Socialized Medicine

My apologies if this has been discussed before, but as you may know, the search engine sucks ass.

So what’s wrong with socialized medicine? There are an ungodly number of people in this country who are uninsured or insured by corrupt insurance companies that deny every single claim. And I can’t stand that “pre-existing condition” bullshit. Everyone needs medical care, and those with chronic ailments need it the most.

Seems it would be cheaper if the government acted like one big insurance company, with every worker and employer paying premiums. It would save money because the government wouldn’t have to advertise and wouldn’t have to turn a profit. And there would be none of this “insurance company A covers this treatment, but insurance company B covers that treatment, etc.”

When insurance companies start to tell qualified doctors not to perform the treatments they think are best, that’s when it’s time to start questioning the whole system. Fat cats with dollar signs in their eyes don’t give a fuck if you have cancer.

Are you just trying to get me to write your high school essay for you?

“Everyone needs medical care, and those with chronic ailments need it the most.” Wrong. Everybody does not need medical care, and (generally speaking) those who need it the most are those who treat themselves the worst.

“Seems it would be cheaper if the government acted like one big insurance company, with every worker and employer paying premiums.” If the government handled it, it would be cheaper? Gosh, that sounds nice, except each of the ten gazillion times that governments have handled stuff instead of relying on the competition of the free market system, it has cost more. Too bad. Maybe the next attempt at workable socialism will be the magic experiment that finally works.

“When insurance companies start to tell qualified doctors not to perform the treatments they think are best, that’s when it’s time to start questioning the whole system.” How’s that? Dump your insurance company, if they’re scum.

Who do you think would run the government programs anyway? What jobs do you think the fat cat insurance company people would move into, if they were out of the medical insurance business? They would become the governmental insurance people. How would that help anything? Their venality wouldn’t even be tempered by the marketplace anymore. As government employees, they could do as they like more than now. Have you ever dealt with a government employee?

“So what’s wrong with socialized medicine?” But the main problem with your idea is that it robs me of my rights to choose to live life my own way. You clearly wish to have decisions made for you but not all of us agree with that.

So many things, but here’s a few: (1) peaceful honest people should be free from the coercion of other people; (2) government is not a self-standing entity, but is composed of people — politicians who indeed do make a “profit”, and bureaucrats who are obsessed about paperwork; (3) rather than the freedom to choose among plans, some good, some bad, we would have only one option; (4) my need ought not to constitute your obligation; (5) there is already socialized medicine in the form of medicare and medicaid; (6) government interference (aside from supressing coercion) in the affairs of free people leads to authoritarianism; (7) free people are capable of thinking for themselves (otherwise, what makes them capable to elect the right politicians to think for them?); and (8) freedom matters. Or at least used to. But socialized education is changing all that.

“It is lucky for rulers that men do not think.” — Adolf Hitler

Okay, you guys make some good points (some more assholish than others). It just seems to me like the cost of medical care is totally out of hand. In the 1950’s your average doctor made 2.5 times more than a unionized laborer. Today it’s 6 times more.

If I want insurance, it’ll cost me $75/week!
That’s almost as much as my rent.

In Canada it costs workers $23/week in taxes to pay for the socialized medicine, but the quality of care is far lower.

I believe some kind of middle ground could be worked out where only people who wanted to take place in the system could pay in small amounts and get very basic care or emergency services covered. You could also purchase other insurance to supplement or replace the government coverage.

Perhaps I spoke too soon before advocating entirely socialized medicine. I didn’t really think it through.

The best way to check this out might be to look at what the gov’t already does for socialized medicine - 'cause the gov’t has a long history of socialized medicine.

It’s called the Army, the Navy and the Air Force. Each service cares for its own and the Navy also cares for the Marines.

Let’s see, if you could get opinions from young enlisted guys, young couples with young kids, middle agers and retired people you’d get a pretty rounded up view of socialized medicine in the U.S. of A. might be.

Let me give you my Marine health care story first:

I was waiting for someone in one of those Navy clinics were people had to go to get the routine preventitive shots.

There were mothers with babies or pre-schoolers, young Marines in greens with all their tough stuff clothing sharply pressed and just plain people getting updates on shots to go overseas or something.

The babies go in, cry, come back out.

The Marines go in, you hear a big thud, later they come back out.

People go in, come back out.

Turns out the repeated thuds were Marines (18-19 year olds) getting their first shots in their living memory - fainting. Falling on the floor thud, thud, thud, almost one after another.

Now, no real doctor or nurse in any civilian situation would ever take the risk of letting these (fairly big) guys fall, again, and again. They would be out cold. Fall like trees the the thuds were their heads hitting the floor.

Responsible people seeing this happen once or twice would sit those young Marines in chairs, pad the floors, give them helmets, lay them on the floor before the shot, have a buddy on each side beforehand-just in case.

The frosting here is that the little kids in for routine shots got to see this, too.

Thank you for starting this topic, I’ve wanted to tell someone about that bit of gov’t in medicine for a long time.

Damn, that’s sick Jois. I can’t believe something like that would happen.

The problem in your example is not socialized medicine in itself. The problem is the pathetic pay these people are getting in comparison to their equivalents in the civilian sector.

Your example is rather extreme, though. It displays outright cruelty towards the patients. In normal practice, doctors and nurses in these situations may seem uncaring and hurried, but I doubt they’d show that level of malice towards patients.

Not to through cold water on an obviously ideological debate, but Walter Kronkite hosted a special on PBS, comparing Canadian and American health care; it was instructive in the relative benefits and deficiencies of each.

What Puffington is suggesting, and what Canada has, is socialized insurance. Everyone is insured, no matter what the circumstances (with a few small exceptions). You can always go to the doctor, though prescription drugs are only partially covered, if at all, so you might not be able to afford the treatment. This isn’t very common, given no-name brand drugs and the awareness of doctors that patients need to be able to actually get the drugs; recipients of social benefits have prescription drug plans.

Canada has one of lowest rates of infant mortality in the world because all pregnant women, regardless of their economic ability, receive good general health care throughout their pregnancy, catching problems before they become serious and ensuring that the nine months go smoothly, in general. America has one of the highest infant mortality rates in the first world because pregnant women on Medicaid or without a policy don’t get the usual and necessary general healthcare they need. Most American doctors don’t accept Medicaid (they’re not required to) because it’s often late in payment and pays only a portion of the bill.

America has the best doctors in the world because hospitals can afford to pay them. American private hospitals have lots of the best equipment available, and diagnostic tests like MRIs and catscans are routine and easy. In Canada, you’re scheduled for expensive/equipment dependent tests because the facilities are limited by the government to reduce costs. Doctors in Canada are generally good, but few doctors of really exceptional ability stay because the money is better down south.

A corrolary[sp?] of the top quality facilities and doctors in private American hospitals is that procedures and examinations are readily available: there’s always an operating open for an expensive procedure. In Canada, elective surgery is scheduled months or years in advance; a triple bypass is considered elective if it’s not urgently needed, and it’s possible to wait a long time for such an operation. However, emergency/urgently needed surgery is always done promptly; I don’t recall hordes of people dying on waiting lists. Many Canadians with the money to do so will come to the U.S. for surgery, rather than wait.

American public hospitals are generally in poorer condition than Canadian ones, as they’re in the same boat as Medicaid: underfunded, and a medical solution really only for the poor or those with halfassed HMO health plans.


The difference is fairly obvious to me: an American with money is better off in the U.S., while an American without money is better off in Canada. In the U.S., medicine of the highest quality in the world is practiced for those who can pay for it, at the cost of depriving the lower economic levels of adequate general health care. Ironically, the U.S. government spends more on public health care than the Canadian government: 11% of GDP (at the time the documentary was produced), vs. 9% in Canada. I’m not certain how those figures have changed since then.

There’s been a running battle in Canada for as long I can remember over the creation of a private medical industry for those who can pay. The fear is that a two-tier American system will develop, where private medicine excels at the expense of public medicine. Given the government’s support of public medicine, it hasn’t happened yet, and is unlikely to anytime soon.

Personally, I’ll take the Canadian system.

Never attribute to an -ism anything more easily explained by common, human stupidity.

Two things:

The length of waiting lists for surgery and medical procedures typically varies by geographic density. Large cities have long list, small cities don’t. I’m from Saskatchewan, and the longest I heard of anyone waiting there was about three weeks.

In Canada, medicine is a political football. Because the provincial and federal governments exercise a great deal of control over hospitals and funding, politicians use the medical system for political ends (I’m uncertain how much or exactly how this happens in the U.S.). During the 80s in Saskatchewan, the conservative government consolidated it’s electoral base in the rural areas by opening hospitals in every small town. When they were replaced by the New Democrats, most of those hospitals had to be closed because they were way too expensive, and far underutilized. In the last referendum on independence in Quebec, the french separatist government closed nine english hospitals in the Montreal area.

Never attribute to an -ism anything more easily explained by common, human stupidity.

So, Puffington, get punched in the nose a much?

The problem is not “the pathetic pay these people are getting in comparison to their equivalents in the civilian sector” it’s training the care givers to respect all those who walk through the clinic, regardless of who they may be, rank they hold, or branch of service they joined.

It’s not teaching the care givers safety routines to prevent accidents before they happen.

But mostly it is the government standards - clinics like this one are staffed by the average number of clients per week and the staff is assigned to meet those average requirements…not the excessive numbers who arrive on Tuesday because it is the day the boot camp buses the recruits to the clinic.

And, BTW, normal pre-natal care in the Navy clinics 10 years ago began at three months…

Here,I don’t know about Canada, standards have always been set to the lowest acceptable minimum. Your current doctor has met the lowest standards your state/commonwealth could set and now he can legally take care of you.

The nurse (RN) who gives you medication while you are sick as a pup and can’t move has also met the lowest possible standards your state/commonwealth could set.

Ditto for the guy who does your prescription at the drug store.

Your gov’t in action.

Isn’t that what a standard is, by definition? As, as a doctor or nurse, you must meet these minimal standards to practice medicine: you can be better, but you’re not allowed to be worse?

If you’re suggesting that standards for practicing medicine are low in the U.S., you’re wrong: they’re among the highest in the world, as in Canada. That’s why Canada’s medical system is of a generally high quality, despite the problems normal to any socialized system.

Comparing military medicine to a system of socialed medical insurance is a non-starter. They’re too different, starting with the fact that doctors are officers who can give orders to patients.

Never attribute to an -ism anything more easily explained by common, human stupidity.

Here in Britain we have a National Health Service for all, plus private medicine for those who can afford it. (Also ‘socialism’ isn’t a dirty word here!).

The quality of care is reputedly pretty good in both, but the major difference is in waiting times. My Dad waited over a year for a hip operation on the National Health (classed as non-urgent); you can walk into a private hospital for almost anything immediately (and our politicians do).

I don’t know what is best, particularly with cultural differences between countries. Personally I think it matters how the system treats poor people (or should that be income-challenged!)

In the bathtub of history, the truth is harder to hold than the soap… (Pratchett)

Who wants to know the biggest drawback to socialized medicine???

(I do, I do!!)

Actually, hansel already touched on it. Metaphor: Getting sick when you can’t pay for it is like getting arrested when you can’t afford a lawyer. What do you get? A government-sponsored lawyer (or a “public defender”). As we all know, public defenders are generally not the best and brightest Legal Eagles out there (if anyone here is, or is related to, or knows, or ever met a public defender and takes offense to this statement, don’t even bother getting on my case about it, because I’m just going to ignore you).
Anyway, back to the topic, a career in medicine requires more schooling, more hard work, more competition, more frustration, and more times when you just want to quit than any other profession. So why do the brightest students put themselves through hell just to become doctors? Because (up until the last helf-decade or so) once you got where you wanted to go, it paid off big. However, with the iron grip of the insurance companies tightening, the reward/frustration ratio of medicine is getting lower and lower, driving more and more of junior-genius would-be doctors into other fields.
So the average pedestrian might say “Hey, if insurance companies are putting the ‘Dic(k)’ in ‘medicine,’ why don’t we just hand the whole system over to the government?” A nice thought, but again, a pedestrian one.

Because, as we here well know, the US government is the biggest business of them all. (Which is the true irony of this situation, as well as of many other political situations, but I digress).

I start college next year. I am considering a good number of career paths, all of which are more or less open to me. Medicine is one of them. If I woke up tomorrow and heard that the government had assumed control of health care, medicine would be off the list. And I’m sure that a great number of students around the nation, most smarter than me, would share my sentiments.

The point is, socialized health care would drive the quality of the doctors way the hell down, which is just plain unacceptable.

The IQ of a group is equal to the IQ of the dumbest member divided by the number of people in the group.

That’s a very romantic picture you paint, Rousseau, but it just isn’t true. Doctors in Canada are among the world’s best, because of the schools and the standards to practice. Even in our system of socialized insurance, a Canadian doctor can expect at least an upper middle class lifestyle, if not more (depending on the branch of medicine she chooses). Your comparison to public defenders fails because doctors don’t go into bureaucracies that dole them out on a first-come, first-serve basis. They choose their jobs as they can obtain them, either in a hospital, a clinic, or a private practice.

Glee, perhaps you can comment on Britain’s practices in this respect, as I understand that government there not only provides insurance but pays doctor’s salaries as well.

BTW, Rousseau, how is socialized medicine, as you put it, different from what you’d experience in the U.S., lacking a fat company health plan?

Never attribute to an -ism anything more easily explained by common, human stupidity.

Please look at “Single Payer Health Care” I’ll move it up to the top of the board with this one…


I’m still concerned about poor people falling sick.

  • can US insurance companies refuse to take on chronically ill people?

  • do US insurance companies go bust (perhaps thru fraud)? We had a pension scandal a few years back when a crooked businessman plundered company pension funds, and some pensioners lost all.

P.S. also some doctors I know are in it for the job satisfaction, not the money


I don’t have properly referenced material, but from my personal knowledge, we pay a ‘National Insurance’ tax, which helps fund the National Health Service (hope I’m not confused with pension contributions!). It’s compulsory, and the Government runs hospitals with it.

My town is rather a wealthy place, which pays cheap wages, keeps services high and would prefer that anyone making under 6 figures a year live on the outskirts and they find new and interesting ways to tax everything and everyone each year. A retired doctor visited a friend of mine one year, looked around the city, saw all of our wealthy medicos and their big homes and fine, sprawling clinics – which took no credit – and stated flatly that there was something wrong when the doctors were among the richest people in town.

I agreed. Years and years ago, doctors practiced medicine because they wanted to be healers and they often took their fees in trade. A side benefit was that the townsfolk helped support them because they needed them. They had two sets of records then, one book containing cash customers and paid up accounts and one containing debts owed by people who could not pay and might give the doctor a nice hand made desk instead, or 40 pounds of spuds, or $5 a month, even fix his car for free or punch out any damn lawyer who tried to sue the man because some patient did not follow his advise and got sicker. I know a few old time doctors who aren’t rich and have the two books, but around here, they are getting damn few and hard to find.

Keeping people alive and healthy has become big business. Socialized medicine will not work – check out Britain – because the rich doctors and the medical device companies and the pharmaceuticals don’t want to cut costs. The lawsuit happy attitude of people don’t help none either. Not one doctor in my town, and there are many pages in the phone book full of them, has escaped a lawsuit. One Dr. treated a lady who came in ready to give birth. She was broke, had no prenatal care and no doctor. He took her, knowing he would not get paid, the hospital delivered he baby, knowing it would not get paid, and the kid had a birth defect. It MIGHT have been a side effect of some medication she was given. No one was sure, but it was claimed that the kid pounded his head against things too much and had to wear a helmet. This broke lady got a lawyer, sued the doctor, the hospital and the medication provider. She walked off with millions. The simple fact that the doctor did not know her and her history, plus she had not had any prenatal care, plus she came in ready to pop had little if any bearing on the case.

Plus, medication companies like producing little things like Viagra at about 25 cents a pill and then selling it for $10 a pill because it is needed and desired. They are not going to cut their costs. Look at the price of the medications needed to keep AIDS patients healthy. Some of those poor son of a bitches can pay up to $500 a dose! They got no choice, if they want to live, but to buy the medications and the drug comanies know that.

I figure we’ll have to revamp congress, weed out the corrupt [like 95% of them], stomp out the powerful ‘gift giving’ lobbiests and find some new, honest people to put in there before socialized medicine can even be seriously considered.

Hell, we have a couple of billion in surplus and what does one moron want to do with it? Tax cuts, which will mainly affect the very rich. He and the others have never mentioned the poor, the starving, the needy and the sick here in the States.

You think pharmaceutical companies are gouging people? In the U.S. it can take over 10 years to get a drug to market because of the extreme militancy of the FDA. It can also cost upwards of 200 million dollars. And if you want to protect your drug, you have to take out a patent on it when the trials start. A patent, as I recall, lasts 17 years. So after you get out of your 10 year trial, you have a big seven years left to recover your 200 million, plus your initial research costs, plus the money spent on all the research that didn’t pan out, plus profit. THAT is why drugs are expensive.

You could pass a law to make those drugs cost 25 cents if you wanted to. And drug research would STOP tomorrow.


you said ‘Socialized medicine will not work – check out Britain’.

Well we’ve had socialized medicine since about 1948 (and private medicine runs parallel).

What do you mean?

In the bathtub of history, the truth is harder to hold than the soap… (Pratchett)

I for one prefer an extremely militant FDA that requires drug manufacturers to make sure their drugs do what they claim they do; and prohibits the sale of foods and drugs that are highly toxic, have monstrously dangerous side effects, or cause death, or in some cases don’t actually do anything. Call me nuts, but I think it’s a pretty good idea.

You’re nuts.

An overly cautious regulatory agency can do far more harm than good. For every ‘dangerous’ drug kept off the market, they may keep ten ‘good’ drugs off the market. If they approve a drug that saves a million lives a year, but it took them 10 years to do it when a more prudent interval might have been five, then they killed five million people. If they make drug research and development insanely expensive, people stop doing the research and we ALL lose.

Then there are other problems - before the FDA came along, drugs filtered into the marketplace slowly. Doctors were free to prescribe drugs they thought would help, and patients with high-risk diseases like Cancer were free to try them. If the drug was ineffective or dangerous, it would be discovered by the ‘early adopters’ with a high risk threshold before it hit the general public.

Now, if the FDA makes a mistake, we have a potential disaster, because once the FDA puts its stamp of approval on a drug, doctors start using in en masse. So you tie up all your risks with one global agency. Bad idea.

People have varying tolerances for risk, based on both their personal philosophy and the nature of their particular illness. The FDA’s one-risk-fits-all strategy does not serve us well.