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Doris writes a weekly column for LaGaceta, the nation's only trilingual newspaper, which has pages in English, Spanish, and Italian.  Begun in 1922 for Tampa's immigrant community, it continues to thrive more than a century later.  Her column is titled "In Context," as it aims to put contemporary issues in the context of the past.

The solution is more government oversight

We celebrated the 50th anniversary of Medicare last week. I well remember when it was debated and adopted. My mother worked at St. Mary’s Hospital in Russellville, Arkansas, and she was among the millions of future happy recipients who vehemently opposed it back then. She was strongly influenced by the Catholic family who owned the hospital, which originally had been run by nuns – ala St. Joseph’s and other institutions here in Florida. But as fewer and fewer women were willing to live a life of self-sacrifice and obedience to male authorities who never actually worked in hospitals, most church-supported ones transitioned either to public ownership (ala Tampa General) or to private corporations (almost everything else in our town).

Many hospitals, however, kept their religious names, even as they sold out to for-profit chains. My old St. Mary’s is owned now by Capella, a hospital chain based in Franklin, Tennessee. That’s interesting because Hospital Corporation of America, the first such chain, began in Nashville in 1968 – just three years after physicians with an inclination for business began to see the possibilities of taking federal funds for their poor patients. You may remember Hospital Corporation of America from our current governor, Republican Rick Scott, who headed HCA when it paid the largest fine in history for Medicare fraud. These corporations could not sustain themselves, much less make good profits, were it not for Medicare money that comes from the feds.

But one wouldn’t have known that back in 1965, when a Democratic Congress passed the Medicare bill proposed by Democrat Lyndon Johnson. He grew up poor in rural Texas and understood that poor people, especially elderly poor people, could not afford hospitalization or even preventative health care. Like other progressives who were molded by the Great Depression and World War II, Johnson saw that Europeans transformed their economic systems after the war ended in 1945. One of the principles of their new way of life was that everyone is entitled to health and hospitalization, and we began to emulate that in 1965.

The 1960s rhetoric opposing Medicare was just like today’s opposing Obamacare. My mother and my pastor and way too many others were frightened by “socialized medicine,” without having a clue what that meant. They merely repeated the propaganda of the upper class and voted for conservatives who opposed President Johnson. In the 1968 election – just three years after the Medicare bill passed – many of them voted for conservative Republican Richard Nixon instead of liberal Democrat Hubert Humphrey. At the same time, however, they got their Medicare cards. Mom retired from St. Mary’s in 1972, and until her death in 2002, she depended on Social Security and Medicare. The pension fund into which she had regularly paid, however, disappeared when the family she trusted sold St. Mary’s to a corporate entity.

I told our beloved late Congressman Sam Gibbons about that, and he sighed, knowing that such employee exploitation was all too common. Employers dipped into pension funds, declared bankruptcy, changed names, and then went about business as usual. The result is that private pensions as retirement plans largely have disappeared – and that probably is a good thing. But this change has occurred without serious thought about the fact that many retirees now depend exclusively on Social Security, and their benefits aren’t nearly enough for a comfortable lifestyle.

Medicare secures their health, but other expenses mean that you see lots of people struggling to work when they really are too old to be stocking shelves or standing at a cash register all day. Yet we have presidential candidates like Florida Republican Jeb Bush who recently mused aloud about “phasing out” Medicare. Worse, when his brother was president, Republicans made a brief attempt to “privatize” Social Security. It was brief because voters of both parties saw the risk of allowing Wall Street to play with the public’s money.

Yes, it is public money and indeed a socialized system. That was not unconscious, as the word root was debated when Social Security was adopted. Our grandparents accepted this “social” aspect of the economy and made Social Security a promise between generations. It has worked well since 1935, when President Franklin Roosevelt and a Democratic Congress created it. Yet capitalists regularly predict its eminent demise -- and do their best to make that happen.

Names matter, and President Johnson chose wisely with “Medicare.” Today’s conservatives thought that they could defeat the Affordable Health Act by calling it “Obamacare,” but from the beginning, I’ve thought that the intended calumny will turn out a be a positive legacy for the nation’s first black president. It’s five years old now, and despite upwards of fifty House votes to repeal it, is more and more an accepted part of our economy. Predictions of rationing boards that would let Grandma die have proven as false as similar stupidity against Medicare fifty years ago. I’ll agree that there’s room in both Medicare and the ACA for fraud – but almost all of that fraud is on the part of corrupt physicians and especially insurance and pharmaceutical companies, not on the part of patients. The solution, quite obviously and logically, is more government oversight, not less.

* * *

My allusion to Tampa General above should be expanded. It always has been public, although one of its CEOs back in the 1990s made a strong attempt to take it private. I remember going to candlelight vigils that elected officials Jan Platt and Pat Frank led to draw attention to this takeover. Eventually the pro-privatization side backed down, and the CEO left town when it became clear that he had exaggerated TGH’s financial status and need for private investment. I’ve pondered this a good deal, but I never shall understand how anyone can think that it makes sense to turn a non-profit institution into one that must turn a profit. After all, to make the ten or fifteen percent profit that investors expect axiomatically will add ten or fifteen percent to the cost of doing business. It simply makes no mathematical sense, but many people have unquestioningly memorized this catechism. We must keep a wary eye out for them.

Tampa General began as Emergency Hospital in 1887, when a handful of women without credentials adopted a professional but non-profit approach to dealing with the plagues of yellow fever that regularly hit our town. That, too, goes back to government – or lack of it, as the area had no public water or sewer system until well into the twentieth century. Lack of public sanitation, of course, encourages disease-spreading mosquitoes, and from its 1824 settlement, Tampa summers could mean death. People who could afford it went north from June through October, but others contracted fatal yellow fever. The 1887 epidemic was the worst, killing some 300 people in a population of 3,000. That’s ten percent. Think on it. Our county’s population now is approximately 1.3 million. At a ten percent rate, 130,000 of us could expect to die.

The Ladies Relief Society that quickly formed was Tampa’s first secular organization of women and included both Christians and Jews. After Jenny Copeland and Mary Cuscaden died nursing the sick, Julia Friebele and Josie Weissbroad led other women in creating Tampa’s first hospital. It was in a house donated by another woman at the east end of what now is Kennedy Boulevard, and its Board of Lady Managers raised the money to equip it and hired the staff. The board’s president was Merobe Hooker Crane, who was a member of the founding family of Hooker’s Point and ran Tampa’s best hotel. Called the Orange Grove, the hotel was where the courthouse annex is today. (And yes, the historic marker there primarily credits her husband, not her.) In keeping with the era’s legal segregation, Emergency Hospital was open only to whites, but when the area’s first hospital for blacks began in 1910, its founder also was a woman, Clara Frye.

From 1887 to 1895, the Board of Lady Managers ran Emergency Hospital on their own. After seven years, they finally asked the Hillsborough County Commission for $50, but it became entangled in a business dispute irrelevant to the hospital, and the county contributed little or nothing to the women’s work. Records are obscure on whether Tampa City Council contributed, but the Board of Lady Managers continued to continue. As often happens with successful volunteers, however, moneymakers soon saw an opportunity to take over. The Tampa Physicians Protective Association, which essentially was a doctors’ union, refused to practice alongside some of the other physicians at Emergency Hospital. They went to the county commission and “demanded that the women relinquish control,” something that the women “angrily refused to do.” It happened anyway, as the doctors formed a completely new board composed of their wives.

You can predict what happened next. The county began monthly subsidies of $50, while the city appropriated $25 each month. Despite that, the Tribune reported in 1903 that the hospital was in “bad financial trouble.” Probably much of the reason was that newcomer immigrants built their own mutual aid societies, complete with hospitals and clinics that were non-profit. Centro Espanol, Centro Asturiano, and others provided cradle-to-grave health care, as well as unemployment, disability, and life insurance to their members.

These forms of “social security” were becoming common in European governments, but not in capitalistic America. They were, essentially, single-payer systems that still are worthy of emulation. We modeled Social Security and Medicare on such ideals of mutual societal support, and they have worked. As our late great Sam Gibbons argued, the goal now should be to expand Medicare to everyone who wishes to participate. It’s called mutual aid, and it follows our ancestral principle that no one should benefit financially from other people’s pain.


Doris Weatherford writes a weekly column for La Gaceta, the nation's only trilingual newspaper. With pages in Spanish, Italian, and English, it has been published in Tampa since 1922.
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