WP: 'Socialized Medicine' Quackery
By Ezekiel J. Emanuel
Monday, October 8, 2007; Page A17
Nearly two decades after the West's victory over communism, one might have thought it possible to discuss reform of the health-care system without invocations of the old saw "socialized medicine." But no. "At least Mr. Baucus isn't disguising his socialist goal," a Wall Street Journal editorial claimed about the Montana senator's push to expand the State Children's Health Insurance Program. "In sum, SCHIP turns out to be socialized medicine for 'kids,' " wrote Post columnist Robert Novak. Rep. Paul Ryan (R-Wis.) said the "SCHIP bill is not a back door to get socialized medicine. They went straight to the front door." Rudy Giuliani argued: "The American way is not single-payer, government-controlled anything. That's a European way of doing something; that's frankly a socialist way of doing something."...
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To the extent that any health insurance scheme involves spreading among members of society the financial risk of getting sick, all insurance "socializes" the risk. This is, of course, not what people mean when they level charges of "socialized medicine." This term is never used in reference to police protection, fire departments or highways -- all of which are provided by government....
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Socialized medicine cannot mean that the government pays for part or all of health care while it is provided by doctors in their private practices and at private and (frequently) for-profit hospitals, commercial drugstores and the rest. If that were the case, Medicare would be socialized medicine. Maybe the people throwing around that epithet believe Medicare is "socialized medicine," but they certainly have not told the elderly -- who are well satisfied by Medicare. Most do not have the courage to openly oppose -- and seek to end -- Medicare because it is "socialized medicine." Indeed, some of those who invoke the epithet have praised, as Novak put it, the "popular private Medicare program."
None of the proposals by the three major Democratic presidential candidates can be characterized as socialized medicine....
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It is absurd to call an expansion of government payments for health care in the existing private delivery system socialized medicine. Politics may be full of hype, exaggeration or partisan bickering, but there should be no place for overt deception. A serious debate about whether and how to reform the American health-care system requires that we eliminate comments whose only purpose is to mischaracterize and misinform....
(Ezekiel J. Emanuel, an oncologist and the author of "No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence," chairs the Department of Bioethics at the National Institutes of Health.)
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