Sunday, March 3, 2013

PF March 2013 Health Insurance - What I Saw, How I Voted

Resolved: The U.S. government should not require its citizens to have health insurance.

For part 1 of this analysis, click here.


We just finished our state tournament.  It is a fairly large tournament, I suppose, with some 80 schools, 16 NFL districts and nearly 1000 competitors.  We run Lincoln-Douglas, Policy, Public-Forum and Congress as well as the usual menagerie of speech categories.  As tournaments go, it was well run and remained on schedule, despite being split over three venues which were some 20 minutes apart depending on traffic.  The tab rooms did a fine job with the help of tournament software, keeping it running smoothly.  I am sure several of the staff ran  the equivalent of a marathon, keeping judges corralled and available.  If I could complain about anything, it would be the lack of food at one of the venues.  Sorry folks, it is ridiculous to expect grown adults to live two days on donuts, puffy cheese balls and walking tacos.  A hungry judge is an angry judge and an angry judge is a critical judge.  Nevertheless, knowing what it takes to organize and run a tournament, it was clear to me, there was a lot of thought put in to the planning of the events and the logistics of getting things done, and that, they accomplished very well.

My contribution to the tournament was simple, judge Public Forum debate.  However, that turned out to be anything but simple.  It is very difficult to enter a major tournament, indeed, one of the most important of the year, being forced to debate for the first time, new topics in Lincoln-Douglas and Public Forum debate.  Developing and arguing a good case is often an iterative process of running it, evaluating the reaction and rebuttals and adjusting the case.  Eventually one starts to refine a pretty decent case.  This is especially advantageous to LD debaters who have two months to develop their cases.  Several of the cases I saw were at stage one of the development cycle.  I know my own debaters were adjusting and rewriting in the hotel the first night after competition and I wonder how many others were doing the same in hotel rooms across the area.

So, since the tournament is over, and since most teams in our state will now be finished with formal varsity competition, I thought I would share what I saw in Public Forum and give my analysis of the arguments.  Note, I did not judge any LD or Policy at this tournament (Last year I judged only policy debate as far as I remember).


Most of the cases I heard had some kind of framework and most of the time, that framework tried to make it clear the debate was not about health care, but rather health insurance and the judge should only look to those advantages or disadvantages which arise as a consequence of mandated health insurance.  This got particularly sticky with regard to "Obamacare".  Some teams wanted to allow Obamacare since there is a wealth of evidence about the plan, yet tried to sever out the portions unrelated to the individual mandate. I was also instructed in one case, I should ignore Obamacare since it is a health care system. A few teams, tried to set up an obligatory framework which established that the US had a duty to act in accordance with a given interpretation of social contract theory or a moral imperative.  Only one team said I should evaluate the round on the basis of comparative advantages.  In other words, simply weigh the good versus the bad. Amazingly, I recall one team in particular that did an outstanding job of explaining how each of their contentions applied to their framework.

Framework Fails

In my opinion, a framework is not intended to be some kind of burden to restrict the opponents (even though you may cite burdens which are unfavorable to the opponents).  As I see it, the framework should be a mechanism for me as the judge, to determine the best way to weigh the round.  It is the debater's chance to tell me, "we think this is what you should give more weight to".  In other words, prefer our interpretations or prefer our evaluation because...   Most of the time, the part that was missing is the "because..."  Tell me why I should prefer your framework.  Maybe some other interpretation is not resolutional.  If you want me to look at a theoretical world is it only one without Obamacare, does the current political climate or economic conditions need to be considered?  If you want to cite a philosophical basis for your case, social contract or moral duty as least give me some kind of philosophical construct formulated by a philosopher which supports your position.  Don't expect me to prefer you and partner's theory to the exclusion of your opponent's unless you can back it with something more than your somewhat, biased interpretation.

Specific Arguments

For two days I was assaulted with evidence about the Massachusetts health care law with very little explanation about how it applied, or the model upon which it is based.  I heard one side proclaim the cost of health care premiums went up, the other side claimed they went down.  Overall the cost of health care went up, the cost of health care went down.  The number of emergency room visits increased, the number decreased.  I heard Massachusetts is not a good model for the US because the majority of residents are wealthy, and I heard it is a good model because our studies isolate representative communities which serve as a microcosm for US demographics.  When I am in a round, I know things.  After all, I research these topics pretty thoroughly.  Definitely more than the average PF judge.  Nevertheless, I really try to do my judge's duty and evaluate the round on the basis of the arguments and evidence presented by the debaters.  So for this reason, I can tell you, in most cases, I dismissed all of the Massachusetts evidence from both sides on the basis it was conflicting, poorly warranted and poorly explained why I should prefer one side over the other.  My advice, if you want to use the Massachusetts health care system as a model to support your case, you better tell the judge why it applies, make real sure your numbers are the most recent to March 2013, make very sure your evidence is not politically biased and if your evidence is challenged by equally compelling offsetting claims by the opponent's, you may want to consider a final focus which is not specifically tied to your Massachusetts evidence, because like me, the judge is very likely to just reject Massachusetts completely from her evaluation.

Health Insurance vs Health care
It seems reasonable to me we should consider the resolution asks us to examine the pros and cons of health insurance mandates, not health care in general.  But when a debater tells me I should reject any harms or benefits arising from the current state or projected state of the health care system, things starts to get difficult.  Specifically, if you tell me I should only consider advantages arising from health insurance mandates then proceed to cite reams of well-sourced evidence about the health care system, I am thinking, wait...didn't she just tell me to reject that evidence?  And while you are flying through your eloquent and carefully crafted case through subpoint after subpoint, I am still trying to figure out which parts I should sever and which retain  Quite often at the end, I realize the debater never gave me the link between the insurance mandate and the impact on the health care system.  In fact, unless your case makes absolutely zero mention of the health care system, it is probably too much to ask a judge to forget about the health care system with respect to this topic.  I personally, have no clue why anyone would expect that universal health insurance would not have a significant impact on the health care system in general.   However, that does lead to the next discussion point.

Mandated Solvency
In my opinion, the Con must overcome a very significant problem in the status quo.  Generally speaking we have a dysfunctional health care system (unless you can afford it) that is getting more and more costly everyday, is often unavailable to certain demographics and leads to productivity losses and premature death for many.  So the question is, how will universal coverage fix the harms in the status quo?  For me, this is the crux of the Con case and unless Con can demonstrate solvency for the harms then Con must find a completely different way to win.  The question is, what does does universal health insurance achieve that I should desire it?

Utopian Worlds
Finally, this is Public Forum debate. This means at some point the debate must intrude upon the world in which people like judges live.  In some cases, it is convenient for debaters to avoid certain impractical realities by constructing a kind of Utopian framework.  Such a framework may attempt to focus on, say, the benefits of universal coverage, and since the resolution does not suggest any particular plan, we need not be concerned with things like, how much will it cost, how will it be made into law, and even in some cases, we should not think about the fact that some people, perhaps millions, will decide not to accept the coverage.  We can basically achieve solvency by fiat but this is a form of case abuse I have discussed in the past (see: Affirmative Fiat).  This kind of framework is unlikely to succeed so I advise you to avoid it unless you are very skilled.

How I Voted

At the end of the first day of the tournament, I found I had favored Pro cases mainly based on the lack of solvency in the Con cases.  In some cases, the lack of solvency was due to framework problems in which debaters essentially asked me to ignore the very health care impacts which supported their advocacy.  In a few cases, the lack of solvency resulted from unclear links demonstrating how mandatory coverage produced the claimed benefits as opposed to alternative causes like market forces.  By the second day, I realized the Con cases were better and some were winning.  I am not sure if debaters were making adjustments, or random factors were involved.  I did judge a few break rounds and at this level, the debaters were much more focused upon logical analysis and empirical evidence rather than structural problems such as a faulty framework killing solvency.  The key issues were economics, quality of care and the impact of less than 100% compliance.  It would be interesting to check back in a few weeks to see how the cases have evolved but I will not get that opportunity.  Anyway, its time to start thinking about the April case.  Public much to discuss, so little time.

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