Originally published at http://www.commondreams.org/views/2019/11/17/lets-be-very-clear-medicare-all-not-socialism
Indeed, a socialised health service is not socialism and all schemes around the world are subject to varying budgetary limits on treatments.
Governments determine the health-care expenditure and inevitable they come up short. The UK’s NHS is frequently under-financed. Due to costs, essential new equipment to provide better treatment or diagnosis is often not bought, Staff cuts place extra burdens on over-stretched doctors and nurses. Low pay discourages recruitment. Concern about what is called bed-blocking means that often patients are sent home too early which leads to re-admittance. There are serious deficiencies in the costly care of the elderly and mental health patients. I haven’t even raised the issue of the continued dominance of pharmaceutical corporations despite increased regulation in Europe.
France has seen medical staff protest about similar problems.
So yes socialised medicine is not socialism and when introduced to the US will endure the same market-imposed constraints as any other business. There will never be a fully decent health service as long as there is the market-system. There is no such thing as an adequate health service within a capitalist system of society and there never can be. So don’t expect a miraculous panacea when Bernie’s Medicare-for-all is implemented for the health problems in the US.
That does not mean it is to be opposed. After all, socialised healthcare encapsulates the primary socialist principle that it is free at the point of delivery and priority is based upon someone’s individual needs and not how much money a person possesses. That is what socialism is all about - where the production of everything – everything from food to housing to health care – is provided on the basis of need.
Bravo! A thorough yet concise description of the situation, one of the best and most digestible I have seen in many years. This should be required reading for anyone engaged in the discussion. Thank you for providing a valuable resource.
“GREED CAPITALISM” is the murderer of all things “Social”! THAT is why the wealthy and corporations need to be reeled in! And turning that reel needs to be, at least, one strong populist leader and THE POPULOUS!
Although the US media serially portray an enterpreneurial culture here, unless your enterpreneurial venture is large scale and funded by the venture capital community, you will be stifled in your attempt to succeed with a startup or continuing the operation of an existing small business, mostly because your business will pay a fortune for marginal medical insurance if you can get insurance at all.
For at least the past four decades the only way my small business owning friends could survive in business is if they had medical insurance from a spouse’s corporate or government employment .
Good article for those w/jobs that allow them the non-work-time-energy to read this article, and who’ve done a fair amount of background reading on healthcare systems - whether because it’s part of their ‘educated’ culture to be tuned in to such issues, or because they are politically engaged and their political culture drives them to learn and get it…
(All of which, btw, includes me.)
…Not so good for the low income and a wide swath of the electorate that needs a more direct, non-healthcare-profession-specialized language and program of action thinking about it.
The modern day absence of Marx’s industrial working class (and closely linked class consciousness) fundamentally weakens his idea of class conflict conscious workers grouped to oppose capital…
…but the exploitation of working people - through the political system; by the rich and for the rich - remains, imo, a strong way for working people to think about why they can’t afford an operation for themselves or a loved one.
“Bernie Sanders is right that many of the poor don’t vote. But the Left can’t win without them.”
I support Medicare for All who want it, it’s that simple, and yes I do want it. The American people don’t like to be forced to do anything, they need to be encouraged and educated to make changes, not forced.
We need it! I’m on traditional Medicare thru SSDI at present. Though I love it in comparison to the private health insurance I used to have (was paying $500/mo. In premiums for coverage and I don’t think they ever paid a single claim citing some bullshit technicality as a reason for not paying) it’s certainly got its problems such as the 80% coverage 20% copay. My personal example is this:I was involved in a hit and run accident on my motorcycle which caused me to crash at 70 mph on IH-10 in San Antonio back in 2014. I substained serious injuries including multiple broken bones and a punctured left lung. I was taken to the local trauma center/ER where ultimately my medical charges cost $129,000. Because of the pay structure of Medicare I wound up having to pay 20% out of pocket for what amounted to a crime perpetuated against me. That’s almost $2,600 out of pocket! As I said, I have Medicare because of SSDI meaning my income is also limited to SSDI which believe me is close to a poverty level income. Sure I had a choice as to whether to accept treatment or die but it destroyed me financially. The $129,000!was just the beginning. I had to undergo four surgeries and almost two years of rehab. I’m still paying the bills off for something that wasn’t my fault. If we were like any other civilized country on the planet I wouldn’t be in this predicament. So screw You republicans and conservatives. If you want substandard healthcare that costs 2.5 time more than anywhere else in the world fine. Your pretty fucking stupid but that’s fine too, just stop standing in the way of those of us who aren’t so stupid and pay for your own private inferior healthcare that doesn’t cover anything. I’ll take M4A thank you very much.
Socialism is NOT nationalization. Nationalization can be a part of a socialist form of governance and democratically planned economy, but it is not the answer for everything. Soviet Russia and Communist China both tried nationalization all economic activity, and it didn’t work very well. In fact, it was a fiasco in both countries, leading to mass starvation and stagnation.
I would argue that a true expanded single-payer system of federal government funding of all health care as the sole insurer, and negotiator of fees charged by doctors that are not on salary and hospitals that are not government owned, such as they have in Canada, while not “socialism” is “socialist.” Under single-payer, or the type of Medicare-for-All system being proposed by Sen. Bernie Sanders, a democratic government (insofar as our government can be called democratic!) determines the prices doctors, other health care providers, hospitals, drug companies and makers of medical equipment can charge for their services, and makes the payments for those goods and services using tax revenues raised through progressive taxation and corporate profits taxes. That is socializing risk universally, socializing the cost of health care, and socializing the dermination of how and how much health care will be provided. If that is not socialist I don’t know what is. It doesn’t mean that the society that adopts such a system is socialist. That would involve making a lot of other changes in the economic and political order. But it would mean that society has socialized health care.
Of course, Britain’s National Health Service, which I have had the “opportunity” to test out a few years ago with a five-day hospitalization, and which I found to be remarkably good – indeed far better than what we have here in the US in terms of cost, efficiency and caring staff – is also socialist. It is also beset by political difficulties thanks to decades of cuts by both Tory and neo-liberal Labor governments, and struggles along as best it can. We by the way have a huge example of such socialist health care: The Veterans Administration Health System, which is federally owned with doctors and staff on salary. It too is under attack and being privatized under a “reform” – a scheme that was promoted by the Koch brothers that was pushed through initially during the Obama adminstration and accelerated by the Trump administration and that is being resisted by most veterans.
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Medicare for All is a form of Socialism. People with degrees like to complicate what is basically a simple proposition.
Do we ‘encourage’ people to pay taxes? Because the only feasible way that Medicare for those who want it is going to work is to NOT let people opt out of paying the taxes even if they don’t want “it”. I’ve been a big critic of Tulsi Gabbard on this who has parroted the type of terrible soundbites coming from Pete about taking people’s insurance way being unamerican, but after listening to the latest Jimmy Dore interview of Tulsi (to @LibWingofLibWing, I assume you’ve heard it, but if not it is worth a listen at: https://www.youtube.com/watch?v=O1sWkmuFhPk&t=17s, others - @x1jodonn, @Callmeskeptical, @dpearl, @SkepticTank might also be interested), I see she is not letting people opt out (devils in the details - I’ll need to see the plan which she should have had already if she isn’t just going to endorse the straight House bill). Jimmy brought up the idea that this could be like Australia where unless you have supplemental insurance, you don’t get to choose your doctor (I’m not keen on that idea).
I’d like to see a real poll where someone had to listen for just a couple minutes to the actual question of what choice is being removed (choice of insurance which I suspect most people don’t give a crap about including me) and what choice remains (choice of doctor unless we implement the Australian model). I suspect people that are very briefly informed won’t see this is as being ‘forced’ to do something - in fact most of them will get much more freedom - because doctors won’t be in silo’d networks.
Jimmy Dore also had this amazing video I had never seen on JFK arguing for Medicare for All and then Kyle Kulinski found a longer version (I think). I had my issues with Kennedy (I was only 1 when he was killed, so only historical issues), but my opinion of him went up quite a bit after seeing this footage - where the hell are the politicians with the kind of courage that Kennedy and Sanders have?
I saw the JFK videos and what struck me was the way they underscore the sham perpetrated on us by the incrementalists. 57 years later and healthcare remains a crucial issue – arguably the biggest issue going into 2020 – yet the incrementalists insist that there still a lot of baby steps we have to take toward getting comprehensive and universal healthcare for all Americans.
I could not disagree more, nor can I neglect to point out that each baby step serves to delay progress to the ultimate objective. RomneyCare is a case in point, and now Liz Warren is trying to tell us we need to fix that first. Well, damn, we wouldn’t have to fix it if we hadn’t settled for it in the first place. Incrementalists are tools of the healthcare industrial complex, useful idiots making excuses for the shareholder class who don’t care about covering their fellow Americans even remotely as much as they like cashing in on an inequitable for-profit system.
I also saw the Tulsi/Dore video and I agree with Jimmy: If you create a 2-tier system, there will be a lower tier and the for-profit upper tier will monkey wrench the lower tier. Furthermore, the belief that going Tulsi’s Australian route will cancel out a right wing/May Pete talking point is patently ridiculous. The right wing will trot out talking point after talking point, one replacing the other. The best way to counter them all is to inform the public: A single tier system will become excellent premier care precisely because the elite will insist upon it!
I’ve long considered employer-based insurance the ultimate scam for insurance companies. When people are healthy enough to work, they have insurance. When they get sick enough they can no longer work, the insurance company is off the hook.
I’ve been telling people this all along. But her ‘sound bites’ were intentionally distorted by the David Doels of the world so that people misunderstood her.
I trust her plan will not change on this.
I love and adore Jimmy Dore. I think he is one of the best things to happen to our movement since Dennis Kucinich.
But if I have one criticism of him, it’s that he talks over his guest, he asks questions and then answers them and goes on and on with all sorts of other points.
I watched the video and I came away convinced that just because Jimmy said that about Tulsi’s plan being like Australia that by the time she got to speak the conversation was somewhere else and that doesn’t mean she agreed with him on that one point about doctors.
Tulsi’s plan is based off Jayapal’s with the plus part added. In Jayapal’s plan doctors can’t opt out and so every provider is in and so no one would lose their doctor.
Here’s the sad part that those who are so gung-ho for Bernie’s plan don’t realize- in his doctors can opt out and do the private pay thing.
Bernie may have written the damn bill, but he often talks about it as if it was the old House 676 instead of the compromised Senate bill he did write.
I too want to see her plan. My reason is so I link it over and over at the Humanist Report and David Doel until they finally take back their smears of Tulsi.
Also agreed. I took that as an example of a different kind of ‘supplemental’ insurance I didn’t know about - I don’t like it, but it is better than people going bankrupt, that’s for sure.
On another Tulsi topic, I tried to find a quote from her about Bolivia to respond to someone on another thread who said she had not been as good on Bolivia as Bernie. I saw one Youtube clip where she said she was still gathering information and would wait to comment (not a bad answer in my mind). I know you liked what she had to say about Maduro (I also liked her statement better than Bernie’s as you know - keep it simple, we don’t butt into people’s elections though I’m OK in principle with favored nation status in trade agreements where the most free countries get the most favored status). Did you have a take on this? I’m in favor of term limits but of course would strongly oppose US support for a coup anywhere. I read:
and the first comment in
which if true, doesn’t paint a very good light for Morales. But even if true, the pendulum swing is sounding pretty bad right now.
I’ve been waiting to hear from her on this. I’m expecting her to call it a coup and speak against the OAS, basically an arm of US policy, saying the election was phony.
I’ve heard she actually has been deployed since Veterans Day and she was busy on Veterans Day, so that youtube statement at the end of a busy day on 11/11 and then her being deployed since then, would explain why no statement yet.
Often times her twitter feed and FB posts are actually from his sister. I don’t see her speaking for Tulsi on this, but sending out stuff that Tulsi had agreed to before hand.
Tulsi’s go to position on stuff like this is not to take a stance on the validity of foreign elections but to strongly state the US should stay the HELL OUT OF IT and let the people there decide. I’d hope she’ll echo the Grayzone folk and agree that the people want Morales and the US needs to not recognize the coup folk.
I didn’t bother with the Reddit link since it’s just folk talking about what Tulsi might or might not say. I can do that myself without Reddit.
Yes it is.
It is socialization of health care insurance. That is a service. It’s a " nationalization of the production of … services." It’s the nationalization of the production of the specific service of health care insurance.
Why the fear of the term?
Socialism is a good thing. I’d prefer the entire health care industry was socialized, but I’ll settle for socialization of the insurance part.
I gotta be honest in reading the article and then all the excellent comments I am far more confused than I thought I was.
I thought I had read and understood at least a few of the plans pretty well… . Nay nay… for example I did not realize Sanders Plan allowed doctors to opt out… how’d I miss that? Yikes. I have a lot of studying up to do I guess… thanks to all who posted your insights on the plans. At least I know where to begin again…
My ideal health care system is in large part the VA model. All docs are paid outcomes based salaries, all hospitals are government owned and operated, all other medical specialities are also salaried. All docs are in and there is no private insurance allowed. Like we’ll ever get that…snort…