The Medical Committee for Human Rights: A Case Study in the Self-Liquidation of the New Left (part 3)

Kotelchuk, Rhonda, and Levy, Howard (1986). The Medical Committee for Human Rights: A Case Study in the Self-Liquidation of the New Left. In Race, Politics, and Culture: Critical Essays on the Radicalism of the 1960s. Reed, Adolph, ed. New York, Greenwood Press.

Speck of Light

At long last in October, 1970, a group of health workers and MCHR members living together in Brooklyn who called themselves Hampton's Family, after Fred Hampton, the slain Chicago Black Panther leader, tackled many of the questions the MCHR had stubbornly refused to recognize or had been unable to come to grips with during its first six years.

After suggesting that the MCHR had failed both locally and nationally, the Hampton's Family Paper went on to say that "this failure at both levels can be traced to the fact that MCHR as a whole lacked a sense of its own proper role in these struggles, a clear understanding of who its constituency was, how to reach them, and in general, a strategy for challenging the health empires and their subsidiaries."

The paper went on to argue strongly for the development of a "progressive organization" that could organize "large numbers of middle level health workers" who would relate to community and worker (presumably lower-echelon) struggles. It suggested that the MCHR be that organization and that its priority be a "commitment on the local level to build political activity in local institutions and health science schools." Hampton's Family thought an MCHR national office should exist "to provide and support a full time staff as well as regional coordinators," presumably to foster the local priority aims.

In summary the Hampton's Family Paper called for a membership drive designed to attract upper-level and middle-level health workers, concrete struggles around institutional organizing, and a strengthened national office of the MCHR to assist these efforts. Although the clearest exposition up to that time of the MCHR's problems, the Hampton's Family Paper was not without its own ambiguities. To begin with, its suggested role for the national office was left only implicit, a fact that was soon to have dire consequences for the MCHR's development.

Further, when it came to concretizing its suggested theoretical program, the paper repeated many of the same errors that the MCHR had already made. For example, it called for more and better (meaning "more political") service projects, medical presence, draft exams, and support for sundry movement organizations, and, finally, opposition to chemical and biological warfare. But it was precisely these diverse and multifaceted approaches that had up until then prevented the MCHR from doing what in the main the Hampton's Family Paper argued it must do---define its identity around organizing in health institutions, with a constituency of upper-level and middle-level health workers and health-science students.

To be sure, as the Hampton's Family Paper argued, "Our perspective must be broader than our local hospital or medical school. We are part of a national and international movement and must link up in our struggles to other issues." Unfortunately, the national leadership of the MCHR that was elected in the next year readily seized upon the "larger perspective" without ever bothering about the local building blocks that could have made such a perspective concrete.

The 1971 Convention: The Beginning of the End

Although the Hampton's Family Paper had grasped, albeit tenuously, the critical issues facing the MCHR and had generated discussion within the organization, by the time of the 1971 annual convention, held in April at the University of Pennsylvania, it was an idea whose time had already passed. The paper was hardly mentioned at the convention and, insofar as it had any impact, it helped to push the MCHR in directions diametrically opposed to the intentions of Hampton's Family. Even more ironically, despite profound differences bubbling just beneath the surface, an atmosphere of unanimity and good feeling prevailed at the convention in which there was little if any disagreement or debate. These anomalies stemmed from at least two sources.

First, there was little political sophistication or leadership in the MCHR as of 1971. New recruits swelled the MCHR's ranks, but even old timers lacked the theoretical and practical political knowledge and experience to recognize the essential issues, think through their organizational implications, take an unwavering stance, and engage the organization in meaningful debate. By shortly after the convention it became clear, in fact, that few enough of the members of Hampton's Family themselves really understood the implications of the position put forth in their paper, as several went over to articulating precisely the opposite perspective.

Second, the more politically experienced members, who might have been expected to take leadership, were intimidated from doing so by a sense of guilt for being largely white male doctors and professionals, although these had been among the MCHR's chief constituencies in the past. This pervading sense of guilt was exacerbated by the theme and attendance of the convention but had its roots in developments taking place in the larger movement.

Organized around the theme "The Consumer and Health Care," the convention for the first time drew substantial numbers of articulate and organized women, Third World people, nonprofessional health workers, and consumers. The growth of independent Third World groups, such as the Black Panthers, and the emergence of the women's liberation movement engendered in the MCHR, as in many other groups, a consciousness and concern about its internal racism, sexism, elitism, professionalism and organizational style.

This consciousness and concern were at once the MCHR's critical strength and its critical weakness. They constituted the basis upon which the organization could broaden its membership. Yet at the same time, the guilt borne of the charges of racism, sexism, and elitism led the MCHR to throw out the baby with the bath water, repudiating a major part of its historical constituency (and those with whom it could work most effectively). Indeed, the MCHR carried over a disdain for organizing doctors or medical students who, it was reasoned, if organized could only act ultimately in their own, already privileged self-interest, which would of course be counterrevolutionary. Instead, the MCHR tried to transform itself into precisely what it was not---an organization of women and Third World non-professionals and consumers.

In this atmosphere, the MCHR charted new organizational directions, involving decisions on constituency, program, and structure, and elected a leadership that foreclosed in the immediate future the possibility of the organization coming to terms with the critical issues facing it. In many ways the subsequent years are but a playing out of those decisions, and it could be argued that our story could stop here. Yet what happened during and after the 1971 convention is worth examining in some detail, because the issues then faced by the MCHR continue to be serious and unresolved ones, admitting of no easy solution. Moreover, while the fallacies of the course adopted by the MCHR in 1971 are readily evident in retrospect, the approach, perhaps because it offers a simple formula, continues to have currency for many organizations and activists today.

Constituency: Y'all Come

The April, 1971 convention decided that it was paramount to open MCHR's doors to women, Third World people, nonprofessionals and consumers---a decision implemented in the context of a growing militant national women's movement, the influence of which was enhanced by the large number of militant women at the convention. To their strong voice was added that of the smaller but still significant number of Third World delegates.

While there was no disagreement on this decision, there were radically different interpretations of what it meant---differences that went undiscussed and unresolved. To some this decision meant addressing manifestations of racism, sexism, and elitism within the MCHR and opening up the organization to a broader though still limited constituency of middle-level health workers. To others, including what came to be the national leadership, it meant transforming the MCHR into a mass organization incorporating all strata of health workers and of consumers as well. The MCHR was to be the radical health vehicle of both the doctor and the dishwasher, the medical student and the ward clerk, the administrator and the consumer, the privileged and the poor, the Third World and the white, the man and the woman.

In short, there was no one who was not part of the MCHR's newly defined constituency. It would no longer simply serve the vanguard---MCHR would be the vanguard by shedding its skin and wishing itself a new one. The impact of this shift was devastating. One minimal advantage of the previous serve-the-vanguard approach had been that at least it allowed MCHR professionals, especially doctors, to embrace their own identities. They could still be who they were and use their skills and positions, as privileged as they might be, toward the support of groups judged to be more revolutionary. With its new decision on constituency, the MCHR lost even this.

Now the MCHR was no longer simply at the beck and call of whatever outside group could lay the greatest claim to militance, oppression, or other hallmarks of legitimacy. At least in that circumstance the organization had the theoretical right to decide where to give its support. Internalizing this process, the MCHR now rendered itself superbly manipulable by whomever within its ranks was most adept at social-psychological blackmail. Also, because the MCHR had indeed been guilty of racism, sexism and elitism, it now lost its right to guestion or judge the validity of their claims or how they fit into the MCHR's agenda. Those who tried could be discredited as racist, sexist, and elitist.

Structure: Form Without Content

Two major proposals, both written and circulated before the convention, dominated the discussions of structure and spoke to the issue of broadening the MCHR's constituency. The first, written by the Chicago chapter, argued for a strong national office. It met with hearty response, since many MCHR activists had seen the loose-knit, locally based, almost anarchistic structure of the MCHR's middle years dissipate energy in frenetic activity. What was not agreed on, incredibly enough, was the key question: Should a strong national structure exist to give central direction, create a national image, and build the MCHR from the top down, or should it rather exist to serve, support, and coordinate local activities, building the organization from the bottom up (the Hampton's Family position)? Debate eluded the issue, however, and once more everyone took home his or her own interpretation of the subsequent decision.

The second proposal, drawn up by the East Coast Women's Caucus, also endorsed a strengthened national structure but emphasized expanding the leadership to include women, Third World people, and non-professionals as a means of broadening the MCHR's membership. This broadening, they contended, could evolve only if MCHR adopted a collective style of leadership, a concept clearer in its criticism of the past than its prescription for the future. The women's caucus at the convention demanded a guarantee that half of those comprising the MCHR's leadership structure be women, and the Third World Caucus followed suit, demanding one-quarter. The result was an elaborate structure that was to prove as unwieldy and dysfunctional as it was superficially democratic.

The convention agreed, virtually unanimously, to set up a strong national structure that would function in a collective manner. The National Executive Committee (NEC), the interim governing body, was to consist of four national officers and four representatives from each of four regions. Each set of four regional representatives was to include at least one Third World person and two women, assuring that the whole body would be at least 50 percent female and 25 percent Third World. Travel funds were assured so that no NEC member would be excluded from participation because of financial need or geographical isolation. Permanent caucuses of women and Third World people were to be established, which would be given the opportunity to meet at every MCHR gathering and which would assure that women's and Third World representation and participation in the organization met with their satisfaction.

Thus in 1971 the MCHR painstakingly created the forms of democracy and egalitarianism in its national structure. In so doing it pioneered an approach to addressing issues by implementing changes in form rather than changes in substance---an approach that was to become the hallmark of the later organization. No one asked what the MCHR had to offer women or Third World people, or how it would have to change to meet their needs sufficiently to give them a reason to make the investment that leadership requires. Rather it was assumed that having established the quotas and caucuses and having elected the right number of people of the right race and sex to the leadership, these problems would somehow resolve themselves.

The result was predictable. People were frequently elected to leadership positions because they fit a quota, not because they had necessarily demonstrated interest, commitment, or leadership ability in the MCHR. These representatives in many cases fell away as soon as they were elected, often, one suspects, because they had not resolved the questions whether the MCHR was the most appropriate vehicle for their concerns and whether they were prepared to deal with its residual racism, sexism, and professionalism. The end result was that the newly elected representatives exercised little leadership and the old-timers, intimidated by their own sex, race and status, withdrew from leadership---leaving a vacuum too inviting to go long unfilled.

Quentin Young was elected to head a strong, centralized national office, which was moved from Philadelphia back to Chicago. Felicia Hance and Barbara Maggani, both members of the Eastern Women's Caucus and both part of Hampton's Family, were elected vice chairperson and secretary, respectively, and Ann Garland, a Philadelphia nurse and leader of the Third World Caucus, was reelected treasurer. The convention also resolved to hire three full-time staff members, and shortly thereafter Frank Goldsmith, a former staff member of the United Auto Workers and a friend of Hampton's Family, was hired as national organizer and Pat Murchie, a member of the MCHR's Chicago chapter, was hired as executive secretary. Later Tanganika Hill, a black activist from Houston, was hired by the Third World Caucus to be the Third World organizer. (Her tenure was short and she was never replaced by the Caucus.) The three staff members shared one striking trait---all were virtually brand new to the MCHR.

Program: Jumping on the Bandwagon

While the 1971 convention sported the usual panoply of workshops and passed the usual multitude of resolutions, it focused primary programmatic attention on national health insurance. In fact, an air of excitement pervaded the convention, for everyone felt that the country was on the threshold of this momentous change in health care. Just six months before, Sen. Edward Kennedy had introduced his sweeping bill (the Health Security Act) into Congress, and the political climate of that time was such that it appeared to be a viable if not leading candidate in that arena. Everyone felt that national health insurance would be the major campaign issue of the 1972 election if it had not been passed before then. Indeed, it seemed that issues of health policy were reaching a historic moment in which the MCHR might, just might, be asked to play a vital role.

Prior to the convention, Tom Bodenheimer of the San Francisco chapter drafted and circulated a national health care proposal embodying the MCHR's principles, which might serve as its alternative to existing national health insurance bills. The 1971 convention, again with seeming unanimity, adopted the national health care plan with minor alterations as the basis of a campaign of education and agitation; again there was little understanding of what this action would mean.

This campaign offered several immediate advantages to the MCHR. It addressed an issue seemingly capable of uniting many diverse constituencies; it capitalized on the national interest and momentum around the national health insurance issue; and it seemed tailor-made for the new national role that the MCHR had adopted. Indeed, it offered the hope of being to the later MCHR what the civil rights movement had been to the earlier organization, with one critical difference---there was no popular movement afoot for national health insurance.

Thus the 1971 convention did not come to grips with the critical issues facing the MCHR; it turned the organization in opposite directions. Whereas the Hampton's Family Paper called for a broader but still focused constituency, a more focused program, and a local orientation, the convention gave license for the national leadership to move ahead with a united-front approach to constituency and program and a centralist, as well as centralized, national structure.

Uniting All Fronts

At the urging primarily of Frank Goldsmith and Quentin Young, the MCHR's new program was dubbed the National Health Crusade and was designed to promote five principles, or perhaps more accurately five slogans, boiled down from Bodenheimer's alternative health plan. These included an end to profit-making in health; financing by progressive taxation; provision of complete and preventive health care; local administration of health centers through patients and health workers; and nationalization of the drug and medical supply industries.

At the national level, the National Health Crusade (NHC) was to consist of a series of nationally coordinated local press conferences and the mass distribution of polls, petitions, and a series of leaflets and brochures on the MCHR's alternative national health plan. The first leaflet came out in May, headlined "If you needed it [health care] right now...Could you find it? Could you pay for it?" It briefly critiqued present health care, set forth the five points of MCHR's alternative plan and invited those interested to join MCHR. Local chapters were urged to distribute these leaflets at shopping centers and department stores, in addition to medical schools and hospitals, and to conduct press conferences, polls, and petition-signing campaigns.

Most chapters ignored or laughed off the NHC; some were incensed at its public-relations style. At least one chapter---the one in New York City---actually attempted to follow the NHC's directives, but came to an impasse when it could not figure out what was newsworthy enough to warrant a press conference. Many agreed with the NHC's educational potential but, assuming success in educating and mobilizing people, no one could answer the question that followed: "What can I do?" MCHR did not wish to thrust people into the legislative arena to support existing bills (although later there was to be disagreement on this); it could not pass off its proposal as legislatively viable; and it could not point convincingly to local programs that would make it viable.

As criticisms of the programmatic poverty of the National Health Crusade grew over the summer of 1971, the national leadership became more and more defensive, until it eventually was arguing that implementation of the NHC could include virtually all forms of MCHR activity. Free clinics, occupational health initiatives, lead poisoning and sickle cell screening, institutional struggles, antiwar activity, military organizing, student organizing, prison health---any and all could be seen as implementing some aspect of the NHC. When by late summer some of the underlying questions about the viability of the NHC were raised at an NEC meeting, the doubters were resoundingly put down by the national leadership for being disruptive.

By the fall of 1971, the NHC had begun to quietly collapse under the weight of its own contradictions. Even as it fell apart, however, it highlighted important elements emerging in the style and politics of the national office. First the NHC had the form of a political program, but little consideration had been given to its content---the essence of political bureaucratism. More than this, its lack of programmatic content pointed to the disturbing signs of political opportunism. Sometime between spring and fall it became clear that the MCHR did not take the goals of the NHC seriously in their own right and perhaps never had. Instead of asking what MCHR could do for a national health care plan, the MCHR instead asked what a national health care plan could do for it. The answer was that it could project the MCHR's name and image to facilitate its mass organizing and membership recruitment strategy. Thus its genius was closely akin to its vacuousness: It could encompass all constituencies and mean all things to all people. Further, through the NHC it became evident that the idea of centralization of MCHR also embodied the idea of centralism. Dissent fro within the ranks was not welcome.

The NHC was the MCHR's last attempt to adopt a single programmatic focus and the last juncture at which that was possible. Shortly after its demise the MCHR adopted the model of task forces as the answer to its programmatic problems. Task forces were designed to coordinate similar activities going on around the country and were modeled after the strongest and most successful programmatic undertaking of the latter-day MCHR---the occupational health task force.

The occupational health task force was organized by a small group, including Phyllis Cullen from Denver, Don Whorton from Washington, and later Dan Berman. They began by organizing a training session that could draw together interested workers (both union leaders and rank-and-file) and health activists. The task force spent much of the winter traveling from place to place generating interest and activity in occupational health. The task force raised (and personally contributed) money to hire a full-time staff member in the person of Dan Berman, who had previously worked with the Teamsters in St. Louis. Soon it was publishing a newsletter, pouring forth literature, and holding conferences.

Other task forces were encouraged to follow the pattern of raising money, hiring national staff, producing newsletters and literature and organizing conferences. Soon the MCHR's list of task forces burgeoned to include prison health, national health plans, institutional organizing, community/consumer organizing, women's health, community health programs (including lead poisoning and sickle cell programs and free clinics), antiwar activities, mental health, rural health, patients' rights, nutrition, nursing, house staff, health-science students and health care for the aged.

However sensible it may have appeared, the task force approach had serious drawbacks for the MCHR. First, it codified in a sophisticated form the more primitive do-your-own-thingism that had plagued the MCHR's past. More disturbingly, it could be and was used to deflect or absorb those who argued that the MCHR needed a programmatic focus. Now such dissenters could simply be told to set up their own task force. For the only programmatic approach acceptable to the national leadership was one which, like the unsuccessful National Health Crusade, could embrace all constituencies, a formula in which ultimately everything equaled nothing. Moreover, the task force model could be and also was used to abet the MCHR's publicity and recruitment drive by magnifying embryonic and often virtually nonexistent projects. The vast majority of task forces represented nothing more than a handful of people scattered around the country who shared a particular interest and who saw each other at MCHR gatherings. Yet when asked what it was doing, the MCHR could point with pride to its vast array of task forces.

Bureaucratism Run Amuck

During the summer of 1971, the MCHR national office began to function as it never had before: Membership and mailing lists were organized; literature began to be massively produced; two internal communications, "The Office News" and "The Organizational Newsletter," were initiated and sent to key contacts on a regular basis; liaison with other groups was systematically established; and Health Rights News, the MCHR's house organ, began to appear on a regular basis. During that summer the MCHR raised $60,000 in foundation grants and received $20,000 more in membership dues. There was widespread appreciation throughout the organization that there now existed an organized and responsible national office.

However, with the appreciation there coexisted a growing apprehension about the style of that national office. The upbeat tone of office communications, while possibly appropriate for potential recruits, struck MCHR old-timers as overblown and condescending. "You received a sample of the national petition [for the NHC] which should be reproduced locally. Please do this as soon as possible so your friends and neighbors can Sign Up for quality health care," read an early office communication. Another enthused: "Now is the time to fill your local committees with active new enthusiasts. The last three months has proven that people are ready to move if they are just informed of the opportunities awaiting them with MCHR."

The accomplishments of the MCHR as reported in the MCHR media were often magnified beyond recognition. When four MCHR members attended a two-day occupational health meeting, another internal communique characterized that fact as "This excellent attendance, spurred by MCHR's new emphasis in this health area," and whenever an MCHR member participated in a project or a struggle, the MCHR rushed to add that project to its burgeoning list of accomplishments.

Numbers became the standard of the MCHR's success---numbers of chapters, numbers of members, numbers of names on mailing lists, numbers of leaflets and newsletters distributed, numbers of meetings, numbers of projects, numbers of letters and telephone calls made and received, numbers of resolutions, numbers of alliances. There was little concern for what the numbers meant and there was hostility toward those who asked. While heralding the formation of the fifty-third MCHR chapter, for example, the national organizer, when pressed, admitted that it consisted of three people, none of whom had ever met one another. Their names had simply been lifted from letters of inquiry received by the national office and, ipso facto, another MCHR chapter had materialized. Health Rights News became, at times, little more than a cheerleading sheet, recounting victories and editing out problems. The national office began reprinting any and every article laudatory of the MCHR from the national media, some in spite of the fact that they contained serious misinformation about the organization including one, for example, in which it was claimed that the MCHR supported the Kennedy-Labor national health insurance bill. And in addition to promotional reprints, brochures and buttons, MCHR balloons ascended for the first time at the October, 1971, American Public Health Association convention in Minneapolis.

The bureaucratic style and public-relations tone of the national office combined with its stance on programs make it clear that, all protestations to the contrary, the only significant concern of the national office during this period was membership recruitment, publicity and image-building and that all its activities were in one way or another tailored to that end. It appears, in fact, that the national leadership espoused a critical mass theory of social change, in which what members did was essentially irrelevant, so long as they indicated allegiance to the "right side," which would presumably grow and grow until by sheer force of numbers it would assume power.

The chinks in the armor of the national leadership were not hard to find. New recruits might for a short time buy the MCHR's salesmanship, but for its older members---many of whom had been attracted to the New Left precisely because of their alienation from the Madison Avenue aspects of cornmodified American life and from the rigid bureaucracy, hierarchy, and hypocrisy of their institutions---the style and tone of the new MCHR national office were thoroughly repugnant. Finally, no amount of glib salesmanship, hyperbole, or Sears-Roebuck cataloguing of task forces and projects could disguise the MCHR's lack of a focused and actionable program.