Health Care Reform: Who Benefits?

U.S. workers are well aware of the crisis of for-profit health care. The richest nation is home to an estimated 47 million people without health care coverage. Nearly nine million of these are children, and a similarly sized group are those of between 18 and 24 years old. Five million are classified as “un-insurable” by the industry, mainly due to “pre-existing medical conditions.” 75 million are believed to “lack adequate health insurance,” meaning that even if you can afford “coverage,” it may end up not covering anything!

The U.S. spends more on health care per person than any other country in the world. Premiums for private health insurance have increased by 120 percent since 1999, consuming roughly a quarter of the income of a “typical American family.” Some 18,000 preventable deaths are attributed each year to the crisis. On top of it all, the quality of care in the U.S. is often ranked lower than in many countries that spend far less per person. The driving factor behind all of this is the for-profit nature of the industry.

Health care reform became a major factor during the presidential elections. President Obama, who promised “reform,” held a forum on the issue at the White House on March 5th. However, rather than invite those who seek real change, the meeting was packed full of those with a direct interest in maintaining the current for-profit, insurance-based health system. In fact, it took protest to allow a handful of supporters of single payer in, namely Democrat John Conyers from Michigan, the sponsor of HR676, a bill that would enact a single payer system.

Obama had this to say at the forum: “Now is exactly the time for us to deal with this problem, it’s one of the greatest threats not just to the well-being of our families and the prosperity of our businesses, but to the very foundation of our economy.”

But whose interests are really being served? Obama’s so-called reform policy has been championed by  the private insurance interest group America’s Health Insurance Plans, whose president and CEO Karen Ignagni said, “We look forward to working with the Obama administration and the new Congress to develop workable solutions to the health care challenges facing the nation… We will work collaboratively with other stakeholders to achieve these objectives.”
So while it seems likely that some sort of “reform” will take shape in the near future, it will not be, as they say, what the doctor ordered.

Rather, the Obama administration, backed by AHIP and others are working to save the for-profit nature of health care in the U.S. – at the expense of working people’s health.

During his campaign, Obama presented his position ambiguously, in many statements such as this: “If you’re starting from scratch then a single-payer system would probably make sense. But we’ve got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that’s not so disruptive that people feel like suddenly what they’ve known for most of their lives is thrown by the wayside.”

True to form, Obama is obfuscating the issue, claiming that somehow genuine not-for-profit care for all would “disrupt” lives and overturn “culture.” Yes, it would indeed disrupt lives and overturn culture: it would “disrupt” the lives of the CEOs and upend the “culture” of massive profits for the few at the expense of the many!

Health care under U.S. capitalism has already  gone through various “reforms.” The biggest to date being the rise of the HMOs, which started in the 1970s. But the real question is not simply “reform” in the abstract, but in whose interests these changes are made. After all, the capitalists need to reform some aspects of the industry to just keep the overall system running. Projections show that by 2025 premium costs will eat up entire incomes, not a good thing in a economy heavily reliant on consumer spending. So the Big Business politicians have moved to do something about it.

In Massachusetts, for example, in order to put the brakes on single payer aspirations, legislators quickly passed a bill that now requires all MA residents to purchase private insurance; those who cannot afford it get state-subsidized care purchased through private insurers. These schemes, and others like it that leave the fundamental problem untouched, let alone solved, and are not made for working people, but for Big Businesses.

The WIL is in favor of genuine reforms such as HR676. However, even if we were to win single payer health care or any other significant improvement in workers’ conditions of life within the limits of capitalism, such gains are always under constant threat of being rolled back. For example, the Canadian, British, French, etc. national health care systems all are under attack. Only by winning political and economic power can the working class  safeguard these gains, and truly free medical science from the dead hand of the profit motive. Under capitalism, everything is turned into a commodity. Our health is no exception.

The best prescription to fight against this diseased system is working class unity, organization, political independence and the struggle for socialism!