Socialized Medicine

The term socialized medicine refers to a publicly administered national health care system, also referred to as a “universal health care system.” Versions of socialized medicine systems can range from programs in which the government runs hospitals and health organizations to programs in which there is a single-payer national universal health care plan.

Supporters of universal health care emphasize that single-payer systems save money when compared to multipayer systems in which health care is funded by private and public contributions. Germany and France use the latter. Denmark, Sweden, and Canada are some of the countries that employ single-payer financing of health care.

Health care systems can also be classified according to whether they provide universal coverage, provide portable and comprehensive benefits, have geographically accessible care, offer affordable coverage, are financially efficient, and provide reasonable levels of choice for consumers.

In the United States, the populist view associates these programs with communist-run countries, but most industrialized countries have some form of socialized medicine. The matter is important to the United States now more than ever, due to the high percentage of Americans without health insurance (44.8 million in 2007). The cost of health care and insurance premiums has risen dramatically in recent years, resulting in a high number of employers dropping health insurance benefits for their employees. The rising costs of health care insurance result from higher costs of prescriptions, doctors' fees, and hospi-talization and administrative expenses.

The United States is the only industrialized country without a system of socialized medicine. The only health care programs subsidized by the U.S. government are Medicaid and Medicare, instituted in 1965. Medicare covers Americans over age 65 and some permanently disabled persons, while Medicaid covers a small portion of persons who are poor and aged, blind, disabled, pregnant, or the parent of a dependent child. These two programs are the closest to a socialized health care system plan within the United States.

Great Britain provides its citizens with a National Health Service (NHS), through which the government directly pays all health care costs for all citizens. Implemented in 1948, it was subsequently used as a socialized medicine model by other industrialized countries. Under national terms and conditions of service, doctors, nurses, and other specialists work as salaried employees at hospitals or health care facilities. Funding for the publicly owned hospital and community services comes from central taxation. Before the implementation of NHS, more than half of Great Britain's population—mainly women, children, and the elderly—had no health coverage.

To keep costs down, the NHS has relied on national and regional planning and shifted services to the private sector, severely undermining the fundamental bases of universal health care in Great Britain. The government shifted some costs and risks to patients and discouraged central taxation as the funding base of the NHS. Even with the erosion of the NHS in the past decades, compared to the United States, access to care is much greater and costs of care are far less.

Canada offers universal coverage through a National Health Insurance (NHI) program run by the government as a single payer. Canadian hospitals receive both an annual operating budget and a capital expenditure budget from the government. Hospital doctors are salaried; other doctors who own their practices submit their bills directly to the health insurance system, using a fee schedule negotiated annually between the provincial governments and medical associations.

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