One Cheer for Socialized Medicine

Royal Gwent Hospital (NHS Photo)

Royal Gwent Hospital (NHS Photo)

Ezra Klein writes about what “socialized medicine” would really look like:

Socialized medicine is a system in which the government owns the means of providing medicine. Britain is an example of socialized system, as, in America, is the Veterans Health Administration. In a socialized system, the government employs the doctors and nurses, builds and owns the hospitals, and bargains for and purchases the technology. I have literally never heard a proposal for converting America to a socialized system of medicine. And I know a lot of liberals.

Not that I think we should make this a near-term legislative priority, but I actually think there’s a very strong case on the merits for a limited form of socialized medicine. Which is to say that I think it would be smart for the government to directly provide a certain class of relatively cheap, not-very-interesting preventive services. You would have clinics in neighborhoods where medical personnel (mostly nurse-practitioners and dental hygenists, I would think) directly employed by the government could provide things like vaccinations, regular tooth cleaning, prostate exams, etc. Obviously, you would want actual medical doctors and public health researchers to determine what the appropriate list of services is rather than a blogger. But the general aim would be to identify a list of preventive health services where it’s not desirable for people to be economizing and then we’d bring the services to the people directly as a public service. And the upshot would be a kind of National Health Service but not one that, UK-style, aspires to comprehensively meet all medical needs. Instead, it would have a limited mission to provide basic preventive care.

Now needless to say, we’re not going to build a system like that. But we can try to make sure that health reform strengthens the position of community health centers that do some of this kind of stuff.