Friday, September 4, 2009

"Socialized Medicine"

Part of the health care debate we're embroiled in right now centers around whether and to what degree we should have the government involved in our health care. There are many who would (and do) connect the notion of government involvement with "socialized medicine", which, of course, is a bad word in our country.

Let's redefine the term a bit. I think the term "socialized medicine" should mean any form of medical care that is paid for and furnished by the society one is a member of. Government is one form of this, but insurance is another.

The notion of insurance comes from the concept of shared risk. I may or may not get sick, you may or may not get sick, let's create a pool of money to cover whichever one of us gets sick. I agree that I'll help you, you agree that you'll help me. The money will go to the one that needs it. This seems inherently socialistic to me.

From those that have, to those that need. Kind of the definition of the thing.

The main concern that conservatives have about the notion of a socialistic approach (to anything) is the inherent tyranny of the bureaucracy that social systems depend upon. The government, they say, will muck it up, create inefficiency, waste money, cause rationing, create arbitrary restrictions, etc...

Seems likely. Unfortunately, we have all those problems already. Insurance companies can deny coverage for whatever reasons they decide, and you have no voice (and in most markets, very little option to go to another provider). The insurance companies spend vast amounts of money on advertising, lobbying, etc... which does not help me, as the insured, to be more healthy... this is waste, from my POV.

Rationing? Any time you have a limited resource and an uncontrollable need (there are only so many health resources, we cannot control how many people get sick), the resource will be rationed, in some way. Right now it is rationed by the fact that some people cannot afford health insurance.

So... I think the "socialized medicine" boogeyman is bogus (or, I guess Boogus) because we have socialized medicine now. It's just a question of who controls it.

So, now we get to the notion of "the public option". The right wing says two things about it:

1) The government is terrible at running things. It will mess up any public program.
2) It will create competition that will drive private insurance out of business.

You cannot have it both ways. Either the public option will be terrible (in which case people will not take it) or it will be good (in which case it will provide competition for the private options). Are we saying competition is a bad thing? That seems rather un-American to me.

The truth is, the private insurance companies don't want competition, and they have paid for many a senator to fight this fight for them. It has nothing to do with socialized medicine, it has to do with money. Lots and lots and lots of money.

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