Obamacare and National Socialism Health Care

Churchill thought there was a link too....

There have been comments made recently regarding the parallelism between "Obamacare" and the National Socialist's, or Nazi's Health Care.  Here's a video example:

Although it's attention grabbing, it's jingoistic, and as  such really doesn't effectively lay out the rational for linking "Obamacare", the Democrat's proposed Health Care Plan, to the Health Care reform carried out by Germany's National Socialists, or Nazi's (many people erroneously equate the Nazi's with Conservative politics, when in actuality, they were left-wing Socialists - as their name conveyed).  But the following from Marc S. Micozzi, M.D., Ph.D., a physician and anthropologist, who directs the National Museum of Health and Medicine in Washington, D.C, does provide that conceptual linkage that has concerned many people who are familiar with history, and understand the high potential for apllication of the "Law Of Unintended Consequences":

The German social insurance and health care system began in the 1880s under Bismarck. Ironically, it was part of Bismarck’s “anti-socialist” legislation, adopted under the theory that a little socialism would prevent the rise of a more virulent socialism. 

By the time of Weimar, German doctors had become accustomed to cooperating with the government in the provision of medical care. The reforms of the Weimar Republic following the medical crises of World War I included government policies to provide health care services to all citizens. Socially minded physicians placed great hope in a new health care system, calling for a single state agency to overcome fragmentation and the lack of influence of individual practitioners and local services. The focus of medicine shifted from private practice to public health and from treating disease to preventable health care. During the German “economic consolidation” of 1924-1928, public health improved under new laws against tuberculosis, venereal disease, and alcoholism, with new advisory centers for chemical dependency and counseling bureaus for marriage and sexual problems.

Medical concerns which had largely been in the private domain in the nineteenth century increasingly became a concern of the state. The physician began to be transformed into a functionary of state-initiated laws and policies. Doctors slowly began to see themselves as more responsible for the public health of the nation than for the individual health of the patient. It is one thing to see oneself as responsible for the “nation’s health” and quite another to be responsible for an individual patient’s health. It is one thing to be employed by an individual, another to be employed by the government.

Under the Weimar Republic these reforms resulted in clearly improved public health. However, the creativity, energy, and fundamental reforms found in social medicine during the Weimar Republic seem in retrospect a short and deceptive illusion. Medical reformers had wanted to counter the misery inherited from the first World War and the Second Empire on the basis of comprehensive disease prevention programs. In the few years available to the social reformers, they had remarkable success. But in connection with these reforms the doctor’s role changed from that of advocate, adviser, and partner of the patient to a partner of the state.

Where traditional individual ethics and Christian charity had once stood, the reformers posited a collective ethic for the benefit of the general population. Private charity and welfare were nationalized. The mentally ill, for example, having been literally released from their chains in the nineteenth century and placed in local communities and boarding houses in regular contact with others (the so-called “moral therapy”), were returned to state institutions to become the ultimate victims of state “solutions.”

With the world economic crisis of 1929, welfare state expenditures had to be reduced for housing, nutrition, support payments, recreation and rehabilitation, and maternal and child health. What remained of the humanistic goals of reform were state mechanisms for inspection and regulation of public health and medical practice. Economic efficiency became the major concern, and health care became primarily a question of cost-benefit analysis. Under the socialist policies of the period, this analysis was necessarily applied to the selection of strong persons, deemed worthy of support, and the elimination of weak and “unproductive” people. The scientific underpinning of cost-benefit analyses to political medical care was provided by the new fields of genetics and eugenics.

Given the much greater familiarity with Socialism, Communism and Totalitarianism governemnts that most people had in the mid-20th Century, it's no wonder that Winston Churchill had the following observation:

"Churchill made a speech in 1945 election, having led the British people through hard times, saying that plan of the Labour Party to institute national health care and other socializing reforms, might be all very well in its way but might require a gestapo of bureaucracy. *

* Christopher Hitchens, the author of "Why Orwell Matters" in a discussion with EconTalk host Russ Roberts 


You never know what kind of "fishy" information gathering an Administration might want to conduct on behalf of enacting a Public Health Plan.

Interestingly, if you check out the UK's National Health Service website, you'll see that some of Churchill's perception became actuality.  The NHS is huge; with estimated population of the UK in July, 2009 projected to be 61,126,832 - 2.45 %of the population working for the NHS equals 1.5 Million.

With a Jan of 2009 estimated population of the US was projected to be 305,529,237 - 2.45 % working for the US' NHS equivalent would be 7.5 Million if it were like for like, but since only less than 50% are practitioners, we'll assume that the US Public Plan would not have taken over the doctors and hospitals; so that would still be 3.74 Million employees in an equivalent US Health Care System.  That's a lot of people, and I guess a lot of potential Union employees, dues contributors, and Democrat Party voters.......

In addition, when you do the math, a similar Health Care System for the US population, at today's currency conversions rates that would cost $732 Billion.

Since its launch 60 years ago, the NHS has grown to become the world’s largest publicly funded health service.  With the exception of charges for some prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is resident in the UK – more than 60m people. It covers everything from antenatal screening and routine treatments for coughs and colds to open heart surgery, accident and emergency treatment and end-of-life care.

Although funded centrally from national taxation, NHS services in England, Northern Ireland, Scotland and Wales are managed separately. While some differences have emerged between these systems in recent years, they remain similar in most respects and continue to be talked about as belonging to a single, unified system.

Scale

Nationwide, the NHS employs more than 1.5m people. Of those, just short of half are clinically qualified, including some 90,000 hospital doctors, 35,000 general practitioners (GPs), 400,000 nurses and 16,000 ambulance staff.

Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people.

The NHS in England is far and away the biggest part of the system, catering to a population of 50m and employing more than 1.3m people. The NHS in Scotland, Wales and Northern Ireland employ 158,000, 71,000 and 67,000 people respectively.

The number of patients using the NHS is equally mind-boggling. On average, it deals with 1m patients every 36 hours - that’s 463 people a minute or almost 8 a second. Each week, 700,000 will visit an NHS dentist, while a further 3,000 will have a heart operation. Each GP in the nation’s 10,000-plus practices sees an average of 140 patients a week.

Funding

When the NHS was launched in 1948 it had a budget of £437 million (roughly £9 billion at today’s value). In 2007/8 it received 10 times that amount - more than £90 billion.

This equates to an average rise in spending over the full 60-year period of about 3% a year once inflation has been taken into account. However, in recent years investment levels have been double that to fund a major modernisation programme.

Some 60% of the NHS budget is used to pay staff. A further 20% pays for drugs and other supplies, with the remaining 20% split between buildings, equipment and training costs on the one hand and medical equipment, catering and cleaning on the other. Nearly 80% of the total budget is distributed by local trusts in line with the particular health priorities in their areas.

The money to pay for the NHS comes directly from taxation that, according to independent bodies such as the King’s Fund, remains the “cheapest and fairest” way of funding health care when compared with other systems. The 2007/8 budget roughly equates to a contribution of £1,500 for every man, woman and child in the UK. 

Performance

Measuring the efficiency of healthcare systems is notoriously difficult. The NHS – in common with other healthcare systems – has never consistently and systematically measured changes in its patients’ health. As a result, it’s impossible to say exactly how much extra “health” is created for each pound spent.

However, Obama says that a Public Plan Option can not only cover 45 Million additional people with Health Insurance, it would lower overall costs as well.  

Well, I know the story of the loaves and fishes, and I'm familiar with the miracle at Canna in Galilee, but despite the messianic view that many of his followers have of him, you can call me a skeptic....and that ain't "fishy".