As a physician, I can remember in 1965, when Medicare was first proposed, its architects believed that establishing a successful program for the elderly could serve as a stepping-stone toward future general coverage for the entire nation. To gain support, the idea was to introduce a program that could be incrementally expanded later, rather than presenting a universal health insurance plan upfront.
At that time, the political landscape during the cold war era was marked by much anti-communist sentiment, this form of universal health care was derided as “socialized medicine,” equated with the overall idea of socialism, which, at that time, was also associated with the odious term, “communism.” However, because of Medicare’s current wide public acceptance and satisfaction, this label is no longer appropriate. Nevertheless, the fear that we were succumbing to an abiding form of socialism, coupled with a fear of excessive spending, the idea of Medicare expansion continues to be met with much resistance.
But to adhere to our egalitarian principles, basic health care, along with many other social supports, should be applied equally to the entire population, not to just those who are wealthy. In this process, however, we must consider the meaning of socialism and other common terms.
Communism, socialism, progressivism, capitalism, and democracy are all among our top all-time overused terms. They are complex, abstract concepts that are often misunderstood. Part of this confusion first stemmed from how communism was defined, which, according to Karl Marx’s original idea, describes an economic and political theory that consists of the elimination of private property and the common sharing of all resources among an entire nation. The early 19th-century writers often used the terms communism and socialism interchangeably. Most importantly, however, communism is now most often inextricably linked to political tyranny with permanent one-party rule that excludes democracy, a term which was a concept poorly developed during Marx’s time.
Interestingly, both communism and socialism can now coexist within democracies: for instance, the Kibbutz system in Israel, which is, in effect, is a democratically controlled communistic (commune) system into which one can freely enter or leave as desired. Extending this idea further, the Scandinavian countries provide good national examples of socialism, in the form of “social democracies,” and they seem to provide general satisfaction by providing such services as universal health care and retirement support; all subject to public (democratic) approval. Most people would call this socialism, also defined as progressivism. Capitalism, by contrast, is defined as a system consisting of free markets that are controlled by competing private forces constrained mainly by supply and demand, and free of significant governmental intervention.
Prior to 1929, the U.S. system was basically capitalistic until governmental forces were required to rescue us from a political/economic disaster, thus establishing a form of “democratic socialism” which continues to persist to this day. Contrasting with the controls imposed by authoritarian countries, the government of this nation is merely an extension of societal, or peoples’ (democratic) control and approval, which can be used as a multifunctional entity that can provide the public with environmental services, national defense, arbitrate national disputes, prevent the formation of monopolies, and perform many other services that are beyond the capacity of private enterprise. These services should also include an inevitable, equitably distributed, national health care plan.
In short, we have created a government that acts as an agent of “we the people,” free of monarchs or dictators. As a result, we, as a mixed society, decide how many governmental social services we wish to provide. In the process, we should simply discard the use of the poorly understood names, noted above, and stop using them as a cudgel to condemn and divide our fellow citizens. Also, we must disabuse ourselves of the notion that some vague governmental force will seize the initiative and force us all into a form of vassal servitude. So, as was stated years ago in the comic strip Pogo, “We have met the enemy, and he is us.” Thus, despite all our many misgivings, democracy is not about to die!
Morton Tavel, MD, FACP, FACC of Fort Myers is clinical professor emeritus, Indiana University School of Medicine, and has authored over 145 research publications, editorials, book reviews and a medical textbook.
This article originally appeared on Fort Myers News-Press: Medicare at the outset derided as ‘socialized medicine’ | Opinion
Reporting by Morton Tavel, MD / Fort Myers News-Press
USA TODAY Network via Reuters Connect
By Morton Tavel, MD | USA TODAY Network
