By Joseph Hancock — Editor, Labor Today International
The best example of what a national health service is can be found in England. At the end of WWII, the big three; the Soviet Union, England, and the United States agreed to establish national health service programs in their respective countries as part of the Potsdam Agreement for post-war development of Europe. The Soviet Union already had a National Health Service in place. Britain followed in 1948. The United States established the system we have today which is controlled by large insurance companies.1
The labor movement, led by Walter Reuther, President of the United Auto Workers, in the 1930’s opted for employer funded health care, and established benefit trusts that funded employee health care.[ii] Let us examine what National Health Service is and why it is very different from “National” or “Universal” Healthcare.
In 2008, legislation was proposed to create the Josephine Butler United States Health Service Act.[iii] [iv] This legislation had wide support in Congress but was dropped in favor of H.R. 676 which proposed to keep the insurance system in place and only addressed financing. It would not have changed the health care delivery system from private insurance to the public sector.
HR 3000 provided for a complete National Health Service for the United States. The system would be all federal, just like the VA hospitals are. All federal facilities, all federal employees and federal financing. Under this scenario, private insurance companies are removed from the equation. Under this system, there are no claims to be denied and no limits on care. This is far superior to what exists in Canada, which has introduced what are known as Public Private Partnerships (PPP).
In Europe, these national health service programs are under attack from the neoliberal capitalist class along with retirement and Social Security. There are coordinated movements in Canada, England, Italy, Portugal, Spain, Greece, and Ireland to dismantle public health care systems, replacing them with private sector insurance. [v]
In the United States there is a popular national program being proposed by Sen. Bernie Sanders and the nurses’ union, National Nurses United (NNU). This program is especially popular in California, but it is not the National Health Service. Again, the nurses’ proposal would only address financing of health care, not the way that health care is delivered.
In the United States, because care is organized around insurance companies, not everyone is covered by health insurance, prices are exorbitant, and care is at a minimum. Where the trade unions are concerned, most negotiate their health care, and care for family members is threatened. Employers demand concessions each year. If the cost of healthcare is removed from the collective bargaining process, unions are free to demand higher wage and benefit increases as they do in Canada. Compensation does not have to be deferred because it is not employer based in Canada, England, etc. Unions in developed countries with a National Health Service are free to negotiate improved financial packages for their members. Unions can negotiate for extended vacation and sick days, paternity, and maternity leave for parents, because the unions would no longer be responsible for negotiating health care.
The mechanism for how this would work is that each person would be given a national health insurance card, like a Social Security card. Everyone is in, no one is left out. This is not universal or single payer health care. It is true health care. Each time a family member needs medical services, they present their national health service card. It is comprehensive and not an insurance program. Private clinics and hospitals become public hospitals and clinics. Doctors, nurses, and ancillary staff would become federal employees in a system that guarantees medical care for all.
It is opportunist politically to support national health care when a far superior system exists in H.R. 3000. In revolutionary terms, we are confronted with supporting a minimum or a maximum program. The popular movement led by the social-democrats must be opposed in favor of HR 3000 if we are to be true to our communist beliefs. While it is popular, national health care is not the best option. The question is a very simple one. Why settle for half a loaf of bread? This is the principled communist position.
[i] https://www.historyextra.com/period/20th-century/how-was-nhs-created-when-date-national-health-service/
[ii]https://reuther.wayne.edu/node/8610#:~:text=Reuther%2C%20who%20was%20a%20staunch,of%20which%20he%20was%20Chairman.
[iii] At the helm of the movement for national healthcare was UAW President and national labor leader Walter P. Reuther, who was a staunch advocate for the creation of a universal healthcare system in the United States. Indeed, Reuther spearheaded his national healthcare vision through the formation of the Committee for National Health Insurance, of which he was Chairman.