The Healthcare Bait and Switch

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Candidate Obama’s promise to reform healthcare lit a torch of hope for millions of people. No more postponing doctor visits or feeling helpless before unaffordable medical bills.

But meaningful change is not at hand. In his Sept. 9 speech before Congress, President Obama issued a passionate defense of for-profit healthcare. Yet this is precisely the source of the problem. Real change must entirely remove profit from the system.

In their versions of reform, Democrats and Republicans are ministering tenderly to the concerns of private industry. Working and poor people are still sitting in the waiting room.

The drawing of class battle lines. In the U.S., medical care is a commodity – like orange juice. But unlike the cost of a can of orange juice, the bills for tests, drugs, and hospitalizations are beyond the average worker’s ability to pay.

Hospitalized for an asthma attack? Your bill is $9,100. Your child admitted for leukemia? That’ll be $49,000.

Need immune drugs for your multiple sclerosis? That’s $1,000 a month. Bad migraine keeping you bedridden? Try an Imitrex tablet – only $25.

Such costs bankrupt working people 900,000 times a year. That’s 60 percent of all U.S. personal bankruptcies.

And possessing a typical insurance plan offers little protection. Fully three-quarters of the medically bankrupted have insurance!

One way to treat society’s health needs without inflicting more economic pain on workers is the system known as single-payer. This removes private insurers and their profits from the equation; the government becomes the sole insurer. It’s the option promoted by many healthcare unions, activists, and professionals.

Kay McVay, a California Nurses Association (CNA) spokesperson, calls single-payer the best way to achieve the “genuine, comprehensive reform that addresses the patient care crisis we see every day.” CNA is the nation’s largest union of registered nurses, one of more than 350 locals of the AFL-CIO labor federation that support single-payer.

Single-payer would be a huge step forward and is worth fighting for. But it’s far from the final answer. Beyond the insurers, it doesn’t address the rest of the profiteering in the medical and pharmaceutical industries – and the fact that the government operates to protect the private corporations, not to rein them in or, god forbid, dismantle them. These are the reasons why healthcare as a whole must be nationalized under workers’ control.

But private industry is determined to prevent any solution that would benefit the working class at the expense of sacred profits.

To fight for their interests, the insurance companies drew up a battle plan: lobby to remind Democrats and Republicans whose money put them in office; and let the right wing scare workers with disinformation.

Karen Ignani, the CEO of America’s Health Insurance Plans (AHIP), met privately four times with Obama. And the industry expanded its already massive lobbying efforts with Congress.

For instance, in the first quarter of this year, United Health Group spent $1.5 million, versus $1.1 million in the same period last year. Aetna increased its first-quarter lobbying dollars by 41 percent.

The industry waited in the wings as a variety of reactionary organizations launched a sometimes violent campaign of lies at August meetings and rallies, raising the specter of rationing and “death panels.” Robert Zirkelbach, a spokesperson for AHIP, crowed that “the American people are rejecting a government-run plan.”

This too is a lie. Polls consistently show that a substantial majority of the public supports some form of public healthcare plan – even after the right-wing offensive in August.

False advertising. When campaigning, Democrats and Republicans say what they think workers want to hear. Their goal is to get elected. Once in office, their actions reflect their real class loyalties.

So, in 2003, Obama said: “I happen to be a proponent of a single payer universal health care program.” He was readying his liberal credentials for his 2004 run for the U.S. Senate. But, as president, he stated: “I have not said I am a single payer supporter.”

Indeed, in his September speech, Obama criticized single-payer as too “disruptive” to the current system. This is backwards. It is the current profit system that is too disruptive to people’s health.

Obama said he has “no interest in putting insurance companies out of business” because they provide “a useful service.” They do not!

Private insurers have an inherent profit interest in paying as little as possible for healthcare. These companies are essentially gambling casinos – or mob protection rackets – that take on an individual’s medical risks for a price. They calculate the odds of getting sick. And they know how to win.

Early on, Obama announced his goal of a bipartisan bill. This told insurers that he had no intention of going after them, since Republican legislators are universally hostile to single-payer and even to a government-run public option that would exist alongside private plans. (And, in Obama’s version, would be a caricature doomed to failure, since it would have to “pay for itself” and would receive essentially no government funding.”)

Private insurers will only accept potentially profit-cutting measures, such as not being allowed to deny coverage because of a pre-existing condition, if there is a tradeoff. That explains the proposal that everyone be required to buy insurance: the kickback to the companies is more customers.

The dilemma facing the capitalist parties is how to reform healthcare in the interests of private profit yet sell it to a public yearning for relief. They’ll call it “change,” but the only change we can expect is healthier finances for the corporations – and possibly a system of medical care that actually leaves working people even worse off than they already are.

Feminists including the organization NARAL Pro-Choice America have warned that right-wing forces are attempting to get anti-abortion language written into the final bill. And Obama indeed declared that no healthcare reform bill will fund abortions.

Racists are shouting against healthcare for undocumented workers. Obama reassured them that his plan would absolutely exclude the people he insultingly called “illegals.”

Obama proposes to pay for his plan by cutting back on Medicare funding under the guise of eliminating “unnecessary” expenses. This is a recipe for sabotaging this crucial government-payer system for the elderly.

It’s funny how these politicians never suggest paying for essential social needs from the “unnecessary” expenses of the Pentagon.

The way forward. The fight for nonprofit healthcare must and will continue even after Congress passes a pro-industry bill. The key is eliminating profit from the system. “Healthcare for people – not profit!” declare the Mad as Hell Doctors, an Oregon-based physicians’ group.

Victory will not come from the corridors of power in Washington, but rather from working people exercising their power around the country – caring doctors and nurses, teachers of immigrant children, workers who face job-related injury, soldiers with posttraumatic stress disorder, parents of children with disabilities. A united movement must demand:

Increase Medicare funding!

Single-payer now!

Nationalize all healthcare companies under workers’ control!

Contact Steven Strauss, a Baltimore neurologist at Franklin Square Hospital, at

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