I don’t like the pejorative use of certain words, especially when they’re so incorrectly applied. Today, allow me to vent about the phrase “government-run” health care. Obviously, this phrase is used to evoke a knee-jerk response in people who are opposed to the government running anything. But what does it actually mean? Clearly, there are some cases where government-run is a more fitting description than others.
In the context of health care, there are two main concerns: financing and delivery. In a place like England, the National Health Service both finances health care and by owning the hospitals and paying the physicians on salary, mostly controls the delivery of care as well. That’s about as close as you can get to “government-run.” Still, the actual provision of care occurs between doctors and patients. It isn’t as if there’s a government bureaucrat in the exam room weighing in on treatment decisions–although there is a panel called NICE that makes some cost-benefit decisions that many on this side of the pond would frown upon. Still, they outlive us, so I’m not quite sure what we’re afraid of.
Then, there’s Canada, which people like to lump in with England as being “socialized.” Or, as Wyatt Cenac of the Daily Show recently said, Americans don’t want to become “Nazi Germany, or Nazi Russia, or Nazi Canada.” In Canada, the financing of health care is a government affair, but the delivery is purely private. In many respects, it is no different from the U.S. Medicare program.
Which brings me to the United States. What exactly do people mean when they say Congress is proposing a government-run system? Well, based on my knowledge of what’s in the bills, they can’t mean a government owned delivery system, and they can’t mean much in the way of a government financed system, because there’s not much that would change from where we are today in that respect. Sure, there would be new subsidies, but we’re not talking about Medicare for all. By and large, the private employer-based system would remain intact. So I really don’t see how anything more than partially government-financed can be applied appropriately as a label for the proposed reforms.
Let me put it to you this way: Suppose it’s your birthday. If your Grandma sends you a gift in the mail, that’s Grandma-run. You had next to no say in what you received, where it came from, or how it was paid for. Now, let’s assume she sent you a card with a check in it instead. That’s Grandma-financed. You can choose to spend those resources anywhere you see fit. Of the two, I prefer the latter option. Of course, I suppose I could just buy myself my own gift, but where’s the fun in that?