Are We Ready To Confront The Boogeyman of Socialized Medicine?

Ever since the townhall hollering sessions, the idea of socialized medicine has been lobbed at politicians as a way to reframe the health care discussion. In Newsweek, a writer opines on why a socialized of view medicine benefited her.

Barbie Nadeau pens a quick opinion piece, noting the problems she had with the health care system when she moved to Italy. She blasts the doctors and nurses there for the "anachronistic approach toward mothering and the lack of communication" and reminds readers of an opinion piece she wrote in 2002, titled "Next Time, I'll Pay." So what changed in the ensuing seven years? Just her perspective:

I still dislike the way they treated me, his mother, but my son is alive today and I didn't have to go in debt to save him.

But it never really occurred to me just how important the outcome was, at the expense of all the other atmospherics, until I found my lump. Living without health insurance in America for nearly eight years was a huge risk. Back then I was too old to ride along on my parents' health policy (they were farmers so their policy was complicated and expensive), and I made too much money to be covered by Medicaid or social assistance. I worked for a small magazine that couldn't afford to pay benefits, but I took the job because I needed journalism experience and bylines. I couldn't have afforded even the most basic coverage on my own: cash went to rent, food, and car insurance-because it had to. Like a lot of underemployed, I just hoped to stay healthy. It was before the Internet, and I couldn't Google symptoms or home remedies. When I was seriously sick, I either ignored the symptoms or borrowed prescriptions from friends. Back then I would not have had this lump checked out. I would have ignored it and simply hoped it went away.

A lot has changed since then. Not only have I moved abroad, but I also married into a private-insurance policy that works in conjunction with Italy's socialized health-care system. Many Italian residents have basic public health insurance but navigate the system using private health care when it is urgent for things like fevers and anomalies like breast lumps. (Private insurance costs a fraction of what it costs in the United States.) A basic family policy in the States, according to a USA Today poll, runs up to $13,375 a year, whereas its Italian equivalent costs roughly $1,500. Government-sponsored health care suffices for routine issues like for vaccinations or specialized equipment like mammograms or MRIs. I had my private doctor diagnose my lump and then visited a public facility for the specialized ultrasound. I had a private surgeon remove it last week.

Ultimately, Nadeau wishes the systems were different and notes that each system has it's own flaws. But at the end of her second piece, she reinforces that ultimately, the outcome - a healthy and still living son, the removal of her lump - made it all worthwhile.

Over at the Washington Post, Ezra Klein also tries his hand at demystifying the terms socialism and equal payer, and explains:

About 30 percent of Americans think HMOs are socialized medicine. Which implies a couple things. First, the term "socialized medicine" has been diluted beyond all meaning. Second, it's no longer considered a terrifying outcome. And third, nothing that's this amorphous — and actually preferred by a plurality of the population — is likely to prove a terribly effective attack against health reform. Socialized medicine has become such a stand-in for "not this system of medicine" that it's begun to look good in comparison.

Meanwhile, what we're actually going to get is not socialized medicine or single-payer health care. It's a hybrid system. Private insurers, hopefully competing with a public option. Private doctors and private hospitals. Government regulation and subsidies. It's going to be complicated and messy and inefficient and hopeful and the product of a strange mix of corporate preferences and public compassion and latent populism. It will, in other words, be a uniquely American system, and hard to describe with a single epithet.

So why is there such animosity toward socialized medicine?

Perhaps it started with Ronald Reagan.

Now, my own views on Ronald Reagan are informed by having black parents in the 1980s, so I learned Reagan was like this:

Seriously. I still remember a conversation like this:

Me: Mommy, why are there so many homeless people on the streets?
Mom: Reagan.
Me: Why do they talk to themselves?
Mom: Ronald Reagan closed the places where they could get better in order to save money. They have no where else to go to be alone, so they talk to themselves on the streets.
Me: Was Reagan mean?
Mom: He was the devil incarnate.

But to many conservatives, Reagan is an icon who staunchly defended personal freedom and liberty. In 1961, Reagan - then a private citizen - assisted with Operation Coffee Cup, an appeal to voters to vote against socialized medicine. Here's one of the most famous addresses below (audio only):

The legislation Reagan spoke out against would eventually become Medicare.

These ideas about the erosion of personal freedom are quite powerful. In 2005, the Winter Cato's Letter featured John Goodman speaking out about the myths of socialized medicine. He raises some good points, particularly when discussing how some systems start to thrive on the inefficiencies and how marginalized populations tend to suffer under government run initiatives. (Check out the Indian Health Service for how that plays out today.) However, one of Goodman's key points falls a bit flat:

The cosmetic surgery market is about the only market where patients are really spending their own money. And guess what? It works like a real market. People get package prices. They can compare prices. And over the decade of the 1990s, the average price of cosmetic surgery actually went down in real terms, even as there were all kinds of technological innovations that we are told drive up costs elsewhere.

Well, one of the reasons that cosmetic surgery can function like a real market is because cosmetic surgery is an elective surgery. You can postpone a nose job indefinitely, but not a ruptured artery. So in this case, does our adherence to free market principles still work ? Or is it as Nadeau states, where the outcome is what needs to be prioritized?

On Second Thought [Newsweek]
Next Time, I'll Pay [Newsweek]
Health Reform for Beginners: The Difference Between Socialized Medicine, Single-Payer Health Care, and What We'll Be Getting [Washington Post]
How AMA 'Coffeecup' gave Reagan a boost [SFGate]
Cato's Letter - Winter 2005 [Cato Institute] (PDF)
Who Is Responsible for Your Health Care? [Racialicious]