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On September 15th, the AFL-CIO union federation’s national convention unanimously voted in favor of endorsing the demand for single-payer, universal health care. The AFL-CIO is the largest union federation in the US, and despite the 2005 split of several large unions from the body, the AFL-CIO still represents more than 10 million workers in 56 national unions.
The vote represents a tremendous step forward in the fight to guarantee free, quality health care for all US workers, whether they are organized into unions or un-organized. This is a class question, and ultimately single-payer will only be won by mass movements on the economic and political planes by the working class. Now is the time to begin translating words into action, for the unions to begin mobilizing a mass, nation-wide movement demanding single-payer health care. Now is the time for the unions to break with the Democratic Party, which has taken single-payer “off the table” and instead is proposing what is in effect a massive subsidy of the HMOs at the public’s expense.
The crisis over health care has simmered in US society for decades, but under the weight of the “Great Recession,” the need for a socialized, national health care system is more important than ever. Nearly 50 million Americans either lack health coverage altogether or have fragile access to it, while the millions more who do have health insurance are subjected to rising premiums, co-pays and deductibles and are often denied care when the HMOs refuse to pay.
Many working people who have health insurance today can lose it tomorrow if they are laid off. The unions have been facing the issue of health care directly in almost every contract negotiation over the past decade as the bosses have been trying to unload as much of the cost as possible onto workers.
The right to free, universal, quality health care from the cradle to the grave is a fundamental right, but this right cannot be guaranteed within the limits of capitalism. The fight for single-payer health care can only be won with the class struggle, similar to how the right to an 8 hour day, universal suffrage and the right to form trade unions were won in the past.
The AFL-CIO’s official position on single-payer also poses the question of their support of the Democratic Party, which despite speeches to union members pledging to defend Obama’s “public option,” are pursuing a very different policy in practice. In the halls of Congress and in the mass media, they have scrapped not just single-payer but even a weak “public option” in an attempt to reach a compromise with the Republican minority, the HMOs and Big Pharma.
While the Democrats present themselves as “friends of labor,” the fact is that the party has other friends with much deeper pockets. These friends inhabit the corporate boardrooms — the same corporations that rake in billions from the current, for-profit health system. Even though the party currently has a majority in both houses of Congress and a Democrat in the White House, they refused to fight for the Employee Free Choice Act, a key legislative demand of the unions.
How can our unions really fight for single-payer health care while supporting a party that represents the interests of the for-profit health system a thousand times more than it fights for working people? The answer is that we can’t. Either the AFL-CIO uses its demand for single-payer as a flimsy and easily-ignored “pressure tactic” on the Democrats, as it has done in the past, or it takes the logical and necessary step of breaking with the Democrats and building a party of its own that could make single-payer a reality.
The health care plan being pushed by Obama and the Democrats in Congress is really a counter-reform dressed-up to appear as a step toward single-payer. It is not. It centers around incentives for the big HMOs, such as mandated coverage. As we’ve explained in Socialist Appeal before, mandated coverage will require those currently un-insured to buy insurance from the big HMOs, with those unable to pay being given partial subsidies by the government. What this amounts to is giving multi-billion dollar corporations such as BlueCross/BlueShield millions of new customers and billions more in profits and tax dollars.
This is not a real “reform” in the interests of working people. In reality, it is yet another massive hand out to corporate America, this time to the owners of the HMOs. Instead of improving things for the vast majority of Americans, the Democrats’ plan, which is likely to be approved in some form by Congress, will make the situation ten times worse. This means that instead of “going away,” the need for single-payer will be magnified in the months and years to come.
Some would argue that by breaking with the Democrats, the unions would only be helping the Republican Party by splitting the “progressive” vote. But the problem is that in a two-party system, where both major parties defend the interests of capitalism, eventually the “greater of two evils” wins after working class voters tire of the inability of the “lesser evil” to deliver really meaningful or fundamental alternatives to the status quo. This was the experience during the Clinton administration, which on the whole passed many more counter reforms such as NAFTA and “Welfare to Work” than it did secondary reforms such as the Family Medical Leave Act.
Although illusions in Obama himself remain high, millions are already becoming disillusioned with the Democratic Party and society is becoming more sharply divided between left and right. The “Great Recession” has shaken up the consciousness of millions of working people, who are increasingly questioning the values of capitalism and looking for an alternative to the current state of affairs.
In those countries where the working class was able to win single-payer in the past, this was possible because the workers had class-independant parties based on the unions. By mobilizing the class in the streets and in the workplaces as well as on the electoral front, they were able to win the right to free, universal access to health care. It is time that the US working class and our unions take the same road as our class has done abroad.