Talk:Publicly funded health care/Archive 1

Restore
I am restoring this article because Publicly-funded health care does not neccesarily equal Universal health care (i.e. The United Stated) and the redirect was never discussed on the archived talk page so it is strange the person got away with redirecting it.--Jorfer 01:24, 30 April 2007 (UTC)

Varieties of public systems
"Most developed countries currently have publicly funded health systems that cover the great majority of the population. The notable exception is the United States." The other notable exception is Switzerland, where every adult is legally obliged to purchase health insurance from a private insurance company, and this can be used to cover the costs of healthcare at a private or public hospital. How can we incorporate this information into the article? It might also be worth looking at the Netherlands - as I understand they have a system comprising both public and private elements. At the moment this reads like a dig at America for not following France and Britain's social model --Dilaudid 17:56, 27 May 2007 (UTC)
 * It is very difficult to be correct while generalizing about "most" countries. Norway's system, too, comprises both public and private elements.  UN-Europe puts out reports called "HiT", Health Systems in Transition.  They've done these for four dozen countries, not including the USA.  The Norwegian one from 2006 is a 187-page PDF at http://www.euro.who.int/Document/E88821.pdf .  Analyzing all these, one easily could write a book and still not get it all "right". Hordaland 20:15, 1 July 2007 (UTC)

Newer and Better facilities in Private Sector?
The claim that private hospitals tend to have newer and better equipment and facilities does not reflect my experience of public versus private medicine in the UK. Public hospitals do tend to get the newest and best equipment first because they have the volume of patients to justify the investment. Private hospitals tend to provide simpler surgical procedures and compete on waiting times and non-medical conveniences such as private rooms which are rare in the public hospitals. However, on the surface it may seem that public hospitals also have a lot of old equipment too. But that just reflects the fact that old equipment can still be perfectly functional and does not need to be replaced. Public hospital managemements are very good at achieving value for money. A public hospital might prefer a cheaper CT scan, say, over a more expensive MRI scan if a CT scan is capable of confirming a similar diagnostic. However, if only an MRI can be relied upon, the MRI will be given. Larger public hospitals will have an MRI, smaller private hospitals probably will not. Patients attending a larger private hospital with MRI might end up paying for the expensive MRI though a CT would be cheaper and as effective. I am therefore inclined to remove this claim, but it would be useful to hear from those with experience in other countries providing universal health care. --Tom 09:34, 14 July 2007 (UTC)

Two tier or extended coverage?
I find it odd to refer to a two tiered system just because people buy insurance to cover benefits not covered. That's extended coverage, not two tiered. 199.125.109.109 01:14, 14 July 2007 (UTC)


 * I guess the answer is that because there is a universal service and a parallel private service, it amounts to a two tier service. Of course it is an extended coverage but few people extend to a third or fourth layer of cover, so in practise it is a two-tier system. --Tom 09:34, 14 July 2007 (UTC)
 * Calling it two tiered implies that you get faster and better treatment in one tier over the other tier, which is not true. It is false to use the word tier. 199.125.109.109 19:38, 22 July 2007 (UTC)

Proposal to delete the graphic
I propose that the graphic be deleted. The graphic introduces a concepts which do not in practice occur in publicly funded health care (i.e. government monopoly provision paid for privately) and in most countries where health care is provided, in practice all sectors of this are seen to some extent, according to the field of medicine or procedures covered. The terms "single-payer" and "socialized medicine" are not used outside of North America and therefore do not have general application. See also http://en.wikipedia.org/wiki/Talk:Single-payer_health_care --Tom 22:15, 7 August 2007 (UTC)

Debate section
This section is specific to the United States as publicly-funded health care is not strongly debated for or against in most other countries. I propose that this section be deleted. Health care debate is already located in Health care in the United States which would seem to be a more appropriate place. --Tom 21:40, 7 August 2007 (UTC)


 * Look again. The debate was moved to Universal health care. The debate on this page may seem US centric, but it is important for people to understand the reasons that governments around the world fund health care and the drawbacks to doing so. The amount of government involvement in the economy is always a source of debate although it may be limited. This debate is focused (or at least should be) on more general benenfits and cons for government involvement in health care then those specifically having to do with Universal health care which can be found on that article.--Jorfer 23:41, 7 August 2007 (UTC)


 * Yes most of the debate stuff has indeed been moved to Universal Health Care but it really does not belong there either IMHO. Although the headings read pros and cons of Universal health care, quite a lot of the points on one side or the other are from the US perspective precisely because this is a US debate about the US health system. Nearly all the references are US references. I looked at the talk page for Health care in the United States and I did not find any discussion about this move... it was just done suddenly, and quite recently. If I am wrong about that, please point me to somewhere where I can see that debate at its conclusion. Although its true to say there is always debate about health, that is an inevitable result of bringing health under political influences. But I get the feeling that in most countries there is no great debate for or against Publicly funded, universal health care per se; just tinkering with the way it operates. A good example is what is happening in France right now. I certainly dont think we need to have that same table in several different articles. One is enough. --Tom 01:07, 8 August 2007 (UTC)

International comparisons
The article seems to be very selective about international comparisons and the conclusions drawn.

For example, the cancer statistics do indeed show that the US does indeed have longer life expectancy after the discovery of cancer than say Canada or the US, but attributing it to the health care system may not be warranted. France has a public health care system and it's system has 5 year survival rate for lung cancer than is the equal of the United States. The French spend half as much on health per capita as the US.

One could equally argue that because the US has a higher rate of mortality for all cancers than, say, Italy, Japan, Australia and Sweden, all of which have publicly funded universal health care compared to the US private insurance funded system, this is a plus for public funding over private funding in reducing cancer deaths. Would that be a fair conclusion? Of course not.

It may be, for example, that because the Brits and Canadians are living longer (which they are) than their counterparts in the US, their cancers are mostly happening closer to the normal end of life than their US cousins. In the UK, just as in the US, you'd be very lucky indeed to be alive at 95 if you got your diagnosis aged 90. If more people in the US are getting their cancers at a younger age, then their survivial rate after 5 years might well be expected to be higher. The point I am making is that unless their are rigorous controls in the statistical populations, these international comparative statistics are pretty meaningless. --Tom 15:16, 1 September 2007 (UTC)

Quality of Care Section
At the end of this section there is a sentence stating,
 * "The publicly-funded health care system in continental Europa generally has shorter waiting lists, aand a general high quality of service."

Not only is there no source for this statement, it is incredibly vague and appears to be based more on experience and opinion rather than fact. I'm removing it, but please reinstate it with a credible source. Sneyton 20:52, 7 November 2007 (UTC)

http://en.wikipedia.org/w/index.php?title=Publicly-funded_health_care&diff=next&oldid=168854491 Sneyton 17:57, 8 November 2007 (UTC)

US bias
This article is biased towards discussion of health care in the United States. The debate section is particularly bad in this regard. The section is mostly based on the rights and wrongs of public finance in medicine whereas in most countries this long ago stopped being an issue. The section should be moved to another article. --Tom (talk) 01:14, 31 December 2007 (UTC)

Debate section does not represent a World View. Bits should be moved to other articles
The debate section is US centric. The debate section is mostly couched in terms of the debate in the US. There are issues of debate in many countries but they are not all focussed in this way. In the UK for example one debate is now focussing on issues such as whether doctors practices should offer more evening appointments so people do not have to take time off work for these or whether PFI initiatives has actually cost much more than if the investment was from public funds. Finland's debate has been about nurses pay and whether nurses can take on more routine work from doctors (a successful reform from the UK). I therefore do not believe that the article can carry a debate section. There was such a section at Health care in the United States but it got removed. There is however extensive list of issues a http://en.wikipedia.org/wiki/Universal_health_care#Debate_in_the_United_States.--Tom (talk) 20:37, 31 December 2007 (UTC)
 * Agreed. This section is a mess and bears clear scars from repeated POV edits.  There is no point in dividing the debate into Pro & Con sections if one side of the debate is then allowed to crawl all over the other's case with comments that are just repetitions of the other side of the debate.  It doesn't make the article NPOV or tidy.  It is also almost exclusively written in reference to the debate in the US, with nothing about the many issues (pro & con) experienced within other countries.  The only mentions of other countries are simply in order to compare and contrast with the USA.  If someone isn't going to make the effort to globalise it, it shouldn't be here. -- Escape Orbit  (Talk) 21:15, 31 December 2007 (UTC)

Looking back at the history on this page I see we have been here before. As you may see I have been checking the references in some of these sections and quite a lot of them are dubious and from organizations with a polar position in the US debate. Hardly goog WP material. Like Escape Orbit I think we should just junk these sections. If there is no clear objections I will delete them on January 3rd. If any editor thinks they should stay, please say here why so we can discuss. —Preceding unsigned comment added by Hauskalainen (talk • contribs) 09:52, 1 January 2008 (UTC)

Fraser Institute "Study"
User:Sfmammamia : Your recent edit carried the edit description of replacing a biased source from the Fraser Institute with a better, less biased source. In fact, the article refers to this as "a study" by the Fraser Institute but it was not doing original research but merely representing others data, which of course may well be very selective. But I think you may have slipped up because the Fraser reference is still in the article. Incidentally I read that Fraser article in some detail and the thing that struck me was the conclusions at the end were not a fair representation of the content. For example it says this in conclusion The comparative evidence is that the Canadian health care model is inferior to others in place in the OECD. It produces inferior access to physicians and technology, produces longer waiting times, is less successful in preventing death from preventable causes, and costs more than any of the other systems that have comparable objectives, save the programs in Iceland and Switzerland. and All three countries that outperform Canada on the cumulative rank for mortality amenable to health care..... have private health care alternatives to the public system and some form of user fees at the point of access; none spends more than Canada after age adjustment.

But the USA is in the OECD and the USA data was conspicuously missing from the data sets they used. And in the table of "Mortality Closely Related to the Effectiveness of Health Care" Canada actually came a spectular 4th out of 28 OECD countries (again the US data is missing, but it is well below). Only Australia, Japan and Sweden did better. The statement that "All three countries that outperform Canada ....... have private health care alternatives to the public system and some form of user fees at the point of access" is clearly meaningless and intended to mislead. There will be private health care alternatives also in ALL of the 24 countries that came BELOW Canada in this list and there may well be user access fees in them too. The conclusion we are led to draw from the statement cannot in fact be made. It is pure bias and has no place in the article.--Tom (talk) 12:18, 3 January 2008 (UTC)

Invalid sources for factual information. Cato, The Manhattan Institute and The Center for Policy Analysis
I deleted two reference from two of these sources. The reason is that if we are to put information before the WP audience, the information should at least be accurate. I have examined many of the claims of these organizations and they are almost always factually wrong, deliberately misleading or highly selective. It would be fair to quote these institutions as sources for such material in the context of their inaccuracy, selectivity or general bias, but not surely as legitimate sources for factual information. If anyone wants examples we can examine them. --Tom (talk) 01:21, 31 December 2007 (UTC)

I understand that you fancy yourself an expert on health care policy, but you really need to stop trying to push original research on these pages as fact. Frankly, I don't care what claims you've examined or whether you think that they're valid sources or not, because they're used to support claims that are written as opinions and not in a matter of fact fashion. Accordingly, despite whatever misgivings you may have about their validity, they are certainly acceptable sources. Furthermore, you shouldn't be complaining about their validity, given all the times that you use yourself to make matter of fact statements.Freedomwarrior (talk) 01:25, 31 December 2007 (UTC)

Let's be clear what you are saying. They may say that black is white. And as it is their opinion that black is white, it's okay to quote these institutes as evidence that some say that black is white. Even if they are written in the source "in a matter of fact of way" (i.e. that they are facts). As long as its written up here in Wikipedia as being "opinion". Right?--Tom (talk) 04:10, 31 December 2007 (UTC)

I am not going to waste much time on this, given that your objections amount to nothing more than spurious attempts at censorship. Everyone is entitled to their own opinion. They are not entitled, however, to their own facts. (unfortunately, this is something that you've yet to grasp).

Given the prominence of the organizations on the right, your request would be tantamount to going through all the pages on Wikipedia and stripping opinions that use the New York times (which contains nothing but obscurantist, socialist dribble) as their justification...Freedomwarrior (talk) 08:19, 31 December 2007 (UTC)


 * I see you did not answer the question, and that is quite revealing. The fact is that these 3 organisations do not tell the truth, and it can be demonstrated to be so. In fact they they demonstrate clear bias by distorting facts, mis-representng data, and even telling out and out lies. If WP is to have citations of fact, then they should be citations from non-biased and accurate sources. I think it would be OK to cite these three organisations as having an opinion on one side of the political debate generally and even give a reference to their web sites. The re-direction comes with a clear notice to the reader that the source has a bias. But not on citations about claims of fact otherwise because it has great potential to mislead the reader.  I don't care that these organizations are widely quoted in the media and I don't care whether they are on the right or the left. We must apply the same rule to organizations that have a bias the other way.  The Guilliani cancer statistic was sourced from one of these organizations and it got him into a lot of trouble because The Manhattan Insitute's David Gratzer had mis-used a statistic to draw a false conclusion. Guilliani believed it because he thought it came from a "respected" source. We risk seriously misleading millions of WP readers in the same way. --Tom (talk) 11:14, 31 December 2007 (UTC)

Examples
Here is an example from the current article. Quoting the NCPA as its source it says

In particular, one opponent of public health care identified the facts that about 1 million are waiting to be admitted to hospitals at any one time in the United Kingdom, that there are comparatively low rates of provision of lifesaving treatments such as kidney dialysis, and that half of all prostate cancer patients in the United Kingdom die from the disease, compared to one in five in the United States.[17] First of all this NCPA source (unlike academic journals) does not reveal its sources for the claims it makes. WP should expect this so the reader can check the data for him/herself.

It says that it has identified the following as facts...


 * 'about 1 million are waiting to be admitted to hospitals at any one time in the United Kingdom'

What is this based on? Is it accurate? Is it meaningful? A million is a big number!


 * Accuracy
 * Well first of all recent statistics (Aug 2007 see http://www.gnn.gov.uk/imagelibrary/downloadMedia.asp?MediaDetailsID=216856) show that 636,542 people were waiting. Well, the number has been falling steadily. It was 849,205 in Aug 2004.  So the million figure, if were ever true, must relate to a figure that is very very old. It certainly is not accurate today.


 * Significance
 * The vast majority (557,078 ) of those 636,542 people are treated within 13 weeks. We do not know how many get treated within say 4 weeks because that statistic is not published.  Most surgery is elective and not for life threatening conditions and the prioritization applied means that people needed life saving treatments or in great suffering should not have to queue.


 * The statistics only measure the wait times of those patients that queue. Not all procedures have to be queued so the waiting time experience is not indicative of all in-patient experience which will be mcuh shorter.


 * Comparability
 * What is the comparative wait time in the US? We are simply not told. If you read the statistics for the US (which are few and far between because nobody actually collates the data regularly) are indeed lower. But is that meaningful?  The right to get in the queue for elective procedures in the UK is based on clinical need. The right to elective procedures in the US is based on clinical need  and the ability to pay (whether yourself, or on your behalf by a an insurance company or the government). Not everyone has that right. There are people needing surgery in the US who are queing because they have no funding for their treatment. They are waiting with no date in the future for their treatment. These poor people are not counted in the US as waiting at all!


 * Alternate interpretation from real data (not given in the article)
 * The statistics reveal that in August this year just 0.15 per cent of the English population was waiting more than 13 weeks for any form of non-urgent elective surgery. And every one of them will get treated eventually.


 * 'There are comparatively low rates of provision of lifesaving treatments such as kidney dialysis'


 * Here we have a sweeping statement with a selective data set.  It is indeed true that the US has many more people on dialysis than in the UK. But does that mean that people die of end stage renal failure ESFR in the UK die for lack of dialysis? No!  There are many factors here. First of all the incidence of ESRF has to be taken account of.  Careful management of kidney disease in the early stages can help reduce the need for the patient ever getting to the point of needing dialysis. Also it takes no account of the intensity of use of dialysis equipment. And it takes no account of the incidence of the ESRF in each country. The provision is relative to the need.  This is an example of revealing a statistic and deliberately leading the reader to draw a false conclusion.


 * 'half of all prostate cancer patients in the United Kingdom die from the disease, compared to one in five in the United States'


 * Sounds like the Guiulliani claim again! Source for this claim? We do not know. CPA does not tell us. But if it is true, it surely means that it is better to get treated in the US because the chances of a cure are two and a half times better.  This is what this statistic tells us, right?


 * Wrong! The fact is that death from prostate cancer is running at the same rate in both countries. One should be able to conclude from the claim by the CPA that incidence rates in the US are higher in the US than in the UK. But there is no evidence for this. The truth of this matter is that in the US, doctors are encouraged to run blood tests to discover the presence of prostate cancer. Because the tests are never conclusive, patients are then subjected to further invasive treatments to eliminate those that do not have a cancer. If the cancer diagnosis is confirmed the person is put on a course of drug and other therapies to treat the condition.  In the UK, doctors behave differently. They know that most prostate cancers are not life threatening. Many men get prostate cancer later in life but actually die of something else. Finding the disease early as happens in the US means that many people are put through worry and expensive procedures which carry their own risks and which may not have been necessary in the first place.  So the reason that this statistic emerges is because it refers to patients.  Many of the US patients that did not die of the disease went through expensive, dangerous and probably unnecessary treatment programs. They were never saved by their treatment. There are equivalent men in Britain that did not die of the disease also. But they never got treated as patients and did not go through the expensive and dangerous treatment screening programs and did not ever have to worry about having a cancer which was not a threat to them. Thus the high UK statistic for patient survival rates compared to the US is not what it at first seems.

So as can be seen, The Center for Policy Analysis uses statistics in a less than honest way to mislead its readers. Lies, damn lies, and statistics.--Tom (talk) 13:08, 31 December 2007 (UTC)

The article also currently says a study by the Heart and Stroke Foundation of Canada found that heart attack survivors in Canada, a nation with a publicly-funded health care system, have a dramatically lower quality of life than their American counterparts. Well that may or may not be true, but is it due to it one being publicly funded and the other privately funded? I decided to find out. Following the reference it leads to as web site page http://www.freemarketcure.com/whynotgovhc.php by, guess who? The Manhattan Institute's David Gratzer. He cites as his source an article by Brad Evenson in the National Post from 8 February 2001. The same Brad Evenson who had to leave the newspaper after it learned that stories he had written there allegedly contained fabricated names and quotes. See http://foi.missouri.edu/mediacredibility/writerfab.html  It's possible of course that this isn't one of them. So I searched the web site of the Heart and Stroke Foundation which Evenson had quoted to look for the story there. I could not find it. Hence I will trash the quote from the article.--Tom (talk) 07:44, 1 January 2008 (UTC)


 * And just to clarify another point about the UK. The most recent statistics start the waiting clock when the hospital consultant (medical specialist or surgeon) receives a referral letter from the patient's GP. Therefore it includes the time taken for any tests to be done at the hospital by or for the consultant to investigate the problem and determine the patient's best treatment option. And if the problem is intermittant or the cause cannot be determined immediately it includes all the intervening time until it is finally determined. Most people would not regard this time as "waiting for treatment". --Tom (talk) 14:24, 7 January 2008 (UTC)

The Brazil's case.
There is no mention about Brazil's Social Security System, which maintains a Publicy-funded health care. —Preceding unsigned comment added by 200.152.34.16 (talk) 10:36, 9 January 2008 (UTC)
 * Then Be Bold and make an entry if you believe it adds to the article - that's how Wikipedia works. Dainamo (talk) 01:09, 14 January 2008 (UTC)

Merger proposal
I am in favor of merging Socialized medicine into this article because of a large overlap of material. The Socialized medicine article, however, also goes into detail about various countries' publicly-funded systems, though the neutrality of many parts of the Socialized medicine article has been criticized recently. A section could be added this page regarding the pejorative term 'Socialized medicine'. —Preceding unsigned comment added by Imacsam (talk • contribs) 05:45, 7 November 2007 (UTC)


 * This does not make much sense, since publicly funded health care encompasses many health care systems. Socialized medicine, national health insurance, and any other system where the government is providing funds are all publicly funded health care.  Furthermore, publicly funded health care is not necessarily socialized medicine because socialized medicine requires government control of the system.


 * As far as dealing with redundant information, real implementations of publicly funded health care should be discussed in the most specific article that applies to them. This article should be about concepts and issues that apply to all publicly funded health care systems and should point to more specific articles where necessary.  Kborer 13:25, 7 November 2007 (UTC)


 * I agree with Kborer that there should be no merger but for a different reason. Socialized medicine is most often used to refer to a style of medical care where the government or a branch of government owns the health care system(s), and doctors and health care workers work for organization(s) that are publicly owned. Publicly-funded could mean publicly owned but it can also refer to health care provided by charities or private companies independent of central or local government but which may be funded from the public purse. There is a slighly hazy overlap, but the difference is such that it should not be blurred in WP. --Tom 22:03, 7 November 2007 (UTC)

I don't know where you are getting these definitions. "Socialized medicine" is a pejorative term used by opponents to public health care. Notice they do not refer to public schools as "socialized education" or any other government services that they support. And how is national health insurance different from either publicly-funded health care or socialized medicine? The Four Deuces (talk) 23:29, 11 December 2007 (UTC)


 * Socialized medicine denotes goverment control and government funding (of which a few countries fall under), nationalized health insurance denotes mostly private control and full public funding (of which most developed countries fall under), and publicly-funded health care denotes any system with significant public funding (of which all developed countries fall under).--Jorfer (talk) 05:06, 12 December 2007 (UTC)


 * Support merge or cut dramatically: I agree that the main issue with the term is its inconsistency. If the term has any valid use, it is in a strict sense of government ownership. If it continues to stay, it should be focussed primarily on its usage as a political term, and short discussion of the strict sense of the term (as well documented). I note that Kborer above is supporting this strict definition, but in the article itself is actively removing such explanation - while retaining in the intro an absurdly broad definition that could apply to amost any health care system. There IS an argument to be made that the "term" can be used (pejoratively) to mean almost any system, but that experts use primarily the most restrictive sense.--Gregalton (talk) 16:41, 31 December 2007 (UTC)

I also support merger of the Socialized medicine article into Publicly-funded health care. The Socialized Medicine article has degenerated into a pedantic political debate over terms and definitions. Even the term "socialized medicine" is itself a word with strong political connotations, especially in the United States. By merging Socialized medicine into Publicly-funded health care, hopefully the content will retain a more neutral tone and avoid devolving into political debate. Dgf32 (talk) 03:16, 1 January 2008 (UTC)

Regarding the merger itself, I suggest that the majority of the content in the Socialized medicine article does not need to be added to the Publicly-funded health care article, and what is added needs to be devoid of politically charged terms and have a very neutral point of view. Hopefully we can start by cleaning up the Socialized medicine article and then transferring necessary material. After merger is completely, Socialized medicine should redirect to Publicly-funded health care. Dgf32 (talk) 03:16, 1 January 2008 (UTC)

Looking at the various articles about government involvement in health care, there appears to be no consistency in the use of the different terms. JEF helpfully gave definitions, but the articles do not follow them. Every developed and many developing countries have a mixture between government/private funding and control. People reading these articles deserve to informed about how health care is delivered in different countries rather than endless ideological semantics. My advice to people who have strong opinions is this: ensure that the articles are accurate and trust people to form their own opinions based on the facts. The Four Deuces (talk) 01:30, 3 January 2008 (UTC)

Support merge: The two terms are identical in true meaning, i.e. the glass is half full, the glass is half empty. --Historian 1000 (talk) 09:51, 21 January 2008 (UTC)

Oppose merge. Am I correct in my impression that most of the people who support merge have not been working on the Socialized medicine article? The obvious reasons: (1) Socialized medicine and Publicly-funded medicine are 2 different concepts. They're not synonyms. The Republicans are accusing the Democrats of advocating "socialized medicine"; they're not accusing the Democrats of advocating "Publicly-funded health care." (2) Socialized medicine is controversial and we have been managing, with commendable efforts on everybody's part, to reconcile those controversies; if we merged the articles we'd have to start fighting it out with twice as many people. (3) Both articles are long. If they were merged, a lot of the content would have to go. Who decides what is "duplication"? (4) The 2 articles are both very complicated, and we haven't organized them yet. It's very difficult to merge articles if they're not well-organized and you can't compare the similarities and differences point-by-point. Nbauman (talk) 23:06, 28 January 2008 (UTC)

Support Merge. The two terms are different names for the same thing. Both terms need to be documented, but on the same page. Nbauman suggests they are different concepts; in what way? Other than the fact that different people choose to use the different terms according to their own particular bias? The different definitions I see here on this talk page (such as Jorfer's) appear to be hair splitting without anything to back them up. I see little difference in "having control of", and "providing funding for". If the government funds something, to all practical extent it controls it.

"Socialised medicine" is only particularly controversial in the US, and it is only this dimension that causes the problems on that article. Moving away from this divisive term will remove the US bias, much of the petty controversy, and create a more balanced article. -- Escape Orbit (Talk) 23:39, 28 January 2008 (UTC)


 * As noted, I think most of the content can be moved here. I think socialized medicine should be kept as a stub to deal with the usage of the term (pejorative, political only). The article will otherwise end up getting reconstructed.--Gregalton (talk) 05:18, 29 January 2008 (UTC)

Oppose if I did not make it clear before. The two terms are on opposite sides of health care involvement. "Socialized medicine" denotes an extreme amount of government involvement in health care such as existed in the former Soviet Union, while "publicly-funded health care" is useful in refering to a minimally involved system like the United States that there is public-funding for health care, but not at the level of universal care (even though the term covers basically every health care system in the world). As Nbauman pointed out, there is a reason why this term is slung out by conservatives. It is hyperbole to evoke Soviet era bread lines, but instead of bread, you have health care; basically people being stuck in a bureaucratic mess. Regardless of the content, it is a mistake to try to combine two opposite ends of the spectrum. Extensive editing likely may be needed, but combining the two articles is not the solution. Combining the articles will just make this article worse by making it more politicaly charged. "Socialized" in this context is not used to refer to a health care system which simply cares for the poor as "publicly-funded health care" fills that niche, but is really used for a lack of a better word for a draconian system where doctor's freedom is extremely limited by the government. "Authoritarian health care" or "bureaucratic health care" would probably be a better word to describe the system that "socialized health care" denotes.--Jorfer (talk) 05:21, 29 January 2008 (UTC)


 * HaHaHaHaHa! Very funny Jorfer! Soviet Union, bread lines, people being stuck, bureacuratic mess, draconian, limited freedom, and authoritarian all in one paragraph describing your reasons for opposing a merger! --Tom (talk) 10:14, 29 January 2008 (UTC)

Oppose. I've been trying to think of a set of analogous Wikipedia articles. We have, for example, perfectly good articles on Abortion as well as the terms of political framing on both sides of the debate: Pro-choice and Pro-life. I know that the article on socialized medicine has been much debated, so perhaps expressing an opinion here is less-than-helpful, but I think that that article should focus more narrowly on the usage of the phrase as a term of political framing. I do not see "Publicly funded health care" as a term of political framing. I'd like to see this article as a summary style umbrella that summarizes the global range, enormous variety and complexity of systems of public health care funding, linking to more specific articles on examples and implementations. I acknowledge that it has a long way to go to get there. I'd like to see the U.S. debate material eventually isolated and spun out into its own article, merged with similar debate sections that have sprung up in other articles. --Sfmammamia (talk) 17:22, 30 January 2008 (UTC)

We seem to have a mix of opinions on this. Broadly the reckoning is 5 for (though one suggesting retain a stub), 5 against, and one not really stated one way or the other.

I actually agree with many of the comments made by both Gregalton and Sfmammamia even though they responded to the suggestion in opposite directions. I honestly do not regard the Socialized medicine as an encyclopaedic article except in the sense that that Gregalton suggests. I started editing the article after I was told by another editor that (a) the term is not perjorative (clearly nonsense!!) and (b) after seeing all the lies told about the subject by the reference that led from the article. I personally err on the side of the definition that socialized medicine is about state run, state financed health care. But this type of care arrangement is, I feel, worthy of an article. It is not the same as publicly-funded health care. So under what name should it be titled? I originally objected very much to the use of the term "socialized". I am old enough to remember finding the use of the word "gay" in place of "homosexual" equally odd whereas now it feels perfectly OK. So its perfectly possible to become comfortable with something that at first one finds at first uncomfortable. Because we don't have a neat title for state run, state financed health care, perhaps socialized medicine is as good a term as any.

Because I and my fellow editors have actually started adding facts about socialized medicine instead of all the falsehoods, a frantic effort has begun by a small clique of editors (maybe it's just one) to try to get the subject matter to feel negative again. That is what the recent edit warring has been about. I think we should resist attempts to politicize the article and just tell the straight facts. We have told the history of the term in terms of hostility towards state run, state financed health care so now we need to tell the facts about it - good and bad. In time I (and maybe others) will feel less anxious about calling it socialized medicine.--Tom (talk) 18:08, 30 January 2008 (UTC)

Escape Orbit, you ask me in what way Publicly-funded health care and Socialized medicine are different concepts.

Socialized medicine in most definitions (for example, as defined by Uwe Reinhardt) means that hospitals are owned by the government, and doctors are employees of the government (the Canadian system is not socialized medicine). Publicly-funded health care can be funded by the government through any mechanism. For example, some people would describe as publicly-funded health care a system in which the government subsidized insurance companies to provide health care.

Would you agree that those two usages are different concepts?

In any case, I think it's clear that we don't have consensus for merger. Nbauman (talk) 20:37, 30 January 2008 (UTC)


 * Mild support. Recent developments in the outsourcing of government services haved erased the boundary between the socialized and publicly funded medicine, so now socialized medicine article is just a POV fork of publicly funded health care article. --Doopdoop (talk) 22:48, 30 January 2008 (UTC)

Merge proposals
Attention all editors: The merger proposal discussed in this section was initiated by User:BigK HeX at 17:50, 11 February 2008 (UTC). Please note that User:BigK HeX later withdrew support for the proposal at 01:00 12 February 2008 (UTC), not here but at Talk:Socialized_medicine. Some of the material in Socialized medicine is mostly tangential to the topic of the source article (only some of it). The article seems to be focuesd on discussion of the connotations of the terminology ("socialized medicine") itself. I propose a merger of the indicated bits into this article. BigK HeX (talk) 16:08, 11 February 2008 (UTC)
 * Addendum: This is a discussion for specific sections of the source article only. I believe the source topic itself should stand as a separate topic.  This discussion is about a partial merger. (talk) 17:50, 11 February 2008 (UTC)

See also the last discussion on this proposal as recently as last December which achieved no consensus for a merger. —Preceding unsigned comment added by Hauskalainen (talk • contribs) 17:05, 11 February 2008 (UTC)

Before we go headlong into this I want us to consider one thing. What will the article "socialized medicine" tell us after these changes?

The issue I have is that the article before I started editing it was just using Wikipedia to direct people to articles by Cato and the like which just spin lies about socialized systems... people dying in line waiting for treatment, medicines being denied, doctors not having enough time for patients, doctors sunning themselves in the south of France whilst thousands of their patients died in line in the emergency room, under-investment in medical technology, rationing ...... you know the kind of thing. Those lies have been repeated across the internet in thousands of blogs. No wonder people believe them to be true. Should WP be used as a vehicle for spreading falsehoods? I don't think so. Or should it just lay out all the verifiable information, the claims for and against, and allow the reader to decide for him/herself where the truth is? That is, I think what has been happening to that article in the last 8 months or so and why I believe the article is so much better now than it was before. The problem is that some editors with a certain bias now dislike what the article has become. A real examination of the facts about certain claims. They would much rather those facts were buried in some other article.

I have the strongest of suspicions that one or two editors at socialized medicine are using sock-puppets or else a network of connected people to make an effort to destroy the socialized medicine article in its present form. I pointed out some time ago that Freedomwarrior took editing breaks in 2007 at the same time as Kborer. The same 2 editors made frantic edit changes at Christmastime, and then suddenly went quiet. They have been away most of January 2008 but again they have returned. I warned at the time that other WP user accounts were likely to be created (or have been created recently and re-activated for this purpose). And verily it has come to pass. Many of the recent edits at socialized medicine have been by user accounts recently created and with no previous history of editing medicine articles. BigK HeX is a good example. Doopdoop, another new editor who even made a huge change to an article about Cuba, a subject where Freedomwarrior is a regular contributor. Of themselves, these do not prove my suspicions but they lend a lot of support what I think is actually going on right now. I'm therefore going to add another sub-section to this discussion.--Tom (talk) 19:51, 11 February 2008 (UTC)


 * As to your question,
 * "What will the article "socialized medicine" tell us after these changes?"
 * The answer is from your own words:
 * "The history of the term, the current day usage and the claims made about the topic are all examined here in some detail."
 * The sections that I proposed for merger do not currently have any bearing on the usage of the term. If you can make the relation between those sections and the main subject matter more obvious, then that works fine, as well.  Otherwise, you should move the less-relevant text into the "Publicly funded" article and carry the edit war over that-a-way, I suppose.
 * Also, your claim about puppetry is somewhat amusing seeing as my own wiki-relation with some of your opponents on this article is not very cordial. On the surface, the content of the article seems to be fine.... just out-of-place. BigK HeX (talk) 21:07, 11 February 2008 (UTC)


 * I would note that the "Present day implementations" section could easily be made relevant by simply contrasting the existing material to any of the popular (and probably outlandish) claims being made about "people dying while on the waiting list" or whatever. BigK HeX (talk) 21:16, 11 February 2008 (UTC)

General remark about POV issues. Publicly-funded health care article has much less POV than Socialized medicine article, so I would oppose most of the merging edits. --Doopdoop (talk) 21:33, 11 February 2008 (UTC)


 * Doopdoop, perhaps some specificity would be helpful? If you would oppose "most of the merging edits", that implies there might be some you would support. Perhaps you could tell us if any of the specific sections named in this particular discussion seem appropriate for merger? --Sfmammamia (talk) 21:48, 11 February 2008 (UTC)

Oppose There are many types of publicly funded health care. It does not make sense to pull a more specific article into an overview article, especially when the more specific article is larger than the overview article! Kborer (talk) 00:11, 12 February 2008 (UTC)
 * Problem is that the structure of the article made it far less an article about any type of social program, and more about the debate centered on the connotations of the phrase "socialized medicine." So, by analogy, it was more an article about French fries not being from France, than about any type of food. BigK HeX (talk) 00:43, 12 February 2008 (UTC)

Merger prop-hist
Premise. While the article itself seems to mainly discuss the connotations of the term "socialized medicine," this section does not seem to add to that discussion at all, in it's present state. BigK HeX (talk) 17:50, 11 February 2008 (UTC)
 * 'History' Section

Support The history section in socialized medicine is about the rise of this kind of health care arrangement, not the history of the usage of the term. I believe the history of the usage of the term could be expanded in socialized medicine (it's pretty interesting and amply sourced) and the overview of the history of the rise of such systems should be moved here. --Sfmammamia (talk) 18:00, 11 February 2008 (UTC)

Support: See the reasons at my entry below. --Historian 1000 (talk) 18:40, 11 February 2008 (UTC)

Oppose: The reason the history section of the socialized medicine article talks about actual implementations is because socialized medicine is a type of health care system, not just a term for publicly funded health care. Kborer (talk) 00:11, 12 February 2008 (UTC)

Merger prop-impl
Premise. Same as above .... the article itself seems to mainly discuss the connotations of the term "socialized medicine," this section also does not seem to add to that discussion at all, in it's present state. BigK HeX (talk) 17:50, 11 February 2008 (UTC)
 * 'Present_day_implementations' Section

I support the proposal to merge the implementation section in socialized medicine with the article on publicly-funded health care. As I stated in the earlier merge proposal discussion, I believe the article on socialized medicine should remain but focus more narrowly on usage of the term in political framing. Implementation details of so-called socialized systems do not belong there, in my opinion. As I stated earlier, I see the article on publicly funded health care as a summary style umbrella that summarizes the global range, variety and complexity of systems of public health care funding, linking to more specific articles on the most frequently mentioned national implementations. --Sfmammamia (talk) 17:29, 11 February 2008 (UTC)

Support: See the reasons at my entry below. --Historian 1000 (talk) 18:40, 11 February 2008 (UTC)

Oppose: Again, it makes little sense to take a list of different kinds of apples and put that list in the fruit article.


 * It can in some cases. (Maybe not here, though, if what you're saying is true.) BigK HeX (talk) 00:45, 12 February 2008 (UTC)

Oppose. The section is short and contextual and therefore should remain in socialized medicine. --Tom (talk) 06:21, 12 February 2008 (UTC)

Merger prop-critics
Premise. Same as above .... the article itself seems to mainly discuss the connotations of the term "socialized medicine," this section also does not seem to add to that discussion at all, in it's present state. BigK HeX (talk) 17:50, 11 February 2008 (UTC)
 * 'Criticisms' Section

Support: Socialized medicine is synonymous with publicly-funded health care, albeit it is a negative term. It is not a term that is generally applied in academia. A simple internet search shows it to be used in primarily a politically charged fashion. Since the purpose of an encyclopedia is to educate, the term of socialized medicine should either be a redirect or, at best, a section of publicly-funded health care so readers understand that it is another way of referring to it. And although it is primarily a U.S. term, Americans make up the largest single portion of the English speaking world and this is the English language Wikipedia. The fact that it is principally a U.S. term can easily be covered in the publicly-funded health care article. --Historian 1000 (talk) 17:24, 11 February 2008 (UTC)


 * Comment. Well, the article itself seems a decent breakout of a topic that I wouldn't necessarily want to wade through if I just wanted to get the meat of publicly funded health care. I agree that the articles should be separate, BUT I am suggesting a few of the sections from that article be merged. BigK HeX (talk) 17:33, 11 February 2008 (UTC)


 * Comment: Here is how Columbia Electronic Encyclopedia defines socialized medicine: "Socialized Medicine, publicly administered system of national health care. The term is used to describe programs that range from government operation of medical facilities to national health-insurance plans. In 1948, Great Britain passed the National Health Service Act that provided free physician and hospital services for all citizens..." Even though I firmly believe the two should be one, I support the merging of sections. --Historian 1000 (talk) 17:46, 11 February 2008 (UTC)
 * Understood ... (but I have no desire to choose a side on that debate :-D
 * Seems reasonable that all parties that have chosen a side could see that some bits of the socialized medicine article are not strictly relevant to the usage/connotations of the term. So, this merger should be able to avoid interfering with that on-going debate. BigK HeX (talk) 17:56, 11 February 2008 (UTC)

Oppose I actually think that moving the criticisms section from socialized medicine to this article would be a mistake, as it would unbalance that article (which also has a lengthy "Support" section). This points to a larger problem: there are currently three articles with sections that essentially cover the same territory -- the debate around government's role in health care. There's a short treatment of that in this article, a side by side treatment of it in universal health care and the lengthy, rather rambling treatment of it in the "Support" and Criticisms" sections of Socialized medicine. Is it possible to conceptualize an article just about the debate, and leave only a short summary about the debate in each of these articles with a pointer to the debate article? Thoughts on that? --Sfmammamia (talk) 21:24, 11 February 2008 (UTC)


 * I agree with the problems elucidated by Sfmammamia. Of course, this is why Socialized medicine should be merged into Publicly-funded health care (I realize this has already been discussed with no consensus reached). Regardless of whether these section moves are done or not, the same kind of material will start to creep back into both pieces. Universal health care, though, should remain separate. I don't think that a separate article on the debate is a good idea as it further dilutes the accessibility of information to people who aren't wikiholics. --Historian 1000 (talk) 21:58, 11 February 2008 (UTC)
 * One more thought on this discussion: One reason that I am opposed to the retention of the Socialized medicine article is that it lends credibility to the term "socialized medicine." As I have previously stated, this is not a term that is regularly applied in academe, and it almost always is used in a politically partisan manner by members of the political right. According to Jonathan Oberlander, a professor of health policy at the University of North Carolina "The term socialized medicine, technically, to most health policy analysts, actually doesn't mean anything at all." Since Wikipedia is unlike a regular encyclopedia with professional editors, a disparaging term such as this invites unprofessional POV editing. --Historian 1000 (talk) 08:28, 12 February 2008 (UTC)


 * One thing you may wish to consider Historian 1000. It is a legitimate matter to consider the pros and cons of central planning in health matters. The UK has socialized medicine with a lot of central planning (although a lot is regionally based rather than nationally based) whereas Canada for example is more or less a single payer system where the regional government picks up the bill but does not direct health care matters in quite the same was as is done in the UK. Centralized planning could be a good or a bad thing, but the question is whether there is any evidence one way or the other to say how it affects outcomes (medical outcomes, costs, responsiveness etc.). One the one hand you have mostly free market health providers making their own investment decisions but funded by the public purse on a treatment-by-treatment basis, and on the other centrally funded and directed health care where invest decisions are made centrally. In addition to investment being different, billing structures also vary. One system requires a total cost tracking and billing infrastructure and compensation infrastructure right down to patient level. The British system has no need for any of this. Where in Wikipedia should these comparisons happen? I am inclined to think that it should be in the socialized medicine article, even though like you, I dislike the term enormously. --Tom (talk) 12:29, 12 February 2008 (UTC)


 * Tom, I think your points about the British vs. Canadian system are valid and instructive. I also agree with you that "socialized medicine" is primarily a U.S. term. An internet search will reveal it to be principally a term used by Americans, even when referencing other countries. I also argue that the term of "socialized medicine" violates NPOV since it is used primarily in a derisive manner. I have an answer to your question and what I'd like to put forth as a solution. As to where the comparative analysis of the different systems of publicly-funded health care should go, I feel that it should go into the article entitled Publicly-funded health care. And since "socialized medicine" is primarily a U.S. term, why not rename the Socialized medicine article Publicly-funded health care in the United States. The references to other countries could then be merged into the article Publicly-funded health care and the rest could remain in the newly named piece. Socialized medicine could then redirect to one or the other. Sadly, if this is agreed to, I do not currently have the time to make these changes myself. Also, if the page is renamed, I would not want to lose you as an editor here as you have done excellent work. --Historian 1000 (talk) 21:27, 12 February 2008 (UTC)

Oppose The criticicism section in socialized medicine is the right place for the claims made about socialized medicine to be aired. These claims are often made in the context of the word socialized but not usually in the context of public funding. As Sfmammamia says, it would unbalance the publicly funded health care article which already is unalanced due to a long section on debate which is mostly centred on the U.S.  Publicly-funded health care should carry neutral factual information about health care that is publicly funded and givr a global perspective, Contraversial U.S. focussed claims that are made in the context of socializrd medicine should be kept in the socialized medicine article to prevent further imbalance towards U.S.  politics creeping into the main article. --Tom (talk) 06:18, 12 February 2008 (UTC)

Oppose: I think that section should be deleted. Kborer (talk) 00:11, 12 February 2008 (UTC)

Merger prop- the remaining article
Premise Users of the term socialized medicine make certain claims about the subject which are "verifiably false" or "deliberately misleading". If the criticism section is merged with publicly-funded health care, should the remaining socialized medicine article, if it contains links to example of use that are "verifiably false" or "deliberately misleading" ensure that the reader is aware of this in order not to mis-inform the reader? —Preceding unsigned comment added by Hauskalainen (talk • contribs) 20:26, 11 February 2008 (UTC)


 * No. The "verifiably false" assertions need elaborations about how they were disproven.  If there is NOT still a large following for the assertions, then they need to be deleted from the article outright.  IF there IS still a large following, then it should stay in the article, with notes about the proven falsity.  If there is any material in the proposed sections that is notable and contradictory to the existing text within the "Publicly-funded health care" article, then they can be contrasted for balance.  Merger of any disputed material will likely result in an edit war in the new article, though.  However, the sections I proposed for merger do not have much relevance to the primary discussion of the article -- they should be made more relevant or merged/deleted. I'm not a fan of deletion, so merger seems more appropriate. BigK HeX (talk) 20:56, 11 February 2008 (UTC)
 * Also, I have 3 questions then...
 * Exactly which material is "verifiably false"?
 * Why is it still standing in the article?
 * Further, how exactly is it relevant to the discussion of the usage and connotations of the term "Socialized medicine"?

Oppose: there is no reason to bog down another article with more indirect arguments. Kborer (talk) 00:11, 12 February 2008 (UTC)

Support. The cancer claim by Giulliani is a good example. The claim is examined in some detail in the article and shown how it is a false use of statistics to lead the listener to the conclusion that socialized medicine is somehow failing. The reason it IS in the article is that it is current data and people seem to be interested in it for that reason. There are many other claims that are exposed in lesser detail in the criticism section. It is best that these criticisms are aired in the socialized medicine article and not in publicly funded health care. Therefore '''I support retention of material about the claims made about socialized medicine in the socialized medicine article. ' In answer to the issue of relevance above, it is relevant to usage'' because the users of the term nearly always do so in the context of an attempt to persuade the reader or listener that socialized medicine is a "bad thing"... it is a political device. —Preceding unsigned comment added by Hauskalainen (talk • contribs) 06:34, 12 February 2008 (UTC)