Michael Moore shows in his documentary “Sicko” how universal health care works in Canada, Britain, France and Cuba. In these countries, if you have a medical problem you go to a doctor without worrying about the bill.
It is not surprising that a system of socialized medicine has been established in Cuba, even though it is a poor country
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But no such revolution has occurred in Canada, Britain or France, or in the other industrially advanced countries that have universal health care. What accounts for the fact that citizens of these countries enjoy this social benefit—along with others that U.S. expatriates in France interviewed by Michael Moore enumerated—while U.S. citizens endure a far inferior, profit-driven system?
Fear of the people
The basic answer is provided by one of Michael Moore’s interviewees, who explains that “the government of France is afraid of their people.” And why is that? Moore shows us scenes of militant demonstrations. In fact, the French people, and in particular the labor unions, led by socialists and communists, have a history of conducting political strikes and mass street actions that forced the capitalist ruling class to concede universal health care and defeated subsequent efforts to privatize it.
Tony Benn, a former Labour Party member of Parliament, told Moore that if the British government had tried to dismantle the National Health Service, “there would have been a revolution.”
The history of the U.S. labor movement, at least from the mid 1930s on, is quite different. Militant strikes and even factory takeovers have been carried out by sections of the U.S. labor movement, but they have generally been around economic issues such as wages, hours and working conditions, or union recognition. Demands for benefits such as health insurance and pension plans have been directed at individual employers.
Demands on the government for progressive social measures have usually not been backed up by militant mass action. Instead, the labor movement has relied on electing “friends of labor” in the capitalist Democratic Party.
True, Social Security, unemployment insurance, and other social benefits were won in the early years of Franklin Roosevelt’s presidency. But these gains also reflected “fear of the people” on the part of the U.S. ruling establishment because of the powerful example set by the five-year plans of the Soviet Union and the social gains made by the Soviet workers. The U.S. rulers were also quaking at the powerful rise of new industrial unions organized in the CIO, with socialists and communists playing leading roles. However, universal health care was not part of the “New Deal.”
What accounts for the differing political orientations of the European and U.S. labor movements, the greater political independence and power of the former as compared to the latter?
Parliamentary system versus two-party monopoly
In Europe, the main political tendencies of the labor movement run in elections under their own party banners—that is, they run their own candidates and have thereby achieved representation in European parliaments.
In the United States, the unions generally support candidates of the capitalist Democratic Party and consequently have no representation in Congress.
In Europe, the workers’ parties organize political strikes and mass actions
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In Europe, the parliamentary form of bourgeois rule has mostly prevailed. In the United States, for various historical reasons— a working class divided by racism and inequality, onerous election laws different in every state, and more—the capitalist rulers have established and maintained a two-party monopoly.
Lack of political independence has greatly weakened the labor movement in the United States as compared to Europe and resulted in far fewer social benefits for the people—and no universal health care.
It is true that in the 1960s and early 1970s, additional gains were made by the U.S. working class and oppressed nationalities, including, in 1965, Medicare, a limited form of universal health care for seniors and the disabled.
But it wasn’t labor’s support to Democratic Party politicians that won these gains. Rather, mass actions for civil rights and uprisings in the African American urban ghettoes, coupled with the heroic resistance of the Vietnamese people to U.S. imperialist aggression leading to a mass radicalization of youth and students and many workers again induced “fear of the people” in ruling-class circles.
That fear led even arch-reactionary Richard Nixon to preside over the granting of key concessions, including women’s right to choose abortion, environmental protection laws, and job safety legislation.
Indeed, progressive social gains can be won in the United States despite the straitjacket hold of the ruling class, up to now, over the electoral arena. This is because the decisive battles for such gains are really waged and decided outside that arena.
What will it take to win universal health care?
These historical facts show how universal health care can be won. Only “fear of the people” on the part of the ruling establishment will bring a positive result.
The grassroots effort of lobbying capitalist politicians now being promoted for passage of single-payer legislation in California (SB 840) and at the federal level (HR 676) is unlikely, by itself, to do the job.
The parasitic insurance companies and American Medical Association, which have blocked single-payer legislation in the past, can be defeated. But the unions and other progressive organizations spearheading this struggle will need to engage in a militant mass action campaign to ensure victory in the fight for universal health care.
As “Sicko” documents so well, the condition of the healthcare system in the United States is critical. This makes such a campaign both necessary and possible. The mass actions of the anti-war and immigrant rights movements show the way.
PSL review: ‘Sicko’ exposes the need for universal health care
