Much (deserved) shade was thrown at some of the Democratic Presidential candidates’ plans to institute a “Medicare for All” system that outlawed private insurance plans. I expect that someone got in their ears and told them a – that the European systems they so admire and want to emulate all have private options, and b – the unions, with their gold-plated benefits packages, won’t be thrilled with having to go on government health care.
Front runner Kamala Harris seems to have gotten the memo. She announced, ahead of the second round of debates, that her plan would allow for private insurance coverage… with a caveat.
We will allow private insurers to offer Medicare plans as part of this system that adhere to strict Medicare requirements on costs and benefits.
Harris is pandering here, even more so than the other “Medicare for All” panderers. She wants to avoid pissing off the unions, but, she still wants to sorta-socialize medicine, because promising to do so is demanded by the activist leftists who dominate the discourse.
“Sorta” is the operative word here. The fact is, what they are proposing is not actual socialized medicine.
As bad as socialized medicine is, this is worse. Much worse.
While those of us who engage in political wonkery often use socialism as a blanket term for all things big-government, the reality is that there are three broad flavors of statism in matters economic. Socialism involves government ownership of the means of production. Communism involves government ownership of just about everything.
Fascism, on the other hand, involves strict government control of privately owned business.
Socialized medicine, strictly speaking, means that hospitals, clinics, et al are government-owned, and doctors, nurses, techs, orderlies, administrators, and other staff at all these facilities would be government employees. This is mostly how the UK’s National Health Service works, although there are private providers who get paid via private insurance and private providers who get paid by the NHS.
“Medicare for All” doesn’t go that far in terms of ownership of assets – it leaves ownership to the private sector – but it goes farther in that it prohibits private insurance or parallel programs, or even private, for-cash practice in some incarnations. In essence, doctors and hospitals would get paid whatever the government decided they’d get paid, and patients would have no co-pays or out of pocket expenses of any sort.
This is a “best of all fantasy worlds” gimmick, if you’re a politician selling snake oil to willing rubes. It dumps all the financial risk on the private sector, avoids having to turn medical workers into government employees (with their massive benefits packages and near-guaranteed lifetime employment), allows the government to blame “private sector greed” when things don’t go as planned, and leaves the government unencumbered when a hospital or clinic or office goes bankrupt.
From Bernie’s website:
In a single-payer system, the government can use its leverage to negotiate more reasonable prices for basic medical services.
“Can use its leverage” implies there’s a negotiation to be had. What sort of negotiation is there, though, when your only customer is the government, when your only alternative is to take what they give you or shut your doors, and when you’ve got millions or billions in assets that will become worthless if you do the latter? It’s a “negotiation” the way Don Corleone “negotiated” Johnny Fontaine’s contract away from his former manager – with Luca Brasi pointing a gun at hospitals’ heads.
Medicare payments already fall short of covering health care costs. Big hospitals suck up the loss because they can draw more money from younger patients and/or Medigap coverage. Many private doctors won’t take new Medicare patients.
What happens when everyone is forced to work with only what the government decides it’s willing to pay? And, what happens when the elimination of co-payments removes any disincentive to visit doctors for minor or trivial stuff? When hypochondriacs decide they should go to a dermatologist to have hangnails excised, or when someone gets a sniffle and decides it might be plague?
Bernie’s plan purports to save massive amounts of money in bureaucratic costs and from the profits that insurers currently make. But, the existing Medicare/Medicaid system loses more to waste and fraud every couple months than the entire health insurance industry earns in profits in a year. Why would any sane person believe that all those losses will go away by making the program bigger? Or by putting the screws to the private sector? Whence the corrective forces that keep efficiency up, when competition and market forces are outlawed?
Socialism’s “mad men” have been extremely successful in rebranding the term. They’ve suckered a generation into thinking that it’s a Good Thing, that “socializing” a private-sector function means better outcomes for all. Fascism, socialism’s black-shirted brother? It has been re-branded as well, as deceptively, but in a different direction. Already a bogeyman, it has been flipped, in Orwellian doublethink fashion, so that the thuggery it includes is proudly exhibited by its front-line foes. It’s been made an even dirtier word.
Yet fascism is the most accurate descriptor for the Democrats’ various plans. Hospitals and health care providers would remain in the private sector, but they’d be wholly dependent on the government for payment. It’s a recipe for disaster. But, hey, if it gets one of them elected, that’s all that really matters.
Accuracy is not of much interest in politics, sad to say. To call the Democrats’ ideas fascist medicine is accurate, but they’ll never permit it. Nor, more importantly, will the Press, not when most of them like the idea of even more government in health care, and abandon their integrity to advance this and other pet causes.
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This comment made me think of how military medicine has been shaped by that phenomenon: “…what happens when the elimination of co-payments removes any disincentive to visit doctors for minor or trivial stuff?” In the military you have what are called Sick Bay Commandos. These are Soldiers, Sailors, etc. who habitually go to sick call for every ailment, and often just to get out of the days duties. (You rarely see very many at Sick Call on a Friday morning, but Mondays are packed.) Not wanting to be branded a “Sick Bay Commando” or worse, most servicemen eschew going to the doctor and “tough it out”. In addition, not wanting to waste your morning sitting for hours with a bunch of fakers is a disincentive. There will always be hypochondriacs, Drama Queens and fakers. If you make the clinic free with no disincentive, what I describe above will inevitably occur.
Every “scarce resource” has a rationing mechanism. “Free” health care of any form will produce exactly the phenomenon you describe (apart from the “tough it out” crowd – the public doesn’t have that culture) i.e. long waits, whether it be sitting for hours or waiting weeks or months for an appointment or procedure.
This should be enough of a disincentive for most Americans, but the supporters of socialized medicine choose to ignore this reality.
I think we are going to have to come up with different labels than socialism and fascism.
Fascism is so tied to Nazism that many cannot differentiate them. I found a definition for it that basic says that all activity is done for the benefit of the State/Country. that is probably a political definition where you are describing the economics.
Socialism is tied to the Soviets, China, Vietnam, Cuba, Venezuela… why the term isn’t shunned like Fascism I guess we can attribute to the Left not having an issue with these countries…(I know they weren’t real Socialists they were dictatorship, try using that excuse for the Fascist and the regime in 1940’s Germany) the definition I found for Socialism was all activity is done for the benefit of the People.
What they both have in common is that they will lead to Central Planning no matter what good intentions they start with.