Talk:Socialized medicine/Archive 1

message: This article loses wikipedia some of it's credibility. Admins have to be objective and clean these articles of their one-sidedness.  —Preceding unsigned comment added by 74.76.253.228 (talk) 03:11, 6 November 2007 (UTC)
thread_title: Extremely biased

message: Refutations of the criticisms are presented as the final word, most of them nothing more than assertions and shifty rebuttals that don't address the criticisms they say they do.  —Preceding unsigned comment added by 65.207.7.91 (talk) 12:49, 29 October 2007 (UTC)
replies: text: Everything about this article is completely biased, but you're right - the criticism section is particularly heinous. How do you go about requesting the deletion of an article?--J.Dayton 12:50, 1 November 2007 (UTC)
thread_title: Criticism section totally biased

message: Opponents of "socialized medicine" pretend that all "socialized" systems are like the British NHS. This is not true and makes for biased commentary. David.Monniaux 10:24, 1 Apr 2004 (UTC)
replies: text: Why the hell is there "commentary" at all? Also, the POV I see in this article all seems to be coming from the author of the article. Personally, I think the whole thing should be trashed.--69.253.92.203 22:47, 26 October 2007 (UTC)
thread_title: Opponents of socialized medicine

message: Users of Wikipedia may be unaware that "socialized medicine" carries political overtones and messages of opprobrium. Those associations began in the mid 1930s as the (U.S.) American Medical Assciation reacted with a public relations campaign to proposals emerging from the Committee on Economic Security headed by U.S. Secretary of Labor Frances Perkins. The short article that has been inserted to replace the former redirect to Publicly-funded medicine is intended to describe controversies involved with the phrase.
Craig Bolon 14:24, 16 April 2006 (UTC)
replies: text: Regardless, many sources online that define the term do not suggest that it is necessarily derogatory, but is more commonly used literally, to describe a type of health care system.  Therefore, I do not think it is appropriate (NPOV) for Wikipedia to define it as such in this article.  Of course, we should have information in the article about the origins of the term. Kborer 00:37, 17 January 2007 (UTC)

text: Dude. The term "socialism" isn't used negatively because Republicans actually believe its a good thing but want to smear the hell out of it. They, and most Americans, believe that socialism will actually tank the economy and destroy our society. They have historical evidence supporting the fear (Germany, Russia, China), and a bunch of Democrats touting socialist principles. Also, universal healthcare is a form of socialism. Why are we pretending it isn't? This is the problem with Wikipedia: a bunch of people with very strong political ideas trying to re-write history and re-define words and terms to fit their agenda. --69.253.92.203 16:01, 23 October 2007 (UTC)
replies: text: You make your own point very nicely :)  --Tom 21:14, 23 October 2007 (UTC)

text: I can't find a specific quote from Ronald Reagan attributing progressive taxation to Marxism, but I know that is a common belief. According to Herbert Stein's review of an edition of The Wealth of Nations on the Wall Street Journal editorial page, it was Adam Smith who first advocated progressive taxation, because those who benefited most from society had an obligation to bear a disproportionately greater proportion of the cost of running society. Curiously the Wikipedia pages on Adam Smith and Wealth of Nations don't mention that. Nbauman 23:38, 14 February 2007 (UTC)
replies: text:  It isn't curious at all. None of this shit is information; it's wikimation, and that means liberal: especially when you happen upon an article like "socialized medicine." --69.253.92.203 22:50, 26 October 2007 (UTC)

text: Your first point is that the term still carries negative connotations.  However, if you observe present day discussions of health care you will see that many proponents of socialized medicine refer to it as such.  They point to the social health care systems currently implemented in various nations as examples of good health care policy.  Furthermore, most resources that define the term do not even insinuate that it might be used disparagingly.  Your second point is that it is important for the article to recognize that the term can be used in a denigrating way.  I agree that this should be included in the article as a historical note.  I do not think it can be justified to include it as part of any definition, especially in the introductory paragraph, as that immediately colors the term in a way that is not consistent with common usage in a very biased way.  Kborer 01:01, 19 January 2007 (UTC)

text: I think these comments are indicative of the confusion that surrounds this particular topic.  Universal health care and socialized medicine are distinct ideas.  It is true that when a government socializes the medical industry, it generally does so in such a way that the benefits are universal.  On the other hand, a government could mandate universal health care without socializing the medical industry.  You are correct that someone who is in favor of socialized medicine might call it UHC, and I think a discussion of this would be an excellent addition to health care politics.  Furthermore, it is important to understand that the reasons behind these semantics go beyond the simple fear mongering of the last century.  However, the point of this article is to explain what socialized medicine is.  Defining it as a pejorative phrase in the introductory paragraph gives the wrong impression to the reader.  I think that these points are more appropriate in sections on the history and politics of socialized medicine, both of which could link to more involved articles. Kborer 19:04, 19 January 2007 (UTC)
thread_title: Opprobrium

message: This page is a bit odd. It reads a little like somebody has just invented definitions for things and decided to write about it. The lack of references reflects this. The "Universal health care" section,  defined as different to "socialized medicine" because the former isn't required to "be controlled or funded by the government" is one of the oddities, for instance. I don't know of any universal health system that isn't "funded" by government, and certainly can't even imagine one not in some way "controlled" by government - even US health care, which is certainly not universal - is regulated by law. I suggest changing this, or if I'm wrong, putting references in. Wikidea 18:20, 21 May 2007 (UTC)
thread_title:  Oddness 

message: Being an Australian I have never heard of this term before. Is it used any where outside of the US? Ozdaren 02:19, 28 June 2007 (UTC)
replies: text: I'm British, and have only ever come across it in an American context. To generalise to the extent that it is "often used to describe publicly administered health care systems such as the British National Health Service" is simply not true: the phrase is barely ever used by Britons. I'm going to change it to "often used in the United States". 86.132.137.231 00:57, 26 July 2007 (UTC)
thread_title:  Where? 

message: Congratulations Kborer on your new graphics editing program. 
What is the system in the quadrant labeled "government monopoly"? Where is there a system with private financing and government employment? Nbauman 19:24, 1 August 2007 (UTC)
replies: text: It does not happen with the health care industry, but an example would be the United States post office.  Kborer 20:42, 1 August 2007 (UTC)
thread_title:  Graphic 

message: :I think there have been a significant number of quotes tracing back the origin of this term; we can certainly try to track down more. As for support for the comment "often used disparagingly", I should think this article and series of quotes should support this - the term "socialized medicine" is clearly used as a form of guilt by association with socialism: Giuliani attacks democratic health plans as 'socialist'. Or to quote directly: "That's why when you hear Democrats in particular talk about single-mandated health care, universal health care, what they're talking about is socialized medicine." The previous sentence makes the link explicit: "The American way is not single-payer, government-controlled anything. That's a European way of doing something; that's frankly a socialist way of doing something."--Gregalton 08:11, 11 August 2007 (UTC)
replies: text:  We don't need a lot -- just one reference that supports that the term is "often  used disparagingly" to talk about government run, government financed health care will be fine.  Kborer 14:27, 11 August 2007 (UTC)
replies: text: Incorporated inot the article. Note if you would like to see more.--Gregalton 14:50, 11 August 2007 (UTC)
replies: text:  I meant a reference that talks about how the term is often used disparagingly, not an example of it.  If you find it, just stick it as a reference right after the phrase so that the phrase itself is referenced.  Kborer 23:21, 12 August 2007 (UTC)
replies: text: I'd be happy to oblige, but would also welcome any suggestions as to the types of references you might find acceptable. For example, googling for socialized medicine and socialism makes it pretty clear that there are many, many examples, and few are positive. Leaving out socialism doesn't substantially alter the frequency of the use of the term in a negative context. Quoting a presidential candidate making a direct, clearly negative link does not directly demonstrate frequency, but does demonstrate that this view is certainly not rare. But honestly, if you have suggestions on the type of source that might be acceptable, I would appreciate - statistical analysis of "positive/negative" is not really my field.-- Gregalton 04:46, 13 August 2007 (UTC)
replies: text:  There are two problems.  The first is that anecdotal evidence is not effective.  The second is that when someone expresses a negative opinion about something, it does not necessarily mean that whatever term they use for it is pejorative, disparaging, etc.  I am going to remove the claim until it is referenced, since the definitions that I have found have not even insinuated that the term could be used in such a way.  Kborer 23:54, 16 August 2007 (UTC)
thread_title:  term 'disparagingly' in intro 

message: To Giovanni33    Why have you removed the criticsm section? The entire history of the edits to this article has been littered with criticism of the use of the term. It is right and proper that the criticism of the term should be aired.  Your edits and those of kborer have just led to the removal of issues negative to the term socialized medicine and left in all the edits that mentioned the way it was used. One could be thinking that the edits are motivated by something other than achieving clarity to the article.
To other editors here. Should this article have a criticism section?--Tom 11:11, 11 August 2007 (UTC)
replies: text: I agree that the criticism section can perhaps be left as 'history of the term.' I find the phrase 'types of socialized medicine' as a section heading below still effectively has the effect of describing the types described below as 'socialized' (i.e. 'socialist.') The discussion above outlines why this is POV itself. There is no reason to classify single-payer health care as 'socialized' in the original term (i.e. nationalized in the socialist sense), nor universal health care. It is clearly a loaded term.--Gregalton 14:57, 11 August 2007 (UTC)

text: I disagree with Gregalton regarding the criticism section. The points made in the criticism section will not sit easily under history.
As for Giovanni33's points about criticism, I think he is mistaken. I think that WP policy is talking about critical analysis of the subject. My section was a explanation of the term and its use, pointing out how it has been seen and describing the inconsistencies of use. The WP policy article is about criticism of the subject of the article and I was neither talking "socialized medicine" up or down. I would therefore strongly disagree that it was POV.  
To allay these concerns I will see if I can find another title under which to group them. Maybe it was the word criticism that you disliked so much. I'll see if I can find another term for it--Tom 17:00, 11 August 2007 (UTC)

text: My other problem is one of undue weight. For have various sections talking about problems with the use of the term gives undue weight to this POV, i.e. criticism of the use of the term. Each criticsim doesnt need its own section, as it then dominates that article and thus gives undue weight. That point is best made within the body of the article under the category "usage of term." That is what I have restored.Giovanni33 19:37, 11 August 2007 (UTC)

text: I see that. I dispute your changing the structure of the article, and I stand by my comments that doing so is POV pushing. You don't need a new section for every critical comment/example about its negative use, esp. when its one sentence, and even somewhat trivial. Also, you are deleting other sections that add information. Contrary to what you claim, they are not irrelevant. This article is entitled Socialized medicine, not "Criticism of the use of the term." But since we disagree then let me point out that you dont have consensus to make these major changes, and the version/structure I will revert to is the long standing version, and is supported by myself and the other editor here. Until you obtain some consensus for your major changes (many of them I incorporate happily into the article), you can't expect to get your way by edit waring.Giovanni33 03:10, 12 August 2007 (UTC)

text: I think including information on arguments for and against socialized medicine is out of place in this article. There are terms that are accurate and not pejorative, and well covered in those articles. Rather than repeat those points here, we should minimise the for/against socialized medicine and link to other articles.--Gregalton 04:54, 12 August 2007 (UTC)
replies: text: To Giovanni33. I removed the section on UHC because its not deserving of a section for much the same reasons as you are arguing against sectioning the sectioning of usage. It makes the article unbalanced and, to me, just seems to be trying to tie together the term SM with UHC (in much the same way that SM was being tied to SPHC.  But we are still discussing the UHC section  below so I will let that one play out a bit first and see how the arguments for and against its inclusion as section develops. I reconstructed the criticisms and put them in a usage section, which actually seems more appropriate because it is the usage of the term that is disputed. I said that we can perhaps argue about the points being sectioned off individually. So why did you not just remove the section headings? Which edits were trivial?  I am not sure I deleted any very relevent information that cannot already be gleaned from the linked articles such as Universal health care. --Tom 19:23, 12 August 2007 (UTC)
thread_title:  Criticism section 

message: US health care professionals have a clear definition of what "Single Payer" means. It is 
* An approach to health care financing with only one source of money for paying health care providers. 
: In other words it is a pooling of risk cover into a single fund. It says nothing about the role of government, whether as the provider of finances through taxes and nothing about whether the money can only be spent in government administered health care.  
Similarly there is little doubt that "socialized medicine" is about 
* government financed, government regulated, and potentially publicly managed health care
So single payer is, by its very definition, not connected to the term "socialized medicine". Tying them together sows confusion rather than delivers clarity. --Tom 15:39, 11 August 2007 (UTC)
replies: text: That's ridiculous. "Government financed?" Where does the government get the money? The government gets its money from the people... in a "Single Payer" situation. Why are we pretending that the systems aren't socialized? There's one reason - this isn't a discussion, it's a debate. There are a bunch of people trying to distance socialized medicine from the word "socialized" because they believe in it, for America, and they know that Americans are weary of socialism. --69.253.92.203 16:06, 23 October 2007 (UTC)
replies: text: I think you missed the point completely. Of course the government gets its money from taxes!  Who is saying otherwise? The point is that the term "Single Payer" references a single source for paying out for health care. The íssue is that the term is used in the US to imply that a single entity, the government as a centralised insurer pays out money to hospitals for health care provided by them. In other words, as the term "Single Payer" is used in the US, in means replacing the multitude of insurers (who pay out money) with a single insurer, but the insurance principle remains. The point I was making is that socialized medicine is also a single payer in that there is ultimately just a single entity that controls the flow of money, but there is no insurance principle being applied. So it is also Single Payer in principle, if not Single Payer as the term has its narrow interpretation in US health politics. Of course, whether in an insurance based system or a tax based system, there are many payers (policyholders/taxpayers. That is not in dispute and is not what was being discussed. The issue came up I think because there was a graphic that segmented socialized medicine from single payer, but logically there is an overlap because socialized medicine is logically also single payer (though not in the narrow sense as it is used in the US), --Tom 19:53, 23 October 2007 (UTC)

text: I assumed you meant "wary" of socialism rather than "weary". The parallel to socialism is one of the emotive drivers to the the term socialized medicine and is not reflective of fact. The most populated socialist country, China does not have a "socialized" medical system for all its citizens, but many capitalist countries such the UK, Spain, Japan, etc. do. People in these capitalist countries do not regard it as a socialist arrangement to fund health care in whole or in part from taxation, just as a person soemwhere in say, New Jersey, would not think that he or she drives every day on socialist highways or sends his/her kids to a socialist high school or uses a socialist library. --Tom 20:51, 23 October 2007 (UTC)

text: Those are good points, but I disagree that is has nothing to do with each other. Alghouth its true that single payer is clearly defined, socialized medicine is more broad and applied generally to programs that guarantee universal health care, no matter the form. Its the same with socialism, which are broad enough to encompass varous forms and means to acheive a social end. I'm ok with removing the "types" section, as long as the article links to the main article on these types.Giovanni33 19:40, 11 August 2007 (UTC)
replies: text:  Tom is right about those definitions.  Socialized medicine and single payer health insurance are types of single payer systems.  The confusing part is that some people use the term single payer to refer to single payer health insurance. Kborer 23:29, 12 August 2007 (UTC)
replies: text: Just to be clear, I disagree with the statement that "socialized medicine and single payer health insurance are types of single payer systems". You can have socialized medicine with multiple funds (that are not single payer, as in Germany) and socialized medicine with single payer (as with the UK and Canada) and socialized systems where there are still multiple payers (for example most countries apply charges to users as well as funding from either one or multiple funds which may or may not receive tax funding). And of course multiple payers with non-socialized systems as in most of Africa. The terms are logically independent. Putting them together is a bit like saying some homosexuals are pedophiles. Sure, some are, but most are not and the two things are not connected because most pedophiles are heterosexual and most hetrosexuals are not pedophiles. It adds nothing to the sum of knowledge. We need more clarity here not more confusion. --Tom 08:57, 13 August 2007 (UTC)
replies: text:  I think the real confusion stems from the fact that countries usually use various types of hybrid health care systems rather than purely using free market, single payer insurance, socialized medicine or government monopoly.  When a system is close to one of those, people tend to categorize it as such.  As far as your definition of socialized medicine, please provide some sources so that we can include them in the article.   Kborer 23:49, 16 August 2007 (UTC)
replies: text: Kborer/Giovanni33: Do I take it that you now agree that the terms are logically independent? I must admit I do not understand WHY Giovanni33 believes they are connected. I think you can have socialized medicine (through government regulation) without a single fund. Incidentally, I assume that in the US you have government rules about what minimum insurance cover is necessary when driving on the public roads in case you cause damage or injury to other people or their property.  Is that called socialized traffic insurance? What is the right term for that? Compulsory medical insurance in Germany I believe is run on the same lines. Everyone has to have it but there are multiple funds.--Tom 17:34, 20 August 2007 (UTC)

text: Kborer.  I have seen several definitions of socilized medicine. Some that just mention regulation and do not suggest government ownership of facilities (e.g that at http://ie.thefreedictionary.com/socialized%20medicine (and several other sites that seem to have the same definition), and this seems to agree with many of the articles that talk about  socialized medicine in Canada (e.g. those awfully biased Cato institute references). And there are some that do imply that there is government ownership of the facilities and employment of the doctors (e.g. that at http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=SOCIALIZED%20MEDICINE). For this reason I think both defintions should be in the header.  --Tom 17:34, 20 August 2007 (UTC)

text: Please see my recent edit, which I hope might be acceptable to both "is more accurately characterized as...". There are also some wording changes I have made for accuracy, comments welcome.--Gregalton 18:31, 26 August 2007 (UTC)
replies: text: Thanks Gregalton for your efforts. It seems OK except it had too many clauses so I split it up but retained the main information.  I simply think people tag it as single payer because it is (er.. how can I put this delicately?) single payer.  I don't think its called single payer because it isn't socialized medicine in the British sense (which I think is Kborer's point). I suspect that people clearly do call it socialized medicine for the reason Kborer gave before, i.e. because it's heavily regulated and publicly financed. Hopefully its OK now.--Tom 19:06, 26 August 2007 (UTC)
replies: text: I tweaked a bit further, and thank you - it had indeed grown into a monster sentence. I have edited the reference before ('a Canadian doctor') - it does not seem to support the text (all it says is Cdn socialized medicine is 'government run'), and does not seem to me to define the term in any useful way.--Gregalton 20:25, 26 August 2007 (UTC)
thread_title:  Single payer and Socialised medicine are not connected 

message: The revisions are going from bad to worse. The first section is now headed Relation to Universal Health Care but goes on to give a reference to North Korea and talks about expropriations, but at the end the editor comes clean and says that few UHC systems have been achieved through the use of nationalization. Why on earth bring it into the article at all? Its another example of the article being expanded to associate it with language likely to introduce feelings of negatively. --Tom 17:39, 11 August 2007 (UTC)
replies: text: I see your point, and I agree there is now a problem with that section as it stands. But, just to clarify some points, I think it true that universal health care is typically the goal. Universal health care is certainly a goal, and socialized medicine is the means by which it can be obtained, i.e. society, collectively, taking charge to make sure everyone is covered, hence socialism or socialized medicine. Medicare is limited by age restrictions, so its universal only to that segment of the population. I'll take a look and see how this can be fixed.Giovanni33 19:46, 11 August 2007 (UTC)
replies: text: The points referred to by Tom could easily go in the usage of the term or an etymology section. The point is that socialized medicine comes from the term socialization, which was originally a euphemism for nationalization / expropriation. The North Korea quote was a pre-emptive citation, to show that this is where the term is from (any other similar citation would do). How does it relate to universal health care? Barely. As the paragraph makes clear. Hopefully ;) --Gregalton 20:01, 11 August 2007 (UTC)
replies: text:  If "Universal health care is typically the goal of socialized medicine" (and I concede that it usually is) then it belongs in the header paragraph, not in a sub-section. --Tom 17:56, 12 August 2007 (UTC)

text: The statement about politicians is rather loose right now. What percentage of say, politicians in congress, confuse the terms "socialized medicine" and "universal health care"? If it is very small, then perhaps it is not a very relevant fact. Usage by certain politicians is an example of "usage" and belongs in that section. --Tom 17:56, 12 August 2007 (UTC)

text: I think that pre-emptive reference to North Korea is going a bit too far! None of the bills in congress as I have heard them would require the government to nationalize or expropriate any assets. The insurance sector might loose the right to trade in sectors they now trade in freely, though this is actually not a feature of Socialized health care, but more a feature of one of the bills layed before congress. In the UK for example, medical insurers can  compete in direct competition with the state sector for health care of all kinds. But I agree with Gregalton that the association is there to add negative emotions and it therefore belongs with the etymology as a perjorative under the "usage" section. --Tom 17:56, 12 August 2007 (UTC)
replies: text: The point of that quote is only that socialization was originally a euphemism for nationalization, and now the term is being used - pejoratively - to refer to something (universal health care) that does not correspond to the meaning of the word. As you point out, virtually none of the systems in operation or the proposals to implement can be described that way.--Gregalton 04:06, 13 August 2007 (UTC)
thread_title:  Relation to universal health care 

message: I added a section called usage and sectioned it off into sub sections. I'd be grateful if editors would look at the section as it was sub-divided at close of play on August 11 and how it looks now. Is it better with or without the subdivision?  I would argue the sub-division is helpful. Here is my reasoning.
The prejudicial nature of the term SOCIALIZED MEDICINE is at the heart of its use, non-use and (I would add) abuse. This was very effectively described in the sectioning and content of August 11. A lot of the power of the edit and some content has been lost in my opinion by the recent edits of Giovanni33 which now makes it much harder to see the different ways in which the way the term is used, not used and abused. They are now much less visible. One has to wander through a wafting text to understand the points, and conseqently the facts have been buried and in some cases cut.
I agree that there has been some edit warring going on. I am accused of pushing POV but I equally will argue that the present article is POV. I think some editors are deliberately trying to use the article, its sections and the references to push an agenda. If this article was really about socialized medicine, it would actually discuss the subject, would it not? 
It is important. The term "socialized medicine" seems to have been in use in the US for so long that people may be blind to the way it is or has become prejudicial. These things usually happen the other way around. Terms like "insane", "mentally defective" and so in the field of mental health were meant to be descriptive but it took a long time for people to realize how language led them to isolate these people and lock them away as no-hopers instead of realizing that these conditions could be treated or ameliorated. Conversely, loaded terms such as "socialized medicine", created to deliberately associate the idea with negative feelings, seems to have shaped peoples thinking for the worst. 
And here is how I gained that perspective. 
:Articles linked from this article carry statements like "I wouldn't trust the government to take care of my health - government can't do a damn thing right", or words to that effect are witness to how powerful this false imagery can be. The reality is, however, for me as a user of "socialized medicine" that I put my faith in publicly paid for doctors, just as I would if I were consulting a private doctor. They all sign the same hippocratic oath. It makes no difference to him or her whether I can afford the treatment being given or if I have an insurer to do it for me. And the statistics show that socialized medicine works and provides good outcomes at very low cost. It is because people seem to have been misled about the truth about socialized health care that I am so passionate to make sure the article is more balanced.
:I have more than 50 years of experience of so called "socialized medicine" in the UK and the articles I have read following the links in the article paint a picture of health care in the UK that is a million miles away from the truth. Reading back over the history of this article, I see that many other editors, especially from the UK, have had similar objections to the article for much the same reason. Most people seem to have given up making edit corrections that then get changed about and eventually dropped. But the evidence is there to see. Being semi-retired and seeing what I perceive to be ignorance and misconceptions of "socialized medicine" in the US (yes this statement is POV but are we not all here editing WP to enlighten people rather than to confuse or mislead them?) I want to do something about it, and can now do so that I have the time.  But I prefer that we get there thru consensus, hence this posting seeking support from other editors. --Tom 20:03, 12 August 2007 (UTC)
thread_title:  Usage section 

message: I like the table very much, but since it is already used (prominently) in another article, repeating it here seems excessive. In general, it appears to me odd to attempt to add more to the section on universal health care if the link with 'socialized medicine' is simply that the latter tends to be a slur regarding the former. In other words, the usage section seems to be the most crucial (and could be cut down further by excluding text on whether or not 'socialized' medicine is good or bad). Other views?--Gregalton 00:26, 14 August 2007 (UTC)
replies: text: I await the opinion of others but maybe I can say a few things. 
1. To be honest, I agree with your point about the slur - I do not think the article needs a section relating to a relationship to UHC... it can (and once was) said in a single sentence in the header. 
2. I agree the useage is more crucial. It could indeed be trimmed and shhould be higher in the sequence of sections
3. Re the table. IF a section on the relationship to UHC is needed,  I thought it might be useful to show how the country with the most socialized model (the UK) seems to deliver a more universal coverage and more bangs-for-buck. The table is interesting because it contains countries using diffrent models ... multiple payers with private hospitals under formal rules (Germany), with single payers under formal rules with private only providers (e.g. Canada) and multiple payers with private providers and little formal rules (the US). Refering to that in the article might seem like OR so I resisted mentioning it.--Tom 21:26, 14 August 2007 (UTC)

text: So let's drop the section and the table. The point can be made in a sentence - "socialized medicine is sometimes used to refer to universal or government-run health care." And then start cutting unnecessary stuff, as we previously proposed and discussed. Most of these points can go in the universal health care article.--Gregalton 02:55, 15 August 2007 (UTC)
thread_title:  Inclusion of table 

message: Two links were removed from the see also subsection for other types of health care systems: free market and government monopoly.  The comment about the edit was that these articles are not about health care specifically.  We should leave these links in, even if the articles are not dedicated to health care, since their material is relevant to this article.  Kborer 00:21, 23 August 2007 (UTC)
thread_title:  See also: other types of health care systems 

message: The portion of this article about the criticism's of socialized medicine was simple just one sided. It was disgusting to read this article because there was no support against socialized medicine. One can plainly see that the author of this article if for socialized medicine and it trying to convince people to vote for it.  I found to actually criticism's in the section Criticism of socialized medicine, but only arguments for socialized medicine.  —Preceding unsigned comment added by Andrew ritchey (talk • contribs) 21:22, 14 October 2007 (UTC)
replies: text: Andrew. I have added the criticisms that I have read about socialized medicine, many of which contain distortions. I think it is fair to include fair criticisms but not distorted ones. The cancellations criticism for example is a fair one if it can be proved that cancellations happen more frequently in socialized medicine (which I am inclined to believe it does, perhaps because in a private medical system, failure to deliver according to an agreed schedule could be construed as a breach of contract and lead to expensive litigation). That cannot happen in socialized systems as there is no contract. But the story reported of a cancer patient having an operation cancelled 48 times is not symptomatic of a socialized system... it was clearly a teething problem with a new bookings system and the way the story was reported was quite misleading.  I can see how some editors here are objecting to my pointing out of these distortions, but clearly, if this article and others like are used to point WP readers to these kinds of articles which are non-academic and contain misleading information, it is only fair to warn readers about these failings. Otherwise we should remove references to these articles completely. The funding of health care from taxation does mean that tax rates will be higher in systems with socialized medicine. That is a fair criticism. And it means that the wealthy and those with above average health will pay a lot more into the system than they get out of it, and conversely the poor and the sick will get more out than they put in. That is another. There are many valid criticisms that one could add and I am not against adding them if they are verifiable or are so logically true that verification is not needed. I personally think that the issue of having, say, a hip replacement operation cancelled because someone needs the theater for a life saving procedure comes into the logic category. A person who objects to that is in need of a common sense transplant. --
Tom 14:06, 15 October 2007 (UTC)
replies: text:  No, Tom. Sorry. The section is complete hogwash. You have a clear political agenda, and because of it your article is crap. A read of the criticism section allows a person to walk away with more information concerning the criticism of criticism than the actual criticism! It's backwards and useless, and what's worse is this: there's no fixing it because the moment someone tries somebody else will erase or edit the bite out of the criticisms provided for fear of, what is it? Oh right, the facts. --69.253.92.203 16:13, 23 October 2007 (UTC)
replies: text: Where is your proof that it is hogwash? I actually think that Wikipedia should enlighten people to the truth, and all I am doing is pointing out some facts. If I criticise the NASA Apollo mission by saying that in fact, NASA did not send a man to the moon but it was all set up in a film studio, I would rightly be expected to prove the case I am making. So why is that if I expose the falsehoods in the claims made against socialized medicine, then I am following a political agenda?  I am actually only interested in the truth and if there are untruths or misleading statements, then it is only fair that they should be exposed or revealed for people to determine the facts for themselves. BTW, it's not my article.... its a collaborative effort.  --Tom 20:15, 23 October 2007 (UTC)
thread_title:  Criticism of socialized medicine 

message: Let's begin by recognizing that not all systems are the same. For instance, once the funding allocations have been approved by the Congress in the United States, it is then up to the civil service to determine what research projects or services get funded. While the health professionals do play a role in the fudning process (through their requests for funds), they are not the ones who are ultimately in control of the process. Freedomwarrior 17:25, 15 October 2007 (UTC)
replies: text: So who are these people with the ultimate decision in the US? Surely these people making these decisions are professionals and are not making arbitrary decisions. Using the term "bureaucrat" makes it sound like they are not trained. If the government or a government agency was using pen-pushers or someone without professional training or expertise to make these kinds of decisions it would indeed be scandalous and heads would roll. That's why I think "professionals" is a more neutral term. I know that the US has something of a tradition of political appointments in the civil service, especially at the higher levels. That would be considered corrupt practise in the UK and cannot happen there because there is an independent body that makes civil service appointments (The Civil Service Commission) which ensures that only people with the requisite skills get appointed. And as we are talking about socialized medicine it is Canada and the UK seems that most often get discussed, not the USA.  --Tom 17:56, 15 October 2007 (UTC)
thread_title: Bureaucratic Control

message: Clearly, a significant edit war has started. If this does not settle down I would like to take the points at issue to a dispute resolution process. Are you OK to that Freemdomwarror?  Perhaps it would be more productive to use this page to agree the points of dispute and our repective postitions and take them to arbitration.
----  —Preceding unsigned comment added by Hauskalainen (talk • contribs) 18:24, 15 October 2007 (UTC)
replies: text: That's probably for the best. This is a hot topic right now, and emotions are running high regarding it; in addition to an edit war, there's an interpersonal war of social and political differences taking part here, and the article is suffering for it. - Prestonmarkstone 19:27, 15 October 2007 (UTC)

text: As I say, I think there are fair criticisms that can be made, but the criticisms that are often made and peddled here by certain editors contain distortions and there seems to be a huge reluctance to have those aired. I contest that this is OR and would counter that some of other additions here of late by others are also OR (like drawing parallels between marginal tax rates and socialized medicine). Most of the distorted articles I have been referring to have no academic credibility but they are frequently quoted on WP, and thus it is only fair they they be challenged when they mislead. I am not using WP as a personal blog but wish that WP gives a fair and balanced picture of something which I as a European am familiar with. A very small number of editors on the other side of the Atlantic who have little direct experience of this type of medicine are so very fond of criticizing it. It was because the article was so distorting that I got involved in editing it in the first place. --Tom 21:00, 15 October 2007 (UTC)
thread_title:  Edit war 

message: Your edit accuses me of "extrapolating the performance of the NHS over a year from one data point. That's unacceptable".  There is no extrapolation going on. The data is what the data is and it represents waiting times as they are today (or at least as far as the last data set was published).  There may be a slight change in the number over time since the CPA collected their data but I doubt very much that it has changed 800 fold. --Tom 20:43, 15 October 2007 (UTC)
replies: text: Well, I think that is pushing the limit. How many people are waiting for "some type of care in the free market"? I am giving some hard facts. Whare does the MI gets facts?  Does the article comprise OR? If so, does it deserver to be quoted? I had this discussion once before with Nbauman and his view was these views are often reported therefore they should be quoted. But that is frankly nonsense if you can add articles that contain OR and I cannot add information based on hard facts!--Tom 21:09, 15 October 2007 (UTC)
replies: text: I don't know where the author of the article got his information from since he provides no citations. However, it is worth noting that this article is an adaptation from a larger report on the issue. Anyway, you can eliminate it if you want since I'm not going to search for one that's sourced. 
Moreover, I was mistaken in saying that you extrapolated the performance of the NHS over a year. In fact, I do not know the time period over which that data was collected. It could have been since the start of 2007, since the previous year, etc. I don't quite know. Nonetheless, in the absence of the lenght of time that the performance of the NHS was surveyed (both in the Manhattan Institute report and the NHS report), you cannot make a valid comparison of the data sets because that would be comparing apples and oranges (once again). Freedomwarrior 20:58, 15 October 2007 (UTC)

text: As I say, the NHS data reflects the state at a single point in time. It cannot be extrapolated. --Tom 21:09, 15 October 2007 (UTC)
replies: text:  Then it adds nothing to the discussion, since we do not know whether it's talking about problems over an 8 month period, a year, two years, etc. Freedomwarrior 22:27, 15 October 2007 (UTC)
replies: text: I added back the statistics. The table in the reference shows the historic trend in the data over 5 years. There is therefore comparable data. Tony Blair's party was elected on a promise to invest more in health and reduce waiting times. That is clearly seen in the trend over the 5 year period.  To:Freedomwarrior. You asked me to provide a reference for the statement that national statistics inform the public debate. To me that seems so self evident that it should not need a reference. What kind of reference do you want??  —Preceding unsigned comment added by Hauskalainen (talk • contribs) 17:59, 17 October 2007 (UTC)
thread_title:  waiting times over 6 months exaggerated 800 fold 

message: I too removed the re-addition of that reference by Freedomwarrior but for a different reason. 
International statistics from the OECD data reveals that Finland actually has more nurses per capita than most and considerably more than in the US. See http://www.nationmaster.com/graph/hea_nur-health-nurses. So far from their being a shortage, in theory there ought to be a surfeit!  But the hospitals are still claiming they have a shortage of nurses and that the problem is going to get worse. This incredible discrepency has been the subject of some debate here in Finland, but despite further digging by one of the regional universities which was published recently, there has, as yet, been no simple explanation. There is therefore a suspicion that nurses here are just not used as intensively as they are in other countries and that nurses here have a relatively easy time of it. The uses of mass resignation ínstead of strike action by the one trade union that did not sign the recent pay deal (TEHY only accounts for 25% of all nurses) may backfire (there was a report in the newspaper this morning of nurses switching to the other union) but it does seem to have a measure of public support http://www.yle.fi/news/id72739.html. --Tom 16:11, 19 October 2007 (UTC)
replies: text: As an additional rider, I was informed today that there is a significant political motive for the nurses taking this strike action. In the national elections held earlier this year, the political parties, including the conservative party had promised to significanyly raise the pay of public health care workers. This was popular policy with the electorate and the conservatives ousted the social democrats into 3rd place for the first time since 1962 gaining the the highest number of popular votes and the second largest numner of seats in Parliament. The conservative party leader now holds the national purse strings as the country's Finance Minister. But he and his party are now reneging on their political promise and this has enraged the nurses and is one reason why the nurses have so much public support. The political background to the dispute is for those whose who are interested is to be found at  http://www.eurofound.europa.eu/eiro/2007/05/articles/fi0705029i.htm--Tom 19:29, 25 October 2007 (UTC)
thread_title:  Finland short of nurses?  Think again! 

message: Here's an essay in the Washington Post that's exactly on point, by Ezekiel Emanuel, who is a medical ethicist at the National Institutes of Health and has substantial credentials. Unfortunately the original link to the Washington Post is dead, but the article has been posted in several other places, including Usenet. 
This is a good article for somebody who needs to quote a reliable source to replace their own opinions. 
Washington Post
soc.retirement
'Socialized Medicine' Quackery
By Ezekiel J. Emanuel
Monday, October 8, 2007; Page A17
Nearly two decades after the West's victory over communism, one might have thought it possible to discuss reform of the health-care system without invocations of the old saw "socialized medicine."
But no.
"At least Mr. Baucus isn't disguising his socialist goal," a Wall Street Journal editorial claimed about the Montana senator's push to expand the State Children's Health Insurance Program.
"In sum, SCHIP turns out to be socialized medicine for 'kids,' " wrote Post columnist Robert Novak.
Rep. Paul Ryan (R-Wis.) said the "SCHIP bill is not a back door to get socialized medicine. They went straight to the front door."
Rudy Giuliani argued:
"The American way is not single-payer, government-controlled anything. That's a European way of doing something; that's frankly a socialist way of doing something."
Apparently, this old bogeyman is just too tempting.
The U.S. health-care system has two distinct parts -- financing and delivery.
[snip]
Nbauman 23:53, 24 October 2007 (UTC)
thread_title:  Ezekiel Emanuel essay 

message: Someone has placed a marker indicating that the article is not neutral and requested that the neutrality marker is not removed until this is resolved.
I have placed this section here so that we can discuss the issue of nuetrality and determine how we can get the marker removed.  --Tom 12:43, 28 October 2007 (UTC)
thread_title:  Neutrality 

message: Someone has placed a marker indicating that the article contains weasel words and requested that the marker is not removed until they are removed.
I have placed this section here so that we can discuss the issue of weasel words and determine how we can get the marker removed.  --Tom 12:44, 28 October 2007 (UTC)
thread_title:  Weasel words 

message: I have been doing more digging on Cato's claims.... another of the "myths" discussed earlier. http://www.cato.org/pubs/catosletter/catosletterv3n1.pdf I seem to have come across another whopping distortion. This time its the so-called Myth of Equal Access. Cato rightly says that equal access to health care is a key aim of the NHS. It then talks about 2 reports on equality of access to health care in the NHS done in the 1980s and another 10 years later in the 1990s. Basically Cato charges that the first report stated that "things (in the 1980s) were worse than they were 30 years ago" and it claimed that the second follow up report ten years later found "that things had got even worse".
Its B U L L S H I T  !!!
I have since discovered the paper that this brief paper was based upon http://www.cato.org/pubs/pas/pa532.pdf and that paper gives the source reports as being the Black Report and the Acheson Report.   And guess what?  The papers are not even on the topic that Cato claims it to be!  The Black report http://www.sochealth.co.uk/history/black.htm looked at inequalities of health by social class or similar measures. It was not about equality of access, it was about inequalities of health by socio-economic class. It was not about the NHS per se. It showed that there were inequalities in health across the social classes and that they were probably explained by socio-economic environment features (such as work accidents, overcrowding, cigarette smoking) which are strongly class-related. Of course its hard to summarise a large report in this way, but that summary is more accurate than the Cato report.  It made many recommendations but they were largely not about improving access.  I've scanned through the report and can't find a trace of it implying that the NHS had failed to offer equal access to people in these groups. Ensuring higher 'take-up' of services on offer by the lower socio-economic groups was mentioned, but 'ensuring take-up' is way different from failing to grant equal access. Neither could I find Cato's main conclusion that things had got worse in the 30 years since Britain gave up Free Market health care and introduced the NHS. The Acheson report is not available on-line but a reference to its conclusions and the steps taken by the Blair government followin it can be read here http://www.sochealth.co.uk/news/TacklinghealthInequalities.htm.  
Comments welcome!--Tom 17:19, 29 October 2007 (UTC)
replies: text: There is one place where social class influences and access is mentioned. It reads as follows
4.48 Class differentials in use of the various services which we have considered derive from the interaction of social and ecological factors. Differences in sheer availability and, at least to some extent, in the quality of care available in different localities provide one channel by which social inequality permeates the NHS. Reduced provision implied greater journeys, longer waiting lists, longer waiting times, difficulties in obtaining an appointment, shortage of space, and so on. A second channel is provided by the structuring of health care institutions in accordance with the values, assumptions and preferences of the sophisticated middle class 'consumer'. Inadequate attention may be paid to the different problems and needs of those who are less able to express themselves in acceptable terms and who suffer from lack of command over resources both of time and money. In all cases, for an individual to seek medical care, his (or her) perception of his (or her) need for care will have to outweigh the perceived costs (financial and other) both of seeking care and of the regime which may be prescribed. These costs are class related. 
I think the authors ought to have taken a lesson in using plain English. I think it means that rich people can travel further to get better care, have an option not to wait (because they can go private), and because they are often more artiuclate amd knowledgeable, are better able to know what they need and negoitate their way around the system to get it. But that required a lot of reading between the lines. But I still think it does not meet Cato's claims.  In any case its more than 25 years old, so is hardly relevent to today's NHS.--Tom 17:53, 29 October 2007 (UTC)
thread_title:  Cato Myths - Equality of Access 

message: Kborer. I think you are not being neutral in your edits.
1. I did not imply that there was an equivalence in my edit. 
2. The evidence surely is that insurance companies are an overhead because they have costs like advertising, administration, and they have profits to be paid to shareholders. 
3. Another of their functions, from what I have heard, is to block claims and deny coverage for things like pre-existing conditions, a practise which denies people care and penalises the sick. That does not happen in socialized systems, so its another cost that can be dropped.
4. You make an assertion in your edit summary that there is no incentive to keep costs down in a "socialist system". I hope you meant a socialized system. Anyway, where is your evidence for this? On the contrary I would think that a socialized system where the budget is capped ensures that doctors squeeze the best value out of the money they are given. In a free market system with insurance, there is some evidence that doctors do indeed carry out unnecessary procedures and add to costs. They get paid well for doing things to people but very little for doing basic things like giving advice. As Michael Cannon, Director of Health Policy Studies, at the Cato Institute once said of the US health care system,
 I think our system is a mess and spends a lot of money on unnecessary care, and even harmful care, so I think that when you do compare nations against one another its very hard to find any benefit that we're getting for all the additional money that we are spending on health care.  I think we spend 50 per cent more than the Canadians or something like that, and its very hard to find any health outcomes measures that would justify that greater expense.  I think that maybe the only two are that we have greater access to treatment for chronic illnesses (and thats just access, not even outcomes) and we have higher cancer screening rates which result in lower cancer mortality to incidence ratios. But that's about it.
See http://www.wilsoncenter.org/common/dsp_popup.cfm?media_link=DIR/DIR_2007103.wmv&title=Video%20of%20Event%20%28Windows%20Media%20Player%29  
5. Its not supported by evidence. Just look at the money that the UK spends annually on health care. It is way below the US level. If there was a high degree of waste in the NHS, wouldn't the UK public be clamouring for changes in the system? Nurses and doctors are taxpayers too and see the system at close hand.--Tom 19:16, 29 October 2007 (UTC)
replies: text:  I am not sure why this is directed at me. Kborer 20:24, 29 October 2007 (UTC)
thread_title:  Tax being offset by savings elsewhere 

message: To Freedomwarrior: The linked reference gives a fully adequate explanation of the statistics and even a table showing how the main wait time stats have changed for each quarter over a 3 year period. The stats show a clear trend... a gradual and gentle decline in wait times over that period. You seem to be sowing doubt into the article about the data where none is needed. You seem to be pushing a POV.--Tom 19:45, 29 October 2007 (UTC)
replies: text: Sorry, but I had to undo your edit once again. The statistics reflect the view of the waiting lists taken at a point in time. A snapshot is taken once a quarter and this is what is reported. The full data for the last 3 years. It is not so difficult to understand. I believe we discussed all this once before in the context of extrapolation which I said was not very meaningful. Is this a classic 3RRR maneuvre you are trying to force?--Tom 20:15, 29 October 2007 (UTC)
replies: text:  I'm not trying to force anything. I'm simply trying to keep you from using wikpedia to peddle socialized medicine.
Very simply, the way that the report is presented in the text of the article is misleading. The reader has to go to the text of the link to find out that the report is a " snapshot is taken once a quarter" that covers a three year period. I'm insisting that it be reflected in the text. That is, I'm insisting that it be explicitly recognized in the text that the preformance of the health service is variable, and that the health service has not always performed as well (or less poorly). Freedomwarrior 20:59, 29 October 2007 (UTC)
replies: text: I changed the edit for hopefully the last time today to a form of words that I hope you'll be happier with. Of course there has been variation in the numbers waiting over time, and no doubt at some time they will go up. I'll put in the November 2007 statisitic when its published, be they up or down. But its worth remembering that the figure is the average time waiting for those that are waiting. There are those patients that get dealt with immediately for whatever reason and will not have appeared on the waiting list. Thus the wait median time for all patients will be much better than these statisitics seem to show. I'll see if I can get confirmation of that from the contact point given on the stats sheet and let you know what they say. People needing emergency surgery such as happened when my father had stent inserted following a sudden heart attack, and people needing splints, plaster leg casts, removal of embedded foreign objects etc.. will always be dealt with on a triaged turn-up and wait basis. I assure you, they don't need to bring a sleeping bag and 6 weeks' change of clothes! The stent was fitted (at the Royal Surrey County hospital) within an hour of his arrival! --Tom 22:52, 29 October 2007 (UTC)
thread_title:  NHS wait time statistics 

message: Can regulation in the US private medical industry really cost the industry $339 billion per year (at 2002 prices!)?? The industry only covers 165 million americans! That's almost 2000 dollars per customer!  The figure has to be wrong, surely.  I have exposed some of Cato's whoppers. Is this another one, I wonder. I am hoping that someone cleverer than me has already tackled this claim and either proven or disproven it. Can anyone help?--Tom 20:47, 29 October 2007 (UTC)
thread_title:  Cost of regulation 

message: --Tom 20:16, 31 October 2007 (UTC)
thread_title:  Country by country qualifications / socialist and mixed economies 

message: I don't think people that read this article will think that the money to pay for "Free" healthcare was planted by the Health Care Fairy. The meaning as it used in the UK is "Free at the point of use" and though it is less often mentioned it is also "disconnected from contributions to tax receipts".  The same is true in Finland.  In order to avoid the need to keep qualifying the word "Free" perhaps we need to make this clear just once at the top of the article.--Tom 20:34, 31 October 2007 (UTC)
thread_title:  Free means Free at the point of use and disconnected from contributions to tax receipts 

message: Speaking in London recently Rudy Giuliani said 
I had prostate cancer seven years. My chance of survival in the US is 82%; my chance of survival if I was here in England is below 50%.
 http://news.bbc.co.uk/1/hi/uk_politics/7003286.stm 
The claim is repeated in his campaign ads where he says
I had prostate cancer, five, six years ago. My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82 percent. My chances of surviving prostate cancer in England, only 44 percent under socialized medicine.
The UK Health Secretary responded when prompted that "The British NHS should not become a political football in American presidential politics. Our rate of prostate cancer survival is actually much higher than has been claimed. The latest data shows a survival rate of over 70 per cent – and increasing." The Times Newspaper in London investigated the statistics further. This was what they reported
"US health experts also disputed both the accuracy of Mr Giuliani’s figures and questioned whether it was fair to make a direct comparison. Doctors in the two countries have different philosophies for treating the disease, with the US putting more emphasis on early diagnosis and surgery. An analysis of mortality rates suggests that about 25 out of 100,000 men are dying from prostate cancer each year in both Britain and the US. Brantley Thrasher, at the University of Kansas Department of Urology, told The Washington Post that it was “impossible to say” whether a prostate cancer patient has a better chance of surviving under a “capitalistic” or “socialistic” medical system. Ian Thompson, of the University of Texas, said: “Certainly, if you intensively screen for prostate cancer, you will find early disease. And simply because you find it earlier, you will always have longer survival after the disease is diagnosed”. http://www.timesonline.co.uk/tol/news/world/us_and_americas/article2781602.ece
In other words, even if the UK screened everyone over 50 as is recommended in the US, but treated none of them, it is quite possible, even likely, that the UK statitic would improve and edge closer to the US figure. So why doesn't the UK screen like the US does?  Here is the answer (from http://www.cancerhelp.org.uk/help/default.asp?page=2719)
Before screening can be carried out, there must be an accurate test to use. At the moment, there is no single, effective screening test for early prostate cancer in healthy men. The use of the PSA blood test as part of a screening programme is still under discussion in the UK.  PSA alone is used in the USA for men over 50, or men over 45 thought to be at high risk of prostate cancer. PSA alone is not recommended for screening in the UK because (1) Men with prostate cancer may not have a raised PSA, (2) two out of three men with a raised PSA do not have prostate cancer and (3) there is uncertainty about the best way to treat early prostate cancer.   Generally speaking, the higher the PSA level, the more likely it is that there is a cancer in the prostate. The higher the PSA level in someone with prostate cancer, the more likely it is that the cancer has spread.  But there are other causes of raised PSA, such as infection, a non cancerous enlarged prostate and even exercise and sex. In early prostate cancer, PSA levels are relatively low. It is not possible to pick out a particular PSA reading and say “those above this level have cancer and those below do not”. The level of PSA varies from man to man.  For one thing, it naturally increases with age. 
If PSA was used as a screening test, some men who did have prostate cancer would be told that they didn’t.  Two thirds of men with a raised PSA level would go on to have other tests such as needle biopsy and rectal ultrasound when they did not actually have a cancer. These tests can be uncomfortable and many men find them embarrassing. They also have risks. A few men having a needle biopsy may have infection or persistent bleeding afterwards. 
When doctors plan a screening programme, they have to think about what happens when the disease they are looking for is found.  Is there an effective treatment?  What would happen to those people if they were not screened?  Prostate cancer is not always an aggressive disease.  It can be very slow growing.  Many men with prostate cancer don't have symptoms.  Prostate cancer grows slowly in many older men and they are unlikely to die from it.  These men don't really need treatment.  The treatment has side effects and could cause more problems than their cancer. 
Other men do need treatment. But, unfortunately, doctors cannot always tell with any accuracy which prostate cancers are aggressive and need treating and which can safely be left alone. 
So if prostate cancer screening was introduced (1) some men with cancer would be missed, (2) other men without cancer would be given tests they did not need, (3) some men with very slow growing cancers would be given treatment they did not need
There is still a lot of discussion about prostate cancer screening. Are the risks of not finding cancers (and giving men false reassurance) or side effects from tests greater than the benefits of screening? Will a screening programme using the tests we have at the moment reduce deaths from prostate cancer?
 
 
...... and so it goes on.
Not exactly as catchy a soundbite as Giuliani used in London and repeated in his presidential ambition campaign!  But it clearly illustrates that British medicine, far from being ineffective is behaving thoughtfully, rationally, and with the interests of patients firmly in mind. The US practice may actually be curing people of cancers that did not need curing at all, and be exposing their patients to unnecessary risks, unneccssary treatments, unneccssary costs, and will create a lot of unneccessary fears about this cancer.  Maybe this is an illustration of why the UK spends less on health care than the US but achieves broadly the same or better outcomes overall.
I am likely to be away from editing for a period. If anyone would like to incorporate this into the article (ideally in less detail) during my absence, feel free to do so. --Tom 23:39, 1 November 2007 (UTC)
thread_title:  Giuliani's unfair criticism of socialized medicine. More lies, damn lies, and statistics! 

message: You tagged this page as though it is part of a WP project regarding Israel. I assume that is a mistake because its mostly a politically charged phrase used in the US against government involvement in health care amd is not per se connected to Israel.
There is a section in the main article for national implementations of socialized medicine and anything you could add regarding Israel would be most welcome.--Tom 10:24, 4 November 2007 (UTC)
replies: text: I don't see why the section I added on Israel is not relevant here. Canada & UK have sections, and I added one on Israel. Because Israel has always had a system of socialized medicine (where it is not a derogatory term) I believe that adding it to Wikiproject Israel is in keeping with the aims of the project, which is to tag pages that are related to issues that also (though not necessarily exclusively) affect Israel. You are welcome to add any other tags you think are appropriate. --Gilabrand 13:42, 4 November 2007 (UTC)
replies: text: Ah. I did not see that you had already added the section on Israel to the main article. That is indeed very useful because you are right that it is not exclusively about Canada and the UK!! But my issue is that it does seem odd to me that you tag a talk page which has only tangential relevance to Israel. This article's talk page (and others like it with international content) could easily become very cluttered with tags like this. It may suit your project to have pages tagged this way but it may not suit other readers. Lets see what other editors think about this.--Tom 19:24, 4 November 2007 (UTC)

text: I removed the tag, only due to the tangential link to the article - put another way, should we tag it for every country where there is discussion about universal / "socialized" health care? Does it help the average reader? For the purpose of letting readers know that there is some content related to Israel, a category tag would probably be sufficient.--Gregalton 20:45, 4 November 2007 (UTC)
replies: text: I wouldn't call it tangential at all - socialized medicine is a very important aspect of Israeli society, and has been a formative influence since before the establishment of the state, when huge numbers of immigrants, many sick and poor, came to the country. It is a crucial factor in Arab-Israeli relations: Arabs and Jews receive equal treatment, and Israeli hospitals are packed with Arabs, both Israeli Arabs and Arabs from the territories, because they know they are in good hands and will receive the best care possible, no matter what their politics. --Gilabrand 21:35, 4 November 2007 (UTC)

text: It's not that socialized medicine is not important to Israel; but that only a relatively small number of readers/editors interested in socialized medicine would see Israel as central to the concept. Or to put another way, I'd equally not consider adding the wikiproject Canada, UK, or half a dozen other countries' project flags to this article.--Gregalton 02:46, 5 November 2007 (UTC)
replies: text: I am glad to see that my introduction of material on Israel, which was so appalling and shocking to everyone, has prompted a section on other countries and an attempt to open the eyes of people who insist that socialized medicine is only something related to their own experience.--Gilabrand 11:06, 11 November 2007 (UTC)

text: Not sure if I understand: were you offended by something? I for one have no objection to the Israel information (although I personally think the article should be pared to information that the term is essentially just pejorative and has little meaning otherwise), I just thought (and think) the wikiproject Israel tag on the talk page is a little out of place. At any rate, the Israel info remains and appears informative; thanks.--Gregalton 17:30, 11 November 2007 (UTC)
thread_title:  Socialized medicine in Israel 

message: Tom, please stop making unsubstantiated generalizations about socialized medicine that are exclusively based on the UK health service, because you are simply wasting my time and your time. If you want to add something, make sure that it's sourced. Additionally, if you're going to say that something is benefit of all socialized systems, make sure that's the case. The bottom line is that not all socialized systems are the same and not all of them conform to your ideal model--the UK's.  Freedomwarrior 17:42, 11 November 2007 (UTC)
replies: text: They are not based on exclusively on the UK Health Service. See also my warning to you on our personal talk page. I want to make improvements to the article. Your edits (like adding the word some" to my edits, seem to sow doubt and uncertainty where I do not believe that exists. Frankly, I believe that you are just oppposed to socialized medicine and you are making edits to the article that are POV. I said that I was prepared to provide references. Why don't you just add requests for citations instead of deleting and chopping all the time. I really may be forced to make a formal complaint about you.  PS  How come you managed to delete that WP home page of yours that said something like "WP is not a forum for people outside the US to air their inferiorites"?? I really liked that!! :)  --Tom 18:02, 11 November 2007 (UTC)
thread_title: Generalizations and Unsubstantiated Claims

message: The article currently says "central planning is inefficient and under investment leads to capacity shortages and that a lack of willingness to invest in expensive technology leads to shortages in areas such as MRI scanning."  Its another claim made by those right wing think tanks that I thought would be worth investigating. 
There actually has been MRI over-capacity in the US. Units are working at about 50% of their antipated economic operating rate. Or as the medical imaging industry would have it, there is under-utlilization, because their response seems to be to want to get doctors to do even more referrals to utilize the over capacity they have invested in. In other words, they want medical costs to go even higher!
Here are some figures. The UK set has both old and new data but the US set has only old data but fairly contemporary with the older UK set I am comparing it to.  
US
The average number of examinations per MRI unit per year in the US fell between from 3143 in 1985 to 2361 in 2000 whilst at the same time the reibursement rate fell markedly leaving many US MRI units running way below their capacity. At this low level (in part due to free market/single-payer health care rationing), at 2001 prices, the cost of an exam in the US was 400 US dollars per exam.
Source http://www.imagingeconomics.com/issues/articles/2001-05_03.asp
UK
"...because patient throughput has increased dramatically over the period, the average cost of an MRI scan decreased from £179 in 1988 (=£276 at the 1997 price level or about 441 US dollars per exam)  to £115 in 1997 (about  184 US dollars per exam at the prevailing exchange rate of 1.6)."
Source:  http://bjr.birjournals.org/cgi/reprint/72/857/432.pdf
The trend in higher throughput rates in the UK has continued. By 2005 the least efficient units in the UK (the lowest 5% of all units) manage to achieve 1956 exams per year and the best 5% managed throughput of more then 6860 exams per year (the median being about 4000 exams per year or almost twice the rate as the machines in the US 
Source: http://www.healthcarecommission.org.uk/_db/_documents/Imaging_AHP_report_tag.pdf  
So there you have it. The US in 2001 was oversupplied with MRI units and its average cost of delivering an examination was (several years ago admittedly) about double that of the same exam in the UK.  It kind of mirrors the national statistics we see on health spending. 
This seems to me to be another indication that co-ordinated national health planning can achieve more cost-effective medicine. I'm not saying its perfect in the UK. Hospitals in the UK are sometimes given unexpected windfall gifts of new scanners which can throw their financial planning if they are not gifted the trained staff and  funding needing to operate them. See http://news.bbc.co.uk/1/hi/england/3557976.stm
Do waiting times mean there is underfunding?  Its a good question but not an easy one to answer. Remember that in the US, rationing is done by the price mechanism and by insurance companies. But in the UK everyone is seen but they are prioritised and that means waiting is caused by low relative need rather than lack of funding.  There have been wait times for non-ugent MRI scans in the UK but these are now much better. The waiting list of non-urgent cases (urgent cases are of course dealt with immediately) is at present equivalent to about 22 working days of patient throughput. More than 99 per cent of non-urgent MRIs are now being  done within the NHS target of 13 weeks and 78 per cent of those waiting will wait for 6 weeks or less http://www.performance.doh.gov.uk/diagnostics/downloads/monthly/Excel_Download-WEB-Diagnostics_August_2007_Commissioner.xls   The fact that there is a waiting list at all does not mean that there is an investment failure. Under-investment can be deliberate policy option because it always ensures that the equipment you have is working to maximum effect, and this is especially important with equipment like MRI that has high capital costs. Not all MRIs are so urgent that they must be done immediately.--Tom 16:14, 12 November 2007 (UTC)
replies: text: I am making no claims of superiority. I am just pointing out that the US had a surplus of MRI units at the beginning of this decade and that this had an economic cost. I know that you argue that the US system is socialized, but this article is not here to reflect your opinions. When Guiliani made the false comparison between the UK and US cancer survival rates, he thanked God that he was treated in the US and NOT under socialized medicine.  The comparison UK and US is often made in the argument about socialized medicine. Just read the stuff put out by Cato, The Manahattan Institute, and the CPA. Your case is really not strong at all. I will revert the delete you made to my edit.--Tom 05:48, 13 November 2007 (UTC)
replies: text:  This is what you tried to add: "Centralized planning can be more efficient than the de-centralized planning typical in Free market or Single Payer Health care." How is this not making a claim of superiority? You are criticizing the centralized planning that happens in the United States, and saying that it somehow proves that another model of socialism (one, perhaps, with a different structure of regulations) is better. That doesn't prove that central planning is more efficient than de-centralized planning, rather it proves that some forms of centralized planning are worse than others. I don't care that other groups use the United States as a stand in for free medicine, it is not. Indeed, I have already demonstrated how the United States fits the definition of socialized medicine put forth in this article. That the United States has socialized medicine (a variant, which you do not like) is a fact, not an opinion. Again, not all variants of socialized medicine have to conform with your idealized vision. Stop trying to make this article conform to your POV of what constitutes socialized medicine. Freedomwarrior 06:23, 13 November 2007 (UTC)
replies: text: can be does not mean always is and I did give a specific example with a reason why overcapacity may have occured. It was hinted at in the article I quoted from. i.e. that the imaging industry at one time could raise high fees which made the investment seem worthwhile. But the industry expanded too quickly and prices started to fall so that many units became much less viable and overcapacity (euphamistically labelled under-utilization) then came about. If this was somehow due to socialism, pray tell me how socialism caused these private operators to over provide capacity. I think the example is a good example of the way the free market works. New business come about but as competition grows some firms may have to leave the industry. This is quite normal in new business areas where those early to market get the rich pickings and those late in fail to succeed because the competition has forced prices down. Its not something you as a supporter of free markets should be afraid of admitting. I am not saying that socialized medicine is superior, despite your assertion to the contrary. The widely held  criticism of socialized medicine is that it underinvests and that it has capacity and performace implications. The point I was making is that free market medicine can over invest and that can have cost implications if the technology is capital intensive. I guess the other benefit of socilaized systems being slow adopter is that they acquire the technology at a lower average price (prices tend to fall in real terms) and one can plan things centrally so that units are purchased that will be defintitely be utilized because the purchaser is the user.  —Preceding unsigned comment added by Hauskalainen (talk • contribs) 13:11, 13 November 2007 (UTC)

text: This looks like a lot of WP:OR to me - several sources used to create a conclusion.  There are many many aspects to a health system, particularly one like the U.S. that certainly is not free market, that could lead to higher prices.  I would think that the oversale of MRI machines would actually lead to a decrease in prices in an free market since there is so much competition.  I couldn't find it, but does the source directly say that oversale was the direct cause of higher prices?  If so, the statement should be attributed as such would be a claim or argument.  Either way, I agree with Freedomwarrior on the comparision being made here with centralized and de-centralized.  Morphh  (talk) 16:08, 13 November 2007 (UTC)
replies: text: I don't think it is original research. There is nothing new here. All I have done is pull togther some data to determine utilization levels and shown that utilization levels are higher in one socialized system than in another system which is far less socialized. I know that Freedomwarrior would contend the "less socialized" point. But that is not how users of the term "socialized medicine" categorize it. If Freedomwarrior really thinks that socialism in the US system created the overcapacity (I prefer "overcapacity" to "oversale" because the latter makes it sound like it was the MRI vendors' fault!) then it is not unreasonable to ask how that has happened. The UK has underinvested in new technologies compared to some other countries, but that was not the point of the edit that was removed. The issue was oversupply and and the impact on average cost. I would agree with you that the logical effect in a free market would be for the price of commodities like MRI scans to reduce if there is oversupply. The problem seems to be that this would mean the medical imaging units would make a loss because they would be struggling to recover all of their fixed costs. It seems that companies have been able to charge something approaching their average costs but the business is not very profitable. Hence the suggestions in the quoted article that doctors should be encouraged to send more Medicare/Medicaid patients for MRIs to generate more revenue for the imaging companies. --Tom 20:14, 13 November 2007 (UTC)
replies: text: To quote from WP:SYN, "Editors often make the mistake of thinking that if A is published by a reliable source, and B is published by a reliable source, then A and B can be joined together in an article to advance position C. However, this would be an example of a new synthesis of published material serving to advance a position, and as such it would constitute original research.[2] "A and B, therefore C" is acceptable only if a reliable source has published this argument in relation to the topic of the article."  Morphh  (talk) 0:10, 14 November 2007 (UTC)
thread_title: Centralized Planning and Capacity Shortages

message: Tom, you have not refuted, nor can you refute, my contention that the US has a semi-socialized system. Therefore, stop trying to use the United States as a stand in for free medicine. This is a cheap straw man argument, and I'm not going to allow it on here. If you have a valid criticism of the United States' system, then go ahead and add it. 
Sadly, most countries in the West have adopted most of the planks of the Communist Manifesto without realizing the full implications of their actions, because most people think that socialism merely involves direct government control. Just realize that socialism is more than just direct government control, it includes indirect government control in the form of regulations, taxes, etc., and stop scapegoating free medicine for the faults of socialized medicine.
:Since the implicit definition of socialism you are employing differs from that widely held (per your comment "most people think that socialism merely involves direct government control"), it would seem that the onus would be on you to find some credible sources that say that the US system is socialized or semi-socialized.--Gregalton 12:46, 13 November 2007 (UTC)
replies: text: Over the months that I have been editing this article I have searched many articles on this subject on the net. The overwhelming number of recent articles, blogs, news stories and usage by politicians etc.. can be traced back to output emanating from a very small number of sources. The three main ones seem to be the Centre for Policy Analysis, another is the Manhattan Institute and the other is Cato. Their reports on socialized medicine do not appear to be peer reviewed yet they are widely quoted. They all refer to health care systems in places such as Canada and the UK as reflecting "socialized medicine" and compare these systems with an alternative system, that in the US, which by their own logic cannot also be regarded as "socialized medicine" otherwise their conclusions would be meaningless. So the assertion by Freedomwarrior that the UK and the US are not at opposite poles on the issue of "socialized medicine" is not in accord with the way users of the term mean it to be interpreted.--Tom 21:01, 13 November 2007 (UTC)
thread_title: US and Free Medicine

message: At one point in the article it is pointed out that most people would regard Canada's system of health care as being a "Single Payer" system rather than a "Socialized" system. But in the opening paragraph the article boldy declares Medicaid and Medicare as examples of socialized medicine in the US. But aren't these also better describes as Single Payer systems?  I would have thought the Veterans and Army Medical Services would be better examples of socialized medicine in the US to be included in the opening paragraph. I know that a certain editor will probably strongly disapprove of that, but it would be less disputable.   --Tom 21:18, 13 November 2007 (UTC)
thread_title:  Opening paragraph.  Medicaid and Medicare are single payer. Replace with better examples?  

message: I would like to archive the talk page in the next day or two, unless I hear otherwise. Kborer (talk) 18:00, 5 December 2007 (UTC)
replies: text: Please do, good suggestion.--Gregalton (talk) 13:18, 6 December 2007 (UTC)
thread_title:  archive 

message: :Taking a look at the current version: the first sentence says that socialized medicine is partly financed by the state, whereas the definition linked to says "government takes responsibility for entire population", "at no direct cost or a nominal fee." The entire population point is key, as is the point that substantially all financing is provided by the state.
:The second sentence goes on to say "Socialized medicine can refer to any system of medical care that is largely both publicly subsidized and subject to public policy", which does not correspond at all to the reference provided: "A system of health care in which all health personnel and health facilities, including doctors and hospitals, work for the government and draw salaries from the government."
:In this case the paraphrasing has ended up misleading as to the key points of the actual references provided. Under one definition, the government provides health care for the entire population (essentially at no or cost to them, i.e. close to 100% financing), and in the other, the government controls (directly, not through regulation) all supply. Paraphrasing as currently done considerably broadens the scope of the term, well beyond what these references justify.--Gregalton (talk) 13:27, 6 December 2007 (UTC)
replies: text:  I checked over the references and added some new ones.  They are fine now.  Kborer (talk) 14:52, 6 December 2007 (UTC)
thread_title:  Opening definitions do not correspond to references