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From Labor Action, Vol. 13 No. 18, 2 May 1949, pp. 1 & 3.
Transcribed & marked up by Einde O’ Callaghan for the Encyclopaedia of Trotskyism On-Line (ETOL).
President Truman has set up another Fair Deal tenpin to be knocked down by Congress. This time it is a wide health insurance program. Senator Murray, committee head to whom It has been referred, “expressed the hope” that the bill could be taken up by the current session.
Perhaps Truman advocates his health insurance program as a war preparation measure on the theory that people must be healthy to stand the stress of modern war. Or perhaps is interested in public health as “one of the great challenges to our democracy” as he put it in his message to Congress, because of course American capitalism must show itself better than British “socialism” and above all better than Russian “communism.”
However, whatever the motives, the masses of Americans to whom modern medical knowledge and techniques are unavailable, pricked up their ears and listened. Here is something which concerns them vitally, sometimes as vitally as life itself.
What a commentary on the capitalist system that today, in President Truman’s words, “It is no longer just the poor who are unable to pay for all the medical care they need – such care is now beyond the means of all but the upper-income groups.” Again, in the words of one of the physicians who supports the President’s plan: “... the dollar barrier ... now blocks four out of five families from the full measure of medical care they need.”
What a commentary on American capitalism, which budgets $16 billion a year for war preparation but does not provide any general hospitals at all, or only substandard ones, in 40 per cent of all the counties of the country! What a disgrace that in 1200 counties, with nearly one fourth of the whole population, there is no public health department at all or only part-time health officers performing the crudest services.
The lack of all kinds of facilities, of nurses, of doctors, is appalling. Yet schools for training doctors are so inadequate that there are ten to fifteen applicants for every opening in the medical schools.
To be sure the federal government and also some state governments have some kind of public-health programs, but they are merely tokens of good intentions. For example, in 1946 Congress passed the Hospital Construction Act, authorizing the payment to states and cities of one third the cost of new hospitals and improvements. But thus far only four per cent of the nation’s need for new hospital beds has been met.
Apparently the president has been well advised about the inadequacy of past performances in the field of public health. His proposal is more far-reaching and comprehensive. It approximates the health-insurance plan of the British government.
Based on the payment of a payroll tax of 1½ per cent by both employers and workers, for no additional cost the plan would provide examinations, doctor’s visits, limited dental treatment, sixty days’ hospitalization, home nursing, laboratory service, X-ray service, ambulance service, expensive medicines, hearing aids, wheelchairs, eye-glasses, crutches and other special appliances.
Besides the health insurance aspect, the president’s bill would enact federal subsidies for medical schools, for students, for local health units, for hospital construction, for rural doctors. The cost of the plan to the government is variously estimated at from three to eighteen billion dollars a year. The lowest figure is given by the friends of the measure while the highest is the prediction of the bill’s most deadly enemy, namely, the American Medical Association.
The biggest concession the bill makes to reactionary pressure is in the way the money is to be raised. The assessment would be levied on the first 54,800 of individual income, so that the largest contribution by any person would be $72 a year. This is undoubtedly to meet the argument that the rich will be using their own doctors anyway – though the government services that they too would be able to make use of would be a bargain for them also. This feature means that the bankrolls with the biggest figures will be paying a comparatively small percentage of the cost – far, far less, at any rate, than they ought to bear.
The CIO and AFL leaders, who know too well that 325,000 persons a year die for lack of medical care, support the president’s bill. So does the NAACP, whose policy makers also know that in the state of Mississippi, for instance, there is only one Negro doctor for each 19,000 Negroes. Undoubtedly the passage of the president’s health insurance plan would be a step in the right direction – though one may ask: “Why so little for health and so much for bombs and bomb carriers?”
However, the president’s bill is not going to be passed by Congress. There is the Dixiecrat-Republican coalition to contend with. Two other public-health bills are now before Congress. No Congressman dares come out on all fours against federal aid to public health; so these bills are also called public health bills.
One is authored by Republican Senator Taft. He is opposed to the whole idea of public-health insurance. Instead he would have people who arc unable to pay for needed medical care go hat in hand and beg for it, the federal and state governments to split the cost of this charity.
The Taft bill would also provide federal subsidies for medical schools, for examinations of school children, for free treatment of needy children, for local hospital construction, etc. But this grandiose program of the Republican senator would cost the comparative pittance of $1,817,000,000 in five years.
The third bill is sponsored by Senator Hill from Alabama, member of the Democratic Party along with Mr. Truman – for whom labor voted when it voted for the Democratic Party. Senator Hill, being a dyed-in-the-wool private enterpriser, wants the government to subsidize the private health-insurance plans, and only for limited services.
His bill makes no provision for general medical care, office calls, home nursing, etc. The Hill bill has the distinction of being supported by many state medical associations, which, along with the American Medical Association, stand as an example of what the private-profit motive can do to the spirit of men. (Parenthetically it must be stated that not all members of AMA have been thus corrupted. There are some three thousand doctors, members of AMA, who favor public health insurance and have organized a separate group known as Physicians’ Forum with Dr. Ernst P. Boas as chairman.)
Considering the emaciated specimens offered by Senators Taft and Hill as substitutes for the Truman bill, one can foresee what kind of public-health act will emerge from the Congressional wringer, that is, whenever the representatives of the people get around to that issue.
It is being bruited about that CIO and AFL leaders have abandoned all hope of getting any measures they support passed by the 81st Congress, and are setting their sights for the 1950 elections. But will labor do better after the 1950 elections if it doesn’t create its own political party for that election?
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