Health Activism, New Left

HEALTH ACTIVISM, NEW LEFT. The Health left revived in the 1960s, reflecting and interacting with the broader social movements of the time. Earlier generations of left health activists had focused primarily on public health issues and on the financing and regulation of health care. The left health movements of the 1960s and 1970s added a focus on the operations and control of the institutions that delivered health care, the experiences of workers and patients in the health care system, and the larger social impact of medical care. Taken as a whole, the Health left was perhaps the standout example of a cross-class, cross-race and ethnicity, and cross-gender movement of the era.

In 1964 left and liberal health professionals formed the Medical Committee for Human Rights (MCHR) as an adjunct to the civil rights movement. Initially its main contribution was “medical presence.” The physical presence of mainly white physicians and other health professionals at major civil rights demonstrations in the South added credibility to the events and increased the safety of all participants. Health workers also provided first aid and minor medical and surgical care.

Subsequently, MCHR members set up a community health clinic and program in Mound Bayou, Mississippi, and a similar clinic in Boston. Funded by the Office of Economic Opportunity, the clinics sought to provide “community-oriented primary care” in which the community was considered to be the patient and the health center’s charge was to address whatever problems threatened the health of the community. The Mississippi and Boston clinics provided a model for many others. Although the advent of Medicare and Medicaid resulted in medicalization of the model, clinics influenced by the model still embody many of the original left values, including community control, access regardless of financial status or insurance, and comprehensive services, and have grown to be a major source of care for many poor communities.

In the mid-1960s, after northern whites separated from most southern civil rights organizations, MCHR became a multi-issue left organization. It continued to provide medical support at demonstrations, developed an occupational health project, opposed the war in Vietnam, and supported government policies and programs to eliminate or ameliorate the plight of the poor. It developed the principles that served as the basis for the National Health Service bill introduced in 1977 by Congressman Ronald Dellums, an avowed socialist.

Under the leadership of Dr. Quentin Young, Chicago became a major center of MCHR activity. Young had established a health politics course, the Urban Preceptorship at the University of Illinois/Chicago, gone south with MCHR, and helped organize a medical presence for the 1968 Democratic Convention protests. He was active in the Socialist Caucus of the American Public Health Association and served a term as its President. He was a strong advocate of a single-payer health care system.

In 1972, Chicago MCHR sponsored a conference of medical professionals and union leaders that led to the formation of the Chicago Committee on Occupational Health (CACOSH). The model was replicated in Philadelphia, New York, San Francisco, and other cities. Tony Mazzocchi, a left-wing officer of the Oil, Chemical and Atomic Workers, became the leading labor voice on job safety and health. The MCHR Occupational Health Project was led by Daniel Berman, who published Death on the Job in 1979. These activities contributed to the passage of the Occupational Safety and Health Act in 1970.

In Chicago, as in other major cities, the public hospital, Cook County Hospital, was underfunded and overcrowded and the working conditions chaotic. Like public or “charity hospitals” elsewhere, it was threatened with closure. As chair of Internal Medicine at Cook County, Dr. Quentin Young gathered around him a group of interns, residents and attending physicians to lead efforts to stop closure of the hospital and to improve staffing and working conditions. There were two major labor actions by the interns and residents, in which they stopped admitting new patients and presented the county board, the hospitals funding agency, with a long list of demands.

Health care students also moved to the left. In 1965, medical, nursing and public health students who had participated in activist organizations in college met in Chicago to form the Student Health Organization (SHO). In contrast to many profession-specific student organizations, such as the Student American Medical Association, SHO was open to nursing, social work, medical, and dental students, united by a commitment to community service to people in poverty. One of SHO’s organizing strategies was to establish summer service projects in poor communities. Funded by the federal government’s Office of Economic Opportunity, three SHO summer projects ran in 1966, six in 1967 and nine in 1968.

Another outgrowth of the New left and other movements of the 1960s was the free clinic movement. One of the first was formed by white professionals in the Haight-Ashbury neighborhood of San Francisco in 1967. Free clinics, staffed by volunteer medical students, residents, and nurses, spread rapidly to other cities, often in inner city areas, offering a range of health care services. Many of the free clinics were explicitly linked to left organizations. The Black Panther Party opened thirteen clinics around the country, beginning in 1970, and in 1972 added the right to free health care to its Ten Point Program. The Puerto Rican- based Young Lords Organization and I Wor Kuen, a New York City Chinatown-based radical Asian-American organization, also opened free clinics. The free clinic movement was perhaps most effective in pressuring local hospitals to provide care to the unserved and underserved populations that surrounded them.

The Black Panthers, the Young Lords, and I Wor Kuen also engaged in a wide range of other health-related activities. These included drug treatment programs, free breakfast programs, community-based testing for lead poisoning and tuberculosis, and actions to demand better garbage collection. The Young Lords, working with organizations of non-professional health care workers such as New York’s Health Revolutionary Unity Movement (HRUM), community activists such as the (NY) Lower East Side Neighborhood Health Council, and groups of young health care professionals, engaged in a variety of insurgent activities.

HRUM developed a 10-point program that included demands for community-worker control of health institutions, free health services, increased preventive services, and open admissions to medical school for minority students. For two weeks in 1969 the organization took over the mental health services at Lincoln Hospital, a city-owned hospital in the South Bronx. Professional administrators were replaced with nonprofessionals, most of whom lived in the community. Rather than strike, they chose to “occupy” and run the institution. Their main goal was to improve services. After the arrest of 23 mental health workers and extended negotiations, senior administrators at the Mental Health Center were reassigned and workers elected their own board to run the center.

Inspired by HRUM, the Lincoln Hospital Pediatric Collective was formed in July, 1970. The Pediatric Collective emerged from SHO. When activist students graduated from medical school, they looked for opportunities to maintain their commitments. In early 1969, Dr. Charlotte Phillips, one of the founders of SHO, had moved to New York City to join the Pediatric residency program at Lincoln Hospital. Lincoln served one of the poorest communities in the United States and rarely attracted U.S. medical school graduates as residents despite its affiliation with Albert Einstein College of Medicine. Phillips and other members of SHO initiated a campaign to recruit residents to Lincoln to build a community Pediatrics program. They were able to recruit a majority of residents at all levels of the program. Their success afforded them the power to transform the residency program both within the hospital and in its services to the community.

In its first year, the Pediatric Collective collaborated with the Young Lords Party and the Black Panther Party, who were developing free clinic programs in the community. The Collective assisted in providing services through the clinics. At the same time, it initiated reforms within the hospital. In the pediatric outpatient clinic, patients had historically been given 9 am and 1 pm appointments, first come/first served. The Collective replaced this with a timed appointment system to reduce waiting time and so that every patient knew when the doctor would see them. On the inpatient service, team rounds which had previously usually been limited to doctors, now became multi-disciplinary. A night float system was designed, so that residents would not be required to have 36-hour shifts, but only 12-hour shifts. Community members were invited to participate in the resident admissions committee that interviewed and selected residents for the next year. In its second year, the Collective was approached by the Community Medical Corps (CMC), a group of community health workers employed by the New York City Department of Health. CMC wanted training to perform skin tests for tuberculosis and blood tests to detect lead poisoning. The Collective provided the training and medical back-up for the CMC.

More conventional efforts at organizing hospital workers also accelerated in the mid and late 1960s. Local 1199, the “old left” led union of New York City pharmacists and drugstore clerks, moved successfully into organizing hospital workers, first in New York City. By 1969, 60 per cent of workers in New York’s not-for-profit hospitals and a large fraction of those in public and for-profit hospitals were unionized by Local 1199. District Council 37 of the American Federation of State, County, and Municipal Employees also successfully organized workers in public hospitals, and Local 144 of the Service Employees International Union organized in for-profit hospitals. Unionization was not limited to non-professional workers. Technicians and therapists, nurses, and even interns and residents were also organized. The greatest successes were limited to the northeast and on the west coasts.

In some areas, hospital unionizing drives became integrated with the civil rights struggle. In 1969, after an epic 110-day strike of heavily Black non-professional hospital staff in Charleston, South Carolina, supported by weeks of mass demonstrations by the Southern Christian Leadership Conference and a threatened closing down of the port of Charleston by the Longshoreman’s Union, 1199 succeeded in organizing the hospitals.

The unions were successful in assuring higher wages, shorter hours, and better job security in an industry notorious for its exploitation of its employees. Local 1199, in particular, reflecting its left leadership, continued to be active around other social issues, including support for national health insurance and opposition to the war in Vietnam. However, many younger leftists were critical of the health worker unions for their failure to join efforts to reform the health system more radically and for their failure to ally with the community and patient groups seeking more radical changes.

Meanwhile, the emergence of second wave feminism in the late 1960s gave rise to a vibrant women’s health movement. Jane, a woman-run abortion service, was started by Heather Booth while she was still a student at the University of Chicago. A collective emerged to assist the large number of women seeking help. Women could call a phone number, ask for “Jane,” and leave contact information. Initially the abortions were performed by trained, largely male physicians, but as the numbers grew and dissatisfaction with some of the doctors mounted, some of the collective received training in how to perform the procedure themselves and over time took over all of the work. In 1972, one of the apartments where the collective worked was raided by the police and seven members arrested. The case was delayed until the 1973 Roe v Wade decision rendered the it moot. The Jane collective performed nearly 11,000 abortions. Abortion rights groups and underground referral services emerged in other cities as well.

Other issues that became foci of struggle for the women’s health movement emerged in response to popular books and pamphlets or out of women’s consciousness-raising groups. These included critiques of radical mastectomy as a treatment for breast cancer; sterilization abuse, especially among women of color and American Indian women; the medicalization of childbirth; the safety of birth control pills; misogyny among male health care providers; and the potential of gynecological self-care. By 1973, more than a thousand women’s self-help health groups had emerged around the country.

In early 1971 the Boston Women’s Health Collective published Our Bodies, Ourselves. The book included discussions of health and sexuality, sexual orientation, gender identity, birth control, abortion, pregnancy and childbirth, violence and abuse, and menopause. Its many editions have sold more than four million copies. Several other popular books and widely circulated articles both grew out of and helped stimulate the movement. These included Barbara Seaman’s The Doctors’ Case Against the Pill (1969), Phyllis Chesler’s Women and Madness (1972), Doris Haire’s “The Cultural Warping of Childbirth” (1972), and Barbara Ehrenreich’s and Deirdre English’s Witches, Midwives, and Nurses: A History of Women Healers (1970) and Complaints and Disorders: The Sexual Politics of Sickness (1973).

In the 1980s, women of color also began creating organizations focusing on health issues, These included the National Black Women’s Health Project, the National Latina Health Organization, and the Native American Health Education Resource Center. In 1992, six organizations formed the national Women of Color Coalition for Reproductive Rights, and in 1997 Sister Song Women of Color Reproductive Justice Collective, a national activist organization dedicated to reproductive justice for women of color, was formed by sixteen organizations of women of color.

Although less well integrated into the women’s health movement than other parts of the health left of the 1970s, women health workers also became very active. Nurses, other lower level professionals such as lab technicians and respiratory therapists, and non-professional hospital and nursing home workers such as nurse’s aides and kitchen and laundry workers, all predominately female occupations, flocked into unions. Women associated with HRUM and the Young Lords played a key role in the struggles for community-worker control of health care institutions in New York and other cities.
Many of the late 1960s/early 1970s intellectual efforts to analyze and understand the health system and the health movement centered on the New York-based radical collective, the Health Policy Advisory Center (Health PAC). Health PAC was founded in 1968 by Robb Burlage and Maxine Kenney, later joined by other New left activists and by left health professionals who had been active in MCHR and SHO. Health PAC carried out research and conducted training programs for medical and nursing students and community and worker activists. It worked closely with insurgent community and worker groups and published the monthly Health PAC Bulletin. Many of the Health PAC Bulletin articles were subsequently compiled in two books, Barbara and John Ehrenreich, The American Health Empire (1970), and David Kotelchuck (ed.), Prognosis Negative (1973).

Health PAC’s analysis of “medical empires” – the interlocked networks of New York City health care institutions, dominated by medical schools and large teaching hospitals – shifted attention from doctors and the AMA as the main conservative force in the American health care system to hospitals and for-profit corporations. Strongly influenced by then Professor of Community Health Harry Becker, the Health PAC analysis provided a model that led to critiques of health systems and governance structures in other cities, as well. In its November 1969 issue, the Health-PAC Bulletin also described what it called the “Medical Industrial Complex” – the tightly linked complex of government, drug companies, medical supply and equipment companies, health insurance companies, hospitals (public, for profit, and not-for-profit), and the like. The “Medical Industrial Complex” has become a central concept for understanding the problems in the American health care system.

Left health professionals also organized the health and medical component of Ralph Nader’s Public Citizen (the Health Research Group, led by Dr. Sidney Wolfe), the Health Law Project of Philadelphia, and the National Health Law Program. Among other activities, these, along with MCHR and Health PAC, pushed the concept of health as a human right (originally laid out in the United Nation’s 1948 Universal Declaration of Human Rights) and embraced its broad definition of health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Two other health left journals were founded and guided by academic physicians with left credentials predating the New Left: International Journal of Health Services (Vicente Navarro, 1971) and Journal of Public Health Policy (Milton Terris, 1980). The articles in these journals, along with their editors’ own research and publications, have shed much light on the politics and economics of the health field. Along with several other left physicians with teaching positions in medical and public health schools, they have had an enormous influence on the thought and practice of many health professionals.

In the late 1960s, radical graduate students, young academics, and young professionals in many professional occupations had begun to develop a critique of professionalism and of the content of their professional activities. In the health care sector, this critique was heavily influenced by the analyses coming out of the women’s health movement and the health-related movements of Black and brown people. In addition to challenging the institutional arrangements of American health care, the health left increasingly raised profound ideological challenges to modern health care, asking: Who owns medical science? Who owns the body needing care? What are the larger social control implications of health care? Many of the formal expressions of this critique were included in John Ehrenreich’s (edited) The Cultural Crisis of Modern Medicine (1978) and in Barbara Ehrenreich’s and Deirdre English’s For Her Own Good (1978).

During the 1960s and early 1970s, many left health professionals also actively participated in the anti–Vietnam War movement; best known is pediatrician Benjamin Spock, author of the influential Baby and Child Care (1946), the preeminent book on child rearing of the post-War period. Many of these left physicians were also ardent supporters of “solidarity” with the successful socialist revolutions in China, Cuba, Nicaragua, and Vietnam, and with the people’s liberation struggles in Central America, South America, and Southern Africa. Some of the solidarity organizations had a specifically medical/health focus (e.g., the U.S.-Cuba Health Exchange and the Committee for Health in Southern Africa), while others were more broadly focused (e.g., the U.S.-China People’s Friendship Association). The educational aspect of this solidarity work highlighted socialized health systems as well as the people’s health needs, and prioritized visits of health professionals in both directions.

These organizations also raised substantial amounts of money for medicines, medical/surgical supplies, and professional textbooks and journals; in a few instances they funded the construction of a clinic or hospital.

The vibrant health left that had emerged in the mid-to late 1960s waned in the mid-1970s, along with the rest of the left of the period. However, a number of specific areas of what could broadly be called left action continued to emerge.

In the 1980s, the AIDS epidemic engendered a militant movement of people with HIV/AIDS, initially gay men, in San Francisco, New York, and elsewhere. Although rarely grounded in left theory or practice, the activists admired and built on the confrontational “in-the-streets” style of student and civil rights activists of the previous decades. The Gay Men’s Health Crisis, formed in 1982, established an AIDS hotline, buddy programs to provide day-to-day help for people with AIDS, and became a hub of activism. Five years later, frustrated by what they perceived as its political impotence, Larry Kramer and other HIV/AIDS activists started ACT UP, which led militant, disruptive demonstrations to inform and mobilize public opinion.

The AIDS organizations demanded massive increases in funding for research and for national, regional, and community-based organizations to fight HIV/AIDS, an end to discrimination against HIV patients, and lowering of the prices of drugs used to treat HIV/AIDS. The movement of people with AIDS also fought the “doctor knows best” ideology, the elitism, sexism, and racism of medical science, the homophobic-based neglect of the epidemic by government and politicians, and the greed of the pharmaceutical companies. It forced the mainstream to accept models of patient care and medical research in which the customary power relationship between those needing care and cures and those providing care or doing research were greatly altered, giving much more power to those needing care and cures.

Long a low prestige, underpaid field, public health over the years has attracted many left activists. In the 1960s, many health activists participated in the growing environmentalist movement, which led to the establishment of the Environmental Protection Agency (1970) and the passage of the Clean Air Act (1970), and the Clean Water Act (1972). Along with the Occupational Safety and Health Act (1970), these represent major public health achievements which have resulted in many lives saved.

Writers in the 1950s and 1960s such as Rene Dubos and Thomas McKeown had urged a renewed attention to ecological factors determining health. The left critique of individual medical care and medical care institutions, along with a new focus by academics on the “social determinants of health” (e.g., M. G. Marmot’s and ‎Richard G. Wilkinson’s Social Determinants of Health; 1999), reinvigorated the field. Lorrie Garret (Betrayal of Trust: The Collapse of Global Public Health; 2000) and others warned of the dangers of neglect of a robust public health infrastructure, in the United States and around the world. Left health professionals and students lobbied for new public health schools and coursework. They warned that neglect led to a nation ill-prepared for the threat of epidemics, a reality that proved disastrous when the covid-19 pandemic appeared in 2020. The pandemic also exposed the massive and persistent racial, ethnic, and class inequities in both the social determinants of health and in the health care system. Together with the sweeping unemployment that accompanied it, the pandemic brought into stark relief many workers’ lack of paid sick leave and their loss of health insurance when they were out of work.

This catastrophic event contributed to already widely-shared concerns about the lack of universal health insurance coverage in the United States. The struggle for comprehensive and universal health care has a long history in the U.S. and has waxed and waned with the power of progressive politics, parties and labor unions. A national health insurance program was an important part of the political agenda of the CIO in the postwar 1940s and enjoyed support from the Truman administration. With the failure to enact legislation, negotiating health insurance for union members on a company by company basis became a priority instead. The struggle picked up with Lyndon Johnson’s Great Society, with the enactment of Medicare for the elderly and Medicaid for the poor. Both programs were fought bitterly by the AMA, insurance and pharmaceutical companies.

Renewed demands for a program of National Health Insurance emerged in 1969, when then-President Nixon declared that rapidly rising health care costs had created a “massive crisis.” Many health left activists were critical of even the most comprehensive of the several plans that were proposed, noting that they would not address issues of the organization of health care delivery systems, the relationship between the providers and recipients of care; or power, accountability; and priorities in the health care system. In any event, in the context of the Watergate Scandal, Nixon’s support for a program of national health insurance faded and the opportunity was lost. In 1987, Physicians for a National Health Program (PNHP), a national physicians’ organization to advocate for single payer national health insurance and health care as a human right was launched. Dr. Quentin Young of Chicago was, for many years, national coordinator. In the early 1990s, however, a national health insurance program proposed by President Clinton was once again defeated by health insurance industry and conservative opposition.

The left was not central to the struggle to establish the Affordable Care Act under President Obama, which preserved the role of private insurance corporations. In the years following enactment of the ACA, third parties such as the Green Party often included universal health care as part of their platform. In 2016 and 2020, the campaigns of democratic socialist Bernie Sanders for the Democratic Party nomination for President focused attention on the limits of the ACA. Sanders proposed replacing the ACA with a “Medicare for All” program, doing away with the role of private insurance companies altogether. While the Sanders campaign did not succeed, Medicare for All became part of the mainstream political discourse for the first time since the 1940s.

Ehrenreich, Barbara, and Deirdre. Complaints and Disorders: The Sexual Politics of Sickness. Feminist Press, 1973.

Health PAC Bulletin, Digital Archive. www.healthpacbulletin.org.

Hoffman, Lily M. The Politics of Knowledge: Activist Movements in Medicine and Planning. Albany: State University of New York Press, 1989.

Morgan, Sandra. Into Our Own Hands: The Women's Health Movement in the United States, 1969-1990. Rutgers University Press, 2002.

Mullan, Fitzhugh. White Coat, Clenched Fist. New York: Macmillan, 1976.

Sidel, Victor W., and Ruth Sidel. Reforming Medicine: Lessons of the Last Quarter Century. New York: Pantheon Books, 1984.

– John Ehrenreich, Walter J. Lear, and David Simmons, with Oliver Fein and Charlotte Phillips