The costs and benefits of socialized medicine

Republican President Dwight D. Eisenhower spoke with great respect of “our socialist friends� in Europe who, after World War II, were developing socially responsible approaches to public health care. Ike reminded Americans that the defining characteristic of America is neither “capitalism� nor “socialism,� but democracy.

Since then, we have had half a century of experience to compare for-profit costs and outcomes in the United States with the not-for-profit costs and outcomes of our democratic “socialist� friends in Europe. What’s the verdict?

A Sharon friend and avid reader of The Lakeville Journal told me recently that what he likes to see in TLJ articles are “facts.� Another close friend mailed me a 60-page report for the U.S. Congress by the Congressional Research Service (CRS) on “U.S. Health Care Spending: Comparison with other OECD Countries� (Sept. 17, 2007), and suggested using its findings in a piece in The Journal. (These CRS data closely conform to the World Health Organization’s own health statistics report in 2009.) OK, so what are the facts as reported by the CRS?

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Of the 30 member countries of the Organization for Economic Cooperation and Development (OECD), the United States ranks number one in excessive health-care spending, namely $6,102 per capita, compared with only $3,159 (almost 50 percent less) in France and $2,438 (60 percent less) in all OECD countries combined. Health-care spending as a percentage of GDP is 15.3 percent in the United States, 10.5 percent in France and only 8.6 percent in all OECD countries combined.

Thus, the United States is by far the heaviest spender on health in the OECD. But what does the United States get for the money, and how does it compare with our “socialist� friends in Europe and across our Northern border?

According to the CRS study, the average life expectancy in the United States is 77.5 years, in Canada 79.9 years and in France 80.3 years. Infant mortality per 1,000 live births in the United States is 6.9, in Canada 5.3 and in France only 3.9 (40 percent better than the United States.) Overall mortality rates per 1,000 people in the United States is 6.1, in Canada 5.2 and in France 5.1 (16 percent better than the United States).

The United States has a higher rate of deaths from natural and disease causes (we won’t even count murders and suicides) than 17 other OECD countries. In short, the United States pays the most money for health care, to reap some of the worst health outcomes among developed countries, including our “socialist� friends. The CRS verdict is clear.

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True, the United States is a leader in medical science, but not in making the benefits of that science available to our citizens. The largely privatized for-profit health insurance industry in the United States is a big part of the problem. How well are our health-care professionals used — doctors, for example? France, for all its lower costs, has 30 percent more doctors per capita than the United States, and has twice as many doctor visits per capita compared with the United States. Yet there is plenty of innovation in France, e.g., the recent first successful facial transplant. The United States trails many other countries in stem cell therapies.

Thus, there is nothing inherent in for-profit medicine that ensures performance superior to socially responsible medical science.

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Americans are a pragmatic people. If someone comes up with a better mousetrap, we’ll buy it. The label is not as important as whether it catches mice.

Maybe we should take a tip from Ike Eisenhower. Maybe our “socialist� friends have something to offer us. There’s nothing un-American about “socialized medicine� or national health planning. As Malcolm X used to say, “If someone’s doin’ better ’n you, he’s probably doin’ somethin’ you ain’t.� He has a point.

The United States is the only major developed democracy in the world that has thus far failed to adopt “Health for All� as a basic human right and a means of social justice. Cynically, the label of “socialized medicine� has been used perjoratively to deny to the American people the very justice, general welfare and liberty affirmed by the Constitution of the United States and already enjoyed by many of our “socialist� friends.

The facts are clear. The conclusion is self-evident. The means are at hand. Now is the moment of opportunity. Shall we seize it?

Sharon resident Anthony Piel is a former director and legal counsel of the World Health Organization.