The New York Times and the privatization of Medicare

In an editorial published on Sunday, the New York Times discusses the pros and cons of “premium support” for Medicare. As with every Times commentary devoted to health care “reform” since the Obama administration initiated its campaign to overhaul the US health care system, the editorial is steeped in cynicism and dishonesty.

Headlined “What About Premium Support?” the editorial purports to offer a balanced examination of plans that would give Medicare beneficiaries “a set amount of money to shop among private plans for their own insurance.”

The Times begins by pointing to the “most extreme version of premium support,” proposed by Republican Congressman Paul Ryan of Wisconsin, which “would save the government money mainly by shifting costs to the beneficiaries, who would have to decide whether to forgo treatments or pay more for coverage.”

The editorial then notes that while “most Democrats have been fiercely opposed to privatizing Medicare” and believe “the traditional system can be reformed to reduce costs without demolishing the whole structure,” these opinions are now shifting. Due to “concerns about the rising deficit and the long-term sustainability of Medicare,” the editors write, “some centrist Democrats are backing the premium support idea.”

It is important to be clear from the start. Any proposal that takes money from Medicare and funnels it into the pockets of private insurers—whether in the form of “vouchers” or under the guise of “premium support”—constitutes privatization of the government-run health care system for the elderly and disabled. It means the destruction of Medicare as a universal government health care program—the most significant social program enacted after World War II. The Times’ agenda in weighing the advantages of this or that version of premium support is to promote such privatization.

The Times has relentlessly campaigned for cutting health care costs for the government and the health care industry by reducing supposedly “unnecessary” procedures and “overtreatment” of patients. With the promotion of premium support, it now takes this campaign one step farther.

In Sunday’s editorial, it argues in typically duplicitous fashion that while “it is far too early to talk about scrapping traditional Medicare,” nonetheless “serious analysis and testing of premium support are clearly worth pursuing.” What follows are a series of arguments aimed at concealing the implications of implementing such a proposal.

The best approach to premium support, the Times opines, would protect beneficiaries “from any added costs if competition does not keep prices down.” The suggestion that either party or any faction of the thoroughly bribed US political establishment would impose price controls on the insurance industry is absurd, and the Times knows it.

The editorial goes on to say patients “could pocket the difference” if they chose a less costly plan, i.e., hard-pressed seniors would be driven to sacrifice health care to pay for rent and food.

The editors then get to what really concerns them: whether under the pressure of rising premiums patients “will think seriously about whether they need a costly CT scan.”

“We are skeptical,” they write, “that patients who are chronically ill or nearing the end of life … would second-guess their doctors and choose cheaper care.” The Times’ subtext is that people are living too long and receiving too many costly services and that any reform of Medicare must impose draconian cuts on such “end of life” care.

The closing paragraphs of the editorial point out that implementation of the Obama health care plan will provide a testing ground for the destruction of Medicare. Under the legislation, the government will provide subsidies to lower-income individuals and families to purchase private insurance on an insurance “exchange”—i.e., another form of premium support. The big question, the Times notes, is “whether premium support can work to hold down costs while providing good coverage.”

They already know the answer to this question: the overriding objective of Obama’s health care overhaul is to slash benefits for ordinary Americans while cutting costs for government and boosting the profits of private insurers, pharmaceutical companies and health care providers. The Times has consistently supported this agenda.

What Obama presented to the public in his presidential campaign as a drive for universal health care became, once he took office, a drive to cut costs. Now, with the endorsement of the main organ of the liberal Democratic Party establishment, its socially counterrevolutionary essence is revealed in support for the destruction of Medicare. And why should the axe stop there? The very same arguments can—and will—be used to justify the gutting of Social Security.

More than two year ago, as Obama’s health care plan began to take shape, the World Socialist Web Site warned: “His drive for an overhaul of the health care system, far from representing a reform designed to provide universal coverage and increased access to quality care, marks an unprecedented attack on health care for the working population. It is an effort to roll back social gains associated with the enactment of Medicare in 1965.” This analysis has been thoroughly vindicated.

The attack on Medicare, Social Security and other social programs is part of a broader assault on working class living standards being carried out by the ruling class and its political representatives in the US and internationally. At the same time that the US political establishment moves to destroy Medicare, it squanders trillions to subsidize the banks and prosecute a growing list of imperialist wars.

The Socialist Equality Party urges working people to adopt the standpoint that quality health care and a secure retirement, along with good-paying jobs, education and housing, are basic and inalienable social rights. These rights must, however, be fought for through the mass, independent mobilization of the working class.

They are incompatible with the crisis-ridden capitalist system. They can be secured only through a revolutionary political struggle against the Obama administration and both big business parties on the basis of a socialist program, including the nationalization of the insurance conglomerates, drug companies and health care corporations and their placement under public ownership and the democratic control of the working class.

Kate Randall

The author also recommends:

Renewed calls for Medicare cuts
[26 November 2011]

Obama’s health care counterrevolution
[28 July 2009]