Socialized Medicine - History of The Term

History of The Term

When the term "socialized medicine" first appeared in the United States in the early 1900s, it bore no negative connotations. Otto P. Geier, chairman of the Preventive Medicine Section of the American Medical Association (AMA), was quoted in The New York Times in 1917 as praising socialized medicine as a way to "discover disease in its incipiency," help end "venereal diseases, alcoholism, tuberculosis," and "make a fundamental contribution to social welfare." However, by the 1930s, the term socialized medicine was routinely used negatively by conservative opponents of publicly funded health care who wished to imply it represented socialism, and by extension, communism. Universal health care and national health insurance were first proposed by U.S President Theodore Roosevelt. President Franklin D. Roosevelt later championed it, as did Harry S. Truman as part of his Fair Deal and many others. Truman announced before describing his proposal that: "This is not socialized medicine".

Government involvement in health care was ardently opposed by the AMA which distributed posters to doctors with slogans such as "Socialized medicine ... will undermine the democratic form of government." According to T.R. Reid (The Healing of America, 2009):

"The term was popularized by a public relations firm working for the American Medical Association in 1947 to disparage President Truman's proposal for a national health care system. It was a label, at the dawn of the cold war, meant to suggest that anybody advocating universal access to health care must be a communist. And the phrase has retained its political power for six decades."

The AMA conducted a nationwide campaign called Operation Coffee Cup during the late 1950s and early 1960s in opposition to the Democrats' plans to extend Social Security to include health insurance for the elderly, later known as Medicare. As part of the plan, doctors' wives would organize coffee meetings in an attempt to convince acquaintances to write letters to Congress opposing the program. In 1961, Ronald Reagan recorded a disc entitled Ronald Reagan Speaks Out Against Socialized Medicine exhorting its audience to abhor the "dangers" which socialized medicine could bring. The recording was widely played at Operation Coffee Cup meetings. Other pressure groups began to extend the definition from state managed health care to any form of state finance in health care. President Dwight Eisenhower opposed plans to expand government role in healthcare during his time in office.

In more recent times, the term was brought up again by Republicans in the 2008 U.S presidential election. In July 2007, one month after the release of Michael Moore's film Sicko, Rudy Giuliani, the front-runner for the 2008 Republican presidential nomination, attacked the health care plans of Democratic presidential candidates as socialized medicine that was European and socialist, Giuliani claimed that he had a better chance of surviving prostate cancer in the U.S than he would have had in England and went on to repeat the claim in campaign speeches for three months before making them in a radio advertisement. After the radio ad began running, the use of the statistic was widely criticised by FactCheck.org, PolitiFact.com, by The Washington Post, and others who consulted leading cancer experts and found that Giuliani's cancer survival statistics to be false, misleading or "flat wrong", the numbers having been reported to have been obtained from an opinion article by Giuliani health care advisor David Gratzer, a Canadian psychiatrist in the Manhattan Institute's City Journal where Gratzer was a senior fellow. The Times reported that the UK Health Secretary pleaded with Guilliani to stop using the NHS as a political football in American presidential politics. The article reported that not only were the figures 5 years out of date and wrong, but that US health experts disputed both the accuracy of Mr Giuliani’s figures and questioned whether it was fair to make a direct comparison. The St. Petersburg Times said that Giuliani's tactic of "injecting a little fear" exploited cancer, which was "apparently not beneath a survivor with presidential aspirations." Giulliani's repetition of the error even after it had been pointed out to him earned him more criticism and was awarded four "Pinnochios" by the Washington Post for recidivism.

Health care professionals have tended to avoid the term because of its pejorative nature, but if they do use it they do not include publicly funded private medical schemes such as Medicaid. Opponents of state involvement in health care tend to use the looser definition.

The term is widely used by the American media and pressure groups. Some have even stretched use of the term to cover any regulation of health care, whether publicly financed or not. The term is often used to criticize publicly provided health care outside the US, but rarely to describe similar health care programs in the US, such as the Veterans Administration clinics and hospitals, military health care, nor the single payer programs such as Medicaid and Medicare. Many conservatives use the term to evoke negative sentiment toward health care reform that would involve increasing government involvement in the U.S health care system.

Medical staff, academics and most professionals in the field and international bodies such as the WHO tend to avoid use of the term. Outside the US, the terms most commonly used are universal health care or public health care. According to health economist Uwe Reinhardt, "strictly speaking, the term 'socialized medicine' should be reserved for health systems in which the government operates the production of health care and provides its financing." Still others say the term has no meaning at all.

In more recent times the term has gained a more positive reappraisal. Documentary movie maker Michael Moore in his documentary Sicko pointed out that Americans do not talk about public libraries or the police or the fire department as being "socialized" and nor do they have negative opinions of these. Media personalities such as Oprah Winfey have also weighed in behind the concept of public involvement in healthcare. A 2008 poll indicates that Americans are sharply divided when asked about their views of the expression socialized medicine, with a large percentage of Democrats holding favorable views, while a large percentage of Republicans holding unfavorable views. Independents tend to somewhat favor it.