Sickness & struggle, part 4
Radical movements create context for 1960s health care reform
Published Sep 3, 2009 10:42 PM
The 1960s was a decade of worker mobilization, youth and student
radicalization, and revolutionary struggle inside the United States and around
the world. The 1959 Cuban revolution, on the eve of the new decade, was a sign
of the struggles to come.
That revolution, incidentally, was accompanied by great advances in health
care. The Cuban medical system has since developed into one of socialist
medicine’s greatest achievements.
The Great Proletarian Cultural Revolution was launched in China in 1966 with
the support of Mao Zedong. The Cultural Revolution was the largest movement of
revolutionary youth and students in world history. Its recognition of the need
for continual revolution in all spheres of society—political, cultural
and economic—sent chills down the spine of the ruling class, from Japan
to Western Europe and the United States.
This is the same decade that the U.S. saw the development of the Civil Rights
Movement, the Black Liberation Struggle, and the student-based anti-war
movement to stop the U.S. war in Vietnam. These radical movements posed a
challenge to national oppression, war and capitalism itself. As such, they
forced elected politicians to pay attention to the plight of poor and working
Voices such as those of Martin Luther King Jr., Malcolm X and Huey P. Newton
captured the imagination of all those struggling under the weight of capitalist
injustice, especially the nationally oppressed. In April 1963 King wrote from a
rotting jail cell in Birmingham that “freedom is never voluntarily given
by the oppressor; it must be demanded by the oppressed.” These leaders,
and others like them, organized a movement to demand freedom through the
churches, mosques, unions, campuses—anywhere the poor and dispossessed
could be reached.
Michael Harrington’s 1962 work, “The Other America: Poverty in the
United States,” exposed the extreme poverty of that decade. Harrington
estimated that at that time there were some 50 million poor people in this
country. Harrington was a self-identified socialist, a former editor of The
Catholic Worker and an organizational secretary for the Workers Defense
In his chapter entitled “The Invisible Land,” Harrington speaks to
what he calls one of the most familiar forms of the vicious circle of poverty:
“The poor get sick more than anyone else in the society. That is because
they live in slums, jammed together under unhygienic conditions; they have
inadequate diets, and cannot get decent medical care. When they become sick,
they are sick longer than any other group in the society. Because they are sick
more often and longer than anyone else, they lose wages and work, and find it
difficult to hold a steady job. And because of this, they cannot pay for good
housing, for a nutritious diet, for doctors. At any given point in the circle,
particularly when there is a major illness, their prospect is to move to an
even lower level and to begin the cycle, round and round, toward even more
The political turbulence created by the 1960s-era social movements and the
popular response to Harrington’s work have been credited with pressuring
President Lyndon Johnson’s administration to create the Great Society
Two key Great Society programs dealt with the struggle for access to health
care. The 1965 passage of Medicare and Medicaid represents the biggest health
care reform won by the working class in U.S. history. These two popular social
programs, insufficient as they are, represent a type of concession that can
only be won when a mass movement of workers and oppressed stands up and
challenges the system.
Medicare and Medicaid were enacted as Title XVIII and Title XIX of the Social
Security Act. Medicare extended basic hospital and physician coverage to
elderly individuals aged 65 or older. Medicaid addressed the medical care needs
of a fraction of the poor by providing coverage to low-income children and
their caretaker relatives.
The Medicare program was opened to the public in 1966. On July 1 of that year
the true state of U.S health care was exposed as 19 million individuals
enrolled in the program.
Medicaid eligibility has been confined to certain low-income individuals and
lies. An applicant’s income is just one factor in determining
eligibility. The program was not intended to provide medical assistance for all
poor people. Even the very poor are ineligible unless they meet criteria for
one of the designated eligibility groups. Both programs were modified in 1972
to expand coverage for the blind and disabled.
Medicare and Medicaid, popular despite their overwhelming inadequacy, did not
end the struggle for health care reform. Martin Luther King Jr. saw this
clearly, stating in his March 25, 1966, speech before the National Convention
of the Medical Committee for Human Rights in Chicago that “of all the
forms of inequality, injustice in health care is the most shocking and the most
The struggle for pro-worker health care reform has continued in the spirit of
King, just as the cruelty and injustice of inadequate care has continued to the
Next: Cuban socialism builds a model health care system.
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