Publicly funded medicine

Publicly funded medicine is a level of medical service that is administered and provided by the government and paid wholly or in majority part by public funds (taxes).

Publicly funded medicine is often referred to as "socialized medicine" by its opponents. It is the primary provider of medical services in most industrial societies, including in Europe, Canada, Australia, New Zealand, Israel, and Japan. The United States is a notable exception. Even among countries that have publicly funded medicine, different countries have different approaches to the funding and provision of medical services.

• In 1948, Great Britain passed the National Health Service Act that provided free physician and hospital services to all citizens. Most doctors and nurses are on government payroll and receive salaries, a fixed fee for each patient assigned, and enhanced payments for specialized treatments or skills. The British National Health Service has been amended from time to time, but is largely intact. Currently, prescription medicines and eyeglasses are no longer free but are provided at a subsidized rate. Funding comes from a health insurance tax and from the national treasury. A private health service also operates in Great Britain.

• In Sweden, the publicly funded medicine system is compulsory. Physician and hospital services are free to all citizens, but are funded through the general taxation scheme.

• Canada has a federally-sponsored publicly funded medical system, but each province may opt in or out. A private health service also operates in Canada.

• In Israel, the publicly funded medical system is universal and compulsory. Payment for the services are shared by labor unions, the military, and the treasury.

Proponents of publicly funded medicine cite several advantages: universal and equal access to care, removal of the profit incentive reduces the percentage of the societal resources devoted to medical care, and creation of uniform standards of care. Proponents often cite these by comparing the state of health of the population after adoption of publicly funded medicine with the state prior to such adoption.

Critics of publicly funded medicine fall into differing groups each citing different disadvantages. One group criticizes the lack of egalitarianism espoused by proponents by pointing to the existence of parallel private providers (either locally or internationally) that removes the equality of service. Further that private providers are typically better paid, those medical professionals motivated by remunerative concerns migrate to the private sector which because of such demand will hire the best practitioners, creating an inequality in quality of care. These critics note studies that show many Canadians go to the United States for care, but the opposite is not true.

Another group of critics opposes publicly funded medicine on doctrinal grounds, espousing the view that the government has no place in health care much less mandating and managing it. This group points to the advantages that capitalism has played in advancing medical technology and practice; that competition is good and allows consumers to decide what they wish to provide; and to the long waits for procedures that occur in some publicly funded medical systems.

Another group of critics focuses on the cost-benefit decisions inherently made by the publicly funded medical boards. Because these decisions invariably affect humans and their medical well-beings, they are particularly controversial. This group points to decisions by various boards based on value judgments not to provide certain services, such as circumcision, cosmetic surgery, contraception, abortion, mental health care, immunizations, often with serious negative consequences.

See also: Health science.