Socialism, Medicare, and the Yoke of European Dictatorship

Brian Dolan, PhD

Socialism and the History of Medicare 1 Q: “We use this term loosely, but are we turning into the U.S.S.A.?” A: “It sounds like hyperbole, but ABSOLUTELY.” - Fox News, “Trading Pit”1

Figs 1 & 2: Commentary on Obamacare on a blog “Norwegian Shooter”

2 Medical History for Medical Students An abridged version of this article recorded as a podcast with archival audio clips is available at: www.UCMedicalHumanitiesPress.com

“It is a purely self-interested falsification of the bourgeois to see every interference of the state with free competition as ‘socialism.’ We should criticize that, not believe in it. ... So choices will be imposed by state authorities instead of by factory foremen. What a beautiful socialism! That is where one comes out if one believes in the bourgeois who pretends, but does not really think, the state is equal to socialism.”

- Letter from Friedrich Engels to Eduard Bernstein, 18812

PART ONE

his is an anniversary year. about the government’s role in declaration: he called himself a Fifty years ago, in July providing healthcare. Looming Democratic Socialist. T1966, the Medicare and over these debates is not only a In some sense, associating him- Medicaid programs were enacted, concern about the economics of self with socialism should not have a year after the bill passed through healthcare. Those for and against been very surprising since he long Congress. But it is not so much for national health insurance are ago stated his position. Here he is this reason that American health- characterized by political ideology. during a televised interview in 1989: care is presently in the news. 2016 What is interesting, though, is is a presidential election year in that in our predominate two-party I am a socialist. There are, in our the United States, and among both system, Republicans who condemn country, probably a dozen different Democrats and Republicans health- national healthcare are not attacking socialist parties. None of them have care features in the debates. On the a democratic ideology. Rather they terribly much influence. I happen not to one hand, Democratic candidates characterize it as something much be a member of any; my goal is to see see administrative weaknesses and more unsettling: socialism. that we start a third party in this country limitations to the Affordable Care One presidential hopeful, Senator which represents, as I indicated before, a Act that was passed in 2009 under Bernie Sanders, an Independent wide spectrum of people.3 President Obama’s administration. running under the banner of the On the other hand, Republican Democrats, re-defined himself It’s one thing for an Independent candidates campaign on repealing during the course of the debates Senator from Vermont to identify the entire Act, reigniting the debate on social reform with a provocative as a socialist; saying it a quarter

Socialism and the History of Medicare 3 Fig. 3: Bernie Sanders portrayed as a communist on the conservative website www.frontpagemag.org

century later as a potential presiden- view we should expand that concept to himself in front of a historic attack tial candidate is another. It begged all people. I believe that everybody in against the government’s role in the question offered by George this country should be entitled to health- healthcare that explicitly linked Stephanopoulos on ABC news: care as a right, and the most effective it to the evils of socialism. His “Is it really possible for someone way to do it is through a Medicare-for-all open admission stands against the who calls himself a socialist to be single-payer program.5 wind of Republican criticism, or elected president of the United fear-mongering, about the invasion States?” Bernie’s answer: “So long Because Sanders defined his of socialist ideology that was so as we understand what Democratic allegiance to socialism in terms of prevalent during debates over the Socialism is.”4 social reform, including extended Affordable Care Act. Comments by In fact, it was the act of defining healthcare provision, he put Representative Michele Bachmann, the term that would get Sanders into political trouble. Here is one way he defined it on the campaign trail:

When I talk about Democratic Socialism, I am talking about Medicare. A single-payer healthcare system for the elderly. And in my

4 Medical History for Medical Students conservative commentator Glenn Beck, or former House Speaker Newt Gingrich, are examples.6 The perceived threat, of course, is not that someone calls himself a socialist. It’s when someone has the power, like a president, to allow or encourage socialism to grow. Liberal commentators are bemused by such affronts to Obamacare, in large part because the allegations sub- stitute concern over the welfare of uninsured Americans facing staggering medical bills with an anxiety over the effects that an evil political ideology would have on America. They are bemused because the attacks mischaracter- ize socialism, tagging it to government control and loss of freedom. But what, altogether, is condemned when socialism is condemned? Liberal talk-show host Lawrence O’Donnell examined the conservative response to Obamacare and put this statement to them: “Here is my message to all right wing conspiracy theorists: If you think socialism is bad, then you’re against Medicare.”7

Michele Bachmann: “If you look at Glenn Beck: “Hey has anyone noticed Newt Gingrich: “The boldest effort to FDR, LBJ, and Barack Obama, this this crazy thing that we’re on the road to create a European socialist model we have is really the final leap I think towards socialism? I’m just saying.” seen.” socialism.”

O’Donnell’s accusation is indubitable. Yes, they, and most republicans for over half a century, have been against Medicare, or the antecedent principals of national healthcare insurance. In fact, there is nothing new about the warning that this puts us on the road to socialism. And yet curiously in the early 20th-century, the idea that healthcare should be provided to those most in need was based on the very premise that socialized medicine was a good idea. What is surprising is that those who would rank among the strongest opponents of national health insurance were early proponents of socialized medicine. Consider statements made by Dr. Otto Geier, Chairman of the Preventive Medicine Section of the American Medical Association. In a New York Times article written in 1917, just months after the US joined allies to fight in World War I, he proposed establishing “adequate public health machinery by reorganizing Federal, State, and municipal health work. … This type of socialized medicine,” he concluded, “will be intensively preventive. It will

Socialism and the History of Medicare 5 6 Medical History for Medical Students discover disease in its incipiency … this shortly. But taking the long they would vote for a candidate [and] our general sickness would be historical view, in fact, going back who was woman, or Hispanic, reduced by one-half.”8 almost exactly one hundred years, or Jewish, or Gay, or Muslim, or That was an official from the we ask: why was there a reversal atheist. The bottom of the list, the AMA actually calling for a national in supporting socialized medicine? only candidate who would receive reorganization of healthcare that he And considering that the Socialist fewer than 50% support from those referred to as socialized medicine. Party of America was founded in polled, was a socialist.10 This was not just an op-ed piece; 1901 and had members elected to Despite alternative arguments that the AMA’s Section on Preventive Congress and state government, can be made to question national Medicine and Public Health set up why did the term become anathema healthcare, such as organizational committees to investigate this quite to American political life? (The SPA logistics or the economics of it, thoroughly and made reports in changed its name in the 1970s but it seems the specter of socialism the Journal of the American Medical as Sanders indicated, there remain is considered more effective in Association.9 different socialist political parties debunking the government’s role. It has been well-documented with little influence.) So let’s unpack this. that, subsequently, the American As a sign of how irascible the Medical Association strongly mood is today, a 2015 Gallup poll opposed healthcare reform by asked Americans if they would vote condemning it as socialist. We’ll for a presidential candidate with a consider some examples of particular identity. Over 50% said

PART TWO

plans, which protected workers Labor Legislation (organized in hen a centralized from economic loss from illness or 1906) whose members included government intends to injury rising out of occupational President Woodrow Wilson, the Wprotect citizens from hazard, was a predecessor to plans progressive economist F.W. Taussig, the ills of misfortune—including that provided health insurance for social activist Paul Kellogg, and economic distress and poor other vulnerable populations: those Dr. Alexander Lambert (personal health—socialized actions have in old age, the disabled, dependents, physician to President Roosevelt). long been considered a useful and children. It was accepted that In 1912 they formed a Committee and valuable function of civilized society provide socialized plans for on Social Insurance, the first of its society. The primary concern was the care of those in need. kind in the US, to study the design the health of the working class, In the 1910s a few organizations of European health insurance the backbone of the nation whose spearheaded campaigns to legislate programs and their viability if productivity was essential for for these sorts of protection. One adapted in the United States. A society. Workmen’s compensation was the American Association for few of these committee members

Socialism and the History of Medicare 7 Fig. 4: Social Security Administration poster, ca. 1939. National Archives.

were physicians, who in 1915 nursing association or every labor were well aware of the reforms worked with the American Medical organization that testified in favor occurring in Europe. Foreign Association (AMA) to establish of health insurance, opposition correspondents regularly updated their own, similar, Social Insurance emerged among manufacturers and American physicians. And while Committee. By 1917 these commit- commercial insurance companies.12 fully cognizant that government tees, in cooperation with the AMA, Meanwhile the leadership of the restructuring of healthcare meant drafted bills for health insurance American Medical Association was a change in the business model for that were introduced in fifteen state writing editorials in the pages of medicine, the editorials in JAMA legislatures.11 the Journal of the American Medical were overall supportive. As a JAMA In the years to follow, nine states Association (JAMA) explaining to its editor wrote in 1912, the year after had established commissions to physician membership that its Social the British parliament passed the investigate the conditions upon Insurance Committee was collecting National Insurance Act, “The which legislation for a mandatory data to educate its members about state in the future must protect health plan might be enacted, “the absolutely essential part which the citizen against disease, just as the most comprehensive reports the medical profession must play it now protects him from foreign coming from Illinois, California, in a successful adaptation of this invasion.”14 Massachusetts, and New York. But new legislation to American con- However, the course of World for every medical, hospital, and ditions.”13 Members of the AMA War I, in particular the alarming

8 Medical History for Medical Students success of Germany and the State delegates of the Association Report they will see that it is within Central Powers against the Allies, had read Commission reports from the context of further discussion turned attention away from health Illinois and New York and declared of the projected costs of health legislation. The activities of the that they had identified “a number insurance ($50-60 million a year AMA’s Social Insurance Committee of medical sociological problems for that state) and the disquieting were suspended when its senior which should be read with interest statement that, because of the costs members had entered the armed by every physician ….”16 to the state, “This would inevitably services. The “Medical News” section lead to political control and By 1920, forty-three states had in JAMA in 1919 referred to the management.”18 enacted workman’s compensation Illinois report and drew attention The cost of the program and legislation, but the more compre- to its conclusion that “compul- potential burden of finding funds hensive health coverage for old age sory Health Insurance is not an to support it was secondary to or illness was left alone.15 Also by important factor in the prevention the concern over the notion that 1920, consideration and support for of diseases or in the conservation politicians would “control” medical social insurance appeared suddenly of health.”17 While the JAMA note care. Given the way future discus- and decisively to turn within the essentially begins and ends with that sions evolved, that statement was American Medical Association. quote, if one consults the Illinois probably the pin that was stuck into

Fig. 5: Workmen’s compensation laws in U. S. and Canada, 1921. Adapted from the map published by the American Association for Labor Legislation, Frank Fetter, Modern Economic Problems (New York, 1922)

Socialism and the History of Medicare 9 the bubble of interest about social Every department of the government, one of the pioneers of the social insurance among the American from the United States Army and the insurance movement in America Medical Association. So in what Public Health Service down to the was a Russian-born but American- seems otherwise an abrupt change smallest town council, has always looked educated physician named Isaac of tone, it was announced by the to representatives of our profession Max Rubinow. A member of AMA’s Committee on Hygiene and rather than to chiropractors, osteopaths, the American Association for Public Health at the annual meeting or faith healers, to safeguard and Labor Legislation and (from its in New Orleans in 1920: “That maintain the highest possible standards establishment in 1916) the executive the American Medical Association of health. Although it is true that in Los secretary of the AMA’s Social declares its opposition to the Angeles and certain of its environments Insurance Committee, he was also institution of any plan embodying cultists of various types have influenced a polymath statistician, political sci- the system of compulsory contribu- local governments and secured entrée to entist, and economic consultant to tory insurance against illness, or any public and endowed institutions, where the US Department of Agriculture other plan of compulsory insurance they have attempted the practice of and Bureau of Labor. In 1913 he which provides for medical service medicine along lines not always confined published his comprehensive tome, to be rendered [to] contributors to the teachings of their schools of Social Insurance, with Special Reference or their dependents, provided, medicine.20 to American Conditions, a book that controlled, or regulated by any state explained the unfamiliar concept of or Federal government.”19 Immediately following World War I, “social insurance” to Americans by At this time, within the pages discussion of “government control” comparing it to European models.21 of editorials and state reports, began to sound like dictatorship. The book defined social insurance nothing is mentioned of socialized The war provided a repository of as “nothing if not a well-defined medicine, or socialism. Not once in metaphors used to make people effort of the organized state to the Social Insurance Commission’s question government motives. come to the assistance of the reports do we find the term “social- Perhaps historically fortuitous, but wage-earner and furnish him ized” or “socialist.” The expressed concern was along the lines of disciplinary control of medical authority. It was a concern over who makes decisions regarding diagnosis and treatment. A San Francisco physician who was ostensibly sympathetic to social insurance opined upon the perceived risks of handing control over patient access to healthcare to the government. In a 1931 article about national health Fig. 6: Isaax Max Rubinow insurance in the New England Journal (1875-1936), from Central of Medicine, the author wrote: Zionist Archives, Jerusalem CM437

10 Medical History for Medical Students something he individually is quite No European sociologist is as competent from the imperial laws of Germany, unable to obtain for himself.” It was to judge what is best for California as the making health insurance compul- published in the midst of the work- man who has lived in and intelligently sory and depriving citizens of the man’s compensation efforts and studied the welfare of the state … right to decide for themselves when was well-received in press reviews. while there may be many things made they are ill and what physician shall However, drawing heavily on in Germany which are good for some treat them. It authorizes the imme- comparisons between Europe and Germans and there may be some things diate enactment of health insurance America, he consciously avoided made in Romania which are good for legislation that would cost the State the association between “socialism” many Romanians, it does not necessarily at least $62,000,000 annually. It is and social insurance. But this did follow that because these law are toler- highly objectionable and its rejec- not matter. His Russian heritage ated by European people, or have been tion at this time is a patriotic duty.”25 and interest in nineteenth-century found necessary to their welfare, that the As a side note, it is interesting to German healthcare models would same law is necessary to the people of observe that this election had three work against him. A few years later, California.23 candidates for governor: the incum- it would be remembered that social bent Republican William Stephens, insurance was, in the words of the “Is the system to be condemned for no better reason than that even physician from California quoted Russia or Romania have learned to use it?” above, a movement “born of propa- ganda, bred and spread by a man of To this, Rubinow replied wondering an Independent Theodore Bell, and Russian name.”22 whether it was prudent to reject a Socialist Party of America can- Here the argument noticeably social insurance just because it was didate, Henry Roser (who received transformed into nationalistic a European and not an American 4% of the vote). A reminder that protectionism. It was not so contro- invention. “Is the system to be “socialism” as a political ideology versial to use the term “social” or condemned for no better reason was not as alien as we might think. “socialist” in America before World than that even Russia or Romania Invoking Germany as an ill-ad- War I, but during and after the War have learned to use it?”24 vised model for protecting the it was problematic to suggest that All too easily, government-sup- health of American citizens was America was following the lead of ported health care—even at the both political and historical. Not Germany or Russia on anything. state and not the federal level—was only was it the enemy, but it was the As early as 1916, the President of cast as un-American and tyrannical. first country to institute social insur- the San Francisco County Medical During the Gubernatorial elections ance under Otto von Bismarck’s Society invited Rubinow to a debate in California in 1918, where health Health Insurance Bill of 1883.26 about health insurance where fears insurance was on the ballot as a Over the next decade, the oppo- over the motives of welfare reform state amendment, the Los Angeles sition to health insurance grew in were expressed by the president: Sunday Times advised readers momentum state-by-state. In 1929, to reject the proposition. Their Dr. Alice Hamilton, the pioneer explanation: “A device borrowed physician, first female faculty

Socialism and the History of Medicare 11 Fig. 7: Unemployed outside a New York soup kitchen, circa 1930. Getty Images.

member at Harvard University, unemployment of millions of administration strategically put into expert in toxicology and champion American workers, was that the abeyance any public discussion of of occupational health, summarized national discourse over social wel- national health insurance in favor of the opposition and defeat of social fare returned to original concerns “problems related to the economic insurance following the states’ com- about fiscal security as an issue security of individuals.”31 mission reports by identifying the separate from health insurance. Princeton University historian efforts of the AMA, the American Large agencies such as the Congress Paul Starr reflected on Roosevelt’s Federation of Labor, and “the two of Industrial Organizations and the careful path to reform during an largest industrial insurance compa- United Auto Workers canvassed the interview with Bob Garfield of nies.”27 The American Association federal government for legislation WNYC: of Labor Legislation (AALL), to find protection for workers, who had provided the strongest only cautiously offering support Roosevelt never took on the AMA, advocacy for social insurance in the for national health insurance directly. The Committee for Economic 1910s, was no match for organized legislation.30 Security, which recommended the old opposition of the 1920s.28 As histo- The emergence of the New age insurance system that we know of as rian Daniel Hirshfield wrote, “Faced Deal in the 1930s concentrated Social Security, they also recommended by a hostile medical profession and federal legislative focus on old age health insurance. But when Roosevelt a largely apathetic, if not unfriendly, assistance, unemployment, and aid had to decide what was he going to public, they could do nothing but to disabled and dependent children. submit to Congress in 1935, he held withdraw from the battle.”29 This culminated in the passage of back the health insurance provisions. He One consequence of the Great the Social Security Act of 1935. was afraid of the AMA’s opposition, and Depression, which saw the To accomplish this, the Roosevelt so, decided to leave it to a later day. But

12 Medical History for Medical Students during the Great Depression, Franklin health insurance until after the a bill proposing amendments to Roosevelt and the American people had elections of 1936, at which time the Social Security Act which a lot of other things to worry about, and Roosevelt was safely re-elected. In became the first legislative proposal so he never got back to health insurance, 1938, the results of the Technical for national health insurance in and it was only Harry Truman who then Committee on Medical Care were America and rekindled the public was the first president to make national discussed at the first national forum debate on its viability. Immediately, health insurance a cause.32 of its kind, the National Health rising opposition—once again, Conference. In 1939, President notably by the American Medical A detailed history of the relation- Roosevelt submitted the reports to Association—stopped the bill ship between health insurance and Congress, titled “The Need for a from going to vote. Undeterred, social security as negotiated by the National Health Program,” and “A the administration redoubled Committee on Economic Security National Health Program.”34 its efforts, and two additional and the corresponding Technical The reports recommended a congressmen joined Wagner’s Committee on Medical Care has wide range of federal assistance for efforts to propose a number of been provided by other historians.33 medical care and the extension of bills that appeared throughout the Suffice it to say here that Roosevelt public health services. That same 1940s that are referred to generally admonished his administration to year, Senator Wagner, a democrat as the “Wagner-Murray-Dingell avoid raising the issue of national from New York, introduced S.1620, Bills.”35 No manifestation of these

Fig. 8: Washington New Dealer, 1938. University of Washington Labor Press Project.

Socialism and the History of Medicare 13 proposals would ever make it to a coverage, with consideration of the citizens. That is the aim of my report as vote on the floor of the House or development of a National Health shortly as I can put it.38 Senate. Insurance scheme. This became Not that healthcare measures known as the Beveridge Report, a The NHS would eventually be were completely overlooked in document that provided the foun- established in 1948 following the 1940s. In 1943, for instance, dation for post-war reforms leading various parliamentary acts. As a Congress authorized emergency to, among other things, the creation program of post-war reconstruc- health provisions for the depen- of the National Health Service in tion, it is reasonable to see national dents of enlisted servicemen Britain. health coverage as a consequence under the Emergency Maternity Sir William Beveridge described of particular pressures created by and Infancy Care program.36 the main points of his plan in the war. This applies to the American Interestingly, that same year a following way: context for these concerns as well. British academic from Oxford Following Roosevelt’s death University spent two months on a The security plan in my report has three in 1945, and just three months lecture tour of America discussing sides to it. The report proposes first of after dropping the atomic bomb trans-Atlantic “problems and an all-in scheme of social insurance, on Hiroshima, President Harry methods of Social Security.”37 The providing for all citizens and their Truman sent a message to Congress person was Sir William Beveridge, families all the cash benefits needed for proposing a new national healthcare a liberal economist and champion security, in return for a single, weekly, program. Echoing arguments made of social welfare reform in the U.K. contribution by one insurance stamp. during World War I, Truman’s Just the previous year, in 1942, he The report proposes second a scheme comprehensive statement reported published a parliamentary report of children’s allowances, to be paid both that an alarming percentage of on behalf of the Committee on when the responsible parent is earning, men and women who registered for Reconstruction Problems surveying and when he is not earning. The report military service were rejected by the social insurance, including work- proposes third, an all-in scheme of Selective Service System because man’s compensation and health medical treatment, of all kinds, for all they failed medical examinations. It

Fig. 9: Sir William Beveridge (1879-1963). Getty Images.

14 Medical History for Medical Students Fig. 10: Truman’s 1948 State of the Union. Getty Images. Full audio of the speech available through Truman Library and Museum. was an indictment on the health of the population and the strength of the nation. It was a statement reflecting the national importance of healthcare to improve the health of its population. “We should resolve now that the health of this Nation is a national concern,” Truman wrote. “That financial barriers in the way of attaining health shall be removed; that the health of all its citizens deserves the help of all the Nation.”39 In his 1948 State of the Union address, Truman underscored his commitment:40

“The greatest gap in our social security structure is the lack of adequate pro- vision for the Nation’s health. We are rightly proud of the high standards of medical care we know how to provide in the United States. The fact is, however, that most of our people cannot afford to pay for the care they need. I have often and strongly urged that this condition demands a national health program. The heart of the program must be a national system of payment for medical care based on well-tried insurance principles. This great Nation cannot afford to allow its citizens to suffer needlessly from the lack of proper medical care. Our ultimate aim must be a comprehensive insurance system to protect all our people equally against insecurity and ill health.”

Socialism and the History of Medicare 15 Fig. 11: Leone Baxter (left) and Clem Whitaker, founders of Campaigns, Inc. Getty Images. Their work is discussed in Jill Lapore, “The Lie Factory,” The New Yorker.

The resurging interest in national improve the companies’ public “Political medicine is bad medi- health insurance, preceded by images and promote pro-business cine.” In the words of Jill Lepore, piecemeal congressional legislation legislation. They were also famous, whose 2012 article in The New Yorker but now a presidential mandate, or notorious, for masterminding magazine titled “The Lie Factory” prompted the American Medical the art of negative advertising in examines the history of Campaigns, Association to raise the ante in their politics. Inc., “Whitaker and Baxter took a own counter-offensive. Soon after Their experience with condemn- piece of legislation that most people Truman’s address on healthcare ing healthcare reform began in liked and taught them to hate it.”41 insurance, the AMA hired two indi- earnest in 1945. The California Four years later, when Truman viduals to run a campaign against Medical Association ponied up announced his interests in health the health plan. Their names were an annual fee of $25,000 to have insurance during his state of the Clem Whitaker and Leone Baxter, Whitaker and Baxter take down union, the AMA knew who to call. both political journalists who honed Governor Warren’s proposal—laid With a retainer of $100,000 and their Machiavellian insights to the out in his State of the State address a staggering annual budget of $1 world of politics to run political earlier that year—to institute million (paid through special assess- campaigns. In 1933 they founded compulsory health insurance. ment to AMA members), Whitaker a company called Campaigns, Inc., They purchased massive amounts and Baxter devised a new slogan to the first ever political consulting of newspaper advertisements. They characterize Truman’s plan: social- firm. Large corporations like invented an event called Voluntary ized medicine. But just the term was Standard Oil and PG&E had this Health Insurance Week, and pro- not enough. Their marketing plan California power-partnership on vided 9,000 doctors with prepared and speeches put forth the most retainer, paying them to manage speeches against the Governor’s disturbing portrait of a future for a media messages in an effort to project. They coined the slogan: country that just battled a world war

16 Medical History for Medical Students Fig. 12: Sir Luke Fildes’ painting The Doctor, adapted for the AMA cam- paign against compulsory national health insurance. See John Harley Warner, “The Doctor in early Cold War America,” The Lancet.

to protect their liberties. of compulsory health insurance, insurance to the elderly through an “Basically,” wrote Whitaker and if allowed to spread to our New amendment to social security. It met Baxter, “the issue is whether we are World, will mark the beginning with criticism which waged that the to remain a free Nation, in which of the end of free institutions in bill uniformly taxed people unfairly the individual can work out his America.”42 who would use the health service own destiny, or whether we are to The campaign was successful, disproportionally since wealthy take one of the final steps toward and Truman’s efforts failed to result constituents were in no need of it. becoming a Socialist or Communist in any congressional measures. He (So why tax them for it?) In other State. We have to paint the picture, left office after two terms in 1953, words, the socialist approach was in vivid verbiage that no one can and over the next eight years during too inclusive. But Congressional misunderstand, of Germany, the Republican administration hearings persisted, and in 1960 Russia—and, finally, England.” of President Eisenhower barely both the House of Representatives Again, now in a speech to the anything more than a mumbling was and the Senate held hearings on Council of the New England heard about healthcare reform. the Forand bill, with senator and Medical Societies under the auspices But certain congressmen did now presidential candidate John F. of the AMA’s National Education continue to make noise about it Kennedy sponsoring the bill.43 Campaign, they said: “Hitler and and made sure that it would play a Here is Senator Kennedy on the Stalin and the socialist government prominent feature in the lead-up campaign trail in 1960 commenting of Great Britain all have used the to the presidential election in on this. opiate of socialized medicine to 1960. Aime Forand, Democratic deaden the pain of lost liberty Representative from Rhode Island, Well the medical care for aged bill and lull the people into non-re- was one. In 1958 he sponsored has been introduced in the House of sistance. Old World contagion a new bill to provide hospital Representatives by Congressman Forand

Socialism and the History of Medicare 17 and I’ve introduced it in the United cost of their examinations and drugs, “Operation Coffeecup” through States Senate. The Forand Bill provides and also receiving some assistance in local chapters of the AMA’s that those who are on social security, paying their general medical bills.44 Women’s Auxiliary. A package contributing to social security, should with letters to congress was sent make a contribution so that when they Predictably, the AMA lodged an to these groups along with a LP are 65 years of age and over if they are expensive advertising campaign to record with a message from Reagan: men, 62 if they are women, or if they are kill the bill by again invoking the “Ronald Reagan speaks out against over 50 if they are totally disabled, they yoke of socialism and dictatorship. Socialized Medicine”45 can receive assistance from the fund in In 1961, they hired Hollywood paying their hospitalization, paying the actor Ronald Reagan and launched

“Back in 1927 an American socialist, Norman Thomas, six-times candidate for president on the Socialist Party ticket, said the American people would never vote for Socialism but he said under the name Liberalism the American people would adopt every fragment of the Socialist program. One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humani- tarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it. Now, the American people if you put it to them about socialized medicine, and gave them a chance to choose, would unhesitatingly vote against it. We had an example of this under the Truman administration. It was proposed that we have a compulsory health insurance program for all people in the United States and of course the American people unhesitatingly rejected this. So with the American people on record as not wanting socialized medicine, Congressman Forand introduced the Forand Bill. This was the idea that all people of Social Security age should be brought under a program of compulsory health insurance. But Congressman Forand was subscribing to this foot-in-the-door philosophy because he said if we can only break through and get our foot in the door, then we can expand the program after that. Walter Ruther said that it’s no secret that the United Automobile Workers is officially on record as backing a program of national health insurance. And by national health insurance he meant socialized medicine for every American. Well let’s see what the socialists themselves had to say about it. They say, once the Forand Bill is passed, this nation will be provided with a mechanism for socialized medicine, capable of indefinite expansion in every direction until it includes the entire population. Well we can’t say we haven’t been warned. One of these days, you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America, when men were free.”

Fig. 13: LP Cover of Reagan’s warnings about socialized medicine. Audio recording available on YouTube.

18 Medical History for Medical Students In keeping with historical LAWRENCE SPIVAK: Mr. Secretary, needs and I think he also said that it was precedent, Reagan’s warnings about as you know the AMA and others have a foundation on which to build. Don’t socialism and dictatorship was charged that the medical aid bill for the you think, since it is a modest proposal consistent with wartime concerns aged under social security is an opening only, that pressures will grow to add to it, about the invasion of European wedge to socialized medicine. Now if and that eventually there will be doctor’s ideas since it was the Cold War, and you thought there was a chance the bill care added to it? the creeping tentacles of commu- might be an opening wedge to socialized RIBICOFF: I personally don’t think so.48 nism had to be checked by assuring medicine, would you still be for it? that no freedoms were lost in the SECRETARY RIBICOFF: Well it’s not On this last point, Ribicoff would effort to provide healthcare to aging an opening wedge to socialized medicine. be proven wrong; that is, support and dependent citizens. I’m for the bill. for physicians’ fees would become The successor to the Forand SPIVAK: I’m asking, if you thought it Medicare Part B. But he was toeing bill considered in congress at was an opening wedge … the party line. this time was the King-Anderson RIBICOFF: I would be against a bill if it In the years preceding Britain’s bill, so-called from the spon- were for socialized medicine. introduction of the National sorship introduced by Senator SPIVAK: If it opened the door to Health Service in 1948, the British Clinton Anderson and House socialized medicine? Medical Association, not unlike the Representative Cecil King. This bill RIBICOFF: It doesn’t open the door to AMA, expressed fear that the “free provided for hospital insurance for socialized medicine. choice” of doctor among patients the aged through Social Security SPIVAK: Will you tell us what makes would cease. In response to this, and had, like every other bill, a you so sure that it doesn’t. the Socialist Party of Great Britain, tumultuous political history.46 RIBICOFF: Because you and I, and writing in the Socialist Standard But by this time, proponents every other American, Mr. Spivak, has magazine in 1944, was pragmatic. of health insurance began to the right to choose his own doctor. Under the free market for the protest the AMA attacks on There is nothing in this bill that has working class—for whom these medical reform. In 1961, the anything to do with doctors. This bill programs were intended to serve— Health, Education, and Welfare takes care of the health needs of the there already was no choice of what (HEW) Secretary Abraham people of America, our aged over 65, physician to see. “A worker may Ribicoff debated Republican and basically takes care of their hospital not choose to see a Harley Street Senator Kenneth Keating over the bills, their nursing home bills, and their specialist,” they wrote, referring to King-Anderson Bill, criticizing the visits to the home for home care. The elite London doctors, “but most “scare tactics” and negative ads run bill specifically provides that each and have a general practitioner … [and by “organized medicine.”47 Here every American has the right to choose the] doctor chosen is usually the is Secretary Ribicoff rebuffing his own doctor and his own hospital. nearest, in order to save time.”49 allegations of promoting socialist SPIVAK: Well now, Mr. Secretary, when It was an insightful sociological medicine on “Meet the Press” in the President sent the special message to point that the rich have more 1961: congress on health and hospital care, he freedom to choose than the poor. specifically said that it was a very modest But did doctors or patients actually proposal cut to the absolutely essential lose freedom of choice under

Socialism and the History of Medicare 19 national healthcare? Let’s look at Private Practice Committee of the of healthcare a mission of his pres- Britain during the year Medicare BMA, “if the right of the citizen to idential platform. Five days after was passed. In 1965, members of a completely independent medical Kennedy’s death, President Johnson the British Medical Association and opinion from the doctor of his or addressed Congress and discussed writers to the British Medical Journal her own choice was lost.”50 While in fulfilling the dreams of his prede- were commenting on management America, British socialized medicine cessor. Placed within the context of of private medical practice and was invoked in stories about losses civil rights was healthcare: the terms of the contracts under in freedom of choice, in Britain the which physicians worked for the conversation about their healthcare The dream of care for our elderly, the NHS. Maintaining “freedom” was was about maintaining the freedoms dream of an all-out attack on mental defined by these writers as: the that physicians and patients contin- illness, and, above all, the dream of equal “freedom to practice to the best of ued to possess. rights for all Americans, whatever their his ability in a place of his choosing, After President Kennedy’s race, or color. … We will carry on the freedom to develop his special assassination in November 1963, fight against poverty, and misery, and skills and inclinations by his own President Lyndon Johnson, in ways disease, and ignorance in other lands, and efforts.” “What a tragedy it would reminiscent of Truman’s succes- in our own. We will serve all the nation, be for the public and for British sion to the presidency following not one section, or one sector, or one medicine,” wrote the chair of the Roosevelt’s death, made the reform group, but all Americans.51

Fig. 14: President Lyndon Johnson signing Medicare into law with former President Truman, July 30, 1965. National Archives.

20 Medical History for Medical Students While the commitment to health- which helped the elderly to pay staunchest opponents of social care reform was here pronounced, for doctor’s bills. Thus became insurance, and especially those privately, Johnson was more what is known as Parts A and B, who touted the idea that socialized decisive. As he said to congressman respectively, of Title XVIII of the medicine meant a government Mills during a telephone conver- Social Security Amendments of dictatorship of physician services, sation: “I’ll spend the goddamn 1965. Together, this is what we were actually initiators of the money. I may cut back on some call Medicare, a popular term that proposal to extend coverage to tanks. But not on health.” actually originated in the military in physician fees. They did this by Owing to the extensive the early 1950s referring to feder- abandoning the rhetoric that it Democratic victories in the ally-supported care specifically to was un-American to provide such elections of 1964, the proposal for servicemen and their dependents.52 insurance, and they did this despite “hospital insurance for the aged” Just to complete the story, a third more legitimate concerns that costs was expanded. Representative John proposal, Title XIX, was added to would grow out of control. When Byrnes, the ranking Republican the Amendment which provided in 1965 republicans helped modify on the House Ways and Means federal grants to states for the the Social Security Amendments Committee, saw the writing on the destitute, which became known as to expand Medicare, they made it wall and offered what is called the Medicaid.53 a bipartisan bill, thereby making it “Byrnes proposal” which added What is ironic is that the more difficult for them to criticize it a second tier of federal subsidies in the future.

PART THREE

he critics of national health care. It’s telling that in the same national healthcare based on the insurance who invoked the speech to congress where President idea that it was European, it is Tspecter of freedom-killing Johnson vowed to realize Kennedy’s interesting that Bernie Sanders socialism, associating it with vision of healthcare reform that he decided to present the example of the tyrannical governments that reminded America of what side of a European country to illustrate America fought wars against, European dictatorship we stood. just what a democratic socialist even sometimes hinting it could “We have proved that we are a good healthcare-for-all program could be part of a Communist plot, and reliable friend to those who look like. “I think we should look were disingenuous if not outright seek peace and freedom. We have to countries, like Denmark, like duplicitous. Attacking a program shown that we can also be a formi- Sweden, and Norway, and learn that essentially began by providing dable foe to those who reject the from what they have accomplished veterans with medical help with the path of peace, and those who seek for their working people.”55 rhetoric that it was “statism” akin to to impose upon us, or our allies, the However, there happens to be enemy governments was an affront yoke of tyranny.”54 some disagreement about whether to all who need and receive medical After decades of attacks against this indeed is a good example

Socialism and the History of Medicare 21 of the ideology. Giving a speech to Harvard’s Kennedy School of Government, Danish Prime Minister Lars Lokke Rasmussen said, “I would like to make one thing clear. Denmark is far from a socialist planned economy. Denmark is a market economy.” Given the highly polemical, political, and problematic uses of the term, how is anyone to make sense of what true socialism means? Here’s Noam Chomsky, professor of linguistics at MIT on C-SPAN, reflecting on the propagandist uses of the term socialist in 2003. Fig. 15: Marx and Engles from Wikimedia commons. (Comments below at mark 1:21:00 on the recording.) the means of production, a cooper- nation? It isn’t. Marx’s socialism As far as socialism is concerned, that ative (in the moral and ethical sense) was not about workers relying for term has been so evacuated of content enterprise, rather than competitive support on the centralized bureau- over the last century, that it’s hard even as demonstrated in capitalist cracy of an established authority to use. I mean the Soviet Union, for markets. (like the US government). example, was called a socialist society When there is mention of own- Government regulation of welfare and it was called that by the two major ership over means of production, provisions doesn’t fit the Marxian propaganda operations in the world, the the question is: producing what? definition of socialism at all. It’s US – the Western one – and the Soviet The all-encompassing answer is only when we witness the misap- one. They both called it socialism for wealth. The way Marx and Engels propriation of socialist ideology opposite reasons. The West called it defined socialism, it did not mean that we begin to understand what socialism in order to defame socialism; repossessing and divvying-up social critics of national healthcare were by associating it with this miserable wealth. It meant enabling demo- presumably referring to. tyranny. The Soviet Union called it cratic ownership over the means to Those who point to Germany’s socialism in order to benefit from the produce wealth and use it for social healthcare as an example of the moral appeal that true socialism had good.57 menacing model of socialism among large parts of the general world How is the government adminis- either do not know or hide the fact population. But this was about as far tration of a healthcare fund that is that Bismarck was one of the first from true socialism as you can imagine.56 used to pay toward medical bills of “anti-socialist” socialists. Shortly those in need, an act of empower- after unsuccessfully banning all Socialism is often basically defined ing the laboring class so that they organized activity of the German as the communal ownership over can contribute to the wealth of the socialist party in 1878, he coopted

22 Medical History for Medical Students the slogans and implemented a socialism. Reflecting on British of healthcare reform pivoted political system to work against labor reforms and health insurance, to talk about socialism either as Marxist socialist ideals in attempt to Walling, a noted progressive social the coming evil or to rebuke its render it obsolete. Seeing the failure reformer in America, wrote: “the connection to health insurance. of his anti-socialism laws, three whole scheme may be looked on “It is possible,” writes political years later Bismarck initiated health not so much as a measure to aid scientist Max Skidmore in his insurance programs to draw work- the sick and wounded of industry analysis of Medicare and the American ers away from social democratic financially, as to set at work an Rhetoric of Reconciliation (1970), “that and socialist party supporters.58 The automatic pressure working towards the antagonists recognized the political preconditions for this were the preservation of the health, nonsense inherent in the hysterical particular to the late nineteenth-cen- strength, and productive capacity of debate over ‘socialism’ and cynically tury German empire and could not the people, and incidentally to the used the term to influence public be recreated in twentieth-century increase of profits.” In support of opinion on the emotional level.”60 America even if the government this view, he quoted then Chancellor Part of the portrait of socialist intended to. of the Exchequer Lloyd George: medicine was that the government In the first two decades of the “I want to make the nation more would strip freedom from patients twentieth century, there were healthy than it is. The great mass and doctors to the point of dictat- “reformist” moves in a number of illness which afflicts us weighs ing where doctors could live and of countries – including France, us down and is easily preventable. practice medicine. Harboring fear Britain, Australia, and America – to It is a better thing to make a man over a description of a situation enable their governments to enact healthy than to pay him so much a that never existed is a function measures protecting the welfare of week when he is ill.”59 State social- of what famed economist John “Government involvement in such social reforms was dubbed ‘state social- ism’ (or sometimes ‘philanthropic administrative socialism’) ... worked more to protect capitalism than promote socialism.” workers through labor legislation ism was the name for a government Kenneth Galbraith called “The as well as municipal investment program that sought to protect the Age of the Wordfact.” He defined in transportation and housing. economic value of labor by keeping this as the political ploy to create Government involvement in such it functioning. semantic confusion when “to say social reforms was dubbed “state Classifying healthcare reform as that something exists is a substitute socialism” (or sometimes “philan- European socialism, hyped during for its existence.”61 The “yoke of thropic administrative socialism”) times of war and exemplifying tyranny” that America fought wars and a detailed analysis of it, such communist plots, served to reshape against was not invited into America as provided by William English the debates about curing people through healthcare reforms despite Walling, shows that it worked more to killing their freedom. Both all suggestions to the contrary. to protect capitalism than promote opponents as well as supporters Nevertheless, the word socialism,

Socialism and the History of Medicare 23 like illness itself, spread fear. It’s to the history of American, home- Perhaps the lesson learned from almost metaphorical. It’s reminis- grown, socialist movements and the history of the association cent of Susan Sontag’s thoughts their failure as a warning against the between healthcare reform and about disease, where she says, “Any futility of government programs. the concept of socialism is that disease that is treated as a mystery They could have pointed to the the looseness of language allows it and acutely enough feared will be disappearance of the Socialist to work for, and not only against, felt to be morally, if not literally, Party of Eugene Victor Debs by those who favor national health- contagious.” Shifting discussion of 1920, or the demise of La Follette’s care. Just accept it, recommends illness away from the experience of political career and the end of the liberal commentator Lawrence American patients and toward the Progressive Party (backed by the O’Donnell, with whose words threat of foreign ideology made Socialist Party) in 1924. Roosevelt’s we end: “I have explained in this government ideas the real disease to own avoidance of healthcare space before how Newsweek reached be dealt with. reform in the 1936 election was an the logical conclusion expressed The fact that political discourse example of the ideological weakness on its February 16, 2009, cover successfully shaped popular with regard to anything appearing “We are all Socialists Now.” We opinion tells us something about socialist. Labor unions, which have are all socialists in this country to the evolution of political language historically been pro-capitalist support public education, state which continues to frame our in America, sided with left-wing funded universities, government run understanding of social actions. politicians to create, if anything, a hospitals, Medicare, social security George Orwell discussed this in his social democratic political platform, – classic socialistic programs that 1946 essay “Politics and the English not a socialist one. It would have have sensibly found their way into Language.” While, in Strunk and been more effective if Ronald the American economy. The truth White fashion, he condemns the Reagan had not introduced Norman is that in this country, we are all “decadence” of bad writing, he Thomas as some sort of cunning socialists in varying degrees and we points out that language is an revolutionary, but as the figurehead are all capitalists.”63 instrument to be handled carefully. of a failed Socialist party, thus “One ought to recognize that the discrediting attempts to socialize present political chaos is connected America through healthcare reform with the decay of language,” he because it has a history of not wrote. “Political language—and working. with variations this is true of all political parties, from Conservatives to Anarchists—is designed to make lies sound truthful ….”62 It is ironic, if also a sad reflection on political discourse, that lies and mischaracterizations were favored over meaningful criticism. Opponents of national insurance Fig. 16: Newsweek, February would have been better off pointing 16, 2009.

24 Medical History for Medical Students REFERENCES

1 “Trading Pit,” Fox News, July 20, 2009: https://www.youtube.com/watch?v=xL9Tr1ygxms 2 Quoted in Michael Harrington, Socialism (New York: Saturday Review Books, 1970), p. 69. 3 Downloaded April 30, 2016: https://www.youtube.com/watch?v=Psp-r68mo8k 4 https://www.youtube.com/watch?v=dbtnheO61x0 5 https://www.youtube.com/watch?v=AXXUOOqURBI 6 https://www.youtube.com/watch?v=qQGvVf6iMbo 7 https://www.youtube.com/watch?v=qQGvVf6iMbo 8 “So many Men Are Drafted for the Trenches That People at Home Must Systematize Prevention of Disease, Says Dr. Geier,” New York Times July 1, 1917. Available online at: http://query.nytimes.com/mem/archive-free 9 See for example the “Minutes of the Sections” in JAMA 68 (1917), pp. 1856-1857. 10 http://www.gallup.com/poll/183713/socialist-presidential-candidates-least-appealing.aspx 11 Robert Stevens and Rosemary Stevens, Welfare Medicine in America: A Case Study of Medicaid (New York: The Free Press, 1974), p. 9. 12 Forrest Walker, “Compulsory Health Insurance: ‘The Next Great Step in Social Legislation,’” The Journal of American History 56:2 (1969), 290-304. 13 Odin Anderson, “Health Insurance in the United States, 1910-1920,” Journal of the History of Medicine and Allied Sciences 5 (1950), 363- 396, p. 376. 14 Quoted in Ronald L. Numbers, Almost Persuaded: American Physicians and Compulsory Health Insurance, 1912-1920 (Baltimore: The Johns Hopkins University Press, 1978), p. 31. 15 Roy Lubove, The Struggle for Social Security, 1900-1935 (Cambridge, Mass: Harvard University Press, 1968), p. 54. 16 The full Report of the Health Insurance Commission of the State of Illinois, 1919, is available here: https://babel.hathitrust.org/ cgi/pt?id=uc2.ark:/13960/t8kd1zq0s;view=1up;seq=7 17 JAMA, 73:9 (1919), p. 703, referring to page 164 of the Illinois Report. 18 Report of the Health Insurance Commission of the State of Illinois, 1919, p. 165. 19 JAMA 74:19 (1920), p. 1319. 20 Philip King Brown, MD, “Organized Medicine’s Interest in a Health Insurance Plan for Small Wage Earners,” New England Journal of Medicine 205:27 (1931), 1285-1291, p. 1288. 21 J. Lee Kreader, “Isaac Max Rubinow: Pioneering Specialist in Social Insurance,” Social Service Review 50:3 (1976), 402-425. 22 Philip King Brown, MD, “Organized Medicine’s Interest in a Health Insurance Plan for Small Wage Earners,” New England Journal of Medicine 205:27 (1931), 1285-1291, p. 1287. 23 Quoted in Arthur Viseltear, “Compulsory Health Insurance in California, 1915-18,” Journal of the History of Medicine and Allied Sciences 24:2 (1969), 151-182, p. 162. 24 Viseltear, p. 163. 25 “State Amendments Analyzed,” Los Angeles Sunday Times, November 3, 1918, p. 7. 26 Dorothy Porter, Health, Civilization, and the State: A History of Public Health from Ancient to Modern Times (London: Routledge, 1999), p. 198. Socialism and the History of Medicare 25 27 Quoted in Walker, p. 303. 28 David Moss, Socializing Security: Progressive-Era Economists and the Origins of American Social Policy (Cambridge: Harvard University Press, 1996) and Theda Skocpol, Protecting Soldiers and Mothers: The Political Origins of Social Policy in the United States (Cambridge: Harvard University Press, 1992), pp. 178-185, for further discussion of opposition. 29 Daniel Hirshfield,The Lost Reform: The Campaign for Compulsory Health Insurance in the United States from 1932 to 1943 (Cambridge: Har- vard University Press, 1970), p. 25. 30 David Rosner and Gerald Markowitz, “The Struggle over Employee Benefits: The Role of Labor in Influencing Modern Health Policy,” Millbank Quarterly 81:1 (2003), 45-73. 31 Edwin Witte, The Development of the Social Security Act (Madison: University of Wisconsin Press, 1962), p. 3. 32 http://www.wnyc.org/story/132467-in-sickness-and-in-health/ 33 Hirshfield, above; Paul Starr,The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry (New York: Basic Books, 1982) 266-269. 34 The reports are reproduced here: http://www.presidency.ucsb.edu/ws/?pid=15699 35 Stevens and Stevens, Welfare Medicine in America, pp. 20-21. 36 Martha Eliot, “Emergency Maternity and Infant Care Program for the Wives and Infants of Men in the Armed Forces,” JAMA 124:13 (1944), 833-838. 37 William Beveridge, “Social Security: Some Trans-Atlantic Comparisons,” Journal of the Royal Statistical Society 106:4 (1943), 305-332. 38 Video of Beveridge: https://www.youtube.com/watch?v=l2DhvTCuK_s 39 Harry Truman, “Special Message to the Congress Recommending a Comprehensive Health Service,” November 19, 1945, available online at the Truman Library: (http://www.trumanlibrary.org/publicpapers/index.php?pid=483&st=&st1= 40 Annual Message To The Congress On The State Of The Union--January 7, 1948, broadcast on national radio. Social Security Admin- istration website, Presidential Statements. https://www.ssa.gov/history/hststmts.html#annual. Audio recording on Truman Library website: http://www.trumanlibrary.org/audio/mp3s/play.php?aud=sr61-29.mp3 41 Jill Lepore, “The Lie Factory,” The New Yorker, September 24, 2012. Online at: http://www.newyorker.com/magazine/2012/09/24/ the-lie-factory. Her October 12, 2012 interview with WNYC is online at: http://www.wnyc.org/story/243263-worlds-first-politi- cal-consulting-firm/ 42 Quoted in Lepore, “The Lie Factory.” 43 Stevens and Stevens, above, p. 28; Robert Peters, “The Social Security Amendments of 1960: Completing the Foundation for Medi- care and Medicaid,” Journal of Health and Human Services Administration 26:4 (2004), 438-469. 44 Video clip of Kennedy at https://archive.org/details/jfk1 45 “Ronald Reagan speaks out against Socialized Medicine” https://m.youtube.com/watch?v=z43NCL6Fxug 46 Stevens and Stevens, above, 46; Theodore Marmor, The Politics of Medicare (London: Routledge and Kegan Paul, 1970), Chapter 2. 47 Marmor, p. 54-55. 48 http://pastdaily.com/wp-content/uploads/2014/02/Meet-The-Press-Abraham-Ribicoff-Feb.-21-1961.mp3 49 Socialist Standard (1944): http://www.worldsocialism.org/spgb/socialist-standard/1940s/1944/no-478-june-1944/concerning-na- tional-health-service 50 Anthony Ferris, “Importance of Freedom,” British Medical Journal 1: 5439 (April 3, 1965), p. 928; I.M. Jones, “Private Practice Com- mittee,” British Medical Journal 1:5534 (January 28, 1967), p. 26. 51 Recorded speech online at The History Channel: http://www.history.com/speeches/lyndon-johnsons-address-to-congress-after-ken- nedy-assassination

26 Medical History for Medical Students 52 Marmor, p. 61. 53 Stevens and Stevens, p. 49. 54 History Channel audio recording of Johnson’s speech: http://www.history.com/speeches/lyndon-johnsons-address-to-congress-af- ter-kennedy-assassination, at 3:34. 55 See excerpt from Sander’s speech on CNN video: http://www.cnn.com/2016/02/17/politics/bernie-sanders-2016-denmark-demo- cratic-socialism/ 56 Chomsky interview on C-Span: http://www.c-span.org/video/?176809-1/depth-noam-chomsky, comments at 1:21:00. 57 Harrington, Socialism, p. 46. 58 Harrington, Socialism, pp. 67-68. 59 William English Walling, Socialism As It Is: A Survey of The World-Wide Revolutionary Movement (New York, 1912, 2011). Kindle file location 1167. 60 Max Skidmore, Medicare and the American Rhetoric of Reconciliation (Birmingham: University of Alabama Press, 1970), p. 102. 61 John Kenneeth Galbraith, “The Age of Wordfact,” The Atlantic Monthly (September, 1960), pp. 87-90. 62 Orwell’s essay available online: https://www.mtholyoke.edu/acad/intrel/orwell46.htm 63 O’Donnell on MSNBC: https://www.youtube.com/watch?v=hSGs5bey3xw

All references to URL sites accessed between May 1 - May 14, 2016.

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Additional funding is also provided by the UCSF Center for Humanities and Health Sciences and we wish to thank Professor Dorothy Porter, Director, for supporting these initiatives.

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Medical History for Medical Students Medical Education series:

Issue 1: Healers Through History (forthcoming) Issue 2: Hospitals Through History (2015) Issue 3: Anatomy Through History (2015) Issue 4: Lungs Through History (forthcoming) Issue 5: The Heart Through History (forthcoming) Issue 6: Metabolism and Nutrition Through History (forthcoming) Issue 7: Neurology Through History (forthcoming) Issue 8: Cancer Through History (forthcoming) Issue 9: Immunology Through History (forthcoming) Issue 10: Pediatrics Through History (forthcoming) Issue 11: Geriatrics Through History (forthcoming) Issue 12: Alternative Medicine Through History (forthcoming)

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Socialism, Medicare, and the Yoke of European Dictatorship (2016)

28 Medical History for Medical Students