>Socialized (or single payer) health care exists only in those advanced
>capitalist countries where it was achieved *before* the insurance
>industry achieved its present political strength. I have encountered
>few left prophecies so wildly optimistic as this one. I hope Kelley is
>right, but I suspect revolution would be easier than getting
>socialized medicine through Congress.
Socialized medicine does not equal single payer. The Single-payer arrangement mply lowers the transaction cost of health care delivery (i.e. reduction of administrative staff hospitals must hire to find out what is covered by the plethora of insurance plans, filing paperwork required by them, etc. as well as administrative staff of insurance agencies providing coverage). So it is primarly a cost-efficiency issue.
The most politically important (at least for the left) aspect of socialized medicine is universal coverage and that does not require a revolution. In fact, such coverage does not even require a marxist ideology to justify it - neo-classical concept of "market failure" (or public good) will do the trick. In other words you can keep private health insurance "as is" with one important exception - treat all uninsured persons as a "market failure" which becomes the responsibility of the state. The state provides health insurance to those people either through a commercial or a not-for-profit insurer by subsidizing the premiums. The state's cost is then passed on either taxpayers directly or as an uninsured surcharge to private health insurance plans (pretty much in the same way "uninsured motorist" covrage works in auto insurance industry).
The bottom line is that attaining "socialized medicine" in the sense of universal coverage is much easier than it appears -- all it takes is effective lobbying to include permium subsidies for the uninsured in the budget. Striving toward a single payer is a distraction from that goal.
wojtek