dissolution post

This discussion is based on the required reading for this week (Starr, Chapter 6), and previews your reading for next week (Starr, Book 2, Chapter 1).

Some important concepts to review:

  • In the 1900’s, following the gains made after the Civil War due to science, technology, nursing, improved hospitals, and establishment of creditable medical schools and professional associations, physicians were still struggling to establish their medical authority, status, and prestige.
  • Most physicians advocated for the “private practice” model where there was nothing (other medical providers or employers) that came between the physician-patient relationship.
  • Competing with the physician private practice model was “contract practice” where employers hired physicians to take care of employees. Often the employer who hired the physician had opportunity to influence medical practice to cut costs. Providing medical care through contract physicians, or offering a health plan, became perk that labor unions adopted. Healthcare sponsored by labor unions was huge in the 1920’s and 1930’s and contributed to their dramatic increase in membership.
  • Corporations were new during this time and they started offering contract physicians and health plans-sometimes without a medical license to do so.
  • There is another side to this: Much later, in 1945, Kaiser Permanente got started. Kaiser is the most successful model of employer-provided contract physician model in the history of the U.S. Regardless of your opinion of Kaiser Permanente, the integrated medical services using a large physician group practice is the most efficient (profit making) and high quality (based on performance measures called HEDIS) health care service today.

So, here is my point: In the 1900’s, most physicians wanted nothing to come between them and the patient. Most physicians considered socialized medicine (at that time, getting its start in Europe), corporation/union involvement, and other medical practitioners (pharmacists, lay-healers, contract physicians) as a threat to their sovereignty of medicine. And the concern (or the fight) goes on today…

When it comes to the history of U.S. health care, you are living in an extraordinary time. There are some real important things happening right now-and you are a witness to history.


This is important for you to know: As the instructor for this course, I will not interject my personal views or beliefs about health care into the course. You must contemplate the information presented and form your own opinion. With that said, the intent of the following exercise is to give you the political context of what health care has endured over the years.


Since the 1930’s, opponents of universal health care (a system where all Americans have health care) and single-payer health care (federal government funds and manages all health care) used the term “socialized medicine” to vilify (make the villain) any efforts for health care reform.

It seems, even in our modern time, “socialized medicine” is sometimes used to characterize the Affordable Care Act (Obama Care), or more recently the Medicare-for-all Democratic campaign promise by Bernie Sanders (whether it is true or not-that is up to you).

Since you will be voting in the Presidential Elections this November, you should arm yourself with information to make an informed choice.

Albeit we don’t hear much about “Medicare for all” anymore, the idea of universal health care is still popular, especially in California. For the past 15 years, there has been initiatives to start universal health care in California and each year it has been defeated.

Listen to how “socialized” is used as a bad term in this short speech (38 seconds):

“We don’t want the socialized healthcare they have in Canada:” Mike Pence on healthcare (Links to an external site.)"We don't want the socialized healthcare they have in Canada:" Mike Pence on healthcare

Don’t forget to skip the ads…

If the link is broken, search Youtube for “We don’t want the socialized healthcare they have in Canada: Mike Pence on healthcare”

Listen to this doctor explain how Medicare is socialized medicine (3 minutes, 38 seconds):

It Turns Out, Medicare IS Socialized Medicine. (Links to an external site.)It Turns Out, Medicare IS Socialized Medicine.

Don’t forget to skip the ads…

If the link is broken, search Youtube for “It turns out, Medicare is socialized medicine”

For the last video, watch and listen to a former U.S. president lobby on behalf of the American Medical Association (AMA), which was opposing the amendment of the Social Security Act to include Medicare (Yes, it’s a long one-10 minutes and 6 seconds; but it’s worth every second if you want to learn about the attitude of free enterprise and physician autonomy during the 1960’s):

Ronald Reagan – Medicare Will Bring A Socialist Dictatorship (Links to an external site.)Ronald Reagan - Medicare Will Bring A Socialist Dictatorship

Don’t forget to skip the ads…

If the like is broken, search Youtube for “Ronald Regan-Medicare will bring a socialist dictatorship”

Discussion Board Questions:

Answer both questions (there are 2) and respond to at least one classmate.

  1. Our law enforcement and fire protection are government services that are universal to all people in America. The Police and Fire departments provide the same level of service to all within their jurisdictions. Police and Fire departments are tax-payer funded and run by the local government. Some would argue that these services (police & fire) are a form of socialism. Others argue that these services do not fit the definition of socialism and that they are only a public-good project funded by the tax-payers. So…how would you classify a single-payer universal health care system in America? Socialized medicine or a public good funded by the tax-payers?

2. Did you know, that if you are working, you are contributing money from your paycheck into the Medicare system? You are pre-paying for your entitlement to have health insurance once you retire or if you have a disabling injury or illness. Ask someone you know (retired parents, grandparents, or an elderly neighbor) if they think Medicare is a good thing or if it needs to be changed.

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