Budding Policy Wonks: Get Your Terms Right
(Part One In A Series)
Isn’t this an exciting time? People are really truly discussing health care reform options–and I love it! This post comes as a plea in the debating. I’m down on my knees, people. Please.
I’ve said it several times, and I’ll say it again: please, if you’re going to debate health policy, get your basic terms right. I’m picking on GruntDoc and KevinMD, because I read them a lot, and think their opinion matters, and respect their opinions. One more time:
Honestly, I think many people in the media use “socialized medicine” as a scare term, a blanket term for any sort of “government” health care. If that’s how you’re using it, fine, but if you’re presenting information as policy arguments, you sound a little sophomoric if you use it incorrectly. (This is like referring to the rectum as “the poop chute.”)
Socialized medicine is what the UK has. This is also known as nationalized (or national) health care, or a national health system. They pay taxes, and with those taxes, the government builds hospitals, employs physicians, etc. (For an awesome overview of a number of countries’ health care systems, see here or here.)
Socialized insurance is what Canada has. This is also known as single-payer, or national health insurance. They pay taxes, and with those taxes, health care is provided privately to citizens through private doctors and private hospitals.
“Pay or play” is an employer-based system, where employers either have to offer coverage, or contribute to a fund to provide coverage to the uninsured. This is like my Governator’s plan.
I see people either writing (or linking to writing) that talks about how much the UK sucks, and they then conclude that “single-payer is a terrible idea,” or saying that Canada sucks, and then saying that “Hillarycare is terrible,” which is just totally wrong.
For the health care providers reading, these mistakes would be akin to confusing cholelithiasis to choledocholithiasis; while similar, they’re clearly different. You wouldn’t want to say the wrong thing, because you would be conveying the wrong information to someone, and, uh, look dumb.
You’ve got to post this on Kevin’s site somehow. It’s hilarious reading the heated debates in the comments section. There is a level of frustration though because there are a lot of uninformed scare tactics being used.
Nice points.
However, I’m not sure misusing these terms has much bearing on the actual debate. Both single payer and socialized medicine, at least in the countries used as examples, enjoy a global budget (well, let us say that Canada does for all intents and purposes; more “true” single payer systems clearly do).
I’ve never heard any complaint against the UK or Canadian health systems that didn’t stem from the relatively more conservative rationing of health care dollars.
* Provider reimbursement issues
* Patient access and wait times, etc.
Both of these systems suffer from nearly identical access to care issues associated with global budgets. Since that is, by and large, the complaint you hear out in the blogosphere, I’m not sure using the terms interchangeably does anything to take away from the points or arguments made.