Ramparts Magazine existed from 1962 to 1975. It was a glossy and often illustrated American political muckraker that captured the revolutionary zeitgeist of the era. Ramparts was perhaps best-known as one of the most respected organs of the American New Left. The New Left can perhaps best be defined as a loosely organized, mostly white student movement that advocated democracy, civil rights, and various types of university reforms, and protested against the American war in Indochina. But the term New Left was first popularized in the United States in an open letter written in 1960 by sociologist C. Wright Mills titled Letter to the New Left.

He argued for a new leftist ideology that he hoped might transcend the traditional and often dogmatic (“Old Left”) focus on labor issues, into a broader focus on issues such as opposing alienation, anomie, and authoritarianism. Mills argued for a shift from traditional leftism toward the values of the counterculture, and, echoing Karl Marx, emphasized and advocated an international (rather than nationalistic) perspective on the movement. Mills also claimed that the proletariat (collectively the working-class referenced in Marxism) was no longer the revolutionary force; the new agents of revolutionary change in the decades after World War II were, Mills believed, young intellectuals such as college students, scholars, and editors of leftist academic books, journals, mand uckraking publications (such as Ramparts).

There was perhaps no greater example of the dire gap that existed between the rich and poor in American society than in the realm of healthcare (or lack thereof, depending on one’s socioeconomic status). Ramparts depicted the healthcare industry as one of the most egregiously corrupt and broken aspects of the American system in the 1960s and 1970s. It was but another glaring example of the corporate welfare that shaped American society in the 1960s and 1970s. In November 1970, for example, the magazine published an essay titled “Kaiser: You Pay Your Money, and You Take Your Chances” written by Judith Milgrom Carnoy, who was a staff member of the Pacific Studies Center specializing in the health care field. Her article described an archaic multiphasic medical system at Kaiser’s San Francisco hospital in which physicians were ostensibly “private entrepreneurs” that constituted an army of pushcart vendors in an age of supermarkets.”

Oddly, Carnoy noted, Fortune, Scientific American, and CBSTV seemed to think Kaiser was a paragon of state-of-the art medical care. Carnoy’s article did not. Nurses she interviewed told her that mechanical failures at the hospital occurred with astonishing regularity, and the physicians themselves remained very unsure of the reliability of the test procedures associated with the multiphasic screening computerized system, which often lost patients’ records. Carnoy could not understand why, considering the multiphasic screening system was so unreliable, Kaiser was expanding the program, or why, considering how inefficient and alienating for its members the Kaiser Health Plan was, it was being hailed as an answer to “fix” the healthcare crisis in American society.

To answer these questions, Carnoy wrote, was to confront the malaise of market medicine and the incurability of its own chronic disorder. Centralized medical care under the market system, she explained, functioned against people because it was designed so that the system could never square private interest through private profit with the task of promoting the general welfare. There was, as such, she lamented, a lot of talk about providing services (always shaped by market economics) for the community, but there was hardly a word about planning health services with the community. The community recipient of health services, she argued, had a right to determine the structure and content of its health services, and that hospital workers around the country were at last beginning to organize around this issue, as well as around wages.

But what the patients or the hospital workers knew was needed was unfortunately irrelevant because the government, the AMA, the medical industry, and Kaiser were already deciding the kind of health care the community was going to get, whether it liked it or not. And it would be, Carnoy explained, inefficient and insensitive; it would lose records and keep patients standing for hours against the wall; it would use the illusion that they were getting something cheap to keep them from complaining. But the” real answer to America's medical problems,” she concluded, could not be found in such ersatz solutions, which did nothing more than offer sugar-coated versions of the same old priorities and medical incentive system. The answer was not in Kaiser; it lay rather in decentralized medical care, organized not for profit but for humanity.

In February 1971, Ramparts published an essay aided by a grant from the Fund for Investigative Journalism titled “Madness in the Mental Health Industry,” written by Andrew Kopkind and James Ridgeway, who were the editors of the Hard Times section of the magazine. Like Carnoy, they argued that the corporate nature of the health care industry was deleterious beyond the point of repair. Even the mental health profession was fueled by a profit motive rather than the humanity of the patient.

Corporate law, much like the mental health profession, they wrote, defended helpless innocents while it solidified business and political monopolies. Corporate education provided useful instruction while it supported imperial extension. The corporate industry provided consumers with plastic toys while it grabbed the nation's wealth. Corporate Mental Health, too, the authors lamented, soothed patients’ nerves with drugs while keeping them men mad.

In May of 1971, Ramparts published an editorial titled “Blue Cross.” The Blue Cross system was, the editors informed readers, an amalgam of 74 local, non-profit, tax-exempt insurance organizations chartered under state law. Blue Cross also sold life, auto, and health policies. It was usual to consider the different lines separately, but they were all part of holding company operations,s and thus the corporation should have been viewed as one. Nixon had removed, at least for the moment, the threat of federal regulation in one area of the business, and he was proposing a subsidy through the health scheme in another segment of the industry.

Because of their quasi-public nature, Blue Cross had never been closely regulated. During the 1960s, however, this loose federation of local plans became more centralized through the Blue Cross Association, which ran commercial life insurance companies, giving Blue Cross incredible lobbying power in Congress. As such, it was left to Blue Cross to reform a system that the corporation had a large hand in breaking in the first place. It was, they explained, like asking King Midas to undo making things gold by making them gold.

Ramparts published another essay written by Frances Lang and James Ridgeway titled “Health Economics” about the broken American healthcare system in July 1971. The magazine presented Nixon as King Midas because he often expressed a desire to make the system better, but had concomitantly sharply cut money spent for medical research and scholarships. His 1971 budget request involved cuts in hundreds of research projects, and for the second year in a row, it made no provision for the construction of research facilities. To demonstrate his enthusiasm for training medical professionals, Nixon asked for $12 million for student loans—a reduction of $3 million from the sum appropriated in 1970, and $14.5 million below that granted by Congress in 1969.

Nixon signed the Emergency Health Personnel Act of 1970, which permitted health professionals to do alternative draft service by practicing medicine in areas where there were few doctors. But the act had never been put into operation. Instead, the Administration sought unsuccessfully to close down the Public Health Service clinics where many of the new doctors were to practice. Similarly, the President vetoed a bill to provide medical schools with money for the development of family medical programs, a few months after expressing in public his interest in such programs.

In September of 197,1 Ramparts published another essay written by Ridgeway titled “The Economics of Health” in reaction to Senator Ted Kennedy’s recent proposal for a rebooted healthcare system. Ridgeway argued that although the Kennedy legislation seemed radical compared to Nixon’s, close inspection suggested it might actually reinforce the existing structure. Under the Kennedy proposal, for example, amounts of money spent on healthcare would have been allocated by regions and based on prior health-spending patterns. That could mean, for instance, that the Northeast, which spent a lot on health, would continue to get a good deal of money for health care, while the South, which was much poorer and thus spent relatively little, would continue to get small amounts.

The creation of a health security board appointed by the President was meant to change authority from the hospitals and doctors to the government, but the health industry already included the government as an important part of its structure. The board, Ridgeway concluded, would thus likely perpetuate the health industry by including representatives of government, Congressional committees, doctors, hospitals, drug companies, and other suppliers, with consumers not in a policy-making role, but on the outside as advisors.

Ridgeway contributed yet another essay titled “Health: The Blue Cross We Bear,” which was published in the April 1972 edition of Ramparts. He elaborated that the system being irreparably broken was actually good business for Blue Cross-Blue Shield, whose contractors charged the federal government an administration fee for handling the federal health insurance program. That fee was set at 4.5 percent of costs. This fee provided a positive incentive to increase costs, thereby producing more income for administration. The contract was designed to increase expenses and add inflation. For the first time, members of this subcommittee began to seriously question why it was necessary in the self-insured federal employees program to use Blue Cross-Blue Shield or any other insurance agent. If they were to decide to cut out the fiscal agents, it would have marked a radical departure, sure to be imitated by other major insurance programs. “And,” Ridgeway concluded, “it would be a substantial contribution towards bringing about the reforms contemplated in the Kennedy bill.”

In April of 1973, Ramparts published an expose titled “A Matter of Life and Death: The Scandalous Conditions at Boston City Hospital,” written by Jonathan Kozol, who was a resident of Boston and the author of Free Schools and Death at an Early Age (1967). As the title of the essay suggests, there were widespread problems at Boston City Hospital, including not enough trained professionals, such as anesthesiologists, which cost one of the women in Kozol’s case studies her life. He argued that the endemic failures at Boston City Hospital were a microcosm of the endemic failures in the American system.

In February 1974, Ramparts published an essay titled “Hospitals for Sale. (And Other Ways to Kill a Public Health System)” written Elinor Blake and Thomas Bodenheimer, who were staff members of Health-PAC in San Francisco. Health-PAC was an organization that had researched the American health system since 1968. Blake and Bodenheimer described a kind of Hunger Games-like scenario that was a result of the “ominous trend in the nation's collapsing public health system,” which included the closing of scores of county hospitals. County hospitals, which were long maligned for their endless waiting lines, dirty and crowded wards, and rushed and impersonal treatment, were fast going the way of the Dodo. And 20 million “medically indigent” Americans, those who fell in the crack between Medicaid and health insurance, had no place to go.

These people—the seasonal farm workers, the black maid who earned $60 a week, the small owner whose business was failing, the warehouse loader out of work six months a year, the single alcoholic ineligible for welfare—were dependent on public hospitals. Those public hospitals that were not closed were systemically privatized. As long as a small, underfinanced public system coexisted with a large, wealthy, private one, there would, the essayist explained, be competition for paying patients, doctors, money, and power. And the private system would inevitably win. Thus, the struggle to preserve the public system was, they asserted, more than the preservation of a rundown, half-empty, understaffed city or county hospital. It meant fighting to divert resources from private to public control. It meant attacking private hospitals when they took public money but left behind the public responsibility to care for everyone. “Eventually,” Bodenheimer and Blake concluded, it meant “forcing the new, well-staffed local private hospital to become public.”

In July of 1974, Ramparts published an essay titled “National Health Insurance: The Care and Feeding of Medi-Business,” written by Bodenheimer and Ronda Kotelchuck, that continued the pervasive theme of the American healthcare system being a de facto corporate welfare system designed to enrich the already wealthy at the expense of the indigent. Kotelchuck and Bodenheimer, however, seemed optimistic that, in the midst of Watergate, National Health Insurance was soon to be a reality because Nixon was desperate for a popular social program to “save his skin” and there was likely to be a more liberal Congress in 1974. As such, they surmised that Blue Cross-Blue Shield would likely be more amenable to having a plan sanctioned by the conservatives in the House and Senate than the alternative that might await if Democrats had the majority.

Either way, the essayists noted that National Health Insurance would prove to be a boondoggle for the medical-industrial complex—the hospitals, insurance companies, nursing homes, medical supply and hospital construction industries, and all the other corporations that profited hand over fist from the sickness and death of poor Americans. The final NHI law that they prophesied would, they asserted, surely be a mixture of various bills, rather than the passage of one. And NHI would not, they predicted, arrive in one big leap; it was, they concluded, likely to come step by step over the next decade.

In September 1974, Ramparts published an article contributed by Melissa Sones titled “Giving Birth.” The article provided readers with advice on how to best take control of the process, including not having the child in a hospital. However, if a woman did decide to give birth in a hospital, Sones urged her to know what to expect. Sones also compared and contrasted the options available to pregnant women in other parts of the world to the United States. In places such as China, the Soviet Union, Sweden, Denmark, and Czechoslovakia, trained professionals could be summoned to a woman’s home rather than her having to be trapped in a hospital during childbirth. In other words, her article made plain how progressive the childbirth experience was in other parts of the world compared to the U.S. and offered potential alternatives for making childbirth less frightening and safer for American women. Sones believed that one of the primary problems in the American healthcare system was that the doctor was the dictator of the process, rather than the experience being a partnership between the woman giving birth and the medical professionals tasked with aiding the process.

As sure as Kotelchuck and Bodenheimer were that NHI was inevitable, it was decades before the Affordable Care Act (Obamacare) was passed, and NHI was a reality in American society. As such, the disparity in the quality of healthcare available to rich and poor Americans seemed to have closed slightly in the early decades of the twenty-first century. The more equitable access to healthcare associated with the ACA was, however, vociferously attacked, challenged, and undermined by conservatives as was Johnson’s War on Poverty in the 1960s.