Medicare for All Represents More Than a Century of Struggle for Guaranteed Healthcare
Since the conclusion of the United States Civil War the question of healthcare policy and its costs has been a major source of political debate
By Abayomi Azikiwe
Editor, Pan-African News Wire
Monday September 21, 2026
Political Review
Note: This report was written and delivered in part for a public meeting on “Medicare for All, Not War” held on Saturday September 19, 2026 at the Historic St. Matthew’s-St. Joseph’s Episcopal Church in Detroit. The event was sponsored by the Moratorium NOW! Coalition.
---------------------------------------------------------------------------------------------------------------
Healthcare policy in the United States has once again become a contentious political issue impacting broad sections of the population.
Historically and during the present period there are no guarantees in the funding of medical coverage in the United States.
The concept of Medicare for All has prompted debate inside the country where an estimated 28 million people remained uninsured. This is the situation within the US which is said to have the largest economy in the world.
Corporate media interests have for decades attempted to denigrate the notions of national health insurance for all residents and citizens of the US. The notions of guaranteed healthcare coverage are often described as “socialized medicine”, making it appear as if such a policy is foreign to the country.
In actuality it has never been accepted as a valid orientation in the US for the ruling class and those influenced by its ideology. However, this negative viewpoint on comprehensive healthcare policy has severely damaged the people particularly those within the working class and nationally oppressed communities.
Healthy people who are not concerned about providing medical coverage for themselves, their families and communities would improve the overall quality of life. Proposals by proponents of Medicare for All say that if these policies were adopted it would in fact lower healthcare costs in the US.
Even among those individuals and families which are covered by private insurance firms along with Medicaid and Medicare, many are still trapped in a cycle of higher costs for co-pays involving procedures and medications. One of the major causes of household indebtedness is medical costs.
In a recent report published by CBS News, it notes that:
“Even Americans with health insurance are piling up medical debt, according to a new analysis. One in three Americans with health coverage through their employer, the Affordable Care Act marketplace or the private market say they have medical debt that they are paying off over time, the Commonwealth Fund, a nonpartisan health policy research group, said in a report on Thursday. Hospital visits are the primary source of medical debt, with nearly two-thirds of U.S. adults reporting carrying debt related to such care. Patients also carry debt stemming from obtaining routine medical care, such as doctor's office visits or getting lab or diagnostic tests, the study found.” (https://www.cbsnews.com/news/1-in-3-insured-americans-medical-debt/)
Irrespective of this crisis of indebtedness and lack of adequate care, many misconceptions are still being fostered through the leadership of both the Democratic and Republican parties. Neither party has endorsed the demand for a universal single-payer healthcare policy which would cover the costs of routine medical visits, hospital stays, procedures and medications.
Some Aspects of the History of Struggle for Guaranteed Healthcare
After the beginning of the Civil War in the US between 1861-1865, one of the first government funded projects was initiated in 1862 in Washington DC, known as the Freedmen’s Hospital. This institution became part and parcel of the Freedmen’s Bureau which was established by the Congress in 1865.
According to one source on the origins of the Freedmen’s Bureau, it says:
“The United States Bureau of Refugees, Freedmen, and Abandoned Lands, commonly known as the Freedmen's Bureau, was created by Congress in 1865 to assist in the political and social reconstruction of post-war Southern states and to help formerly enslaved people make the transition from slavery to freedom and citizenship. In the process, the Bureau created millions of records that contain the names of hundreds of thousands of formerly enslaved individuals and Southern white refugees.” (https://nmaahc.si.edu/explore/initiatives/freedmens-bureau-records)
However, after the presidential elections of 1876, a political compromise resulted in the dissolution of Federal Reconstruction. This was codified with a series of Supreme Court decisions in 1883 which essentially absolved the government of responsibility for the building of a just and equitable society including African Americans.
What many whites failed to realize is that the continued national oppression of African Americans negatively impacted their overall social status and well-being. This was reflected in the fact that the early efforts to develop guaranteed healthcare programs originated in Europe.
An extensive report on the history of healthcare policy in the US was published by the Physicians for a National Health Program (PNHP), emphasizing that:
“Other developed countries have had some form of social insurance (that later evolved into national insurance) for nearly as long as the US has been trying to get it. Some European countries started with compulsory sickness insurance, one of the first systems, for workers beginning in Germany in 1883; other countries including Austria, Hungary, Norway, Britain, Russia, and the Netherlands followed all the way through 1912. Other European countries, including Sweden in 1891, Denmark in 1892, France in 1910, and Switzerland in 1912, subsidized the mutual benefit societies that workers formed among themselves. So, for a very long time, other countries have had some form of universal health care or at least the beginnings of it.” (https://pnhp.org/a-brief-history-universal-health-care-efforts-in-the-us/)
During the period of the late 19th century, there were no serious efforts by the government to create a safety net for people living in the US. However, by the early 20th century, the social impact of monopoly capitalism, industrialization and imperialism created avenues for reform.
The formation of the Progressive Party (also known as the Bull Moose Party) and its campaigns of 1912 witnessed the first political plank related to comprehensive healthcare policies. The then former President Theodore Roosevelt ran on the Progressive Party ticket as a result of the split among the Republicans. Roosevelt did not prevail and due to the divisions among the Republicans, the Democratic candidate Woodrow Wilson won the elections of 1912.
Wilson had claimed he would keep the US out of the burgeoning threats of war in Europe. However, by 1917, the US entered World War I, ushering in a wave of state repression. Those opposing the war or lackluster in supporting it, were subjected to harassment, imprisonment and deportation. This repressive wave continued even in the post-war period with the activities of Attorney General W. Mitchell Palmer who waged a campaign of arrests and deportations against those labelled anarchists, socialists, labor organizers and Black nationalists.
It was during the popular upsurge in response to the Great Depression of 1929-1941 that the demand for comprehensive healthcare reemerged. Nonetheless, the Social Security Act of 1935 excluded provisions for a national healthcare policy. Other efforts in the late 1930s did not prevail as well.
The Second World War of 1939-1945 assisted in bringing the US out of the depression through the massive conversion to military production and the draft of millions into the armed forces. However, when the war ended, the “Cold War” began against the rise of socialism and national liberation around the world.
US President Harry S. Truman, who succeeded Franklin D. Roosevelt after his death in April 1945, also attempted to enact a national health insurance program. These proposals proved to be incompatible with the Cold War atmosphere of anti-communism and institutional racism.
During the early 1960s, President John F. Kennedy broached the idea of Medicare for elderly residents of the country. His assassination in November 1963 left the enactment of this proposal to his successor Lyndon B. Johnson whose administration pushed legislation through a Democratic-dominated Congress during the mid-1960s. Both the Medicaid and Medicare programs were signed into existence in July 1965, just days prior to the signing of the Voting Rights Act of the same year.
Obamacare and the Present Situation
Former Detroit Congressman John Conyers Jr. drafted HR 676, a comprehensive healthcare policy bill during the early years of the 21st century. The theme of this proposal was “everybody in and nobody out.” (https://www.congress.gov/bill/108th-congress/house-bill/676)
This proposal gained significant support leading up to the national elections of 2008 which brought President Barack Obama to power. With a majority Democratic-led House of Representatives and Senate and the first African American president, many believed that there could have been a major push to adopt a comprehensive and guaranteed healthcare policy.
Nonetheless, the Affordable Care Act was rammed through Congress without a substantive debate on the Conyers’ bill. This healthcare reform bill (ACA) relied on the private insurance industry to provide care and abandoned any notion of a “public option.”
Today, in the third decade of the 21st century, the demand for Medicare for All has resurfaced on a mass level as well as through incipient bills in Congress. The same propaganda which has been utilized in the past from the late 19th century to the present is very much in evidence in 2026.
The Wall Street Journal, a mouthpiece for international finance capital, launched a predictable attack on Medicare for All during August. In a recent article it says:
“The notion of a ‘Medicare for All’ system is enjoying a revival. Democratic primary victories by candidates who champion single-payer healthcare, most notably U.S. Senate candidates Abdul El-Sayed in Michigan and Peggy Flanagan in Minnesota, have pushed the proposal back into the healthcare debate. What these candidates fail to understand—or refuse to acknowledge—is that applying Medicare payment rates to all services provided to all patients would destroy the American healthcare system.” (https://www.wsj.com/opinion/the-medicare-for-all-math-doesnt-add-up-1a3a4758)
With rising costs, medical debts and inadequate care for tens of millions, this capitalist-oriented healthcare system needs to be eliminated in favor of a comprehensive system which benefits the majority of people in the US. The reality is it will take a mass movement to enact a system in which the interests of people supersede those of the wealthy.
