Society, Government, and Medicine

In the minds and eyes of some, “socialized medicine” is the product of socialism and must be resisted at all costs. (Think: “Alamo.”) Critics decry what they call “socialized medicine” at every turn. One claims that the federal government funds medical research “…from taxes confiscated from the people at the point of a gun.”

I think that the arguments against socialized medicine are really arguments against the possibility of a US national health care system. For me, these arguments against government-sponsored or mandated national health are specious, fallacious. Why?

What is “Socialized Medicine?”

According to Merriam-Webster, “socialized medicine” is:

“…medical and hospital services for the members of a class or population administered by an organized group (as a state agency) and paid for from funds obtained usually by assessments, philanthropy, or taxation.”

The Health Care “Marketplace”

According to some, a marketplace for health care exists and should be encouraged by less restrictive or—ideally—no government regulation and interference. There’s a problem with this concept, however. While it is true that one can “shop” for practitioners, hospitals, and clinics, one’s shopping is limited to the choice of a named individual or facility.

The classic concept of a marketplace is a mall or street lined with entrepreneurs offering their products or services for sale or hire. How does one choose from amongst these? By comparing prices and inquiring about other tangible elements, such as warranty, service, period of performance, and so forth. When you go to a dealer to purchase a car, do you select a make and model, along with the add-on enhancements and sign a contract without knowing the price?

Okay. Use your favorite Web search engine or go immediately to the Web site for a hospital or doctor—any hospital or doctor. Do you see a list; can you find a list, of prices for the procedures and services offered?

“Boston hospitals form an oligopoly, dominated by an almost monopolist Partners Healthcare, which last year earned around half a billion dollars in profits. As for health insurance, many employers offer a choice of one – or a choice of firms with virtually identical policies. And if you need an operation, there's no way to learn about histories and prices of potential surgeons…If this is a market, I am Angelina Jolie.”

Regina Herzlinger, The Boston Globe (February 18, 2009)

Procedure and services costs are published, but only to select groups. For instance, prices must be reported to the Centers for Medicare and Medicaid Services (CMS). Why? So that CMS staff can evaluate them against other data and derive maximums paid by these programs.

It’s a safe bet that the companies that own hospitals and that comprise modern medical practitioners groups research their competitor’s costs, too. Whether they do this so as not to undercut the others or to offer better prices to health care “consumers” is another matter.

You will see the price for the services and facilities you choose. When they bill you.

The “Socialized Medicine” Impetus

Despite the wailing and gashing of teeth by supposedly “conservative” squawkers, most US citizens expect and appreciate federal and state “intervention” in the health care “market.” The questions about our health care system include:

• Cost
• Rationing
• Availability

Cost

Despite all apparent efforts—which I believe are little more than political posturing—health care costs have risen exponentially every year. (Some would claim that, without the moves to contain costs, the efforts I characterize as “political posturing,” health care costs would have risen even more dramatically.)

• In 1950, the estimated cost of health care paid by individuals, companies, and government was $12.7B, or 4.5% of the gross domestic product (GDP)
• By 2000, we spent approximately $1.2 trillion, or 14% of our GDP, on health care

We are often told that there are many fewer people covered today by health insurance than had such coverage even ten years ago. Wonder why?

Economists have found that rising health care costs correlate to drops in health insurance coverage.

The Uninsured: A Primer, Key Facts About Americans without Health Insurance, The Henry J. Kaiser Family Foundation (10 November 2004)

Rationing

Another major argument used against a national health system in the United States involves the horror of health care rationing. This is stridently trumpeted in today’s media:

• Obama Will Ration Your Health Care (The Wall Street Journal)
• Rationing health care (Editorial, The Washington Times)
• Ruin Your Health With the Obama Stimulus Plan, Commentary by Betsy McCaughey

If you read any of these, you may come away with the scary thought that our very popular President and his henchpeople really want the federal government to tell your physician what to and what not to do with you and your loved ones. And, besides, the Administration’s plans are intended to move the US squarely into a socialist state, too.

Consider:

Our health care has been rationed for quite awhile—even before Medicare and Medicaid—to say nothing about the still unsubmitted Obama health care reform package.

• If you cannot afford something, you don’t get it done. That’s pretty simple, and it is rationing.
• If your HMO refuses to provide a treatment, procedure, or prescription drug, that’s rationing. And, it happens every day here in the US. (Okay, it happens elsewhere, too.)

Since rationing is a fact of our health care lives, the issue is not well-used as an argument against a national health care system.

No, I am not in favor of a bureaucrat dictating treatment to a patient and her or his doctor. I don’t care whether that bureaucrat works for the Acme Beneficially Superfluous Health System, Inc. or for the federal government. On the other hand, we make decisions—sometimes, unfortunate situations require us to make decisions—that ration health care. None of us possess unlimited resources.

Availability

A complaint often made about the British National Health is that patients are required to use NHS facilities and practitioners. While this is not technically true, in practical terms, most choose to use the “free” NHS over private facilities and doctors.

Using the same comparison between the theoretical and the practical, all US citizens are free to choose a doctor or a hospital. The reality is, of course, that our freedom to do so is limited by our ability to pay.

Public law requires that hospitals, whether private or public, serve indigent patients through their emergency medicine services. We read complaints by some of how poor people, or supposedly poor people, flood emergency rooms with complaints ranging from the common cold to serious trauma. Critics point out that no service is free; that the costs of treating the indigent are passed along unfairly to those who have insurance and the means to pay.

Are health care practitioners and facilities available to all US citizens and legal immigrants?

Yes and No.

Would public access to health care be more restricted by a national health care system?

It is hard to see how that could happen.