In the wake of Tuesday’s collapse of the Senate Republicans’ efforts to repeal Obamacare, President Donald Trump summoned GOP senators to the White House on Wednesday and demanded that they keep working to “repeal and replace” the 2010 health care overhaul.

Trump contradicted Republican Senate Majority Leader Mitch McConnell, who had announced Tuesday that he would hold a vote next week on a bill to repeal Obama’s Affordable Care Act (ACA) devoid of a new plan to replace it. The bill would instead delay for two years implementation of the repeal while Congress worked to fashion a substitute plan.

McConnell had called for the vote knowing he lacked the 50 Republican votes needed to pass the measure, with four GOP senators having declared they would not support it. He had proposed the “clean” repeal bill after two more Republicans announced Monday night that they would vote against the White House-backed “repeal and replace” legislation (Better Care Reconciliation Act), bringing to four the Republican opponents of that measure and dooming it.

Following the lunch meeting with Trump, McConnell said he would proceed with a vote next week, without making clear whether the Senate would be voting on the “repeal” bill or the “repeal and replace” measure.

Either option would represent a devastating and unprecedented attack on health care for tens of millions of people. According to the Congressional Budget Office, a simple repeal of the ACA would strip 32 million people of health coverage by 2026, while the Republican “repeal and replace” legislation would deprive 22 million over the next decade. The latter bill would impose $770 billion in spending cuts over 10 years to the federal-state Medicaid program, which currently covers some 70 million poor and elderly Americans, and impose spending caps, meaning Medicaid would cease to be an open-ended, guaranteed entitlement program. It would also sharply raise premiums and deductibles from the already outrageously high Obamacare levels and give the wealthy hundreds of billions in tax cuts.

The Democratic Party response to Republican disarray over health care is to step up its campaign for negotiations with the Republicans to pass a bipartisan bill that would “fix” Obamacare to make it even more punitive for working people and more profitable for the giant insurance companies. The statements of leading Democratic politicians and the editorials and commentaries in newspapers generally aligned with the Democrats, such as the New York Times and the Washington Post, make clear that the overriding focus of the establishment opposition party is the defense of the capitalist market and the interests of the health care industry, not the health care needs of working people.

On Tuesday, Democratic Senate Minority Leader Charles Schumer held a press conference at which he spelled out his priorities. Denouncing the White House and congressional Republicans for “continuing to deny the insurance markets the certainty they need,” he said the GOP could “start today working with the Democrats…to stabilize the markets…”

Schumer endorsed a proposal from Democratic senators Thomas Carper and Tim Kaine (Hillary Clinton’s vice presidential running mate in 2016) to create a permanent “reinsurance” program for the individual health insurance market. One of the key demands of the insurance industry, such a program would provide billions in taxpayer funds to reimburse private insurers for high costs linked to care for particularly sick policyholders.

This call to “stabilize the insurance markets” has become the mantra of those factions of the political establishment and media calling for a bipartisan alternative to the Republican “repeal and replace” proposals. In none of the statements of leading Democrats or “liberal” newspapers can one find a call to expand medical coverage to the entire population, reject all proposals for cuts in already hopelessly inadequate benefits, or in any way rein in the profiteering and power of the insurance and pharmaceutical monopolies.

Nor are there clear statements opposing in principle the termination of Medicaid as an entitlement program—which everyone in the political and media establishment knows is the first step to dismantling and privatizing Medicare and Social Security.

Wednesday’s Washington Post carried an op-ed piece by Neera Tanden, president and chief executive officer of the Center for American Progress (CAP), and Topher Spiro, the organization’s vice president of health policy. The CAP is a Democratic Party think tank, founded and chaired by John Podesta, White House chief of staff to President Bill Clinton, counselor to President Barack Obama, and chairman of the Hillary Clinton campaign in 2016.

Headlined “Time for the parties to work together,” the column puts forward a proposed bipartisan plan tailored to the demands of the insurance industry. “Our plan,” the authors write, “calls for the Senate to pass those portions of the [Republican] BRCA that would help stabilize insurance markets. …” They specifically call for a government guarantee of Obamacare subsidies to health insurers, federal funds to reinsure the firms, and government intervention to provide coverage in those areas deemed insufficiently profitable by the corporations.

This approach is echoed in editorials published Wednesday by both the Times and the Post. The Times writes: “Under the human approach, with a stronger health care system a shared goal, Republicans and Democrats could work together to fix the marketplace problems and restore confidence among insurance companies.”

The Post, under the headline “Time for repair, not repeal,” editorializes: “The House and Senate Republican health care bills contained a variety of provisions that would have shored up existing individual health insurance markets. Those can be copied and pasted into a new, bipartisan bill.”

The Times also features an op-ed piece by Ohio Governor John Kasich, a leading Republican opponent of the White House health care bills and champion of negotiations with the Democrats to come up with a bipartisan “compromise.” Between 1983 and 2001, Kasich served nine terms as a right-wing budget-cutter and opponent of entitlement programs in the House of Representatives. He left to make a fortune as an investment banker with Lehman Brothers, a position that ended when the bank’s reckless and semi-criminal speculative activities led to its declaration of bankruptcy on September 15, 2008. The failure of Lehman was the event that triggered the global financial crisis and “Great Recession.”

Kasich spells out more clearly the agenda that underlies the maneuvers of the Democrats and the euphemistic commentaries of the “liberal” press. He calls for shoring up the profits of the insurance companies first, and then moving to gut Medicaid:

“After two failed attempts at reform, the next step is clear: Congress should first focus on fixing the Obamacare exchanges before it takes on Medicaid. … Once we see these repairs taking hold, Congress should then take up needed improvements to Medicaid as part of comprehensive entitlement reform.”

Under conditions of broad and explosive popular opposition to attacks on health care—with polls showing a derisory level of support for the Republican bills—the maneuvers between the Democratic Party and Republican dissidents amount to a conspiracy against the American people. The aim, in the name of defending health care, is to impose further cuts for the masses and increased subsidies for the corporate elite.

The last thing the Democrats want is for the mass popular anger that exists to be mobilized in a struggle against the corporate plunderers who are consigning many thousands of people to untold suffering and an early grave. The declarations of Bernie Sanders and others that the evident failure of the Republican health care bills is a “victory for the people” should be rejected with contempt.

Working people must be warned against any illusions that the Democrats can be pressured to defend their access to decent and affordable health care. The entire framework of the official “debate” on health care is reactionary. It is entirely premised on the subordination of the need for health care to the profit greed of the corporations and the functioning of the capitalist market.

The bipartisan assault on health care is one more demonstration of the incompatibility of basic social and human needs with the capitalist profit system. One or the other must go!

The right to quality health care for all can be secured only through the independent mobilization of the working class, by means of the class struggle, in opposition to the entire political establishment, including both of the major parties, and the capitalist system it defends.

Decent health care is possible only on the basis of the expropriation of the insurance, pharmaceutical and hospital corporations and their transformation into public utilities democratically controlled by the working population—that is, on a socialist basis.