The 'socialized medicine' myth

ANGRY CONSERVATIVES HAVE a two-part plan for dealing with the nation's severely broken health care delivery system. First, they say that even if sick poor children are suffering unimaginable pain and misery, at least we don't have "Hillarycare." Then they wave their arms, jump up and down and shout "socialized medicine."

Neither phrase provides any useful information about health care reforms being promoted by anyone (perhaps least of all Hillary Clinton). Whether muttered by Nevada career politicians like U.S. Sen. John Ensign, U.S. Rep. Jon Porter and Gov. Jim Gibbons or featured in an editorial in the local right-wing newspaper, "Hillarycare" and "socialized medicine" are just pejoratives designed to mock the idea of any reform that discomforts the insurance industry.

Sadly, the reduction of the health care debate to simplistic sloganeering that Rush Limbaugh listeners might mistake for an argument is not just Nevada-centric, but a national phenomenon.

On those rare occasions when William Rudolph Louis Giuliani, Willard Milton Romney or other War Party presidential candidates talk about health care, they put very little if any emphasis on making health coverage accessible and affordable. Instead, they twist their faces into foul expressions and spit out "Hillarycare" and "socialized medicine" with the same vile hatred calculated to appeal to the basest sentiments of America's most poorly informed voters as when the candidates threaten that "Islamofascists" and "radical Islamic jihadists" are going to make Muslims of us all, close the malls and cancel our favorite TV shows.

The term "socialized medicine" appears to exist primarily if not exclusively in the minds of right-wing Americans. If someone wanted to genuinely give them something to cry about, someone would propose a system where the government would own the hospitals, clinics and other health care facilities, the government would directly employ all the doctors, nurses and other health care workers and the government would pay for everything. That might fairly be called "socialized medicine."

No doubt someone somewhere in the United States is proposing that. But it isn't any of the Democratic presidential candidates. Instead, they're proposing plans to provide health care coverage to everyone, i.e., "universal" health care, and that's different.

Of the leading Democratic candidates, John Edwards has proposed the most comprehensive plan. It would protect consumers from the more egregious profiteering practices of private-sector insurers. Edwards would also establish a system of subsidies to help people pay for insurance who can't afford it.

But maybe most important, people could walk away from the private insurance industry in favor of coverage modeled after Medicare. The idea is that over time, the public, by its own choice, could adopt a truly universal and affordable health care system roughly amounting to Medicare for all.

To her credit, when Clinton released her health care proposals months after Edwards unveiled his, they were more or less identical. (Of the three leading candidates, Barack Obama offers the most disappointing health care plan. It has been under attack from Edwards and especially Clinton for failing to cover everyone by virtue of not having a mandate, which is true.)

Under both the Edwards and Clinton proposals, there would continue to be a mosaic of private and public hospitals and clinics. Those facilities, not the government, would continue to be the employer for health care workers within them. Doctors and other providers would retain their private practices. Patients would be able to choose their own doctor. Everyone will be mandated to have coverage, but if people can't afford coverage, they would be subsidized. There would be several coverage plans to choose from.

And there, then, are the leading Democratic schemes to impose evil "socialized medicine" and "Hillarycare" on an innocent population. If such reforms frighten Giuliani or Romney, it's hard to imagine either gentleman possessing sufficient courage to stand up to Iranian President Mahmoud Ahmadinejad.

Unfortunately, while the Edwards and Clinton plans fail to terrify, they can confuse, as was demonstrated when arguments over mandates began heating up last week. How do you force people to sign up for coverage and what happens if they don't?

Edwards said he would "require proof of insurance when taxes are paid and when health care is provided." Those without insurance would be enrolled in Medicaid or SCHIP or in another assigned plan such as Edwards' Medicare-style option. "For the people who refuse to pay, the government will help collect back premiums with interest and collection costs by using tools like the ones it uses for student loans and taxes, including collection agencies and wage garnishment."

However practical, or not, that solution, the mandate issue gets to the disappointing heart of how the Democrats may be failing to take advantage of the nation's desire for fundamental reform.

The Democrats are trying to cover everyone, even those who can't afford insurance or won't buy it, while continuing to allow the private insurance industry to play a significant role in the health care system and relying heavily on the industry's premium-based financing model.

Not surprisingly, that gets really complicated. And the more complicated the plans for health care reform, the easier it is for wingnuts armed with slogans to plant doubt and skepticism in the heads of voters.

Which brings us to another Democratic candidate, albeit one with little chance of winning the Nevada caucus or any other presidential contest, U.S. Rep. Dennis Kucinich. He is one of nearly 80 members of Congress who have co-sponsored legislation to simply extend Medicare to the entire population of the United States. It would be paid for by the $600 billion in system savings estimated to accrue by getting out from under the administratively bloated and failed for-profit insurance industry, as well as a "modest and progressive excise tax on payroll and self-employment income," and "a small tax on stock and bond transactions."

No more premiums. No more co-pays. No worries about mandates, or how to enforce them.

Veins protrude from wingnut foreheads when they work themselves up into a lather about how Edwards, Obama and especially Clinton plan to dismantle the private health insurance industry and replace it with a big government solution.

It's one more example of that oh-so-common complaint about stuff conservatives say: If only t'were true.

Hugh Jackson is a longtime local journalist, former senior editor of CityLife and the proprietor of the Las Vegas Gleaner (www.lasvegasgleaner.com), where he blogs.