What is the fear that people feel, when they hear the words, “Socialized Medicine?” I believe it’s the fear that a government will interfere with the practice of medicine in their country and somehow restrict or ration the medical care, which they can receive. I also believe that this fear is well founded, since that is precisely what occurs in the British National Health Service (NHS) and in the Canadian System. Long waiting lists for surgeries and specialty consultations are the prototypic example of this interference.
Well, just what is the practice of medicine? The practice of medicine, the essence of medicine, is the doctorpatient relationship, from which non-conflicted medical decision making is supposed to ensue. And this is the exact place, where those governments interfere.
What is socialized medicine, really? Socialized Medicine refers to a health system in which the government owns and operates both the financing of health care and its delivery. (http://economix.blogs.nytimes.com/2009/05/08/what-is-socialized-medicine-a-taxonomy-of-health-care-systems/) I refer to this as an economics-political policy definition, and it does not apply to the American healthcare system, outside of the V.A. health system, which is a pure form of socialized medicine (Ibid: above link).
However, what is the effective definition of socialized medicine, the on-the-ground, actual definition? Of course, it must mean socialized doctorpatient relationships, i.e., relationships between doctor and patient, which are influenced, affected, controlled, or obstructed by powers and forces, from the government payer or any other payer, extraneous to the simple, mutual trust between the two participants.
Now, let’s take another look at the American healthcare system. Outside of our government payer for our various entitlement programs, does any other payer try to influence the functioning of the doctorpatient relationship? The answer is an emphatic Yes. Health insurance carriers, managed care companies, and HMOs try to control the functioning of the doctorpatient relationship by forcing various plans and restrictions upon it, ranging from outright obstruction to financial incentives for doctors and patients.
Why do they do this? Because the doctorpatient relationship is the proximal source and cause of healthcare spending in the USA, and their motive is to reduce that spending as much as possible, so that they can keep more money for themselves and their other business agendas outside the practice of medicine.
Thus, American Health Care is already “Socialized” and has been for a long time. However this fact is hidden from the general public (hidden in plain sight) by the continual use of the obfuscating rhetoric, which compares the Private vs. Public payers. As long as the politicians, health insurance carriers, hospital administrators, and other healthcare corporate leaders keep this rhetoric in play, the average person will continue to fear a single payer system. And, that’s their goal: Keep the average person bewildered so that their intertwined web of greed and power can continue, unrecognized for what it is. This web exists for politicians of both major parties, and, I expect, it will also entrap the Tea Party politicians.
The reason to keep this fear spreading among the American people is that a single payer could effectively ‘Unsocialize’ the doctorpatient relationship, i.e., allow it to develop and function free of restrictions imposed by the payer, and ‘Socialize’, bring some order and control to, the unbridled, greed-driven capitalism of our healthcare economic marketplace. This would be the exact opposite of our current system, which privatizes the business of medicine and socializes the medicine of medicine. All of us actively supporting this opposite effort is the path for true healthcare reform. My book, Socialized Health Care Reform ISBN: 978-0-9829947-0-2 clearly explains all of this and describes a way forward, which would benefit everyone living in America, save greed-driven healthcare business people and power-driven, arrogant politicians.
In my next post, I will try to explain how I see this single payer functioning, so that it does not fall prey to the cunning, scheming, unscrupulous, and disastrous manipulations of the healthcare economic marketplace, which is networked with Washington, DC.
R. Garth Kirkwood, MD