To change healthcare, millions must act

September 19, 2009

September 7, 2009

The Obama administration has governed with the support of the majority of the people and the backing of the ruling class since January. Having won a Democratic majority in both houses of Congress, the Obama administration has secured a $780 billion stimulus package and more money for the trillion dollar bailout of the banks.

But things are changing. Obama’s popularity is falling. President Obama declared that he wanted Congress to pass a health-care reform before it went on summer recess. He did not come close to that goal. One committee passed a bill on the last day and the debate on healthcare unfolded this summer with raucous town-hall type meetings dominated by the right wing. Supporters are making criticisms of his policies public.

To win a serious change of the healthcare system beneficial to the majority, with costs estimated in the trillions of dollars, means a significant transfer of wealth from the rich to the middle and working classes. This will only come about with a much larger, broader and deeper movement of working people. This is the reality behind the healthcare crisis.

Proposed bill passes House committee

On July 31 the House Energy and Commerce Committee passed a healthcare reform bill. The bill represents a pro-corporate attempt to respond to the enormous healthcare crisis in the United States. It is likely that even this bill will be modified in favor of the corporations before it passes.

According to a published summary, the bill would prevent health insurers from refusing to provide coverage to someone because of a “pre-existing condition.”  It would also provide, within narrow guidelines, a government sponsored public health insurance available as an option to private plans.

Much of the debate in the U.S. is framed around cost. The United States spent $2.8 trillion on health care in 2008. It represents 20 percent of the gross domestic product. That is $7500 per capita, nearly twice that of the next highest country.

The United States ranks 24th in both male and female life expectancy in 2006. It ranks 20th in child well-being. Nearly 50 million Americans do not have health care of any kind, not including 12 million undocumented workers. Over 60% of bankruptcies in the U.S. are due to medical bills and 70% of the people filing for it have health insurance.

One of the points of agreement across the U.S. left is support for a single-payer health care system, if not as a final goal, as a serious step forward for working people in the United States.  [Note: Single-payer means that there is a “single-payer” for all healthcare, the federal government. A popular slogan to express this demand is “Medicare for all,” after the government paid for insurance for everyone over 65 years old.]

Attacks on healthcare reform in town hall meetings held by Congress people dominated the early summer news. The right wing made up lies about healthcare, like government “death panels” that are authorized to “pull the plug on grandma.”  Many angry “citizens” at these meetings were paid for by the healthcare and health insurance industry. The corporate media, biased against healthcare for all, covered these meetings extensively. In an effort to respond, Obama will address the Congress and the nation next week [September 9].

Many Americans are overwhelmed by the economic crisis and think that healthcare problems are not as important. According to a Gallup poll of July 24-25, less than 20% say the healthcare system is in crisis, a number that has not changed over 15 years. Almost 7 out of 10 Americans say economic-related issues are the nation’s top problem; only 16% say healthcare is the top problem.

In the same poll, while 44% thought that healthcare reform would benefit the nation only 26% thought their own healthcare would benefit; 34% thought their own healthcare would worsen; another sign of the failure of the Obama administration to offer a vision of healthcare reform in the majority’s interest.

The economy remains by far the most important thing on people’s minds. Most people are satisfied with their healthcare, no matter how bad it is. They prefer to keep the health care that they know, however poor it is, for some other, unknown system.

There are conflicts within the ruling classes over the profits being made by the healthcare and health insurance industries. Health care costs continue to rise at three times the rate of inflation. Costs are paid for by other capitalists because 60% of all people have health insurance through their employer. That means that employers, other capitalists, are the biggest purchasers of health insurance. Nationally, family premiums for employer-sponsored health insurance increased 119 percent between 1999 and 2008. Health care reform is partly a question of a conflict among capitalists over profits and their distribution.

Obama has negotiated some price controls with the drug industry that guarantee profits at a little lower level. A similar deal was struck with one of the most notorious organizations for opposing national healthcare, the powerful association of U.S. doctors, the American Medical Association.

If Obama really wants to fight for health care, he would fight for single-payer health care. Without controlling costs through governmental control, “reforming” healthcare is another way for the rich to pilfer public funds through insurance companies and healthcare monopolies.

Workers struggle

The new reality of the capitalist crisis – huge and permanent job losses and wage reductions, loss of a large share of the collective private pension savings of a generation, loss of trillions of dollars of home value – is beginning to sink in with U.S. workers and middle class people. State and local governments are reeling from the drop in property tax revenues and are cutting services and laying off workers, and forcing state workers to take days off without pay. Economists predict a turnaround in employment for next year, but even if that proves true there is no immediate relief. There is deep anxiety and fear, a new, more serious focus on the future of the country and a rising political awareness, first expressed in the election of Obama.

It is also true that the bailout of the bankers and the enormous stimulus package appear to have slowed the slide into depression. The situation appears more stable; people are beginning to demand more justice and equality in the bailouts and the sacrifices.

The problems of the war in Afghanistan — disputed elections, mounting combat deaths and costs – have caused support for the war to fall 10% in 3 months.

Most of the Obama administration’s problems, including the economic crisis, were inherited from the Bush regime. But the Obama team has had nearly 10 months to develop a different policy. On so many key issues, from Afghanistan to Guantanamo, it has supported the Bush administration’s policies.

After its efforts to reach agreement with Republicans on healthcare bore no fruit, its commitment to change is being challenged. Obama supporters Nobel Prize-winning economist Paul Krugman and African-American liberal journalist Bob Herbert, question his strategy for winning healthcare. Supporters more connected to the workers’ and radical movements, like Bill Fletcher and Ron Daniels, are publicly questioning his tactics. They raise important questions about his ability to stand up to the capitalists on any issue after his extensive compromises with the healthcare and drug industries, especially ruling out a government paid for health insurance for all from the beginning. The comparisons of Obama to former presidents Kennedy and Roosevelt are being replaced with comparisons to Johnson and Hoover.

There are other reasons for opposition that go beyond professional hecklers. The economic crisis has shaken the very foundations of the country. President Obama was supported by the majority, in part, as a savior. Like the proverbial knight on a white horse, he could charge in and save the country all by himself. Many working people thought voting for him was a sufficient political act to change U.S. politics. But it is not. There is a struggle between the working classes and the rich. Obama is first and foremost a politician of the rich, although under very exceptional circumstances.

Working class people in the U.S. need to act and think independently of the rich and their political parties. They need to make their needs and voices heard and demand jobs, food and shelter. Aging infrastructure, including the abandoned factories, should be redesigned and rebuilt. U.S. workers need universal healthcare and an end to the Afghanistan and Iraq wars.

The rightwing have used the failure of the administration to meet the needs of workers to attempt to mobilize the frightened people of the lower middle classes and the wealthier sections of workers, those whose monetary losses have been the greatest, against lower paid workers and poor people. They are also using racist fear of Obama.

There is growing discontent among the radical wing of Obama supporters which adds to the criticisms that have come consistently from the socialist organizations since the beginning. It is a challenge to build bridges between the traditional organizations and the new movements but one good effort so far is the support for a single payer system, universal healthcare, over the past few weeks. Another may be some anti-war actions scheduled for the fall.

For the 50 or so million people who are uninsured to become insured, for the other 100 million people to have good health insurance that they can afford, means millions of workers in the U.S. in political motion. It hasn’t happened yet, but the temperature is rising.

Published in Spanish in Sin Muro (


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