Commentary—

What Would ‘Universal’ Be Like?

By Martha Burk

I live in New Mexico, where every other person is running for political office, thanks to the fruit-basket-like turnover created by the retirement of Republican Senator Pete Domenici, who’s been aging in place on Capitol Hill since 1973. The debate between Republican aspirants for the Senate — both current members of the US House — is already heating up. In their first encounter, they predictably tried to “outconservative” each other. Heather Wilson, representing urban Albuquerque, labeled herself a “commonsense” conservative. She attacked Steve Pearce, a downstater with more rural constituents, for his vote against expanding children’s health insurance. Pearce countered that he is the “true” conservative, and said giving poor kids insurance would be “Hillary Care Lite . . .the beginning of socialized medicine.”

W-a-a-i-t a minute. Socialized medicine? With that remark, Pearce shows he’s clueless about medical care, and so are lot of other candidates. Not to mention conservative Rush Limbaugh clones who are out of control in the blogosphere, raving about the government controlling your private medical decisions. Maybe they need a little lesson on what “socialized medicine” is — and is not. And maybe they’d be surprised to learn that the United States already has one form of socialized medicine. But I’m jumping ahead.

Many people, including Pearce, evidently equate “universal coverage,” which Hillary Clinton does advocate, with the dreaded “socialized medicine.” Universal coverage means just that — everyone would have health insurance. Some would have it through employers, some through privately purchased plans, and some through government-subsidized programs if they’re too poor to foot the full bill. Universal coverage does not mean the government would provide health care as a “welfare” or “entitlement” benefit to everyone, regardless of income or employment status.

Though having insurance would be mandatory, type of coverage would be up to the individual. Choice of doctors and hospitals under universal coverage would remain much as it is now — controlled by the type of plan the individual is covered under — and in no small part dictated by insurance companies. In some scenarios, insurance companies would be required to cover pre-existing conditions, stopping the practice of “cherry-picking” only the healthiest patients for inclusion in their plans.

Another term we hear a lot about is “single payer.” Single payer means a system of health care that provides universal and comprehensive coverage, with the government as the insurer issuing the payments. Everyone’s health care would be paid for out of one publicly administered trust fund (paid for by taxes on both individuals and business), which would replace our current multipayer insurance company system and its premiums. In single payer, the government would not be the primary provider of health care. It would just the primary payer. There would still be freedom to choose doctors and other health care professionals, facilities, and services.

Doctors would remain in private practice and be paid on a fee-for-service basis from government funds, just as they’re paid now by insurance companies. The government would not own or manage medical practices or hospitals. Single payer is what we have now with traditional Medicare. Insurance companies are eliminated — no more hassles with gatekeepers, denied coverage, and trying to find doctors “in network.” Ask any senior who has been liberated from HMO hell and you’ll see how easy and popular single payer would be if everyone had it.

If “socialized medicine” is none of these — just what the heck is it? Simple. It’s a system of health care in which all health facilities are owned by the government. Doctors and other health care personnel work for the government and draw their salaries from the government. This is the model used in the US Veterans Administration and the armed services, where the government owns the hospitals, and medical professionals are government employees. It works pretty well for vets, but red-hot rhetoric notwithstanding, none of the candidates — nor either political party — advocates socializing the entire medical system of the United States.

So the next time you hear a candidate hurling “socialized medicine” around like a flame-thrower, ask them if they have any idea what they’re talking about.

(Martha Burk is author of “Your Money and Your Life: What’s at stake for women in 2008 and beyond,” due out in April.)