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 |
Yes |
| Elitist? | Yes | Yes | Yes | No |
| Treatment is for profit? | Yes | Yes | Single-payer:
Yes*
National health service: the supporting industries are still for profit* |
No |
Note:
* 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. <>
September 6, 2007.
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