In the battle for Medicare for All

With the 2020 presidential campaign underway and Medicare for All once again a possibility, NYSNA has lost a dedicated ally and friend in the long fight for affordable healthcare. At the time of his death, on April 19, Max William Fine, the last surviving member of JFK’s Medicare Task Force, considered nothing more pressing than bringing care to a nation.

At his core, Fine knew instinctively what nurses know firsthand: health is almost unachievable without access to quality healthcare. Fine had no doubt. Healthcare is a right not a privilege. In 1978, he told the Boston Globe:

The question in the United States is whether we should continue to build a private health insurance system that uses such devices to limit its own liabilities without controlling overall costs, or whether we should move on to social insurance with everyone covered on an equitable basis, with no exclusions and strong cost controls. The issue is healthcare as a human right under social insurance or as a privilege for those who can afford to pay for it.

Private insurance remains unfettered and caregivers on the frontlines are intimately familiar with its toll—skyrocketing healthcare costs that negatively impact care. Today, the United States spends $3.5 trillion on healthcare.

While industry titans accumulate billions in profits, 34 million Americans still do not have health insurance. Our maternal mortality rates are the highest among all developed nations, according to the World Health Organization, and our longevity ranks 31st in the industrial world.

A national imperative

Like Fine, nurses know that, now more than ever, Medicare for All should be a national imperative. However, the fight remains an uphill battle, as it was for Medicare under JFK. What Max Fine helped teach us is to stay the course, that with a firm resolve we can and will prevail.

In 1963, when President John F. Kennedy tapped Fine to help shape the legislation that would assure affordable healthcare to America’s seniors, the prohibitive cost of health insurance was driving many elderly who needed hospitalization into bankruptcy. Even so, public support for Medicare was hardly a given.

When JFK made Medicare a key part of his bid for the presidency, the legislation came immediately under fire in the form of medical association and insurance industry attack ads. Richard Nixon, JFK’s opponent, sounded the alarm that Medicare was socialism.

Just a beginning

Medicare survived them all—political opponents, the insurance companies, the medical establishment, and the Madison Avenue advertisers. On July 30, 1965, thanks to the commitment and determination of people like Max Fine, the Medicare Act was signed into law by President Lyndon Johnson, who ushered it through after JFK’s assassination.

That law, Fine said, was a beginning, but not enough. JFK and others had intended to extend it to all Americans: Medicare for All.

Labor’s central role

Fine understood that to advance a program of this breadth and significance labor should play a central role. Who better to speak to the needs of working people?

In 1968, with the financial backing of the UAW and key support from other unions, Fine founded the Committee for National Health Insurance. The committee grew as medical and health insurance costs continued to rise, drawing on support from a coalition of religious organizations, consumer groups and public health experts.

A decade later, the Committee dissolved, a temporary setback but not defeat. Fine simply shifted gears, worked with friendly members of Congress to keep Medicare for All a part of the dialogue. Traveling to public forums, he continued to extol the message of healthcare as a human right.

More relevant than ever

Today that message is more relevant than ever. Forty-two percent of new cancer patients lose their entire life savings within two years, the American Journal of Medicine reported in October 2018. Fifty-eight percent of adults have delayed or foregone medical or dental care because of high costs, a recent survey found, and 31 percent of respondents said they did this “often.”

Fine continued to underscore the key role labor must play in the policy and advocacy of todays’ fight for guaranteed healthcare, and we couldn’t agree more! We thank him for citing NYSNA and other nurses’ unions for their leadership on the issue and recognise the essential central role the entire labor movement must have to ensure success. Fine’s optimism has proved well-founded. This January, the Kaiser Family Foundation reported that 56 percent of Americans are in favor of Medicare for All, and those numbers may well be conservative. According to Reuters/Ipsos, support for single-payer has reached 70 percent.

“It was always our intention to extend the guarantees of Medicare to all Americans,” Fine said. Max Fine was 92 when he died.

NYSNA nurses, joined by NNU/VA hospital RNs, at Lobby Day for Medicare for All in Washington, D.C., April 30