U.S. bosses and their politician-servants are arguing over how best to dole out health care to the working class. One side of this battle, mainly Republicans and the so-called “Blue Dog” Democrats, wants to protect the profits of the insurance and pharmaceutical companies at all costs. The other side, mainly liberal Democrats, sees the current health-care situation as a threat to U.S. bosses’ ability to maintain their position against imperialist rivals. As far as the working class is concerned, the likenesses between these sides are more important than their differences.
Neither faction has offered the real solution for all workers: Free and readily accessible health care, as was the situation after the revolutions in the Soviet Union and China. Clinics were widespread and masses of health-care workers were sent into rural areas to serve peasants and farmers.
PLP believes this history shows that workers in power can provide a healthy environment, just as we’ve learned from what happened when these revolutions were reversed and capitalism restored. In the former Soviet republics, workers’ life expectancy, which dramatically increased in the 30 years after the revolution, has decreased since the late 1960s. In China, schistosomiasis, a disease caused by a parasitic worm that ravaged rural areas, was widely controlled due to planned social action initiated after the revolution; it has reemerged.
The results of socialism were a return to capitalism and renewed attacks on the health of the working class. This is why PLP advocates fighting directly for communism and for a society where all aspects of workers’ health will be primary.
Improving workers’ health is not on the top of the agenda for the ruling class, but the faction that now controls the White House and Congress is focused on maintaining U.S. dominance in the world and therefore has two main goals for health-care reform: 1) force the U.S. working class to accept across-the-board low-quality health care as a fact of life; and 2) discipline the sections of the ruling class which are only interested in short-term profits and threaten to undermine the U.S.’s ability to oppose its rivals. Both of these goals represent a move towards greater fascist control.
Here are the bosses’ plans and a communist analysis:
*Require everyone to have health insurance or else pay a penalty.
This requirement is a direct attack on workers who, because of falling wages, find it more and more difficult to divvy up what they have between food, rent/mortgages, heat, clothing, etc. This racist attack will especially affect black and Latin workers who generally suffer from lower wages and higher rates of unemployment.
* Require small businesses to provide insurance that meets “minimum standards.”
These “minimum standards” will attempt to ensure a working class that is only healthy enough to exploit for profit and fight in their oil wars. This means that health care will be rationed and health care for workers who are not “productive” (in the capitalist sense, meaning they don’t produce profits), namely the elderly and seriously ill, will be limited.
* Expand Medicaid to cover the uninsured who can’t afford to buy their own health insurance.
Medicaid fails to provide decent health care now and would have to be expanded just to adequately cover those who already use its services. The financial crisis has swelled the number of unemployed (and thus added to the nearly 50 million uninsured), with black and Latin workers disproportionately affected, meaning more and more workers will come to rely on Medicaid. Their ability to force us to accept these racist conditions is a measure of their ability to prepare us for future attacks
* Tighter regulation of health insurance companies.
This attempt to increase regulation reflects the split in the ruling class discussed above and indicates that Obama & Co. are attempting to discipline those capitalists who care only about their short-term profit-making. It remains to be seen whether health-insurance bosses will submit to this disciplining, but the working class has no stake in the outcome of this battle, because no matter which group of capitalists are running the show, our health will always take a back seat to profits. Of course it’s gratifying to see CEOs get “punished” in public, but it will not mean that Obama and the Democrats actually care about our health.
* Taxing generous insurance plans.
As a legacy of the militant union reforms of the 1930s and ‘40s, there is a section of the working class which has decent health care insurance, primarily industrial and government workers. Not content with helping to wipe out many of these benefits that went along with unionized auto industry jobs, Obama has called for a tax on the remaining decent health care plans.
This plan to tax those few workers who have somehow managed to retain decent health benefits reveals the essence of the entire reform effort: The heavy taxes on the premium plans will drive them out of existence (for workers) and help to create a single, low-quality level of health care for the working class, one that allows for greater government control and discipline, e.g., fascism.
Getting behind either of the factions is a mistake for the working class. Neither side has our interests at heart, a fact clearly indicated when we consider that there has been no mention of a particular super-exploited section of the working class that has a key role to play in this debate: healthcare workers. Mainly women and often immigrants, these workers suffer racist double-exploitation. Their working conditions are awful, especially for home-health providers (who get paid very low wages and have to buy their own gas to get to their patients) and nursing-home attendants (low wages, long hours, too many patients). Improving the health of the working class should begin with improving the health of those who take care of the rest of us.
When we are told of the deaths of workers from disease we often hear “Our mother died of tuberculosis,” or “My sister died from AIDS,” or “My son died from cholera.” These things, the tuberculosis or cholera bacteria or HIV, are only the specific reason for an individual’s demise. The essential point is that capitalism creates the conditions in which these particular pathogens actually kill people. Clean water and adequate sewage treatment, which is the biggest healthcare improvement that’s available, is denied to hundreds of millions of workers in poorer countries (and millions in imperialism’s heartland).
Whatever it is that makes us sick, from treatable infections to imperialist war, from racist police brutality to stress from having to work two jobs (or from being unemployed), it is capitalism that is the real disease. Fortunately there is a cure: communist revolution and a workers’ society.