Stop Calling it Socialism!

By Dennis McClatchey

We all have our little pet peeves.

For example, my wife goes bonkers when people seem to confuse a plural noun with a possessive noun. For example, you may see "the Smith's" when it should be "the Smiths." Unless, of course, the former is followed by the word "house" or "dog" or some other possession owned by the Smiths.

For me, I have always cringed at the incorrect pronunciation of the word, Zoology. It should be pronounced, zo-ol-o-gy. Not, zoo-ol-o-gy. Count the Os.

But I have a new irritant. And, it's driving me crazy. The word is socialism. And commentators on the left, right, and in the middle appear to have no idea as to what it means. Because I hear everything from Medicare to Social Security being labeled as such. And they are not, repeat not, examples of socialism. Not by a long shot.

Go to Webster, or any dictionary for that matter, and you will find a definition such as this. Socialism is "the theory or system of the ownership and operation of the means of production and distribution by society or community rather than by private individuals with all members of society or the community sharing in the work or products."

In other words, in modern political terms in order for an enterprise to be properly labeled as an example of socialism that enterprise must be owned and operated by the government.

In Great Britain, for example, the government owns the hospitals, employs the workers, purchases the supplies, and equipment. The doctors, nurses, allied health professionals, housekeepers, food service workers, janitors are all on the government payroll.

Great Britain has socialized medicine. America's medicine is not socialized. It is free enterprise.

There are exceptions such as hospitals run by the US Bureau of Veterans Affairs and county or city facilities operating to meet the needs of certain population groups such as the indigent.

We keep hearing the refrain from the right that "Obama Care" (the Patient Protection and Affordable Care Act signed March 23, 2010) is a "government take over of our health care." 

As I see it, doctors are still practicing their varied specialties privately, and mostly as for- profit businesses. The hospitals remain private non- profit or for- profit institutions. The pharmaceutical companies, medical suppliers, durable medical equipment distributors continue to operate totally within the free market system.  And, insurance companies are still doing quite well, thank you, especially considering the truck load of new customers the Act will deliver them. Some government takeover.

Okay, the Act does add some new rules for these insurance companies.

The PPAC Act will immediately...

 Eliminate lifetime and unreasonable annual limits on benefits

 Prohibit rescissions of health insurance policies

 Provide assistance for those who are uninsured because of a pre-existing condition

 Require coverage of preventive services and immunizations

 Extend dependant coverage up to age 26

 Develop uniform coverage documents so consumers can make apples-to-apples comparisons when shopping for health insurance

 Cap insurance company non-medical, administrative expenditures

 Ensure consumers have access to an effective appeals process and provide consumers with a place to turn for assistance navigating the appeals process and accessing their coverage

 Create a temporary re-insurance program to support coverage for early retirees

 Establish an internet portal to assist Americans in identifying coverage options

 Facilitate administrative simplification to lower health system costs

Health Insurance Market Reform: Beginning in 2014, more significant insurance reforms will be implemented. Across individual and small group health insurance markets in all states, new rules will end medical underwriting and pre-existing condition exclusions. Insurers will be prohibited from denying coverage or setting rates based on health status, medical condition, claims experience, genetic information, evidence of domestic violence, or other health-related factors. Premiums will vary only by family structure, geography, actuarial value, tobacco use, participation in a health promotion program, and age.

So, that's "Obama Care" in a nut shell. Sound evil and un-American to you? No, doctors are not told how and where and when to practice medicine. There are no death panels. And, despite Rick Santorum's fear mongering to the contrary, citizens will not be forced to wear bracelets stating, "please do not euthanize me!" The program is simply designed to make health care more assessable and more affordable for all of us, regardless of our class.

You remember the Preamble to our Constitution, "...provide for the general welfare..."

Yes, the free market health care system remains alive and well. And, trust me, I'm a fan of capitalism. Really. Well, most of the time.

You see when the free market is working properly it operates in a mutually beneficial way. For example, say I'm in the widget selling business. I want people to purchase widgets from me, not my competitors. To do so I must price my widgets below all others. Or, I must produce a superior quality widget. Or, I must make the availability of my widgets easier to acquire. Or, I must be more effective in the promotion of my widgets.

But ultimately, my goal must be to satisfy my customers. If I satisfy my customers they will return to me for all their widget needs. And, if they are really happy they will tell their friends, and they will come to me as well. The relationship between the business enterprise and the customer is symbiotic.

However, the insurance business turns this model on its head. In order for the insurance company to generate a healthy bottom line, it must avoid paying out claims. The fewer claims paid, the better. That's why such companies are always finding ways to either deny a claim, refuse to cover certain high risk people, and generally looking for opportunities to weasel out of their coverage commitments. This is not a mutually beneficial exchange.

Now, it's one thing to weasel out of fixing a car fender or covering stolen property (as bad as that might be). It is something else when the denial can literally have life and death consequences. As I see it,  we as a society have a choice on the question of health care. We can either socialize it and remove the insurance companies altogether. Or, we can continue to allow the free market system to operate but with certain protections. And, that's what the Affordable Health Care Act does. But for some it is still way too much. And, I'll bet these folks are fully insured and are doing quite well.

But let us return to our discussion on socialism. I must admit, that even within our capitalistic free enterprise free market system there does lurk some institutions that can be accurately identified as representing the true meaning of the word, "socialism." Are you ready?

Libraries, fire departments, city-county-state-federal law enforcement agencies are all examples of this derided conceptual model.  And, I hope you would agree, that is as it should be.

Let's take law enforcement, for example. The purpose of a city police department is to reduce crime. This is done, in part, through the enforcement of the city's laws by responding to and investigating violations of those laws. More resources and the greatest priority, we would hope, would be placed on those crimes that are the most violent and harmful to the welfare of our community:  rapes, murders, assaults, arsons, etc. In order to evaluate the success of a particular police department we would track and report the city's crime rate over time paying particular attention to those crimes that are the most pernicious.

Now let's say this enterprise were to be outsourced to a private for-profit business. Now its purpose has been altered a bit. Now, the goal is to generate a profit through the enforcement and investigation of crime. But, in order to evaluate it as a business, we would be tracking profit and loss statements. And, our priorities would shift to those activities that generate the greatest revenue while requiring the fewest resources (which is the definition of efficiency a goal of all business ventures).

So, if the greatest efficiencies result from, let's say, speed traps, that's where the priorities would go. And, if there are lesser efficiencies in investigating rapes, well, sorry there's just not enough money in it so it becomes a back burner activity.

Now, I know no one is arguing for the privatizing of police departments. At least I hope not. My point is, there should be some activities, some enterprises that are so vital and important to the community at large that it should not be subject to the priorities and needs of the bottom line. And maybe, just maybe health care would fit such a category.

Yes, I know the majority of America's hospitals are run as not-for-profit charitable institutions. But, I also know-having spent 20 years working in this arena-that the same financial pressures apply. I have attended countless board meetings of said organizations and I can report that more time and attention by the boards was placed evaluating the profit and loss statements and reviewing the age of the accounts receivables of the hospital than any quality of care indicators.

This is not to say that non-profit board members are greedy and heartless. To the contrary. Some of the most caring, selfless, and giving people I have met were those I met serving on our hospital's boards. And, they dutifully give of themselves voluntarily. There is really nothing in it for them other than providing a service. It's just that most of them are business men and women. They feel more comfortable examining a balance sheet than infection rates or morbidity and mortality reports. That, they feel, should be left to those trained and educated on the clinical side of the ledger.

So, again,  the fiscal strains of the non-profits are the same as their for-profit counterparts. As one Catholic nun famously said, "no margin-no mission."

Perhaps some endeavors, such as police enforcement, should not be required to have "a margin" only a "mission." And, perhaps health care delivery fits into that category.

Here again, that's not what has occurred with the Patient Protection and Affordable Care Act. It is designed to protect the free market exchange of health care as much as it is designed to protect citizens from becoming bankrupt due to a devastating health catastrophe. But listening to the rhetoric on the right, it's hard to know that.

Yes, I have heard the argument. "Do you want the same people that are running the Postal Service running your health care system?" Well, here's one for them. Do you want the same people running your health care system to be the same ones who were once running Enron?

Give that some thought.

In Defense of the US Postal Service

Actually, the question raised by conservatives and libertarians, "do you want the same people who run our post office running our health care? " is worthy of further examination.

Think about it. For 44 cents you can write a personal note and have it hand delivered to virtually any house, apartment, or business in the country, usually within 2 to 5 days. Can you name any other service of equal or like value?

And, no, the USPS is not funded by our tax dollars. In fact, in 1970 the Postal Reorganization Act mandates that the Service  function as a semi-independent agency in a revenue neutral fashion. In other words, no losses, no profits.

Yes, the USPS is facing a major financial crisis. But it is not from poor management. The cause? In 2006, Congress passed a law requiring the Postal Service to pre-fund the cost of its retiree health benefits covering the next 75 years of obligation, but to do so in a mere 10 years. Trust me, if any other business was saddled with such a requirement it would be sucking air, too.

Fact is, the USPS is efficient. Ten years ago it took 70 employees one hour to sort 35,000 letters. Today, only two are required.

Fact is, the USPS is more reliable, more efficient, and less expensive than either UPS or Fed Ex in most categories of shipments.

And, did you know that each year UPS and Fed Ex pays the USPS to deliver over 400 million of their ground packages in residential areas and on Saturdays?

So, perhaps the answer to the question, "do you want the same people who run our Postal Service to be running our health care?" is a resounding...YES!