We are at war --- an unconventional war. I am not referring to our nation's war against the terrorists --- no. I am referring to war as described by Webster as being in a state of forceful opposition. It has been carried on for a number of years, slowly, craftily and by surreptitious incrementalism with such success that most doctors fail to realize its true origins or the sources of its present strength.
In the 1920s, England had a group of primarily wealthy heirs, writers and self-styled intellectuals who founded the Fabian Society, its aim to transform Britain into a socialist society.
They were the authors of permeation which purpose was to infiltrate major political parties so that socialistic programs could be implemented no matter which party was in power.
Shortly thereafter the Fabians assisted the formation of a sister society in the United States called the Intercollegiate Socialistic Society. Because it failed to take hold, it wasn't long before they changed the name to The League for Industrial Democracy.
The League continued its efforts through the twenties and thirties without obtaining any substantial support for widespread socialism. Around 1932 they tried to get President Franklin Delano Roosevelt to incorporate medical care along with social security for the elderly, but FDR then said no because "it would lead to socialized medicine," which he opposed. I remember: I was in my pre-med at the University of Detroit and on the debate team.
It was in the late thirties that they revised their efforts toward incrementalism whereby they would first seek to socialize medicine for the elderly and then pursue their overall objective, one by one.
In 1941, because progress was still very slow, they again changed their name --- this time to the Union for Democratic Action.
In 1943, their influence began to gain strength and they played a major role in the introduction of the Wagner-Murray-Dingell Bill to provide medical care for the American people via Social Security.* This quickly gained support from American labor leaders. Though never totally successful, the Wagner-Murray-Dingell Bill was introduced in 1943, 1945, 1947 and 1949.
Just four days after its initial introduction in 1943, a specially-called meeting of the American Medical Association's House of Delegates recognized for the first time the importance of political forces and thus authorized the establishment of a Washington, DC, office and the Council for Medical Service and Public Relations. This was the majority decision despite prolonged and at times very heated debate on the part of physicians who maintained that the AMA should stick to medicine, education, research and clinical practice and leave politics to the politicians.
In 1947, for the third time, the Wagner-Murray-Dingell Bill was defeated and the Republicans took over the majorities in both House and Senate. This led admitted socialist, labor leader Walter Reuther to meet with Harvard socialist historian Arthur Schlesinger, Jr., who with only a few leaders of the Union for Democratic Action organized to change the name to the Americans for Democratic Action.
In that same year, 1947, Schlesinger wrote in Partisan Review, "If socialism is to preserve democracy, it must be brought about step by step, in a way which will not disrupt the fabric of custom. The transition must be piecemeal --- it must be parliamentary, it must respect civil liberties and the due process of law." And from a later passage, "Socialism then appears quite practicable within this framework of reference as a long-term proposition."
In 1949, two years later, for the fourth time, the Wagner-Murray-Dingell Bill was introduced, having obtained widespread media attention and increased political strength. This caused the AMA leadership to hire a public relations firm, Whitaker & Baxter, to conduct a national campaign to educate physicians and patients, assisting those who again defeated Wagner-Murray-Dingell.
Following this victory, doctors went back to practicing medicine, while labor leaders, headed by Walter Reuther, continued their efforts towards implementing socialized medicine.
In 1957, resurrected by the Americans for Democratic Action (ADA), the Wagner-Murray-Dingell Bill became the Forand Bill. It was introduced by Aime Forand of Rhode Island at the urging of socialist Nelson Cruikshank of the AFL-CIO and socialist Andrew Biemiller, congressman from Wisconsin. Aime Forand admitted he had never even read the Bill but introduced it following their requests.
Andrew Biemiller was defeated in 1950 at the same time that Claude Pepper, who had adopted Reuther's philosophy for government, was defeated. It was also in 1950 Florida physicians organized the Florida Medical Committee for Better Government, which had been helpfuI in Pepper's defeat. That committee later became FLAMPAC. President Harry Truman's previously admitted support was not evidenced and the Forand Bill died in committee.
Reuther and his AFL-CIO people continued their efforts, and the King Anderson Bill was introduced by Representative Cecil King of California and Senator Clinton Anderson of New Mexico. The King Anderson Bill sought to socialize all citizens over age 65, rich and poor alike, to be financed by Social Security.
Meanwhile, with strong support from Democratic leadership, an alternative bill was introduced, the Kerr-Mills Bill. This Kerr-Mills Bill was designed to help the really needy people over 65 years of age. It did not require penury; it did not demand sales of home or property, and it was designed especially for those who were bereft of adequate income.
With strong support from the AMA and the leadership of the two most powerful Democrats, Kerr-Mills was pushed by Democratic leaders like Senator Smathers of Florida, Herlong of Florida, Watts of Kentucky, Long of Louisiana, Russell of Georgia and Curtis of Nebraska.
Sen. Ted Kennedy then introduced an amendment, pushed by Reuther, to cover everybody over 65 to be paid for with Social Security taxes, but it was defeated.
With tremendous bilateral support in the House, followed by a Senate vote of 89-2, Kerr-Mills was passed on August 23, 1960. A couple of weeks later it was signed by President Dwight Eisenhower and became law.
The Kerr-Mills Law was then sent to the Department of Health, Education and Welfare (HEW) for implementation, but here Reuther's minions took over. Charged with the responsibility to implement the law, they instead put forth every effort to prevent its operations. As I traveled and spoke around the country to urge implementation of Kerr-Mills, I repeatedly ran into HEW Undersecretary Ivan Nestigan, Assistant Secretary; admitted socialist Wilbur Cohen; plus Zumas and Quigly --- other princlpals, who determined to sabotage Kerr-Mills, kept repeating that Kerr-Mills did not do enough and that we needed King Anderson, which Reuther and Kennedy were still espousing to take care of everybody over 65 - their first step toward their ultimate goal to fully socialize medicine.
Despite this strong opposition, Kerr-Mills continued to expand. Signed into law in September 1960, by August 1961 it was in the process of implementation in 33 states. By November 1964, 39 states and the District of Columbia had established programs providing medical assistance for the aged. All covered hospital services, 30 covered nursing home care, 34 covered doctors' visits, and 25 covered prescription drugs.
Despite its favorable progress the power changed suddenly on November 22, 1963, when President John F. Kennedy was assassinated and Vice-President Lyndon Baines Johnson became president. The continuing power of Walter Reuther was quickly demonstrated. I have in my office a copy of LBJ's appointment schedule the morning after Kennedy's assassination. It was obtained from the LBJ Library in Austin, Texas, and heading the list --- in spot number one --- Walter Reuther.
It is significant to note that President Kennedy seemed to shrug off the entire array of welfare state programs promoted by the Americans for Democratic Action, and was quoted as saying, "I never joined the ADA, I never have felt comfortable with those people."
Just three years before the assassination, the ADA had berated then Senator Lyndon Johnson for bottling up their bills in committee, but having been elected to the presidency by way of Walter Reuther and his labor millions, Johnson kept his promise to Reuther and King Anderson was again introduced, this time as House Bill #1 and Senate Bill #1.
During the week leading up to the debates, I still spoke to preserve Kerr-Mills. But with the ADA, backed by Reuther and reportedly hundreds of millions of AFL-CIO dollars, not only was Johnson elected but also 51 newly hand-picked members of Congress. I wish that I had kept copies of the brochure later distributed by the AFL-CIO. It showed a picture of the House and Senate assembly in the House Chambers with the caption: "51 did it --- The Great Society with Medicare its crowning glory!"
During the last week before the final vote for the again King Anderson legislation, I was in Washington. When I arrived, as usual, I went first to the AMA Washington office.
I was then told that two congressmen had asked that, if I was in Washington, I come by their offices. Both related parallel stories. "Dr. Annis, I don't always agree with the AMA but this time you guys are right --- it is bad legislation; however, if I vote with you, you will still lose. I have been called to the White House, and if I vote with you, the people I represent will suffer so I have no choice."
Another congressman told me that during an earlier visit by one of Reuther's men to solicit his vote, "I pointed to a large box filled with letters and told him, 'Look at all those letters, all against you,' only to be told, 'Mr. Congressman, we elected this Congress, not your letter writers.' "
Later that same day I visited four other offices only to be told, "I haven't read the Bill, I don't intend to read the Bill, but I have to vote for it."
A visit to Wilbur Mills received a similar story. He said, "They have packed my committee, they have packed Senator Kerr's committee, and there is nothing that we can do about it. Johnson controls this Congress."
Thus, it was sheer political power and nothing else that introduced the seeds of government invasion into medicine and their growth to provide the mess we are in today.
Shortly after Medicare became law in 1965, Walter Reuther, from his headquarters at Solidarity House in Detroit, organized a Committee of One Hundred for National Health Insurance.
It wasn't long before he felt that for more rapid growth a name change was in order, and it became the National Council of Senior Citizens --- which few understood to be a vital associate of the AFL-CIO.
During the forty years of liberal domination in the Congress, the National Council of Senior Citizens received over 90 percent of its funding from federal dollars --- this usually amounted to sixty to eighty million tax dollars each year. During the last five years, recent government reports show that they received 334 million tax dollars.
The National Council of Senior Citizens has always been a major advocacy organization for Social Security-financed medical care. The organization retained that name from its inception until last year when, because it was losing support due to unwanted attention by some in the media and in Congress over a long series of scandals, it too changed its name. As of January 1, 2001, it became the Alliance for Retired Americans. It still retains its cloak to hide the close affiliation with the AFL-CIO.
Walter Reuther was killed in a plane crash not long after Medicare became a reality. Meanwhile, the ADA laid claim to the accumulating billions of dollars in union war chests derived from steadily-flowing, withheld wages from millions of workers, whether or not they chose to belong to the Union. Few voters realize the socialistic origins of the Americans for Democratic Action as they are persuaded to vote for liberal legislators seeking ever greater government controls.
Though unsuccessful in their earlier years, true to Schlesinger's promise by pursuing both permeation and incrementalism, the socialists have made great progress and today have willing disciples in both Houses of Congress and both political parties, though their greatest power and numbers still dominate in the Democratic Party.
What I have related is not an exaggerated fantasy. It is in fact true history and provides a realistic perspective as to how the Lilliputian-like bands have been steadily applied to harness our profession. In our society, things don't happen --- people make them happen!
We will conclude this article with "Part II: Fighting the Leviathan" in the Spring 2003 issue of the Journal of American Physicians and Surgeons.
* It was this bill that inspired conservative physicians to found the Association of American Physicians and Surgeons (AAPS) to preserve the practice of private medicine and oppose socialized medicine.---Ed.
Dr. Annis is past president of the AMA, an AAPS member, and the author of Code Blue: Health Care in Crisis (1993).
Originally published in the Medical Sentinel 2002;7(4):116-118. Copyright ©2002 Association of American Physicians and Surgeons.