“Socialized Medicine” R.I.P.

Who’s afraid of the big, bad bogeyman?

The media searching for a new healthcare angle to cover during the long wait until the Pennsylvania primary might want to look at a recent poll from the Harvard Opinion Research Program and Harris Interactive. Its key finding: the term “socialized medicine” tossed out by candidates Mitt Romney and Rudy Guiliani early in the campaign—and likely to show up again before November—is no longer the scary bogeyman it once was. The term, shorthand for “medical and hospital services for a population administered by an organized group such as the government and paid for by assessments or taxes,” caught on in the late 1940s, when the American Medical Association hired the PR team of Clem Whitaker and Leone Baxter to shoot down President Truman’s national health insurance plan and keep public opinion hostile to the concept. Whitaker told a reporter at the time, according to Jill Quadagno’s 2005 analysis, One Nation Uninsured: “All you have to do is give it a bad name, and have a Devil. America’s opposed to socialism so we’re going to name national health insurance ‘socialized medicine.’” The name stuck—spoiling every effort at reform ever since.

And it is being trotted out again, despite the fact that no candidate in America has put forth anything even remotely resembling a socialized system, but rather a mishmash of very capitalistic schemes to get more people medical coverage. But now the term “socialized medicine,” says Harvard professor Robert Blendon, “doesn’t have the same potency it had years ago.” Blendon and colleagues found that a little more than one third of adults think that socialized medicine would be worse than the system we have now. More significantly, majorities of people associate the term with popular policies such as Medicare and a government guarantee that everyone have health insurance. Of those who said they understood what “socialized medicine” means, nearly 80 percent said it means the government makes sure everyone has health insurance, and 73 percent said it means the government pays most of the cost of healthcare. Only about one third of adults believe socialized medicine means that the government tells doctors what to do—the AMA’s rallying cry in its decades-long crusade against national health insurance.

The poll found, however, that the old, ideological fears still bug Republicans. Seventy percent of them said that a socialized medical system would be worse than our current system, but 70 percent of Democrats believe it would be better. Still, says Blendon, using the term won’t have much impact on the election because independents have a more positive view. It won’t, that is, unless the press allows the candidates, and the special-interest groups that support them, to make socialized medicine into a demon again.

And the poll, which was released in mid-February, received scant interest from the media. The Los Angeles Times published a story giving some of the term’s history. Reuters also picked it up, emphasizing the split between Democrats and Republicans. Several smaller outlets and Web sites ran those stories. But that was it. Perhaps the news peg had exited the field with Romney and Guiliani, or perhaps news outlets simply didn’t find the poll’s results that exciting. If that’s the case, though, they should look at them again, given how powerful the term “socialized medicine” has been over the years—and, more importantly, the likelihood that it will resurface when the Democratic candidate and John McCain, who has proposed a very limited, Bush-like approach to reform, fight it out over healthcare.

Memo to editors: You don’t always need a news peg to enlighten your audiences. But when a news peg does show up, explain what the term means, how it came to be, and what the public now believes about it.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.