Since Alexandria Ocasio-Cortez’s primary win has a lot of people on the left calling for “Medicare for all” again, Natalie Shure thinks it a good idea to remind readers of The Nation how hard it was to secure Medicare for some back in the sixties:
The most viable push toward NHI [national health insurance] in American history crumbled in the late 1940s, ruthlessly crushed by not only insurers and pharmaceutical companies but also the American Medical Association. (Physicians, whose already handsome salaries began to rise in the postwar era, feared the blow that NHI could strike to their paychecks, professional prestige, and autonomy, since a government payer would also reduce their control over prices.) As such, the AMA famously shook down its membership for $25 apiece to fund the multimillion-dollar campaign that injected the phrase ‘socialized medicine’ into mainstream American culture. …
While insurance companies certainly fought against health-care-financing reforms, physicians associations and hospitals are typically considered to have been the more significant opponents—they believed Medicare to be a likely conduit for eventual full-scale single payer (and all the government interference they assumed would come with it), and struck back with more or less the same zeal that they mustered decades earlier. As historian Jill Quadagno puts it, the AMA fought Medicare with ‘every propaganda tactic it had employed during the Truman era.’ Such tactics included a widespread media blitz, advertising in doctors’ offices, and visits to congressmen from physicians in their districts. One tactic, called ‘Operation Coffee Cup,’ deputized physicians’ wives to host ladies’ gatherings, at which they’d play their guests an anti-Medicare PSA starring actor Ronald Reagan.
Medicare became law in 1965, succeeding where the Truman administration’s earlier effort had failed, Shure argues, only because there rose “a mass movement of people demanding it,” a movement joined at the hip to others calling for an end to poverty and all kinds of discrimination.
Important, too, was the support that the push for Medicare received from unionized labor. The American Federation of Labor and Congress of Industrial Organizations just endorsed single-payer at its convention in 2009, and Shure does a good job of summarizing what might have taken them so long:
For one thing, the unions’ success at collectively bargaining for employer-provided health benefits during the Truman-era reform battles perhaps reduced their motivation to prioritize national health-care solutions, the ongoing absence of which almost certainly highlighted the advantage of union membership. Since the 1970s, ever-rising health-care costs strengthened the case that labor’s interests would be served by removing health-care benefits from tense contract negotiations, but declining labor power during America’s rightward political shift tied them to a Democratic Party establishment unwilling to back single payer during the health-care debates of the 1970s and ’90s.
Shure warns, and I don’t think there is anyone who doesn’t know, that today’s revived push for universal health care “will require a mass mobilization,” and “will demand,” as did the movement for Medicare, “a broad variety of tactics, including direct action, canvassing, printed materials, and public events.”
“It’s up to advocates,” Shure writes:
to compel people living under the US health-care system to see themselves and one another as part of a single constituency, from the poorest uninsured to those saddled with punishing paperwork, office staff chained to bad jobs for benefits, providers-turned-pawns of corporate conglomerates, and expectant mothers bracing themselves for exorbitant out-of-pocket costs atop weeks of unpaid maternity leave. And it must be done in solidarity with struggles on behalf of all oppressed Americans—people of color, the unhoused, the disabled, and others—whose subjugation benefits the very moneyed interests who’d prefer to keep things as they are.
If the United States is to truly become great, and quit merely pretending, then it must join the rest of the advanced world in providing a system of health care for all of its citizens, regardless of so petty a precondition as a person’s ability to pay. In short, “Medicare for all” must be won, and Shure has offered sound advice on how we can win it once and for all.
Featured image: US Army Africa/Flickr