In the words of Amy Winehouse: "What fuckery is this?"
The debate on health care reform in the U.S. has taken such an absurd turn that I cannot help but contemplate the possibility that anything done by Congress to "reform" a broken system can only make things worse, and through the diluting effects of compromise and consensus can only result in the eventual resurrection of the republican party. Never before have I seen a political party with so many aces in its hand fold before a weak and fumbling opposition.
The insurance and pharmaceutical companies, politicians, talking heads, and yes, even many doctors have done a very good job of keeping the American public ignorant of many of the facts about how socialized medicine works in the countries that have it (that is, all the countries that the World Bank classifies as "developed"). I would not be writing this if I had not witnessed the same ignorance expressed here on occasion.
No doubt the first step in understanding socialized medicine (and I am right to call it that, and will continue to call it what it is: the socialization - that is to say de-capitalization - of the practice of medicine) is to understand that it is not a strict set of policies designed to socialize medicine, but rather the understanding that it is a necessary component of the functionality of the modern state to ensure the health of its citizenry, just as roads and education are. Each country has developed its own system of socialized medicine, some with the stroke of a pen, others through more gradual, piecemeal reforms. I personally suspect that the prime reason that the form of socialized medicine in Anglo- countries is discussed so much in the US, aside from the facility of a common language, is the fact that these are some of the more poorly performing models. There is also a reactionary opposition press (curiously also owned by a Mr. Rupert Murdoch) in some of these Anglo- countries who are quick to trumpet the slightest flaws in their respective systems. Generally speaking, however, there are some basic tenets that accurately describe what a system of socialized medicine looks like, and which many Americans seem to fail to comprehend, thanks in large part to a mendacious media and business class.
- Most countries with single payer systems also allow private insurance companies to operate. I suspect that a large reason this is not discussed in the American debate-and-rodeo-show-on-health-care-reform is that the obvious result of such a "mixed" system is that private insurers have to compete against such a safety net, and thus have to keep rates competitive in order to maintain market share. Some people see socialized medicine as a safety net in such countries. I personally have relatives who live in countries with socialized medicine. Some of those who can afford it have private health insurance for various reasons. Many at much cheaper rates than in the U.S. This is a market based solution, albeit one where a government represented by the people competes with private tyrannies.
- Choice is not the number one criterion in any viable, practical health care system. It is certainly not the criterion in our present system, although the insurance companies would like for us to believe otherwise. The number one criterion is access. I have lived in a country where I could not choose my doctor, but he was the same doctor that treated the rest of my family, he was a member of the community, and he was so accessible that he made house calls, something virtually unheard of in the U.S.
- It is not just about access to health care, it is about access to life saving medicines. Pharmacies in countries with socialized medicine are often required to work in rotation to ensure that patients always have access to emergency medicines, and also have broader authority in the dispensing of drugs (antibiotics, for example, are available without a prescription).
- For the most part, socialized medicine empowers members of the medical profession. The decision making process is entirely in their hands. Administrative is there to facilitate the work of health care practitioners, not to hamper it.
- Socialized medicine is an extension of such concepts as the Center for Disease Control. It is a national security matter to have a healthy, hearty and hale populace who can survive pandemic outbreaks, aided by the quick, concerted dissemination of accurate information and unhindered access to medical professionals.
- The money is already there. Our problem in affording single payer is that we cannot have "guns and butter" at the same time. A fraction of the $400 billion dollars that we spend every year on "defense" – more than the sum total of all the military budgets of all other nations combined – could easily cover the costs of converting to and maintaining a single payer program, with no additional cost to the taxpayer and no significant risk to our national security. And it is guns that have made us not only fat, but insular, belligerent and myopic as well. There is an enormous peace dividend available, if only we could reign in the wreckless giant that is the Military-Industrial Complex.
This is by no means a complete list. The point is that the only thing lacking in pushing socialized medicine through in America is political will, and that the political will to do so has been hamstrung by big business afraid of losing market share to public health insurance. The only reason to take a path other than socialized medicine is corporate and congressional greed.