Thursday’s televised health care summit in Washington ended without any agreement on the part of congressional Republicans to support Obama’s health care proposals. Whatever the wrangling between the two parties, however, all sections of the political establishment are committed to two basic propositions: (1) It is necessary to cut government spending on health care programs that benefit millions of people; and (2) health care services for millions more must be rationed so as to reduce the costs to the corporate-financial elite.
A socialist solution to the crisis—taking the profit out of heath care—is excluded from the official debate, which is based instead on the premise that people’s health should be subordinated to the accumulation of private wealth. This is what makes all of the intricate and mind-numbing schemes being cooked up by White House advisers and corporate lobbyists so irrational and backward.
In an editorial published Friday on the previous day’s summit, the Wall Street Journal taunted the Democrats for the right-wing character of their health plan, writing, “To listen to President Obama and his closest Democratic allies, you’d think John McCain had won the election and their bill had been drafted by [Republicans] Paul Ryan, Tom Coburn and the scholars at the American Enterprise Institute.
“In his opening statement, Mr. Obama said the key issue is ‘figuring out how we can control the huge expansion of entitlements,’ especially ‘the exploding costs of Medicare.’”
On Friday, Obama appointed four more individuals to the bipartisan deficit panel he established last week, all of whom are committed to cutting costs. "For far too long,” Obama declared, “Washington has avoided the tough choices necessary to solve our fiscal problems.” By “tough choices” he means policies that penalize the vast majority of the people and are massively unpopular.
The destruction of health care programs is occurring at the level of the states as well. Starved of funding, and with the federal government refusing to provide any serious aid, states are implementing sweeping cuts in Medicaid, the health care program for the poor. Under all of the health care proposals presented by the Democrats—in the House, Senate, and most recently by Obama—millions of people will be dumped into the Medicaid program, which will provide only the most minimal and inadequate care.
Another key feature of Obama’s health care plan is the “individual mandate.” Under this provision, people who are not covered by Medicare or Medicaid and do not receive coverage from their employer will be legally forced to purchase private insurance or pay a penalty. The insurance companies have welcomed this, as it will provide them with millions of new cash-paying customers. This is under conditions where the top five insurers raked in $12.2 billion in profits in 2009, a 56 percent increase over the previous year.
Contrary to the claims by Obama’s liberal supporters—from the New York Times to the Nation magazine—there is nothing remotely progressive in these proposals. Even the fig-leafs designed to sell the plan, such as the “public option,” have been abandoned after running into fierce opposition from insurance companies.
Behind these measures is a very conscious attempt to ration services and implement a more class-based system of health care in the United States.
The vast majority of the population—whether they are in inadequately funded government programs or forced to purchase coverage from private companies—will receive only the most rudimentary care. The wealthy will have access to all the most advanced technologies and medicines. The working class will pay the price with more disease, suffering and death, because this is what the capitalist market demands.
The nature of the health care “debate” is determined by the character of American society, which is dominated by a financial aristocracy, parasitic in its economic activity and rapacious in its social outlook, and which monopolizes an ever greater portion of the national wealth.
From the outset, Obama has bent over backwards to assure the financial elite that he will not interfere with the for-profit health care system. Under conditions where the capitalist system faces an economic crisis of historic dimensions, these profit interests are incompatible with providing decent, quality health care for working people.
With the decline of American capitalism and the vast polarization of society between rich and poor, democratic reforms enacted in the past can no longer be sustained. For the elite layers that control both political parties, the provision of health care and other basic social needs is seen as an intolerable drain on corporate profits and their personal investment portfolios.
The only rational and humane solution to the health care crisis is a socialist one, where economic life is organized to meet social needs, not the accumulation of wealth by a tiny elite. The health care industry must be nationalized and placed under public ownership and the democratic control of the working population.
This requires a political struggle against the financial oligarchy and its representatives, the Obama administration and both the Democratic and Republican parties, and the fight for a workers’ government.