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Socialized medicine

Socialized medicine is a term used in the United States to describe and discuss systems of universal health care—medical and hospital care for all by means of government regulation of health care and subsidies derived from taxation. Because of historically negative associations with socialism in American culture, the term is usually used pejoratively in American political discourse. The term was first widely used in the United States by advocates of the American Medical Association in opposition to President Harry S. Truman's 1947 health care initiative. It was later used in opposition to Medicare. The Affordable Care Act has been described in terms of socialized medicine, but the act's objective is rather socialized insurance, not government ownership of hospitals and other facilities as is common in other nations.

The original meaning was confined to systems in which the government operates health care facilities and employs health care professionals. This narrower usage would apply to the British National Health Service hospital trusts and health systems that operate in other countries as diverse as Finland, Spain, Israel, and Cuba. The United States Veterans Health Administration and the medical departments of the U.S. Army, Navy, and Air Force, would also fall under this narrow definition. When used in that way, the narrow definition permits a clear distinction from single payer health insurance systems, in which the government finances health care but is not involved in care delivery.

More recently, American conservative critics of health care reform have attempted to broaden the term by applying it to any publicly funded system. Canada's Medicare system and most of the UK's NHS general practitioner and dental services, which are systems where health care is delivered by private business with partial or total government funding, fit the broader definition, as do the health care systems of most of Western Europe. In the United States, Medicare, Medicaid, and the US military's TRICARE fall under that definition. In specific regard to military benefits of a (currently) volunteer military, such care is an owed benefit to a specific group as part of an economic exchange, which muddies the definition yet further.

Most industrialized countries and many developing countries operate some form of publicly funded health care with universal coverage as the goal. According to the Institute of Medicine and others, the United States is the only wealthy, industrialized nation that does not provide universal health care.

Jonathan Oberlander, a professor of health policy at the University of North Carolina, maintains that the term is merely a political pejorative that has been defined to mean different levels of government involvement in health care, depending on what the speaker was arguing against at the time.

The term is often used by conservatives in the U.S. to imply that the privately run health care system would become controlled by the government, thereby associating it with socialism, which has negative connotations to some people in American political culture. As such, its usage is controversial, and at odds with the views of conservatives in other countries prepared to defend socialized medicine such as Margaret Thatcher. According to a 2018 Gallup poll, 37% of American adults have a positive view of socialism, including 57% of Democrat-leaning voters and 16% of Republican-leaning voters.

When the term "socialized medicine" first appeared in the United States in the early 20th century, it bore no negative connotations. Otto P. Geier, chairman of the Preventive Medicine Section of the American Medical Association, was quoted in The New York Times in 1917 as praising socialized medicine as a way to "discover disease in its incipiency", help end "venereal diseases, alcoholism, tuberculosis", and "make a fundamental contribution to social welfare". However, by the 1930s, the term socialized medicine was routinely used negatively by conservative opponents of publicly funded health care who wished to imply it represented socialism, and by extension, communism. Universal health care and national health insurance were first proposed by U.S. President Theodore Roosevelt. President Franklin D. Roosevelt later championed it, as did Harry S. Truman as part of his Fair Deal and many others. Truman announced before describing his proposal that: "This is not socialized medicine".

Government involvement in health care was ardently opposed by the AMA, which distributed posters to doctors with slogans such as "Socialized medicine ... will undermine the democratic form of government." According to T.R. Reid (The Healing of America, 2009):

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