Per person, healthcare costs in the United States are the highest of any country in the world; U.S. spending is twice that of countries such as France and Germany. What does all that money buy? Not much! The U.S. ranks only 42nd for life expectancy among highly developed countries and 29th for infant survival. So where does the money go? Into the pockets of greedy corporate executives and wealthy investors in the malignant U.S. medical industry.
And, while other advanced industrial countries provide healthcare to every person, almost 50 million people in the U.S. have no healthcare coverage at all. Millions more are under-insured. At least 18,000 people die every year because they lack health insurance. Medical bills bankrupt 900,000 more – even though three-quarters of those bankrupted did have health insurance!
U.S. healthcare is primarily an employer-based system. About 59 percent of U.S. residents receive health insurance through their employers, and most must pay directly for part of the cost. Another 29 percent are covered by tax-supported government plans, including Medicaid for some of the poor, Medicare for elders and disabled workers, and programs for soldiers and veterans. Insurance rates have risen astronomically since 2000 and co-pays and deductibles paid by workers have doubled or tripled. While layoffs run into the tens of thousands, workers who still have jobs are seeing their health benefits slashed or eliminated. Union workers are threatened with shop closings if they don’t allow corporate takeaways of health benefits in contract negotiations.
If this is not a perfect staging for class warfare, what is?
Battle lines are drawn
When Barack Obama campaigned for the presidency he promised Hope, Change, and Healthcare Reform. After the election many working people had high hopes that he would follow through. But now it has become obvious that “Healthcare Reform” is really a “Health Industry Profits Guarantee.”
Politicians want the public to believe they are responding to outrage over rising healthcare costs. In truth, they are responding to corporate CEOs, who have been complaining for years about “not being able to compete” with companies in countries with universal health coverage subsidized by taxes.
The real motive driving reform all along has been to shift health costs off employers and onto workers to increase corporate profits. Manufacturers and other business leaders have joined insurance bosses in private meetings with the White House, promising not to fight reform if the right tradeoffs were made.
Meanwhile, however, workers, progressives, and radicals leapt on the chance to demand reform in the interest of the majority. Many union members, healthcare workers, and patients demanded a single-payer system: government-run health insurance like the Medicare program, but universal – often dubbed “Medicare for All.”
More than 575 labor organizations and conventions have endorsed single-payer, including the Service Employees International Union (SEIU) convention, the national convention of the AFL-CIO labor federation, and 39 state AFL-CIOs. The California Nurses Association, the largest U.S. nurses’ union, sparked formation of the National Coalition for Single-Payer, which includes over 400 union locals and rank-and-file groups.
The “Mad As Hell Doctors” from Oregon caravanned across the country, speaking out in scores of cities for single-payer and receiving standing ovations. Physicians for a National Health Plan (PNHP) and grass-roots groups held street corner rallies, Internet petition campaigns, and phone-in days to demand single-payer.
Like the Freedom Socialist Party, some leftists went even further, educating about the need to nationalize the entire medical industry under the control of healthcare workers and patients.
Lies and scares and sellouts, oh my!
As a candidate for the Senate in 2003, Obama told a union audience he favored single-payer. As president, however, he has joined other top Democratic Party leaders in refusing to even discuss a single-payer bill, H.R. 676, sponsored by 39 members of the House of Representatives. Single-payer, Obama said, would be too disruptive to the system (no doubt meaning the profit system).
In place of real change, Democratic Party leaders substituted the ridiculous and ever-shifting “public option,” a government-run plan to compete with private insurers and “keep them honest.” Backing this charade of reform were leading liberals and top union officials including SEIU President Andy Stern and John Sweeney, then the AFL-CIO president. Apparently they were willing to defy their constituencies’ support for single-payer in order to give Obama and the Democratic Party a “win,” no matter how hollow.
While Democratic politicians were busy lowering expectations, Republican legislators stamped their feet and just said “No.” They punched holes in the various drafts of reform bills – no coverage for undocumented workers, limits on the amount of money to be won in malpractice cases, a ban on the importing of cheaper drugs.
Republicans and right-wing Democrats joined with big business to unleash a vicious campaign of lies and distortions. Health industry associations spent millions on misleading ads and the creation of “grass-roots” groups. The Tea Party (“Taxed Enough Already”), funded by wealthy capitalists and led by neo-Nazis, raucously and sometimes violently disrupted the local town hall meetings held by national legislators during the August summer break. They held rallies with signs picturing Obama with a “Hitler” mustache and screaming “Don’t Kill Grandma” (a reference to the specter of government “death panels”). They won support from people battered by the economic crisis, mistrustful of government, and desperately afraid for the future.
In spite of all the scare tactics and fabrications, the public still consistently polls as over 60 percent in favor of publicly run health insurance for all.
The final treacheries
First the House and then the Senate chambers of Congress, both with Democratic majorities, have passed versions of the reform bill, still to be reconciled as of this writing.
At the last minute before a vote on the House version, a shock ran through the country as the Stupak Amendment was suddenly added and passed – outlawing the coverage of abortion by any plan receiving government funds or subsidies!
In the Senate, Democratic misleaders seeking the votes of “moderate” holdouts compromised away the public option, already restricted in the House version, almost to meaninglessness. Even an eleventh-hour salvage operation that would have allowed people between 55 and 64 to buy in to Medicare (which kicks in at 65) came to nothing.
The bill that will end up on Obama’s desk for his signature, unless the “reform” process still manages to implode, will be a sparkly gift for the healthcare industry, especially insurers. The key common feature of the Senate and House bills is that all Americans, with a few specific exceptions, must buy coverage or pay fines – so the insurance pirates will immediately gain an estimated 30 million more victims! (Some sort of government subsidies, no doubt inadequate and hard to access, will be available for those who cannot afford insurance.) In return, insurers will no longer be able to deny coverage to people with pre-existing medical conditions, a small price to pay.
Other businesses will gain by being able to dump health benefits for their workers and let taxpayers subsidize them instead.
Toward a genuine solution
The single-payer system would be a giant step forward in removing private insurers and their profits from healthcare. But that would still leave all the other health industry profiteers to continue driving up costs – Big Pharma with its ability to keep cheaper generic and imported drugs off the market, private hospitals, software vendors, medical equipment manufacturers, and the rest. The only solution is to remove the profit motive from all aspects of healthcare – nationalize it under the management of healthcare workers and users!
This current class battle over health reform has opened many eyes: to the sellout role of Democratic Party leaders and some union bureaucrats; to the use of reactionaries by the right wing and corporate interests to scare and mislead the public; and to the power of workers and unions in moving us toward a better world. While the current health reform falls flat, U.S. workers, radicals, and progressives will keep ramping up the fight for single-payer insurance – and even a nationalized healthcare system with no profits and real care!
Lois is the Radical Women Organizer in Port Angeles, Wash., and an initiator of the immigrant rights Stop the Checkpoints Committee on the Olympic Peninsula. Contact her at LFDanks@yahoo.com.