Communism is the only way to provide the working class with true health care unimaginable under capitalism. Though there are limits to perfect health, a growing scientific understanding will give the working class the tools to find new approaches to prevention and treatment of disease.
Communists will use these tools, as well as mass mobilizations, to build a society that will keep people healthy over their lifespan. But we cannot do this without an armed revolution to destroy the profit-maximizing system capitalism, which distorts every aspect of our lives and undermines the use of scientific discovery.
Obama’s health care reform, far from bringing about broad improvements in health, is designed to cut health care costs to free up funds for imperialist wars and to improve the competitiveness of the U.S. Empire.
Health And Racist Health Care
The profit motive and competition inherent in capitalism require companies to overwork, underpay and lay off workers whenever it’s profitable. Black and Latino workers fare even worse in all the social determinants of health because of racism, which through mass racist unemployment excludes entire populations from receiving minimal healthcare.
Capitalist medical care can barely touch the damage done to workers by exploitation, pollution, poor nutrition, stresses of work and unemployment, continual war and most of all, racist and sexist oppression. Capitalist health care patches up a suffering working class providing capitalists workers just healthy enough to produce goods and services, and staff an army to guarantee U.S. capitalist interests globally.
Class struggle is the only way to gain significant reform, but without destroying the capitalist class these gains will be lost. Medicare was forced on the bosses by the movements of the 1960s, including the civil rights and women’s movements, and is now being sharply cut by the capitalists. Unionized workers won health care benefits, which are now under attack, for being, as the bosses say, “too generous.“
Fighting racism is critical to fighting for health care for the entire working class. Students, professionals and workers have to vigorously organize multiracial unity against racist cuts that close clinics and hospitals which serve the poor, such as St. Vincent’s in NYC.
Health Care Reform?
The Patient Prevention and Affordable Care Act (ACA) was passed this spring under Obama and was heavily supported by liberals. It demonstrates how the drive for profits sabotages the efforts of well-meaning reformers and misleads workers. Despite rhetoric to the contrary, the ACA does not restructure health care in a major way since insurance companies will continue to collect premiums and control coverage for services.
Under the ACA:
- Each state will set up an insurance exchange with a range of options and fees.
- Undocumented workers are excluded.
- Many workers who will still be paying large co-pays will lose access to many types of health care, as “comparative effectiveness
research” will justify limited access to procedures and medications.
- Promised gains in coverage for uninsured workers will be offset by cuts in Medicare.
- Access to primary care for many will be limited since many more providers will be needed to guarantee timely appointments.
- Specialists will refuse to see patients from plans with lower reimbursements — an example of rationing under ACA health reform.
- Subsidies to help low-income workers will be too small to allow a worker’s budget to cover insurance so workers would then have to pay fines to the government for not having insurance.
- With the goal of containing costs while nominally expanding coverage, the regulation of insurance companies’ service will be like the government oversight of Wall Street — next to nothing.
Insurance companies generate their profits by collecting premiums from the working class and providing as little health care as they can get away with. They deny payment for hospital days and keep the entire working class on hold to settle bills and get referrals. PLP organizers have heard thousands of such stories during the year building up to health care reform and still the insurance companies were handed the prize of another 30 million customers!
Class Struggle And Health
Healthy lifestyles will be possible as we build a society that provides all workers with the care they need, with no need to generate profits for hospitals, drug and insurance companies.
We have learned from past upheavals in society that class struggle can improve health. The Soviet Union made health care available to all, while attacking poverty and racism and saw rapid improvements in health outcomes. Chinese workers attacked major health issues and eradicated schistosomiasis, destroyed the narcotics trade and developed mass education with local “barefoot doctors” during their communist period. As capitalism returned to these countries, these improvements in workers’ lives are being reversed and health outcomes are deteriorating.
Many workers who were disappointed in Obama’s wars and Wall Street bailouts still believe in him because “he got us health care.” But during the health care reform debates of the last year, rhetoric about improving the quality of care and broadening access disappeared and cost control soared to the top. What we got is a program that the insurance companies love far more than the working class ever will.
In addition, health care reform is being used to mislead sections of the working class into attacking black and Latino workers who will be covered under the ACA. The capitalists are building an increasingly strident racist movement — the current Tea Party’ers — that attacks immigrant workers. The racists portray the ACA as taking away good benefits from deserving white workers, cutting well-earned Medicare benefits and giving benefits to the supposedly undeserving poor. White workers need to stand with black and Latino workers to demand quality health care for all.
Workers have not won health care reform by electing Obama. We did not build a mass movement that forced concessions from the bosses — the bosses themselves reorganized the health system through the ACA to increase their profits! It is time to give up illusions that any capitalist restructuring of society will help the working class, particularly during an economic crisis. We need not spend our energy on trying to tweak this health care reform or telling Obama how to “regulate” the insurance industry. We must continue to build a mass, multiracial revolutionary movement to fight for better health care and to destroy the bosses’ system.