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The New International, May 1939


Paul Luttinger, M.D.

‘Socialized Medicine’


From New International, Vol.5 No.5, May 1939, pp.155-156.
Transcribed & marked up by Einde O’Callaghan for ETOL.


American Medicine Mobilizes
by James Rorty
W.W. Norton & Co., New York 1939; 358 pp., incl. index. $3.

To write a provocative and dramatic book on as dry a subject as medical economics is to most people, a feat indeed! Mr. Rorty’s success is primarily due to his long and varied literary activity, his background in the radical movement and to the social fermentation which has finally thrown up the problem of medical care on the muddy surface of the capitalistic swamp.

American Medicine Mobilizes is the first attempt – in book form – to bring before the American public a compact and inclusive narrative of the history and development of the new forms of medical care: Group practise, hospitalization plans, medical cooperatives, compulsory health insurance, etc. Those who have read some of the chapters of the book which appeared as magazine articles, as long as three years ago, have now the opportunity to preserve in permanent form a vast array of factual information, hitherto available only in stuffy technical publications and in the dusty files of governmental reports.

But let no one be deceived into thinking that this is a book on socialized medicine. Although the publisher’s blurb on the cover begins with the grandiloquent statement that “Socialized medicine is one of the major issues before the American people today”, and notwithstanding the subtitle of Chap.XIV which reads: “Why the Medicine Makers Don’t Want Socialized Medicine”, the body of the chapter contains no reference whatsoever to socialized medicine; nor is it advocated in any part of the book.

And yet, Mr. Rorty is intelligent enough and has been close enough to our circles to know the difference between socialized medicine and the paltry substitutes which lay and medical politicians alike are trying to foist upon us. Or did the publishers delete the corresponding text to prevent the bourgeois reader from suspecting the author of subversive tendencies? The author admits having rewritten the book twice in order to avoid polemical attacks. Was the advocacy of socialized medicine one of the controversial points left out from the final text?

Be that as it may, American Medicine Mobilises is chock-full of valuable data for the average reader and even debater or popular writer who needs quick and condensed facts on a subject which promises to become one of the burning questions in our national economy. Mr. Rorty was present at the National Health Conference which took place in July of last year and is able to give first-hand and succinct information on the personalities and issues behind the event. Even to those who are somewhat familiar with the deplorable health conditions in this country, it will be a shock to learn that the gross sickness and mortality rates for the poor of our large cities are as high today as they were fifty years ago; that 30% of serious disability illnesses among relief families with incomes of less than $300, is more than five times that of families getting $3,000 or above; that 40% of the counties having a population of 18 million (p.23) or 17 million (p.230) are lacking a registered general hospital; that a million workers are exposed to the hazards of silicosis; that 50 million Americans are in families receiving less than $1,000 income a year; that the total cost of illness and premature death is approximately 10 billion dollars yearly; that we spend haphazardly 3¼ to 3½ billion dollars (not 3¼ million as is erroneously stated on p.246) to achieve these “brilliant” results.

There are fine chapters in the book on Unmet Medical Need and on Syphilis; but the one on compulsory health insurance is somewhat sketchy. The author is evidently unacquainted with the most recent work on the subject: Health Insurance with Medical Care by D.W. Orr, M.D., and J.W. Orr, published by Macmillan, December 1938, a first-hand study of the British experience with the “panel” system of national health insurance.

Mr. Rorty writes with great sincerity and force and it is quite evident that he is genuinely concerned over the abuses, the sins of commission and of omission which have developed under the present scheme of medical practise. He repeatedly emphasizes the irreconcilable clash between the science and the business of medicine; between the reactionary economic position of the AMA bureaucracy and the humanitarian aspirations of the medical profession as a whole. Yet, he fails to draw the only conclusion warranted by the facts which he so ably exposes: That the only solution to the incompatibility is the complete socialization of medicine. To quote:

Do the working men and women of this country want health? Do they want security against sickness? Then let them reach out their hands and get it! The means are at hand. The problem can all be solved. The program – even a far bigger program than our National Health Program – would save far more than it cost. What, then, are we waiting for?

The answer to this eloquent question is that no real, planned health program is possible under the present capitalistic scheme. The socialization of medicine goes hand in hand with the socialization of the instruments of production and the collectivization of the land.

In the meantime, the immediate task for trade unions and farmers’ cooperatives is to organize group clinics of their own which should be in a position to take advantage of any grants or subsidies that can be wrested from the government and from employers. Only by retaining complete control of their medical organizations can the workers of America prevent the advent of the new slavery of bureaucratic state medicine.

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