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The label of socialized medicine has killed many a proposal over the years, including Harry Truman's idea for national health insurance in the 1940s. Yet as Ezra Klein points out, the term's meaning eludes many speakers.
The words socialized medicine and single-payer health care get thrown around with such gleeful abandon that they've both become a bit unmoored from their actual meanings. In the American health-care debate, they tend to refer to "whatever the Democrats are proposing." But that's not what they mean.
Socialized medicine is a system in which the government owns the means of providing medicine. Britain's is an example of a socialized system, as is, in America, the Veterans Health Administration. In a socialized system, the government employs the doctors, owns the hospitals, and purchases the technology. I have literally never heard a proposalfor converting America to a socialized system of medicine.
Single payer is a system in which one institution purchases the care. But the payer does not own the doctors, hospitals, or MRI scanners. Medicare is an example of a mostly single-payer system.
What we're actually going to get is not socialized medicine or single-payer health care. It's a hybrid. Private insurers, hopefully competing with a public option. Private doctors and private hospitals. Government regulation and subsidies. It's going to be messy and inefficient and hopeful and the product of a mix of corporate preferences and public compassion and latent populism. It will, in other words, be a uniquely American system, and hard to describe with a single epithet.
Visit voices.washingtonpost.com/ezra-klein
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