Some may say that the debate between Capitalism and Socialism has long been concluded with the fall of the Former Soviet Union. While it is true that large scale Communism will likely never be tried again, the debate continues in smaller forums. Michael Moore’s recent film ‘Sicko’ reignites this debate as it pertains to healthcare.
In so doing, the global pros and cons of either system need to be considered when applied to healthcare. The nutshell ‘con’ of Socialism is that it fails to motivate people and deliver supplies and resources efficiently. In turn, the nutshell ‘con’ of Capitalism is that it can be very cold and tunnel visioned, in that it is only profit seeking, which may go against the true desires of its citizens.
When we apply Capitalism or Socialism to healthcare we see the inherent strengths and weaknesses of either system manifest themselves. Specifically, we find Capitalism style healthcare too cold and non-inclusive. However, Socialized healthcare again has problems of motivation of healthcare providers and delivery of cutting edge technologies and services in a timely manner. We’ll work a few examples to flesh this out.
Suppose you are in your doctor’s office and, heaven forbid, you are given the most feared diagnosis in medicine: Cancer. You may or may not want to live in a country with Socialized medicine. This author lives in Canada which is far from the masterpiece of healthcare that Moore seems to paint in his film. I may remind Moore that another man’s grass is always greener and another man’s bill of health is always cleaner.
Canada has a long history of socialized institutions from gas, phone service, electric utilities, etc. to healthcare. But long gone are the halcyon days of government institutions. In recent years there has been a spate of privatization with private health clinics and tiered systems for healthcare already on the table. Having said all that, Canada still maintains a socialized healthcare system, at least for the moment.
Returning to our dreaded Cancer diagnosis, the word on the street in Canada is that our doctors are often not aggressive enough in treating Cancer. Many hugely expensive, yet promising, courses of treatments are avoided due to long wait times or simple unavailability. It is a common practice of Canadians to drive into Buffalo for example for a faster MRI. Having said all that, suppose you are low on funds and are recommended a course of chemotherapy. In this case, ignoring the wait times, you’d want to live in Canada where this is covered. Make no mistake about it, socialized medicine is something that I’m quite proud of as a Canadian, however, it is necessary to make sure we don’t exalt it as a panacea when in fact, it is not. In the final estimation it suffers from the same inherent problems of Socialism, lack of motivation and problems with resource delivery.
Turning our attention to Capitalism as it pertains to healthcare, we again will use Cancer as an example and this time we’ll examine the Pharmaceutical industry. Imagine for a second that I told you there was a new substance which, in mice, was able to shrink lung, breast and brain cancers. This substance was able to target Cancer cells specifically eliminating most, if not all, of the side effects of conventional cancer treatments. You’d think the pharmaceutical companies would be beating a path to the researcher’s door but they’re not. The reason? The compound the researcher works with is about as common as table salt. DCA (Dichloroacetic acid) is a common laboratory compound already available from any chemical supplier. Most importantly, it’s not patentable. As a result, drug companies have no way of recouping any money they pour into its research in human trials. As a result the researcher (Dr. Evangelos Michelakis out of the University of Alberta) is left to ‘pass the hat’ to try to collect the necessary funds to conduct the human trials. Here we see the tunnel vision of Capitalist style healthcare, overly focused on profit, while failing to accomplish the task it was assigned: providing health care.
Thus we see that neither Capitalism nor Socialism make the perfect pill for solving the problem of healthcare. What then do we turn to? We need only parse out ‘healthcare’ into its two parts, health and care. The key to the problem is in the caring. We can try for as long as we want, and as hard as we want to apply different methodologies, but in the end they will all fail if we try to remove ‘care’ from healthcare. In a socialized healthcare system, we still need doctors who care and are motivated and we need politicians to care enough to manage to keep up with the frenetic pace of healthcare developments. In a Capitalist style healthcare system, we need the system to care enough to occasionally ignore profits and look at the more global picture to avoid having the system tunnel visioned and not inclusive. In any case, the key metric for any healthcare system should be measured in units of caring.
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