 Jonathan Oberlander, a professor of health policy at the University of North Carolina, maintains that the term is merely a political pejorative that has been defined to mean different levels of government involvement in health care, depending on what the speaker was arguing against at the time.The term is often used by conservatives in the U.S. to imply that the privately run health care system would become controlled by the government, thereby associating it with socialism, which has negative connotations to some people in American political culture.As such, its usage is controversial, and at odds with the views of conservatives in other countries prepared to defend socialized medicine such as Margaret Thatcher.