Editors' Introduction

Over the last two decades, the corporatization of medical care and the so-called managed-care revolution in the United States--and increasing efforts to privatize health systems around the globe--have engendered a series of political and social movements: union strikes over cuts in health benefits, health-worker sick-outs in response to workplace speedups and rules restricting the practice of medical care, and popular mobilizations for health insurance coverage and the protection of benefits. Some of these actions, such as the early 1990s strikes against New York area hospitals, are narrowly constructed around particular institutions. Others are orchestrated behind the scenes by corporate interests--for example, health insurance companies' support of the backlash against the pharmaceutical companies. Still others have been manipulated at the highest political levels, most notably the health system reform efforts of the Clinton administrations, beginning in 1993-94 and continuing with more incremental initiatives such as the State Children's Health Insurance Program. Most rousing for progressive interests in the United States has been the renewal of a movement for national health insurance, with growing popular support for the principles, if not the rhetoric, of such a radical overhaul of the American health care system.

Health professionals are participating in increasing numbers in this movement, viewing progressive health reform as consonant with their own economic, social, and medical practice interests--in sharp contrast with the antiunion, antigovernment stance of doctors of yore. Still, in many ways, this renewed participation falls far short of the radical voices of health professionals of the past, voices like those of Lillian Wald and Isaac Rubinow in the 1910s and Henry Sigerist in the 1930s and 1940s, socialist and social-activist doctors and nurses in the United States, whose political activities linking health reform to broad social change made them national figures, or that of Salvador Allende, who filed his political teeth as a medical student leader and precocious health minister in 1930s Chile and used medic0-political rights as a platform for his successful election as the first Socialist president in 1970.

This special issue on "Health Politics/Health Workers" seeks to retrieve this legacy by exploring a series of radical movements of health professionals in the United States, South Africa, and Mexico, efforts that tied the provision of public health services to larger movements for political and social justice. The articles in this issue rethink the history of the health professions in an attempt to understand the relationships among professional struggles, medico-scientific developments, and the public sphere. The issue opens with a discussion of a little-known movement from a decade otherwise well studied and vividly remembered: Naomi Rogers's exploration of the Student Health Organizations in the 1960s and the dilemmas of students challenging the ideology and organization of the medical establishment in which they were being trained. This new medical left distinguished itself from its predecessors in its style and in its call for civil rights and racial justice for providers and patients, as opposed to prior discourses of universalism and classlessness. We then move back in time and south in space to revolutionary Mexico, where, as Ana Mariá Kapelusz-Poppi demonstrates, a group of radical provincial doctors, the Nicolaitas, were facing their own paradoxes when calling for rural health services as part of the social transformation of the Mexican countryside. On one hand, these socialist doctors organized medical services around peasant land collectives; on the other hand, they disdained rural ignorance and sought to displace traditional healers. Like the 1960s U.S. medical students, the Nicolaitas were inspired by the people's activism but understood social inequalities largely as outsiders; as idealistic believers in modern medicine, both groups ultimately worked with and within the health establishment to achieve their goals.

We then turn to three pieces that explore the interaction of health activism "from below" with official programs in the 1910s, 1920s, and 1930s. Daniel Bender argues that the ill health of Jewish garment workers in 1910s New York was understood by the U.S. Public Health Service as a set...