During the past 5 years we have heard a great deal of rhetoric regarding socialism and healthcare as a result of the passing of the Affordable Care Act, particularly in how ACA compares to socialized medicine in England and the UK. The concerns of the people regarding socialism are important as our country is founded on capitalist principals, and to change those principals requires a complete shift in our thinking. A close look at the systems in question reveals important aspects for consideration; indeed it is important to be aware of the potential future of the ACA.
While the English National Healthcare System and the Affordable Care Act have similarities, funding and administrative differences mean that while the ACA could become socialized, it does not currently fit that label. The primary concern of the American people concerning the ACA is, understandably, how this system will fit into the capitalist system that we are so very proud of and whether it will be the start of our nation moving toward complete socialism.
Merriam-Webster defines socialism as “any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods”. In other words, the state controls business and commerce directly rather than through governmental regulations. Social services such as Medicare are a form of socialism in that they are administered directly by the government in order to prevent business concerns from interfering with their stated social goal. Unfortunately, in a modern democracy, business concerns have a great deal more impact.
Socialized medicine could then be defined as a medical system owned and administered directly by the state without third party intervention. Currently the National Healthcare System employed in England consists of a single payer model in which the government oversees all payments of medical treatments and is primarily funded by the taxpayers, with a small contribution from individually purchased insurance plans. This system is not affect by profit or the concerns of shareholders as it would be under a capitalist system.
The fact that this is completely administered by the state and funded by the people, means that this is an example of true socialized medicine rather than capitalistic medicine with strict governmental regulations such as the ACA will provide by using independent business to administer the system. The stated primary goal of both the ACA and the NHS is to provide quality healthcare to all citizens, however the methods employed to pay for it are the primary difference separating the two systems.
The system currently employed in England is funded by the taxpayer and is administered directly by the UK Department of Health. The most that an English citizen can expect to pay is a small cost for some prescriptions, with the entirety of the rest of their medical expenses covered by the government. This permits the government to reduce the cost of providing healthcare to each citizen not only by spreading the cost among the entire population, but also by increasing access to preventative medicine to reduce the need for emergency care.
This differs from the ACA in that by the time the patient has completed treatment, there are no additional out-of-pocket expenses. The method employed by the ACA involves the use of independent insurance companies that will provide insurance purchased by the individuals or their employers, with a government subsidy for those that cannot afford it on their own. This differs not only in the method of administration, but also in that there is no requirement that the entire cost of treatment be covered by the insurance purchased.
While this will help to reduce the cost to the individual, and the individual mandate will reduce the insurance premiums, there will still be an additional out-of-pocket cost that the individual will be responsible for in the form of costs above what the insurance will cover. Because the ACA makes use of independent business, it lacks the one thing inherent in all socialist endeavors, a state of complete and total governmental control of the business in question.
One of the main points of the ACA is the Health Insurance Exchanges which will allow consumers to compare health insurance options across the state in order to increase competition to improve not only the quality of the insurance, but also to reduce the total cost in order to be more competitive. The only controls set into place by the ACA are solely in order to prevent insurance providers from cherry picking those they will cover based on pre-existing conditions, dropping coverage when the insured no longer is profitable, or capping how much they will cover over the course of the insured’s lifetime.
However, it would not take a great deal of change for the system to convert completely to socialism. If, for some reason, the government decided it was needful to take control of more aspects of the functioning and administration of the insurance itself, such as the way the government decided it was needful to control aspects of the Airline industry, then there would be very little that would prevent the system from slipping into a socialistic version where the government would administer the entire system.
Whether this would be a bad thing is definitely open to debate as socialized healthcare certainly has not done Great Britain any harm. Once we clear away the politicking and the rhetoric, the introduction of the ACA into American society does not seem to be counter to the principles of our society. Since we have accepted minor forms of socialism in the US such as Medicare in the past, government sponsored healthcare most likely will become acceptable over time.
Thanks to the Insurance Exchanges, Americans will be able to keep their privilege of choice in their insurance and how much they are willing to spend, which helps to ease the transition. Nonetheless, despite what has occurred in the past, the future of the ACA is something that will be watched very closely by a great many people, some with anticipation and others with a great deal of apprehension. However, while it is important to recognize what the Patient Protection and Affordable Care Act can become, it is just as important to recognize what it is now, our best hope for a healthy nation of healthy people.