Comparison of different health systems

by Joseph Green

(CV #40, August 2007)


. A single-payer system of national health insurance would be a tremendous advance on the present system, but it still will not be socialist care. It will be subject to cost containment and budget-cutting, as all social benefits have been in the period of neo-liberal economic restructuring of the last few decades, and it will be important for the working class to insist that national health insurance is truly universal and covers all residents of this country, including the undocumented immigrants. Meanwhile the California and Massachusetts plans would funnel yet more money to private insurers, have a hard time finding the money to do so, continue the privatization of social services, and despite their promises, will not solve the problem of universal coverage.

Present U.S. system Calif. and Mass. plans

("universal" extension of private insurance)

National health care

(single-payer and national health service)

Socialist medicine
Universal? No Promises, promises Yes (provided all residents, including the undocumented, are included) Yes
Covers all care? If you have the cash Many things not covered Fewer things not covered Yes
Goes through private insurance? Yes Yes No No
Two-tier? Yes Yes Not so much No
Preventive care? Traditional medicine: if you ask for it and pay for it

HMO: if it is "cost effective"

If it is "cost effective" Yes, on many things Yes
Action on workplace concerns? No No Single-payer: No

National health service: Maybe on some things, but not likely

Elitist? Yes Yes Yes No
Treatment is for profit? Yes Yes Single-payer: Yes*

National health service: the supporting industries are still for profit*



* A single-payer system of national health insurance, such as that in Canada, doesn't necessarily eliminate any aspect of marketplace medicine other than the private insurance companies. Single-payer simply says that the health care providers will be paid from a single source, the national health plan. A national health service goes further and removes the profit motive from hospitals and clinics, integrates them into a national system, and also makes doctors into salaried employees, but it still leaves the pharmaceutical companies and other supporting industries as profit-making, marketplace institutions. <>

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September 6, 2007.