I’ve never heard anyone refer to our national parks system as “socialized recreation.” Nor to our public schools and universities as “socialized education.” It’s even been a long time since Medicare was called “socialized medicine,” although its opponents continually did so in the run-up to its passage in 1965. But whenever a new government-involved health care program is proposed, we can count on its being characterized that way.
I know of no other instance when U.S. public perception of a policy question has been more successfully shaped by winning the contest to name it (although the rechristening of the estate tax as the “death tax” helped Republicans gut it at the federal level). “Socialized medicine” was a brilliant tactic to frustrate efforts to institute a universal public health care system. The American Medical Association distributed posters to doctors with slogans like, “Socialized medicine ... will undermine the democratic form of government.”
The AMA ratcheted up its public outreach in response to Harry Truman’s effort to enact a national health insurance program in 1947. He insisted that it wasn’t “socialized medicine” (more on that later), but to no avail. The AMA hired the public relations firm Whitaker and Baxter to make sure the name stuck. And because the Cold War was starting up and few Americans could distinguish between socialism and Communism, the legislation didn’t pass.
During the late ’50s and early ’60s, the AMA conducted Operation Coffee Cup to stave off Democratic efforts to enact national health insurance for seniors. Doctors’ wives would organize coffees at home to persuade their friends to write letters of opposition to their members of Congress. Widely played at the coffees was a 1961 recording called “Ronald Reagan Speaks Out Against Socialized Medicine.” As it turned out, Medicare brought doctors thousands of patients who wouldn’t otherwise have been able to afford medical care.
Versions of Medicare for everyone are sure to be considered in D.C. and in Salem this year, so it’s well to equip ourselves to deal with the predicable campaigns to stigmatize them as “socialized medicine.” I suggest it would be a mistake to respond, “So what?”, although that would be my first impulse. My advice is that if you are present when people are going on in that vein with an abundance of ideological fervor and a dearth of information, simply ask them if they wish to close all the VA hospitals and require veterans to buy private health insurance. That may initiate a productive conversation.
You see, the Veterans Affairs Department runs what might reasonably be called a socialized medical system. Its facilities are publicly owned and operated, and almost all its staff are public employees. That’s very like the British National Health Service (and our public schools). But no legislation proposes to extend the VA model to our entire population. Instead, like Medicare, what’s proposed is some version of national health insurance that can be used to pay for services from any licensed physician or at any hospital (though some plans call for an end to for-profit hospitals, leaving only public or private nonprofit hospitals).
A sizable majority of non-physician health professionals, such as nurses, favor universal access to health care, and many doctors have formed organizations outside of the AMA to advocate for reform. Whether the AMA, which has surrendered control of U.S. health care to the insurance companies, nonetheless will join with them and resurrect the bogeyman of “socialized medicine” remains to be seen.
Herb Rothschild’s column appears in the Daily Tidings every Saturday.