As I stood more than six feet from two of my acquaintances, I listened to their complaints about vaccination scheduling.  One recalled hours on the telephone to arrange an appointment for an elderly relative.  The other described the futility of attempting to get scheduled on-line for any of the three vaccines against Covid-19.  I had heard many other friends and neighbors report similar problems with getting an appointment and had little to add to the complaints. I had no problem or delay in getting scheduled and vaccinated several weeks ago, but this was probably just dumb luck, given the endless tales of woe that I had heard from many people.  When it came to complaining, I was usually a major contributor to the dissatisfied cohort. As I listened to the two men rehearse their misfortunes, I could only listen sympathetically and nod intermittently. As the diatribes subsided, one of the men announced, “And that is why I will never support socialized medicine.”

That comment roused me from my stupor, but it was too late. The two gentlemen stopped talking and exited to their respective offices. At last I had something to add to the conversation, and my audience had evaporated.  It was probably of no consequence. When I have broached this subject with other people, the audience routinely evaporated shortly after I started talking.  Whether they leave before I speak or shortly after I start speaking seems to make no difference.  Most Americans have the view that socialized medicine is to be avoided at all cost. Ironically, these same citizens would probably allow limits put on the number of semi-automatic rifles they can buy before they would surrender their access to Medicare, a form of socialized medicine. You may think one thing (firearms) has nothing to do with another (health insurance), but as a physician who spent decades working in emergency rooms, I can assure you that both things have a profound effect on the general health of Americans.

Medicare is and has been for many years one of the most popular programs the federal government devised and maintained.  Democratic, Republican and Independent legislators have supported it and expanded it.  It faced fierce opposition from national healthcare provider organizations, including the American Medical Association (AMA), as “liberal” forces argued for its adoption.  No less eloquent a spokesperson than Ronald Reagan, a Democrat until 1962, was seen in television ads informing the public of this dangerous innovation.  Reagan and less effective pitchmen argued that Medicare was the first step toward socialized medicine.  The very survival of capitalism in America was at stake. People needed to stand up and refuse to accept national health insurance in any and every form.  The AMA prophesied that the American healthcare system, the “envy of the world,” would decay and collapse if “fee-for-service” healthcare was undermined. These efforts to block Medicare failed. The program was adopted, despite its threat to capitalism, and Medicare is now viewed by most Americans as being part of their birthright, along with limitless supplies of AR-47 rifles.

The point I was about to make to my two vaccine applicants was that we already have socialized medicine and problems with scheduling vaccination appointments has nothing to do with medical practice, socialized or otherwise. In fact, polls indicate that much of America would welcome a Medicare-for-all system.  Alternative insurance plans have enough small print to confound an astrophysicist and enough provisions and provisos to make a corporate lawyer giddy. If you have Medicare, the cost can be deducted from your Social Security (another threat to capitalism) and your bill gets handled by a system that does not send you reams of paper explaining why you ended up paying for expenses your insurance agent told you not to worry about. If you have Medicare coverage, I need not explain the benefits.  If you do not have Medicare, I need not point out the problems with your medical insurance.

Many industrialized nations have had socialized medicine for decades and provide high quality healthcare.  Based on my own experiences in several of these countries, I would argue that they provide higher quality healthcare to most of their population than is available in our country.

As for those scheduling problems for vaccinations, blame your government representatives. You elected those people who knew a year ago that a rapid vaccine deployment program would need to be in place and fully tested as soon as a vaccine was produced and approved.  Archaic computer systems and incompatible programs were not upgraded in anticipation of a massive scheduling challenge. Even as priorities were being set for vaccine distribution, no national coordination was developed (or exists even now).

What used to be called “black market sales” are now being dismissed as misunderstandings or misdirections, rather than as the illegal diversion of essential medicine [Orson Welles explains how this works in “The Third Man,” a movie released in 1949]. As hundreds of thousands of Americans died and many more were crippled by Covid-19, the federal government assured us that we need not inconvenience ourselves with routine safety measures, such as wearing a mask, and that a vaccine would soon put all of this “trouble” behind us without the federal government establishing any mechanism to provide for the mass distribution of medicines and other materials as they became available.

One need not fear the expansion of socialized medicine. It will not kill you or those you care about.  If it continues to grow in our country, we shall end up with health systems that have proved highly successful in many industrialized nations.  If it is kept in quarantine by the insurance and healthcare giants that hoped it would be stillborn, we shall continue to have the opportunity to read insurance policies that seem to offer little more than coverage for radiation burns sustained during nuclear wars. We shall spend a small fortune for little coverage, but at least we shall be spared the horror of socialized medicine.

Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan.  He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the USA, as well as in England, Germany, and France.

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