The Case Against Socialized Medicine

The Daily Beacon ^ | 09/28/2004 | John Brown

[johnnyb325]

One of the greatest dreams of American liberals is a nationalized health care system similar to the one in Canada. They argue in favor of such a system because they believe health care is a basic "right," and because they believe the current system is flawed beyond repair. As with most problems, they advocate government solutions, not private enterprise solutions. Unfortunately, the government has an abysmal record of correcting problems, and American health care would be no exception.

First, let's examine the "right to health care" claim. Obviously, there is no right to health care established in the U.S. Constitution. However, we do have a moral right to health care, some will argue. Unfortunately, those who make this argument do not understand what a "right" is.

A "right" is the ability and autonomy to perform a sovereign action. In a free society founded on the ideal of liberty, an individual has an absolute ability to perform such an action - so long as it does not infringe upon the rights of another individual. Health care is not speech: In order for you to exercise a theoretical "right" to health care, you must infringe on someone else's rights. If you have a "right" to health care, then it means you must also have the right to coerce doctors into treating you, to coerce drug companies into producing medicine and to coerce other citizens into footing your medical bill. This is Orwellian. "Freedom" for you cannot result in slavery for others. Thus the concept of a "right" to health care is an oxymoron: It involves taking away the rights of other individuals.

Surely, though, we can agree that doctors, the pharmaceutical industry and insurance companies earn excessive profits, you say. Well, that depends on what your definition of "excessive" is. Doctors literally hold the lives of their patients in their hands. How much is someone who saves lives everyday worth? The same is true of pharmaceutical companies. While it has become fashionable to condemn their profits, the fact is that these profits fund medical research, which leads to more medicines being produced, and, consequently, more lives saved. Insurance companies spread the cost of health care among many people who might not otherwise be able to afford it, and thus make health care readily available for many.

While on the topic of profits, we should examine them. The word "profit" is considered to be a dirty word by many on the political left, but why? What makes a profit bad? Nothing. On the contrary, profits are very positive. When you come to class in the morning, there is a good chance you either drive a car or ride a bus. Do you think the bus driver and the workers who built your car or the bus did so that you could get to school on time? Of course not, they did because they wanted to make money. Yet their pursuit of a profit benefited them as well as you.

Adam Smith once said, "It is not from the benevolence of the butcher, the brewer or the baker, that we expect our dinner, but from their regard to their own self-interest." As we have seen, profits and self-interest are not bad things.

Let's pretend, for a moment, that the left gets its way, and the United States adopts a universal health care system. This profit motive will effectively be removed. Doctors will then be government employees, and, as such, have far less accountability, as well as lower pay. Could we still expect the best and brightest to strive to be doctors? Probably not. More than likely, they will pursue other careers where they can make more money.

Some love to bemoan the fact that the United States is one of the few industrialized nations without a government health care system. Yet they rarely note that the United States produces disproportional amounts of the new, life-saving drugs, largely because of the profits drug companies make. Will we continue to produce these drugs if we abolish the profit motive? Not likely. Chances are, they will not be produced at all, and more people will needlessly suffer and die as a result.

When we examine countries that have embraced socialized medicine, we find long waiting lists, expansive red tape and little concern for the individual. Do you really want to be told which doctor to go to? Do you want to wait years to have necessary medical procedures performed? If so, then socialized medicine is for you.

But if you believe in individual rights, competent healthcare and sound economic policies, we must get the government out of the doctor's office.

- John Brown is a senior in political science. He can be contacted at jbrown44@utk.edu.

[cynicom]

I was addressing the concerns of physicians here on FR.

Some have made it plain that they should not be forced to serve people that cannot pay and that government has no right to force them to do so. I have to agree.

However these same physicians use the government to enforce the law that ensures there is no alternative. Medical profession cannot have it both ways, use of government to determine the number of physicians and to maintain a closed shop in the labor union mold.

If the people of little or no resources are the bane of the medical profession, by all means do not restrict the same government from providing for someone to service them for what they can afford.

Failure to do will ensure socialized medicine.

[upcountryhorseman]

It is your responsiblity to take care of
yourself, not the taxpayer. There are many ways to provide for illness and injury even though you don't have a lot of money. Kaiser offers individual health plans at a reasonable
price. You can obtain catastrophic health insurance with a
high deductible and put the amount of the deductable in a
savings account.

[Eva]

In case you return to discuss this subject further, I live on the Canadian border and know for a fact that the story I told you about my sister-in-law is not an isolated example. My Canadian friends tell me that it can take six months to see an oncologist after being diagnosed with breast cancer. It can take three to six months for knee surgery, tell that to your budding young basketball player after he blows his knee out in the preseason. I'm not making this up, these are all examples of people that I know. Socialized medicine is nothing but triage. It works for preventative care and minor illness, but don't get really sick or injured, and don't get old.

[socialismisinsidious]

Japan does have a pretty decent system in terms of getting the care to the people. Of late though, because of the aging population and long life expectancy (and the economic problems Japan has had), Doctors in Japan have been complaining that they can't afford to practice. They feel that way because of the rising cost of health care and the low reimbursement from the government to doctors. The last article I read said that doctors in Japan feel that the crisis is critical and that they are facing financial ruin because they are forced to rely on very low fixed government prices for their income. There are also some complaints that drug companies are being paid up to 10 times the cost of the medicines while doctors are not being paid enough. They are warning of a mass exodus from their profession and are continuing to lobby their congress.
It will be interesting to see how they resolve this crisis.

[Mr. K]

SOCIALIZED MEDICINE- DECIDING YOUR HEALTH WITH THE SAME PEOPLE WHO WORK AT THE DMV!

[Mr. K]

"...the United States is one of the few industrialized nations without a government health care .."

And also the best health care in the world...coincidence???

[Marathoner]

Just noticed that this article was written by a PolSci major??? At a state University??? Maybe there's hope for this country yet.

[Veritas et equitas ad Votum]

Then I guess you're one of the majority of Americans who are afraid of freedom.

I believe simply that a person is not entitled to consume more than he or she produces. If a person cannot afford housing, he can sleep in the street. If a person cannot eat, he can go hungry. This is the only motivation that can drive people into actually working/learning to be productive members of society. If welfare programs actually worked, then the past 50 years of them in this country would have eliminated the problems, right? The war on poverty is a failure, and so is socialism in all forms. Why don't liberals accept this as true? It's been tried time and again, and it always fails.

[A Ruckus of Dogs]

Re-read my post. I am not advocating socialized medicine for the US. I should have stated this directly, since on this forum any good thing pointed out about socialized medicine is automatically translated into support for the idea(constricted mentality of too many Freepers who only think in black and white).

There are shortcomings with our system (possibility of personal bankruptcy). And there are shortcomings with the socialized system (long waits and so forth). Both systems have their benefits. That was my argument. If socialized medicine were all bad, Europeans would have ditched it long ago. I have family in Europe - I know all about the good and the bad.

Keep in mind that Medicare is socialized medicine for the elderly. Few retirees are calling for its elimination.

As for the novacaine, there are certain parts of medical treatment my insurance doesn't pay for either.

[A Ruckus of Dogs]

Families, churches, and voluntary associations can do a far better job of caring for the poor and needy than government bureaucrats.

Generally this is true, but in some cases it isn't. For example, the hundreds of mentally ill homeless we have wandering the streets of some of our big cities. The cost of maintaining these folks in an institution goes beyond the budget of the average church and voluntary association. Government is the only entity that has the millions of $ it costs to do it.

[snowsislander]

They feel that way because of the rising cost of health care and the low reimbursement from the government to doctors. The last article I read said that doctors in Japan feel that the crisis is critical and that they are facing financial ruin because they are forced to rely on very low fixed government prices for their income.

The fly in the ointment is the cost, particularly as the population ages; as I said before, it's a gold-plated system.

I hadn't seen the stronger language that you had seen, but I did find a British Medical Journal article that even used the same phrase of "mass exodus."

I then went over the Japan Medical Association's website, and read a bit. Taking into account natural Japanese reticence, I thought this was interesting:

5. Assuring a Solid Financial Basis for Medical Practitioners

Under the Social Insurance System in Japan, the entire population is covered by some form of medical insurance, and people can choose any medical institution to receive medical care at officially-set prices. The government decides a single fee for all forms of treatment. The decision is reviewed by the Central Medical Council on Social Insurance, an advisory body to the Minister of Health, Labour and Welfare. JMA recommends its members for inclusion in this panel to assure that its views are reflected in the council's decisions.

Regarding remuneration, medical institutions must rely on income mainly derived from the very low officially-set prices and are thus facing an increasingly bleak financial situation. The JMA is engaged in various lobbying activities with the National Diet (legislature) and related government ministries in an effort to establish an adequate remuneration system for the medical community.

6. Countermeasures Against an Aging Society (Long-term Care Insurance System)

In tandem with the aging of Japanese society and the yearly increase in the number of bedridden and elderly patients in need of nursing care, the JMA has continuously advocated access to health care services that would enable the elderly to live their lives in security, free from anxieties about health care. A long-term care insurance system that integrates nursing care services aimed at meeting the special health and lifestyle related needs of the elderly and quality health care services that promote health, disease prevention, treatment, and functional training was established from April 2000.

To promote the participation of the elderly in society and to mobilize society in general, the JMA announced its "Grand Design for Health Care in 2015" which introduces its intermediate vision on social security reforms. The JMA advocates the establishment of a new health care system that includes health insurance for the elderly over the age of seventy-five to resolve the various problems that stem from the existing system for the elderly.

7. JMA Professional Medical Liability Insurance System

Unexpected physical disorders or even deaths may occur in the course of routine medical practice. Although still rare in Japan, patients do file claims against physicians.

To settle conflicts under the civil law between patients and physicians regarding medical errors, the JMA created its own system called the JMA Professional Medical Liability Insurance in July 1973. As an academic organization responsible for medical care that is provided to the public, JMA is engaged in a wide range of activities, (1) concluding contracts with insurance companies, (2) establishing an authoritative and neutral body to deliberate disputes among members, (3) offering insurance coverage that enables physicians to pay large liability claims if they are held liable, and (4) cooperating with prefectural medical associations and insurance companies in settling disputes and seeking legal advice when necessary.

We take pride in this system of addressing disputes involving medical accidents, which has no parallel in other countries.

While the system currently works for Japan (and funding it in the future is a legitimate question), I am not sure what we can take away from it. As mentioned in the last paragraph, Japanese don't generally sue; Japan doesn't even have many lawyers, and I don't know if they have any that specialize in liability cases. This is in marked contrast with the U.S., where we have packs of lawyers with big billboards and disgusting television commercials encouraging people to "sue, sue, sue!"

[Eva]

There is a reason why the US has the best doctors in the world, it's called free enterprise. If you notice that the politicians all seem to exemmpt themselves from the socialized programs, as do most wealthy citizens. The public health system was about the only form of socialized medicine that I can support. It provided care for the indigent and would work well if combined with some kind of hospitalization insurance. The main objection that I have to socialized medicine is that it doesn't work without mandatory membership because it creates a two tier system and few doctors would be willing to participate. That is actually the reason that the public health system was abandoned, the doctors refused to participate.

[Veritas et equitas ad Votum]

Surely there are some good points to socialized medicine, and anyone unwilling to concede that simple point is not interested in honest debate.

However, freedom is not about me paying for my neighbor's medical care today so that his child can pay for mine tomorrow. Freedom is simple, if you want to use prescription medication, pay for it yourself. If I want to do so, I'll assume the cost. (Now, by pay for it, I mean obtain insurance or pay the bills) Medicare, prescription drug subsidies, and social security are completely unConstitutional and are not what this country is supposed to be about. They are all socialist at the core, and they undermine individual liberty. Continued federal spending on these programs are going to lead to an America which is totally bankrupt.

***Remember, for those Americans who think the Canadian/German/Japanese/French/British system is so great, and ours is so bad, they are FREE to move there.

[Logophile]

Generally this is true, but in some cases it isn't. For example, the hundreds of mentally ill homeless we have wandering the streets of some of our big cities. The cost of maintaining these folks in an institution goes beyond the budget of the average church and voluntary association. Government is the only entity that has the millions of $ it costs to do it.

Not so. Private charities and religious groups can and do operate extensive charitable organizations, including hospitals and universities. For instance, I just heard a radio ad touting the Shriners' hospitals. They claim to spend a million dollars a day on burn care, at no charge to the patients. That is just one organization out of many.

Besides, government has so much money only because it has taken it at the point of a gun from productive citizens. Reduce the enormous burden of taxation, and these same citizens would be able to support all sorts of charitable efforts.

[Protagoras]

The only good thing I can think of about socialized medicine is that no one has to worry about being bankrupted by medical bills.

No, they usually just die. Their worries are over.

[A Ruckus of Dogs]

Some can certainly afford to do so, but there are not enough of them. There would not be a homeless problem otherwise. The mentally ill need to live in hospitals - they must be maintained by others permanently. It's not the same as helping someone who is temporarily on hard times get back on their feet.

The core problem is that medical care and maintenance (psychiatric, nursing home, etc) are astronomically expensive. Once this issue is resolved, you'll see the private sector do more.

[Logophile]

Some can certainly afford to do so, but there are not enough of them. There would not be a homeless problem otherwise. The mentally ill need to live in hospitals - they must be maintained by others permanently. It's not the same as helping someone who is temporarily on hard times get back on their feet.

The "homeless" problem does not stem from a lack of funding for mental health programs. More important are the changes in vagrancy laws and the move toward de-institutionalizing mental patients. As long as alcoholics, drug addicts, and the mentally ill are allowed to wander the streets, there will be a homeless problem.

The core problem is that medical care and maintenance (psychiatric, nursing home, etc) are astronomically expensive. Once this issue is resolved, you'll see the private sector do more.

If, as you say, the core problem is that care is too expensive, how will more government interference improve matters? Governments are not more efficient at providing goods and services than the private sector--just the opposite.

There is nothing magical about government funding of health care. Whether the government writes the checks or a private organization does, the money eventually comes from the same source: those who work and produce. The difference is that private funding is more compatible with a free society.

[wordsofearnest]

I agree less government interference is the part of the answer along with tort reform. Defensive medicine adds quite a burden to the system.

Medicare and Medicaid don't pay their share they pay less than half and call it their share and force the provider to swallow the rest. That's why prices are so high for us left in the "non-govermental" part of the healthcare market. Cost shifting.

[A Ruckus of Dogs]

The "homeless" problem does not stem from a lack of funding for mental health programs. More important are the changes in vagrancy laws and the move toward de-institutionalizing mental patients. As long as alcoholics, drug addicts, and the mentally ill are allowed to wander the streets, there will be a homeless problem.

In New York City, which is an hour away from me, the homeless problem was increased substantially when the government closed a lot of public mental hospitals because of lack of funding.

No one wants vagrants on the streets, but the private sector obviously can’t handle them all. Some of these mental cases have pushed people in front of trains on the subway. If the private sector can’t afford to care for them, then the government has to, just for the sake of community safety.

Governments are not more efficient at providing goods and services than the private sector--just the opposite.

Depends which goods and services you mean. The private sector is better at some, the government at others. It’s kind of short-sighted to think government does EVERYTHING worse.

Whether the government writes the checks or a private organization does, the money eventually comes from the same source: those who work and produce. The difference is that private funding is more compatible with a free society.

On that I will agree.

[Logophile]

In New York City, which is an hour away from me, the homeless problem was increased substantially when the government closed a lot of public mental hospitals because of lack of funding.

Without more information, I cannot comment on what happened to the public mental hospitals in New York City.

Even if you are right that the government must pay for some services, such as long-term care for the mentally ill, it does not follow that the government should also pay for all medical care for everyone.

Depends which goods and services you mean. The private sector is better at some, the government at others. It’s kind of short-sighted to think government does EVERYTHING worse.

I will meet you part way by saying that that the private sector is better at almost everything. At the same time, I am curious to know which goods and services the government delivers more efficiently.