Tuesday night’s CNN debate on Obamacare between Vermont Senator Bernie Sanders and Texas Republican Senator Ted Cruz was an exercise in cynicism and evasion.
The most notable feature of the event was the performance of Sanders. Where was the champion of the “99 percent” who railed against the “billionaire class” during the Democratic primary contest? Where was the “democratic socialist” who called for a “political revolution?”
That Sanders was nowhere to be found. He was replaced by a more “reasonable” politician who is more than willing to work with the Trump administration and the Republicans to refashion the Affordable Care Act, keeping its “good” features and revising its problematic ones.
The fact that Sanders even agreed to debate Cruz—an ultra-right Tea Party Republican who stands for a scorched-earth approach to health care and all other social programs—points to an effort to present him as a more “mainstream” politician and integrate him into the leadership of the Democratic Party. The hope is that popular illusions in Sanders that remain from his challenge to Hillary Clinton can be utilized to restore credibility to the Democrats following their electoral debacle. Sanders, who used his campaign to channel mass discontent behind Clinton, is himself fully onboard and highly conscious of his role.
There was nothing genuinely progressive in what Sanders had to propose for reforming the health care system or confronting the health insurance crisis faced by a majority of Americans. As for Cruz, he in turn insulted and patronized questioners from the audience, while dancing around issues as he spouted his pro-corporate, free-market agenda.
Sanders’ job was to allude to the excesses of the for-profit health care industry while offering only the vaguest palliatives as an alternative. After saying that if Obama’s Affordable Care Act (ACA) is repealed, people with cancer, diabetes and other conditions will be charged more or denied coverage, he added, “That’s the function of private insurance.”
He failed to mention that Obamacare is based on and tailored to the interests of the private insurance companies. Its so-called “individual mandate” requires uninsured people to purchase coverage from for-profit insurers or pay a penalty. Sanders never questioned the ACA’s reliance on the private market during the debate.
It was left to Cruz to point out that under the ACA, the profits of the 10 largest health insurers had doubled, to $15 billion. To which Sanders responded: “I find myself in agreement with Ted. He’s right. The function of insurance companies is not to provide quality health care to all people. It’s to make as much money as they possibly can.”
Sanders immediately exposed the unseriousness of his rhetorical attacks on the insurance giants by appealing to the arch-reactionary Cruz to “work together on a Medicare for All single-payer program.”
The WSWS has analyzed in detail Sanders’ “Medicare for All” proposal. It has nothing in common with socialism or socialized medicine. Nowhere in his plan does Sanders propose to expropriate the multibillion-dollar health insurance companies, pharmaceutical firms and health care chains. He knows, moreover, that the health care industry will never voluntarily accept any restraints on its profits.
On the cost of health care, Cruz made the ludicrous claim that Americans pay more for health care than countries such as Canada and the UK with government-run health systems, which he falsely labeled socialized medicine, because, “We get a lot more and a lot better health care.” There is a mountain of factual evidence to the contrary, including a recent survey of adults in 11 advanced countries that placed the United States dead last in access to medical care and affordability.
Cruz also pointed to long wait times for procedures in other countries, which he described as rationing. He ignored the reality that in countries such as the UK, government funding for medical care is being cut at the same time the system is being increasingly privatized, leading to deteriorating care.
Sanders countered: “We have enormous rationing in this country. When you have 28 million people who have no health insurance, that’s rationing.” As a solution, he suggested that a “Medicare-care like public option” be offered on all of the Obamacare insurance exchanges, which would “provide real competition to the private sector.” But, as he well knows, the political establishment, including the Democratic Party, has repeatedly rejected even the fig leaf of a “public option.”
The words “working class” left the lips of the Vermont Senator only once over the course of the hour-and-a-half event. He said of health care in the US: “The way we do rationing is, if you are very rich, you can get the best health care in the world. I believe, right here in the United States. We should be proud of that.
“But if you are working class, you are going to be having a very difficult time affording the outrageous cost of health care.” He added: “Every single year, tens of thousands of our fellow Americans die because they don’t go to the doctor when they should,” and people give as the reason: “I didn’t have any insurance” or “My deductible was so high. I couldn’t go.”
This is indeed the brutal reality of health care in 21st century America. But neither the Affordable Care Act, nor its repeal and replacement by the Republicans, with the collaboration of Sanders and the Democrats, is going to change this state of affairs.
On the contrary, what is coming is an all-out assault on the existing health care programs Medicaid and Medicare. Carol, a woman in the audience suffering from multiple sclerosis, asked Cruz: “Senator Cruz, can you promise me that you and Republican leaders in Congress will have a replacement plan in place for people like me who depend on their Medicaid?”
To which Cruz replied: “Medicaid is a profoundly troubled program … we should have a system that allows as many people as possible to be on the private health insurance of your choice rather than Medicaid, because the Medicaid outcomes are not working and people are suffering.”
In other words, good luck with your struggle with multiple sclerosis, but Medicaid should be junked and the private insurance market allowed to work its magic. Cruz got to the heart of his agenda later in the program, saying: “I want a simple flat tax of 10 percent for everyone and to abolish the IRS. That ends the power of the lobbyists. It ends the power of Washington. That’s a solution that empowers the people.”
Such a regressive tax would deepen the chasm between rich and poor and lead to the gutting of health care and other vital social programs.
Trump’s secretary of Health and Human Services, Tom Price, favors block-granting of Medicaid and privatization of Medicare, the government insurance program for seniors and the disabled that covers some 55 million people.
The Democratic Party has vowed to work with Trump and his administration when they see “common ground.” In the realm of health care, that means maintaining the grip of the for-profit health care industry at the expense of the health and lives of the working class.
What Sanders offered up Tuesday night had nothing to do with “socialism” or fighting the for-profit health care industry. A genuine socialist solution to the health care crisis means nationalizing the giant insurers, drug companies and health chains, expropriating their wealth, and placing health care under the democratic control of a workers’ government.