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Health care capitalism and socialism

January 24, 2019
Pine Island Eagle

To the editor:

Let's talk about health care, capitalism and socialism. First, a little math. Think about 10 people you know. Then think about how many have health care that is in some way subsidized or administered by the government. Probably four or more. The most recent U.S. Census report (2017) found that about 40 percent of Americans have coverage through Medicare, Medicaid or the military. This same report found that between 2016 and 2017, the number of people with health insurance increased by 23 million ( That's a lot more people with insurance.

Now some history. I'm a registered nurse, and have been in health care for 30 years, in both administrative and clinical jobs. I have seen Medicare evolve from a program that paid doctor's bills based on "area rates" to an enormous and complex program that calculates reimbursements based on very complicated formulas. This is to contain costs and ensure that our senior citizens get the health care they need. This is socialism. The government runs the program, sets the rates, we pay taxes to finance this program. It's a huge bureaucracy.

What about the Affordable Care Act or "Obamacare." This is a program modeled after the one that Republican Mitt Romney came up with when he was the governor of Massachusetts.This 2006 law mandated that nearly every resident of Massachusetts obtain a minimum level of insurance coverage, provided free health care insurance for residents earning less than 150 percent of the federal poverty level, and mandated employers with more than 10 "full-time" employees to provide healthcare insurance. It was an attempt to work within the capitalistic economic structure and yet achieve coverage for all. People buying insurance in a marketplace environment = capitalism. People getting health care coverage from the government = socialism. Pretty simple.

Well what about drug users and insurance? A study published in the Journal of the American Medical Association in 2016 found that there was a six-fold increase in opioid abuse in Medicare beneficiaries as compared to people on other insurance plans ( So six times as many people on Medicare were diagnosed as drug abusers ... and the government is paying for it. Some folks think these drug abusers should pay more for their health care coverage, shouldn't they?

Anyone who supports Medicare supports the idea of socialized medicine run by the government, even if they don't realize it. Anyone who supports Obamacare supports a capitalist plan for health care, even if they don't realize it. What's the answer? reported in 2018 that the American Medical Association supports a single-payer plan (like Medicare for all) as the best fix for our broken medical system. These same doctors believe that health care is a universal human right.

In sum, people over the age of 65 are no more entitled to government-sponsored health care than anyone else. They have the largest increase in drug abuse of any insured population. They are benefitting from an essentially socialistic program. So, should we argue against socialized medicine including Medicare? Or perhaps listen to those who actually provide medical care and come up with a fair plan that provides basic health care to everyone, something that will reduce costs for all? Be careful what labels you apply to health care programs. They may not be what you think.

Isabel Francis, MSN, RN




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