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Joseph Keller

The Medical Monopoly

(13 December 1948)

From The Militant, Vol. 12 No. 50, 13 December 1948, p. 4.
Transcribed & marked up by Einde O’Callaghan for the Encyclopaedia of Trotskyism On-Line (ETOL).

Capitalism “has left no other bond between man and man than naked self interest, than callous ‘cash payment’,” wrote Karl Marx and Frederick Engels in their Communist Manifesto of 1848. “It has resolved personal worth into exchange value ... stripped of its halo every occupation hitherto honored and looked up to with reverent awe ... the physician, the lawyer, the priest, the poet, the man of science ...”

The American Medical Association today gives striking confirmation of this profound observation about the universally corrupting influence of capitalism. It is the powerful medical monopoly, controlled by a bureaucracy of high-paid officials and supported in part by the drug corporations, which is devoted to maintaining the high cost of medical aid.

Last week the AMA Board of Trustees, after a secret meeting of its House of Delegates in St. Louis, announced it is raising a $3,500,000 fund to campaign against the proposed federal health insurance bill. This fund is to be raised by exacting a $25 assessment from each of the 140,000 physician-members of the AMA.

The high moguls of the AMA, who represent the well-to-do physicians and “society doctors” mainly, claim that any government measure to provide low-cost medical care to millions of American workers is nothing less than “a variety of socialized medicine.” These staunch medical royalists want to solve the “economic problem of the distribution of medical care within the existing framework of private enterprise.”

Unfortunately, as every public health survey and the tragic figures of the medical rejections by Selective Service reveal, “private enterprise” has failed miserably in providing even minimum medical care for tens of millions. Even the higher-paid workers cannot carry the burden of the exorbitant fees demanded by doctors, specialists and hospitals. The wreckage of “private enterprise” in medicine is crowding to bursting the inadequate public hospitals now available.

Of course, the AMA officials’ talk about the “American way” and the “catastrophe” of “any scheme of political medicine” is pure cant to hide naked self interest. They fear that if the government provides a system for better medical care at less cost to the workers, it will cut into the big fees of the medical monopoly. And it will help to break the grip of the AMA over the medical profession.

Fronting for the AMA in Washington is the high-sounding National Physicians Committee for the Extension of Medical Service (NPC). This is a lobby composed of former officials of the AMA which has spent millions to fight public health insurance over the last nine years. The AMA, as a tax-exempt organization, cannot engage in direct lobbying. A large part of NPC funds comes from the big drug firms, who fear the unfavorable effect of national health insurance on their $750 million annual sale of patent medicines.

Not every physician is concerned solely with “callous ‘cash payment’.” Many doctors are, or would like to be, selfless and hard-working, devoted to alleviating suffering and raising the health standards of the people. But they too suffer from the general insecurity of the capitalist system and their ideals are swamped under the cynical philosophy of “hard-cash” that pervades capitalist society.

It is precisely under socialism, where the profit motive and “dog-eat-dog” philosophy will be eliminated, that the physicians and men of science will be able to serve society selflessly, with genuine dignity and honor, free of economic pressure and insecurity.

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