Archive for August 6th, 2012

‘Why Don’t You Like My Son?’

Monday, August 6th, 2012

Uwe E. Reinhardt, Princeton economics professor who specializes in health care issues, asked this question of a Congressman who was berating Britain’s socialized medical system (N.H.S.) during a hearing where Reinhardt testified.  He explains why he asked this question in an article in the New York Times.

Although I personally have never advocated adopting an N.H.S.-style approach to health reform in the United States, I have been puzzled for decades by the almost instinctive habit among many Americans of incessantly running down every other country’s approach to health care and health insurance…

I have found that one effective way I can stop N.H.S.-bashing dead in its track is to ask bashers this simple question: “Why don’t you like my son?” I posed that question to a congressman who had berated “socialized medicine” during a hearing on health insurance reform at which I testified.

In response to the stunned look this question invariably elicits, I go on: ”You see, our son is a retired captain of the U.S. Marine Corps. He is an American veteran. Remarkably, Americans of all political stripes have long reserved for our veterans the purest form of socialized medicine, the vast health system operated by the U.S. Department of Veterans Affairs (generally known as the V.A. health system). If socialized medicine is as bad as so many on this side of the Atlantic claim, why have both political parties ruling this land deemed socialized medicine the best health system for military veterans? Or do they just not care about them?”

Reinhardt then goes on to distinguish between a social health insurance system and one that’s socialized medicine like the N.H.S.

Among policy wonks, “social health insurance” is understood to be health insurance to which the individual makes contributions on the basis of ability to pay, rather than on the basis of health status. Such a system can be coupled, and often is, with purely private health care delivery systems, including for-profit enterprises. Canada, Taiwan, Japan, South Korea, Germany, the Netherlands and Switzerland come to mind.

Socialized medicine refers to systems that couple social health insurance with government-owned and operated health care facilities, such as Britain’s N.H.S. or the Hong Kong Hospital Authority, a still-appreciated legacy of British colonialism. Socialized medicine also typified the health systems operated by the former socialist countries in the Soviet orbit. Evidently, the V.A. health system perfectly fits the definition of socialized medicine.

Beezer here.  Narratives, such as those that anything labeled ’socialist’ is bad compared to what the ’free market’ provides, trip over the real world and how it operates–even in our own country, as Reinhardt points out in his article.   Narratives are useful because they distill beliefs down into bite sized chunks.   However, simplifying beliefs into bite sized chunks means, invariably, important exceptions are overlooked.  Health care is one of those important exceptions.    




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