John Berry wrote:
There are many positive examples of something that could be termed positive examples of socialism in the west, socialistic health care practiced in most places seems more attractive than the capitalistic version in the US being just one example and you don't need to watch Michael Moore's "Sicko" to recognize it.
In the real world, all economies in all nations and cultures are a mixture of capitalism and socialism. Nowhere on earth does the fire department charge you to put out a fire in your house. Nowhere is every single road a privately owned toll road.
In the past there have been some more extreme examples in both directions. In Edo Japan fire departments were private, and when two companies responded to the same fire they sometimes spent more effort fighting one another over turf than putting out the fire. The private, capitalistic model for fire departments does not work well for practical reasons.
Winston Churchill favored socialized medicine and compared it to fire fighting. Firemen do not stop and ask whose house is burning, and they do not charge the victim for their services, so hospitals should not either. The key point is that no one chooses to be sick (or to recover). There is no benefit to being sick. In short, it is an unmitigated and uncontrollable evil, like having your house burn down. (There are some things you can do to prevent your house from burning down such as not using kerosene heaters; and by the same token there are some things you can do to preserve your health, but these methods are not foolproof.)
There are many other reasons that favor socialized medicine more strongly than socializing other sectors of the economy. Three related developments have strengthened the appeal of socialized medicine in recent decades:
1. The cost of medical treatment has skyrocketed because of improvements in technology. Many people who would have died cheaply years ago can now be saved at great expense.
2. Because medicine is now more effective, people want it more than they used to. Most people who are desperately ill will pay huge sums to live. They will bankrupt their families to save themselves or their children, or even elderly parents in some cases. In the past you could not do this even if you wanted to. It wasn't an option. A middle class person could afford to buy all the medial help he could get, because there wasn't much on offer.
3. Doctors, insurance companies and others have taken advantage of this situation to raise their rates. In the 1930s, medical students were told that if they wanted to become wealthy they should marry money. Doctors were expected to scrape by on a respectable but lower-middle-class salary. (The same is true of university professors, by the way. At Cornell, most of the professors' wives worked in the 1930s, to make ends meet, whereas nowadays profs. make huge salaries.) When doctors could not do much for patients they could not charge much, either. Now they have the power of life and death over use, and if they are left of their own devices they will eventually swallow up 20% then 30% then 50% of the GDP.
The situation is obviously out of control. The proof of that is that there is no correlation between the amount of money different societies spend on medicine and the results. Europeans and Japanese spend far less per capita, and a far lower fraction of their GDP, but their treatment and outcomes are superior to the US for middle-class and working-class people (90% of the population). By most measures such as longevity, infant mortality, chronic disease, obesity, diabetes, primary care access, end of life, quality of life and so on, the US is dead last in the developed world, and well behind places like Albania and Cuba. People who have not lived overseas or personally experienced healthcare in Europe or Japan (as I have) cannot imagine how screwed up our system is, or how easily it might be improved. The movie "Sicko" barely scratched the surface. I know several people in the U.S. whose lives have been ruined and families bankrupted by illnesses such as stroke and cancer. I also know many people in Japan who had these diseases and were either cured or cared for to the end at no cost to the family, with far less trauma and heartbreak for everyone, and far superior nursing and daily care.
In short, the competitive, self-limiting mechanisms that normally keep prices reasonable and prevent one sector of the economy from taking over do not work in medicine. Every sector of the economy, every product, and every consumer is unique. The generalized laws of economics are only approximations and do not apply well to some goods and services. They hardly apply at all to medicine. The notion that ordinary people will "shop around" to find a cure for disease is ludicrous.
- Jed
