Times Staff Writer

The term "socialized medicine" may be losing its boogeyman status, according to a survey of voting-age adults. Long uttered in warnings against any sort of government involvement in healthcare, today the term has largely lost its scare power.

That's according to a study led by Robert Blendon, professor of health policy and political analysis at the Harvard School of Public Health.

"This is a term from the 1940s," Blendon says. "We wondered if anyone even knew what it meant anymore." To find out, his team, along with pollsters at Harris Interactive, asked more than 2,000 people in two surveys what they knew about the term. Among the findings, released Feb. 14:

* Of the respondents, 67% said they understood what "socialized medicine" meant. Of those, 79% said the term means that the government makes sure everyone has health insurance. Only 32% said it means that the government tells doctors what to do.

* Of those who said they understand the term, 45% said that if America had socialized medicine, the health care system would be better, while 39% said it would be worse.

* Not surprisingly, opinions differed according to respondents' politics. Among Republicans, 70% thought socialized medicine would make the healthcare system worse. Among Democrats, 70% thought it would make things better.

Independents were split more evenly, with 45% saying that socialized medicine would be an improvement, and 38% saying it would be worse than the country's current healthcare system.

"It's still an emotionally charged term for Republicans. The phrase itself gets them very angry," Blendon says. "But Democrats and independents don't see it as a term that drives them away."

The words "socialized medicine" have turned up at just about every discussion of government-sponsored health insurance in America's history going back to Franklin D. Roosevelt, who, after unemployment insurance and Social Security passed, wanted to develop a national health insurance program. The term was used at that time by the American Medical Assn. to attack the idea.

President Truman followed in FDR's footsteps with a national health insurance plan that once again was attacked by the AMA and some politicians using the phrase; that plan died too. The phrase had its heyday in the post-World War II years and through the 1950s and 1960s, when it was tightly linked to the threat of the Soviet Union and the postwar Red Scare.

The pejorative and loaded term almost killed the famous Framingham Heart Study, which began in the late 1940s and ultimately uncovered major risk factors for heart disease.

Dr. Thomas Dawber, then director of the study in Framingham, Mass., later said he had to work hard to convince volunteers and the town's doctors that the study was not a form of creeping socialized medicine. He held meetings to assure them that government wasn't going to snoop into medical records, steal patients or tell physicians how to practice their profession.

The term raised its head again through the 1960s as the American Medical Assn. used it in attempts to discredit government proposals to insure the elderly and the poor. Those proposals, Medicare and Medicaid, were finally signed into law in 1965, 20 years after Truman proposed national health insurance. Symbolically, Truman was the first to sign up for Medicare.

More recently, advertisements have warned against the prospect of government encroachment into healthcare without the actual use of the words "socialized medicine."

The Harry and Louise ads, funded by the Health Insurance Assn. of America, showed a couple despairing over what they claim to be a government takeover of healthcare. The couple in the ads, which ran in 1993 in opposition to President Clinton's proposed health care plan, conclude: "They choose. We lose."

Blendon said it came as a surprise to him and other pollsters to again hear, during the 2008 presidential campaign, what sounded to them like an antiquated phrase.

Former Republican candidate Mitt Romney, talking about Sen. Hillary Rodham Clinton's new healthcare proposal, labeled it "socialized medicine."

And former Republican candidate Rudolph Giuliani said, "Whether it's HillaryCare or ObamaCare or EdwardsCare, the idea that it's not socialized medicine is a trick. It's a massive growth of government control of medicine."

The phrase, says Blendon, is no longer frightening to most people. "It has sort of morphed in the American mind into making sure everyone has coverage."



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