by Kelly McConnell and Joseph Hancock
Part One: National Health Service (The Time Has Come…)
At the end of the victory over German fascism in 1945 Winston Churchill, Franklin D. Roosevelt, and Joseph Stalin met at Yalta and agreements were signed, etc.
When each went home, two of the three established a full national health service – socialized medicine, in their countries. For the Soviet people this was a continuation of their Socialist mission since 1917. For the Brits it was entirely new. In fact, at the famous 1947 speech at Fulton, Mo. in the US where Churchill called for a Cold War against the Soviets, he proudly pointed to the newly established National Health Service [NHS] of England where hospitals were government owned and operated and physicians, nurses, and all other personnel were government workers. To this day, it’s the gold standard in a capitalist economy. The fight has always been to fund it better; never to get rid of it; even under the regime of ultra-right-wing, Margaret Thatcher.
In the United States, the Wagner Murray Dingle [WMD] bill was in Congress ready to be enacted. It would be the US version of the National Health Service [NHS]. The details were not clear, but the intent certainly was. It would not be as government owned and operated like the NHS of the Brits or the Soviets; and not as the French, Italians and Scandinavians working classes later accomplished. In the U.S. model, medical personnel would probably be independent operators; but it was a giant step forward. It was a companion to the 1930s Social Security Act, but the WMD bill wasn’t enacted then.
In the 1950’s, anti-communism was injected into American society in general, and into health care particularly. The American Medical Association (AMA) became the willing pawn in the hands of corporate America and proclaimed that the US would NOT have socialized medicine on its shores. “Socialized medicine” became a dirty phrase in the US. The AMA became the enemy of the working class and progressive health care solutions.
The 1948 election featured the American Labor Party [ALP] with Henry Wallace at its helm, which had a plank for NHS. It would highlight the Wagner-Murray-Dingle bill at its center.
But the right wing controlled the Democrats lead by Harry Truman. The Republicans had Thomas Dewey, and the Dixie-crats, the states’ rights party, had the vile racist, Strom Thurmond, as their fascistic candidate. Truman won and the barbaric future for the US working classes began.
Workers and their unions still wanted a National Health Service which they thought the Wagner-Murray-Dingle bill would become. Corporate America and their newly created anti-communist trade union minions decided they would kill many of their enemies by enacting the criminal Taft-Hartley Act which would outlaw Communists from union life and elections. The soul and spine of the trade union movement was removed. The infamous Smith Act was included in their anti-democratic mix. In 1957 the Smith Act was later deemed to be unconstitutional, but by then the damage was done. In 1947, Truman in a phony action, vetoed the Taft-Hartley bill, but it passed over his veto, as he knew it would.
At the same time, the auto industry, led by the anti-Semite, Nazi sympathizer Henry Ford, offered the newly elected right-wing United Auto Workers union president, Walter Reuther, a health plan for his workers. That’s right! A “negotiated” health benefits package in return for the union’s promise that UAW would STOP urging for the passage of a Federal, national bill: that is, the Wagner-Murray-Dingle bill. Reuther eagerly agreed. This was mirrored with the Social Security legislation just passed a few years earlier; that is, private pension programs were dangled in front of these same backward trade union leaders and in return they would stop fighting for a stronger Social Security benefit program that everyone would enjoy.
The ultra-right General Electric Company was a corporate leader in the anti-union front. GE offered the International Union of Electrical Workers [IUE], its hand selected anti-communist trade union, and its leader Jim Carey, the same dirty deal. The class oriented United Electrical Workers Union [UE] a left-lead union, of course, balked at this deal and fought for the Wagner-Murray-Dingle bill.
The other remaining left lead unions struggled for their principled positions on health care and social security, but the social democratic and right-wing union leaders succumbed to corporate demands buttressed by the crushing weight of the anti-democratic Taft Hartley and Smith Acts. The die was cast.
Since then, a whole business developed with this corporate led health system of profit creating insurance carriers, hundreds of consultants, and private hospitals. Physicians remained private businesspeople under the political control of the AMA. And, the burgeoning pharmaceutical industry was lying in wait to take advantage of new medical discoveries, often made by government researchers, to reap their Wall Street profits.
Feeble attempts to give decent health care in New York City with the Health Insurance Plan of NY [HIP] failed even though it initially gave excellent ambulatory care. Without a back-up hospital service, the health plan was always behind the 8-ball. Group Health Inc., another insurance carrier, was set up by the unions, and despite the help of friendly lawyers, Group Health ultimately became just another insurance carrier.
On the west coast, Henry J. Kaiser, with his growing aluminum company, started the Kaiser health system with ambulatory care and a hospital back up. Kaiser employee loyalty to Kaiser’s corporation for this relatively new industry was paramount. Various versions of these systems have been tried and ultimately have failed; all needed taxpayer subsidies to survive. Kaiser remains, but it acts like any other corporate entity today.
The massive 1965 Congressional reform of Medicare, health services for those older than 65 years of age and some disabled, and Medicaid for very poor working-class people, relieved some of the pressure. Trade unionists and progressive political forces had demanded more at that time. The Democratic Party balked at enacting a Wagner-Murray-Dingle type bill in 1965, even though this was possible. The Democratic Party positioned itself against “socialized medicine,” choosing to side with the American Medical Association on the issue.
These were primarily finance mechanisms and not medical delivery systems. The costs of the system were not addressed. They were still in the hands of Wall Street insurance, banking, and drug cartels. The term “costs” was just another word for the term, corporate profits.
It didn’t take Ronald Reagan to proclaim health care as a business to be best regulated by Wall Street; meaning insurance, banks and drug cartels. It was already rooted in the US system of capitalism.
In each successive presidential election, on the Democrat part, promised a new day, a new health care system. In the 1990s, Clinton’s proposed system failed on its own weight. Presidents Reagan and Bush 1&2, and Republicans generally, proclaimed the private system worked well.
Throughout the past 60 plus years, Communist Party and other independent candidates for President and Congressional seats demanded National Health Service programs. The torch was kept alive. In the most recent election Bernie Sanders called for a Single Payer system. He acknowledged that single payer was a financing mechanism which may or may not actually control hospital and physician activities.
In 1976, the American Public Health Association, 50,000 members, elected to support a National Health Service for the United States. Congressman Ron Dellums of California introduced legislation supporting the NHS bill, and about 12 members of Congress supported it. Since then, Dellums and his successor Barbara Lee have introduced the Butler National Health Service law named for Josephine Butler who was a community health activist in Washington, D.C.
The 2008-09 Obama Administration promised more in his campaign rhetoric, but when elected answered by delivering a federal health care program to the private insurance market with little or no reform of the deadly drug system. Obama said directly to Single Payer supporters, enacting a reform that would have fixed some of the system, “we can’t disrupt the insurance system.” Obama’s campaign speeches supported Single Payer. But instead, we got the Affordable Care Act, which is neither affordable, nor a real system. It has taken massive amounts of taxpayer money to keep the ACA afloat. That’s right! Our money is paid directly to the profit-making insurance carriers to keep them in the ACA business.
The ping pong game played by both mainstream political parties is a game controlled by the neoliberal policies of privatization and corporate profits. In the first two years of the Obama Administration, the Democratic Party controlled by the Senate and House of Representatives. There were excuses during that crucial 2-year period. In 2010, due to the failures of the Democratic Party, the Democrats lost this kind of power and then just hid behind the Republicans for the next 6 years. What we have now is, once again, a full system in crisis. Each Trump or current Republican Congressional answer is worse than ever for the simple reason that less is provided for more cost to workers. The official policy of the Democratic National Committee is just to save the ACA. PERIOD! That is, to protect the monopoly of the insurance companies under the ACA. For example, Hillary Clinton as a lawyer, served on the board of the Aetna Insurance Company, one of the largest investors in health care.
In the past few years, the system itself has catapulted into a new and deeper, barbaric crisis. We now have a complete monopolization of hospitals with so-called Academic Medical Centers running all the hospitals. Of all the hospitals in New York City there are now just 4 or 5 Hospital systems which all hospitals must belong to: most likely because they are all in massive debt to Wall Street bankers, and each of them pays their top administrators millions of dollars. The fundamental corruption is beyond any description. Prices for services, in this monopoly, are set by Wall Street Bankers not by health care professionals. Insurance and drug company executives sit on these monopolized hospital boards of directors.
The new system has private physicians in tow. Physicians can no longer stay in private practices; which could be a good thing; but it isn’t in this situation. These medical doctor groups, which apparently belong in some way to hospitals, are just another new cog in the Medical Industrial Complex system. The corrupt AMA has no legitimate voice anymore.
Drug companies are running amok with billions of profits and no controls. The cost of individual life saving drugs are marketed with ruthless, barbaric immunity. Patients face drug costs well over $100,000 in treatments. Congress holds hearings and the corporate executives laugh all the way to their banks. Lives are shortened. Lives are lost, and suffering has never been greater due to this prescription drug crisis. This does not take place anywhere else in the world. In other countries governments negotiate prices with drug companies, which is why US travelers buy their needed drugs outside of the US.
Mental health coverage has worsened as the crisis of capital gets worse. Veterans of the US endless war machine are turned loose to potentially hurt themselves and others. Too many examples are mounting. In the Spring of 2017, during the NYC Times Square incident, a mentally ill military veteran drove a car into a crowd of people. This is the latest case in point.
Dental care, hearing, eye care, medical transportation continues not to be included in standard health care. Under coverage of most health plans mental health and substance abuse treatment programs are only provided for at a 50% reimbursement rate. Obviously, this is not acceptable.
The Veterans Administration hospital and ambulatory system, a model of a National Health Service, is threatened with massive underfunding and complete privatization. U.S. veterans are once again treated like dirt.
In a strange but predictable way, this monopolization of health care capital was and is predictable. Marx predicted in his writings that this kind of capitalist centralization of power was inevitable, industry by industry.
Single Payer or as its sometimes called, “Medicare for all,” while maybe it could have been a short-term solution in the recent past, has been timed-out with the capitalist crisis being so deep. The new reforms cannot succeed without full control of hospitals, physician care, control of drugs, and full dental coverage.
Make no mistake, trillions of dollars are being spent. The money is there. Trillions of dollars are spent on drug advertising, hospital advertising, drug company and medical supply company subsidies, and so there is plenty of money. Repudiating the crushing debt owed by every national and local hospital system to the banks they are forced to borrow from to create national and local public hospitals is necessary.
The case for a National Health Service has never been more accessible than it was 70 years ago. There are more than enough publicly owned and operated community health clinics and hospitals in the US. They simply need to be expanded and financed. And, today with physician education debt through the roof, with the cost of tuition, there is a large pool of physicians who would work for tuition forgiveness. In addition, Federal facilities need to be utilized to start producing pharmaceutical drugs that private capital either refuses to produce without the motive of an outrageous profit, or simply because new drugs can replace drugs under their control.
Part Two: Social Security
Social Security has been in existence since August 14, 1935. Social Security was never meant to be a complete income in retirement. It was meant to supplement retirement savings so that older Americans could retire in comfort. Efforts are being made now to enhance and expand Social Security benefits. Social Security stops collecting taxes on income when it reaches the threshold of $160,200. Many capitalists reach that limit after only a few hours in one day. The ‘scrap the cap’ was started in the 1980’s by the Communist Party to guarantee the solvency of Social Security. People earning that much money may not have to rely on social security in old age. But most retired Americans need that revenue to strengthen Social Security.
Where does Social Security income come from? Social Security taxes are deducted from the pay of each worker. Employers and employees each pay 6.2 percent of wages up to the taxable maximum of $160,200 (in 2023), while the self-employed pay 12.4 percent. If the cap is removed, Social Security would have sufficient funding toward the year 3023. This one adjustment would allow Social Security to lower the retirement age, covering more workers. This is a significant struggle. Combined with the struggle for a National Health Service, these two struggles unite the working class. Everyone benefits from these programs.
The main demand of the right wing is to raise the retirement age to 70. We need to fight these proposals utilizing all of our resources. In France there is a significant struggle of the French people to lower the retirement age to 60 years. At the same time, by decree, the French president Macron ordered that the retirement age is 64 years. In Germany, Italy, Portugal, and Greece the same struggle exists. Workers want to retire earlier. In some countries, retirement age is 55 years. Assuming people start working when they are 20 years old. When they work 35 years, they retire at age 55. The bosses want to squeeze as much labor power as they can for their continued exploitation of the working class. Raising the retirement age without altering the date when people officially start working creates unemployment. Officially, everyone should declare themselves in support of retirement at age 55. To cover these golden years of life, we need to ‘Scrap the Cap’ on Social Security earnings so that everyone pays taxes on Social Security without the income cap.
There are countless organizations that can do the political work needed to accomplish the goals which are laid out here. We communists need to provide leadership so that the organizations are pointed in the right direction. The struggle for Social Security and Medicare and Medicaid is a model for the twin pillars of socialist society. A secure retirement at a reasonable age so that the golden years of life can be enjoyed and respected. Complete medical care from cradle to grave. These are the things that American communists fight for. This struggle accompanies the struggle for peace and international proletarian solidarity with the working masses the world over. A plan of political work including all this is what is necessary to grow our Party and our influence in society.