The Marine Hospital Service was enacted and founded in 1798 to furnish health care for US Seamen. It provided free care for US Merchant Seamen who were sick or disabled. The system was greatly expanded in the 19th Century. In 1939, the MHS became part of the U.S. Public Health Service.
The 1920 and 1936 Merchant Marine Acts further amplified and expanded health care coverage for US Seamen who became ill or injured while under US Shipping Articles. The Marine Hospitals and their excellent free coverage were also a reason why the Maintenance and Cure provisions of the above acts were resultantly so low in terms of payment.
The laws providing this free care to US Merchant Seamen are still intact. They further were amended to require things like a Master’s Certificate of Service for Medical Care so that the system was not abused by those actually didn’t sail aboard US Flag Vessels for a specified minimum amount of sea time before becoming eligible.
Further, there were Marine Hospitals all over the US- San Francisco (15th & Lake), Staten Island, Norfolk, Boston, New Orleans, and even more- then there were also Clinics- Jacksonville, NYC (Houston St), Norfolk, Honolulu, Port Arthur, just to name a few…
These were vital sources of health care for active US Merchant Mariners until 1981. Instead of striking down the laws which granted Seamen the right of health care- a nearly impossible task- instead the Reagan Administration chose instead to enact laws which basically defunded the USPHS which granted this benefit to US Seamen.
At first this move was largely supported by Maritime Labor- (I was a Group 2 in the NY-NJ MEBA Hall when Fred Schamann announced this support - much to the hooting, hollering and screaming that we members immediately voiced) It seems that at least the National MEBA (comprised of D1 & D2 back then) wanted to start their own Hospitals and Clinic systems- which never really panned out…
Much to our surprise- after receiving this support the Reagan Administration quickly shut down the USPHS to Seamen- then promptly attempted to destroy an MEBA affiliate - PATCO (Professional Air Traffic Controllers) - the rest is history.
Interesting to note that even MSC supported the closings, and nearly required (they couldn’t force this) that all Civilian Mariners obtain private health insurance to cover medical expenses…