08/19/2026
Perhaps “socialism” is simply prudent accounting.
As a physician, I find America’s approach to healthcare increasingly indefensible.
The United States spends $14,885 per person on healthcare - 2½ times the average of the 38 wealthy democracies that make up the OECD, the Organisation for Economic Co-operation and Development. The OECD average is just under $6,000 per person.
And what do we get for it?
Our rate of preventable deaths (deaths that could potentially be avoided through effective prevention) is 217 per 100,000, compared with 145 across the OECD. Life expectancy in the USA is also 3 years lower too.
Meanwhile, the One Big Beautiful Bill Act, signed into law by President Trump last year, cuts federal Medicaid spending by more than $900 billion over ten years. Its new work requirements alone are expected to leave millions of Americans uninsured.
This is the part I struggle with as a doctor.
Britain has the NHS. Canada has publicly funded provincial healthcare. France and Germany use universal insurance systems. Italy has the Servizio Sanitario Nazionale, Australia has Medicare. They are not identical, and none is perfect. But they share one rather important idea: getting sick should not mean losing access to healthcare.
And universal healthcare should mean just that - universal. It should include preventive care, maternity care, contraception, cancer screening, mental healthcare and the right of a woman to make decisions about her own pregnancy with her doctor, not with a politician.
We have somehow made the phrase healthcare for all sound radical, while accepting a system that costs us twice as much and leaves us with worse outcomes.
If a business spent $14,885 to produce something its competitors produced for $6,000 — and then produced worse results we wouldn't call that capitalism. We'd call it a financial disaster.
Perhaps we should stop arguing about whether universal healthcare sounds “socialist” and ask a much simpler question:
Does it work?
The evidence indicates that spending collectively, negotiating collectively and guaranteeing care collectively can be not only more humane, but considerably more economical and produces better life expectancy.
Sometimes socialism isn't socialism. Sometimes it's just good accounting, with a pulse and a conscience!
www.ruthhaskinsmd.com