to get sick are more productive in their work environments. The saving is therefore not merely in what is spent on treatment but in the illness that never develops. Because free healthcare creates economic productivity in this way, the argument concludes, healthcare should be free.

Context

From a macroeconomic perspective, free healthcare makes financial and fiscal sense. Free access to healthcare means more people visit the doctor and engage in preventative medicine. This means fewer days of work missed and increased economic productivity.

Premises

Counter-arguments

Providing free healthcare will overwhelm hospitals and medical staff--more people will want to visit hospitals, thereby creating long waiting lines. Hospital patients might spend hours or even days waiting for their turn, which will decrease the number of days they go to work. In the long run, therefore, free healthcare will prove detrimental to overall economic productivity.

Rejecting the premises

[Rejecting P1] The comparison is between insured and uninsured workers rather than between systems, so it shows the value of coverage rather than of free provision, and the two groups may differ in occupation, income and baseline health in ways that account for the missing days. [Rejecting P3] Take-up can outrun capacity: if free provision lengthens waiting times, patients may lose more working days waiting for treatment than preventative care saves, which would reverse rather than deliver the productivity gain claimed.