I affirm: The United States ought to guarantee universal health care for its citizens.

Ought is defined as used to indicate desirability. First Policy makers act under conditions of uncertainty; this demands a utilitarian calculus. Gooden
(Robert. Philosopher at the Research School of the Social Sciences. Utilitarianism as Public Philosophy. 1995. pp 62-63.)

Public officials are obliged to make their choices under uncertainty, and uncertainty of a very special sort at that. All choicespublic and private alikeare made under some degree of uncertainty, of course. But in the nature of things, private individuals will usually have more complete information [about] on the peculiarities of their own circumstances and on the ramifications that alternative possible choices might have on them. Public officials, in contrast, are relatively poorly informed as to the effects that their choices will have on individuals, one by one. What they typically do know are generalities: averages and aggregates. They know what will happen most often to most people as a result of their various possible choices. But that is all. That is enough to allow public policy-makers to use the utilitarian calculusif they want to use it at allto choose general rules of conduct. Knowing aggregates and averages, they can proceed to calculate the utility payoffs from adopting each alternative possible general rules.
Consider, first, the argument from necessity.

Second In the context of state policy, ought refers to the protection of citizens. The creation of the state is designed to protect the well-being of its citizens. Individuals sacrifice liberty in exchange for state protection; this obligation is the defining feature of statehood. Additionally, when individual moral theories conflict, only utility can resolve these disputes. Ratner
(Leonard. Professor of Law at USC. Hofstra Law Journal. Spring 1984.)

A monstrous policy can be categorically rejected by an a priori morality, but proponents of the policy can defend it with a contrary a priori morality. Only a utilitarian evaluation can resolve the a priori impasse. Such an evaluation may, in part, underlie the objection of nonutilitarians to monstrous behavior, because all human choice reflects the needs and wants of the chooser and those needs and wants reflect the chooser's perceptions of the needs and wants of others. Third Intent based moral theories fail the test of political responsibility; only consequentialist reasoning allows decision-makers to fulfill their obligations Issac
(Jeffrey. Professor of Political Science at Indiana University. Ends, Means, and Politics. Dissent Magazine. Spring 2002.) As writers such as Niccolo Machiavelli, Max Weber, Reinhold Niebuhr, and Hannah Arendt have taught, an

unyielding concern with moral goodness undercuts political responsibility [for three reasons]. The concern may be morally laudable, reflecting a kind of personal integrity, but it suffers from three fatal flaws: (1) It fails to see that the purity of ones intention does not ensure the achievement of what one intends. Abjuring violence or refusing to make common cause with morally compromised parties may seem like the right thing; but if such tactics entail impotence, then it is hard to view them as serving any moral good beyond the clean conscience of their supporters; (2) it fails to see that in a world of real violence and injustice, moral purity is not simply a form of powerlessness; it is often a form of complicity in injustice. This is why, from the standpoint of politicsas opposed to religionpacifism is always a potentially immoral stand. In categorically repudiating violence, it refuses in principle to oppose certain violent injustices with any effect; and (3) it fails to see that politics is as much about unintended consequences as it is about intentions; it is the effects of action, rather than the motives of action, that is most significant. Just as the alignment with good may engender impotence, it is often the pursuit of good that generates evil. This is the lesson of communism in the twentieth century: it is not enough that ones goals be sincere or idealistic; it is equally important, always, to ask about the effects of pursuing these goals and to judge these effects in pragmatic and historically contextualized ways. Moral

absolutism inhibits this judgment. It alienates those who are not true believers. It promotes arrogance. And it undermines political effectiveness. Thus, because we are evaluating state policy action, and because states must protect their citizens, my criterion is Minimizing the Suffering of US Citizens. We usually reserve the word suffering for the greatest forms of pain and distress. This includes the loss of life and the lack of basic substance to enjoy a tolerable quality of life. Mosbys Medical Dictionary defines Universal Health Care as a health insurance program that is financed by taxes and administered by the government to provide comprehensive health care that is accessible to all citizens of that nation. Additionally, UHC will be contextually defined by using comparable UHC systems from other countries. First OTHER ADVANTAGES
A. 50 million people uninsured in U.S. Universal health care solves. Christie, Les. "Number of people without health insurance climbs." CNN Money. Sept. 13, 2011. http://money.cnn.com/2011/09/13/news/economy/census_bureau_health_insurance/index.htm AW. B. 45,000 people die each year from lack of coverage Abelson, Reed. "Harvard Medical Study Links Lack of Insurance to 45,000 U.S. Deaths a Year." Prescriptions Blog. New York Times, 17 Sept. 2009. Web. http://prescriptions.blogs.nytimes.com/2009/09/17/harvard-medical-study-links-lack-ofinsurance-to-45000-us-deaths-a-year AW. Contention 2: Preventative Care A. The U.S. ranks last among rich countries in preventative care. We could save 101,000 people per year if we had the same type of preventative care other countries have. David Gutierrez. U.S. Ranks Dead Last Among 19 Nations in Preventive Medicine. Natural News. June 13, 2008.http://www.naturalnews.com/023429_death_health_United_States.html AW. B. Universal health care incentivizes people to get preventative care by making it cheap, while placing high copays on unnecessary care to discourage overuse. Klein, Ezra [Editor of Wonkblog and a columnist at the Washington Post, as well as a contributor to MSNBC and Bloomberg. His work focuses on domestic and economic policymaking, as well as the political system that's constantly screwing it up]. The Health of Nations:How Europe, Canada, and our own VA do health care better. The Prospect. April 22, 2007. http://prospect.org/article/health-nations AW. C. Preventative care saves lives and money. CDC. The Power of Prevention: Chronic disease . . . the public health challenge of the 21st century.Centers for Disease Control.2009.http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf AW.

Advantages: Economy key to unemployment; no insurance leads to death; preventative care; medical marijuana

First, definitions: The medical dictionary defines health care access as

"Social medicine The ability of a person to receive health care services, which is a function of 1. Availability of personnel and supplies and 2. Ability to pay for those services" http://medical-dictionary.thefreedictionary.com/health+care+access

oxford dictionary defines guarantee as: provide a formal assurance or promise, especially that certain
conditions shall be fulfilled relating to a product, service, or transaction:

ought _______ Given that the burden upon the affirmative is to prove the resolution true the only proper assesment of state actions requires us to compare policies that already use universal healthcare. i advocate the universal heathcare of the netherlands http://www.commonwealthfund.org/Publications/In-the-Literature/2008/May/Universal-Mandatory-HealthInsurance-in-The-Netherlands--A-Model-for-the-United-States.aspx
In the Literature

In 2006, the Netherlands launched a sweeping national health care initiative to provide universal health care coverage for its population. According to the authors of "Universal Mandatory Health Insurance in the Netherlands: A Model for the United
States?" (Health Affairs, May/June 2008), it is a model that may be of particular interest to policymakers in the United States. Not a single-payer systema policy approach often considered a nonstarter in U.S. policy circlesthe Dutch approach combines mandatory universal health insurance with competition among private health insurers.

http://www.pbs.org/newshour/updates/health/july-dec09/insurance_10-06.html

All Netherlands residents are required to purchase health insurance, which is provided by private health insurers that compete for business. The insurers can be either for-profit or non-profit, but are tightly regulated by the federal government, and are required to accept every resident in their coverage area, regardless of preexisting conditions. 1) the Netherlands economic needs are similar to the US. the unites states economy thrives on free market and competition among businesses; in this case health care providers. 2) the Netherlands Universal health care system has been set im place since 2006 and thus far has been successful in guaranteeing access healthcare for it's citizens and for those going to school and working in the Netherlands 3) Contention One: applying the Netherlans Universla healthcare system alowes for teh continuation of a free market economy and competiton among providers. http://www.commonwealthfund.org/Publications/In-the-Literature/2008/May/Universal-Mandatory-HealthInsurance-in-The-Netherlands--A-Model-for-the-United-States.aspx
In the Literature In 2006, the Netherlands launched a sweeping national health care initiative to provide universal health care coverage for its population. According to the authors of

it is a model that may be of particular interest to policymakers in the United States. Not a single-payer systema policy approach often considered a nonstarter in U.S. policy circlesthe Dutch approach combines mandatory universal health
"Universal Mandatory Health Insurance in the Netherlands: A Model for the United States?" (Health Affairs, May/June 2008), insurance with competition among private health insurers.

Growing dissatisfaction with "top-down" health care rationing policiescriticized for their inability to promote efficiency and innovationled to broad support for incentive-based reform. In 1987, a government-appointed group of advisors proposed a national health care system based on market-driven reform.

the Dutch government worked to lay a foundation for merging competition with universal access to health care. For example, the new system required a system of risk equalization to prevent insurers from seeking only young, healthy customers. Additional reforms included developing a pricing system that would discourage physicians from providing inferior care; determining how to measure quality and outcomes; and arming consumers with more information about the price and quality of insurers and providers. 2006: The Health Insurance Act The Health Insurance Act of 2006 was the culmination of several years of
Over the next two decades, Dutch legislation and policy aimed at achieving universal health care coverage. It requires all people who legally live or work in the Netherlands to buy health insurance from a private insurance company. Insurers are required to accept each applicant at a community-rated premium regardless of preexisting conditions. In 2006, all but 1.5 percent of the population had purchased health insurance in accordance with the new legislation.

The plan is financed with individuals' annual income-based contributions to the tax collector. Employers are required to compensate their employees for these contributions. In addition, all adults are required to pay premiums directly to the selected insurer, which sets its own community-rated premium. Premiums are not required for children under age 18. About two-thirds of Dutch households receive an income-related subsidy from the government
a maximum of 1,464 (about US$2,200) per household per year.

income-based contributions are transferred to a Risk Equalization Fund, which compensates insurers for taking on high-risk enrollees. In addition, insurers can use tools to protect their interests. These include managed care techniques, such as disease management. Insurers are also permitted to provide care in their own facilities with their own staff, to control costs better and may sell other products in addition to
The basic health insurance, like supplemental health insurance or car insurance. Increasingly, insurers ill be allowed greater leverage in negotiating prices, service, and quality of care. Consumer Choice also

http://www.pbs.org/newshour/updates/health/july-dec09/insurance_10-06.html

Legally required standard benefits for insurance in the Nethlands include general practitioners, hospitals, maternity care, lab tests and medicines. Insurers offer a choice of policies at a range of costs. In some of the plans, the insurer negotiates and contracts with the health provider, while more costly plans allow patients to choose their health provider, and be reimbursed by the insurer. The insured also pay a flat-rate premium to their insurer for a policy. Everyone with the same policy pays the same premium, and lower-income residents receive a healthcare allowance from the government to help make payments.
How the Netherlands compare: "What

makes it most interesting from a U.S. perspective is that it uses private insurers," said Michael Borowitz, a senior health policy analyst at the Organisation for Economic Co-operation and Development in Paris. "[Instead of Medicaid and Medicare] the public insurance part is actually covered through private insurance, through the government regulating private insurers," he said.
He points to the Netherlands' strong system of high quality general practitioners that act as gatekeepers to specialized care as a success in helping to keep costs down.

The Netherlands system also has a large degree of choice for consumers, said Francesca Colombo, also a senior health policy analyst at OECD. "It does provide access for everybody, it does not leave people out of the system and it does achieve good outcomes in the end ," she said. However both agree the system is new enough that the jury is still out on its long-term success.

http://www.commonwealthfund.org/Publications/In-the-Literature/2008/May/Universal-Mandatory-HealthInsurance-in-The-Netherlands--A-Model-for-the-United-States.aspx As discussed, insurance companies are required to accept each applicant for basic insurance coverage. Individuals can choose from among 14 private insurance companies and several related subsidiaries. The Dutch government has set up a Web site where consumers can compare all insurers with respect to price, services, consumer satisfaction, and supplemental insurance, and compare hospitals on different sets of performance indicators. Contention 2: the netherlands unniversal healthcare encompase a wide range of medicines medical cannabis is Medical marijuana Medical merijuana has been used for hundreds of years to help fight desieses. The history of the medical use of cannabis dates back to 2700 B.C. in the pharmacopoeia of Shen Nung, one of the fathers of Chinese medicine. In the west, it has been recognized as a valued, therapeutic herb for centuries. In 1823, Queen Victoria's personal physician, Sir Russell Reynolds, not only prescribed it to her for menstrual cramps but wrote in the first issue of The Lancet, "When pure and administered carefully, [it is] one of the of the most valuable medicines we possess."

Between 1840 and 1900, European and American medical journals published more than 100 articles on the therapeutic use of the drug known then as Cannabis Indica (or Indian hemp) and now simply as cannabis. Today, new studies are being published in peer-reviewed journals that demonstrate cannabis has medical value in treating patients with serious illnesses such as AIDS, glaucoma, cancer, multiple sclerosis, epilepsy, and chronic pain.

In the United Kingdom, GW Pharmaceuticals has been conducting clinical trials with its cannabis-based medicine for the past decade. GW's Phase II and Phase III trials of cannabis-based medicine show positive results for the relief of neurological pain related to: multiple sclerosis (MS), spinal cord injury, peripheral nerve injury (including peripheral neuropathy secondary to diabetes mellitus or AIDS), central nervous system damage, neuroinvasive cancer, dystonias, cerebral vascular accident, and spina bifida. They have also shown cannabinoids to be effective in clinical trials for the relief of pain and inflammation in rheumatoid arthritis and also pain relief in brachial plexus injury.

The remarkable 5,000-year safety record of cannabis - there has never been a recorded death from an overdose - and the fact that a metabolite with the desired anti-inflammatory effect is produced in the body when cannabis is used, indicates that the development of targeted, safe, and effective antiinflammatory drugs in this class are possible.[33] CT3 has also demonstrated considerable analgesic effects in animals. In some cases, the
dose-dependent effect of THC was equivalent to morphine, but with a much greater duration of action and far less toxicity.[34-35] In contrast to the NSAIDs commonly prescribed arthritis sufferers, CT3 did not cause ulcers at therapeutically effective doses. Moreover,

it does not depress respiration, produce dependence, induce body weight loss, or cause mutations, as many commonly prescribed drugs do

the netherlandss offers medican cannabis as a prescription Medical cannabis is being distributed by a state-run bureau that has contracted two of the Netherlands' biggest marijuana growers to produce tightly controlled plants of a constant quality and supply the drug on demand. The initial state order was for 200kg. A spokesman for the Health Ministry said: "Medical cannabis is rigorously controlled and tested for toxins, the presence of pesticides, metal etc, and it has to be kept at a constant quality. It is no longer a drug but a medicine, so the actual product cannot be compared to what people would buy over the counter in a coffee shop."

Pharmacies in the Netherlands will stock cannabis from today. The Dutch are the first to permit cannabis to be legally dispensed to those with a doctor's prescription, and other countries - including Britain, parts of the US,
Australia and Canada, where plans for a similar system are at an advanced stage - will be watching the Dutch experience closely.

More than 2,000 pharmacies in the Netherlands are legally obliged from today to stock medical cannabis and dispense advice to users on the merits of brewing the mixture of dried parts of the hemp plant as a tea. They are also expected to provide instruction on how to become high by using it in combination with an inhaler.

the majority of the united states and many medical associations advocate for medical marijuana The use of medical cannabis has been endorsed by numerous professional organizations, including the American Academy of Family Physicians, the American Public Health Association, and the American Nurses Association. Its use is supported by such leading medical publications as The New England Journal of Medicine and The Lancet.

The American Medical Association opposed the first federal law against cannabis with an article in its leading journal. Their representative, Dr. William C. Woodward, testified to Congress that "The American Medical Association knows of no evidence that marihuana is a dangerous drug," and that any prohibition "loses sight of the fact that future investigation may show that there are substantial medical uses for Cannabis." Cannabis remained part of the American pharmacopoeia until 1942 and is currently available by prescription in the Netherlands and Canada. http://americansforsafeaccess.org/article.php?id=4560 Public opinion is clearly in favor of ending the prohibition of medical cannabis and has been for some time. A CNN/Time poll in November 2002 found that 80% of Americans support medical cannabis. The AARP, the national association whose 35 million members are over the age of fifty, released a national poll in December 2004 showing that nearly two-thirds of older Americans support legal access to medical marijuana. Support in the West, where most states that allow legal access are located, was strongest, at 82%, but at least 2 out of 3 everywhere agreed that "adults should be allowed to legally use marijuana for medical purposes if a physician recommends it."

1,552

blocks "The smoking of cannabis, even long term, is not harmful to health...." So began a 1995 editorial statement of Great Britain's leading medical journal, The Lancet. The long history of human use of cannabis also attests to its safety - nearly 5,000 years of documented use without a single death. In the same year as the Lancet editorial, Dr. Lester Grinspoon, a professor emeritus at Harvard Medical School who has published many influential books and articles on medical use of cannabis, had this to say in an article in the Journal of the American Medical Association (1995):