If "socialized medicine" means following the example of what public insurance programs and foreign health care programs do to improve quality, control costs and expand coverage, then it is "high time for a little socialization," Jacob Hacker, a professor of political science at Yale University and a fellow at the New America Foundation, writes in a Washington Post opinion piece.

Hacker notes that both Democratic presidential candidates -- Sens. Barack Obama (Ill.) and Hillary Rodham Clinton (N.Y.) -- have proposed that workers whose employers do not provide coverage should be able to purchase health insurance from a public program modeled after Medicare.

However, former Republican presidential candidates former New York City Mayor Rudy Giuliani and former Massachusetts Gov. Mitt Romney have "lambasted" the Democrats' health reform plans as socialist, Hacker writes. Current Republican presidential candidate Sen. John McCain (Ariz.), while not using the "S-word," also has criticized Democrats, saying they plan a "return to the failed, big-government mandates of the '60s and '70s."

According to Hacker, "socialized medicine" is an "epithet" that "has been hurled at every national health plan," including Medicare, and " it invokes a visceral public fear that government involvement will drive up costs and drive down quality, wrecking the economy and damaging" the health of U.S. residents.

However, critics of socialized medicine "have it backward," Hacker says, adding that "the only proven way to provide good affordable care to all Americans over the long run is to expand public insurance." According to Hacker, the "one-word answer" to expand health care without raising costs "is 'government' -- specifically, government's ability to lower service prices, streamline administration and get a better deal on drugs, thus reducing medical inflation over time." While "these are only the direct savings," reducing the "burden of health care on employers will allow them to compete more effectively (and on a level playing field) with foreign producers," Hacker says, adding, "Just as important, making coverage affordable for everyone will allow people to change jobs or start their own businesses without the fear of catastrophic costs or the hassle, expense and inadequacy of individually purchased coverage."

Hacker concludes, "Maybe socialized medicine doesn't sound so bad after all" (Hacker, Washington Post, 3/23).

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