The Thinking ‘Kat: Capitalism, Socialism, and Everything In-between
Once upon a time, I had written some posts in response to Citizen Tom’s musings on democratic socialism. What with the reboot of Meerkat Musings, those posts are now in the ether, and rather than merely copy and paste them, I thought it would be better to come at this subject fresh, so to speak. Tom provides some food for thought, though I am using his post less as something to debate, and more as a jumping off point. There’s a fair bit of nuance to this, and a fair few elements where matters are quite black-and-white, so with that in mind, where to begin?
It would be fair to say that unfettered socialism (which is similar to communism, though the two are often inaccurately conflated) has frequently been demonstrated to cause a great many problems. The theory is that means of manufacturing and distribution are placed into the hands of the workers, into the hands of society, as opposed to remaining in private hands. Countries which have tried this don’t tend to fare especially well. The extremes (such as communist Russia and China, and North Korea) are not nations that anyone would care to live in. Of course, the opposite extreme – where everything is trusted to profit-led corporations – doesn’t tend to work very well either. A key demonstration of capitalism gone mad can be seen with the American healthcare system, especially when this is compared to the healthcare systems elsewhere in the world.
Private vs Public Healthcare
At its best, the US system is one of the best in the world, but that tends to be for those who can afford it. The uncontrolled pursuit of wealth, and the love of money that pervades US society, has created a tiered healthcare system. As such, 66% of all US bankruptcies are related to medical matters. In the UK, this percentage is considerably lower, at 8%. In the USA, the average cost of an insulin vial is $99; in the UK, it is $7.50.
To look at it another way, is it morally or ethically acceptable to fight so hard for the principles of earning wealth, above and beyond providing healthcare services? Because that is the current US system in a nutshell. Shareholders, not patients, are the priority. Not only is this the case, but there are situations where the outcome is considerably worse, despite the eye-watering sums of money that US citizens have to pay. As a grim example, let’s consider child-birth.
In 2017, the average cost of a planned delivery or C-Section was about $2,300 in the UK. This is not an upfront cost either; it is part and parcel of the NHS, paid for via taxes. In the USA, the average cost of a planned delivery was $30,000 in the same year. Not only is this a staggering difference, the parents are billed by the hospital for the service. Not only that, the USA has a much bigger problem with maternal mortality. In fact, one of the worst places in the entire developed world for maternal mortality is the state of Texas.
On top of all of that, US hospitals even charge parents for holding their baby.
Currently, the best healthcare systems in the world are found in Singapore, Japan and South Korea. Singapore operates a sort of hybrid system, with a significant, unregulated private sector, but also robust public sector involvement too. Incidentally, Singapore has the greatest life expectancy of any country in the world. Japan also has a hybrid system, but hospitals must be run as non-profit organisations, and other fees are under strict regulations, to prevent exploitation. South Korea has a system of universal healthcare, funded by various means.
Among the best healthcare services in Europe, you have Denmark. The Danes enjoy a system similar to the UK’s NHS, with better results. Germany also has a noted healthcare system, and it is once again a hybrid system, albeit one that favours a national healthcare service. Both Denmark and Germany enjoy a healthcare service that scores considerably better than the USA’s system. This is one area where it seems the ‘socialist’ attitude of keeping vital public services in public hands is more beneficial than the alternative. After all, the US system ranks 69th in the list, well below numerous countries to have developed national healthcare services.
There are plenty of areas where government involvement should be muted. It is healthy to have competition in some sectors. In others, corporate greed overwhelms anything and everything else. The love of wealth overcomes the purpose of providing a public service. This can be seen in the UK rail network, which has seen fares rise twice as fast as wages. It can also be seen in the UK’s energy and water suppliers. The decline of these vital public services has been matched by the rapidly-rising wealth of shareholders and executives, yet the suggestion that these industries be returned to public control is met with all sorts of scare-mongering, despite the evidence. Most businesses – especially when placed in charge of huge public-sector operations – will raise prices, cut spending, and cut corners. They will do so via any and all means they can use. I do not pretend that governments are brilliant at operating everything, but the proof that trusting CEOs and executives to look after your interests is a mistake can be seen, in very sharp focus, in the US healthcare system, as well as the UK’s rail, water and energy sectors.
