Health Care Tussle: Workers and Poor Lose

For Free, Quality Health Care for All!

Last week’s 5-4 Supreme Court decision sanctifying the constitutionality of the Affordable Care Act (christened with racist intent by its opponents as Obamacare), while unanticipated by many, was hardly earthshaking. Chief Justice John Roberts, normally a member with Scalia, Alito and Thomas of the court’s right-wing bloc, joined with the nominally liberal justices in issuing the majority decision. Although not a few Tea Party types now see him as a traitor, the decision simply asserted that the government has the power to levy taxes on the populace, a commonplace that does not suggest that Roberts was possessed by the ghost of Lenin.

With Republicans declaiming against the act as an insidious introduction of “socialism,” their Speaker of the House John Boehner promised to rally the electorate to destroy it, including even its popular components, such as barring denial of coverage for preexisting conditions and extending it to dependents up to age 26. For his part, Obama used the occasion of the Supreme Court ruling to modestly offer himself as a fighter for what is good for the American people, untainted by the quest for political power. As we wrote when Obama announced this plan (WV No. 943, 25 September 2009):

“With the official unemployment rate crowding 10 percent—and double that when the underemployed and those who have stopped looking for work are added in—the number of those with no health insurance increases day by day. Obama invokes the plight of the uninsured, with promises of a level of care not much above a pledge to pick up the dead bodies, in order to massively cut health care costs. Some $600 billion in savings is to come from reducing government spending on Medicare and Medicaid. Also being eyed for the ax by the health reform executioners are the now non-taxable employer-paid health programs won through the hard-fought union battles of the past.”

Today, liberal pundits and the AFL-CIO trade-union tops are seizing on the court decision to induct Obama into the pantheon of such Democratic Party “progressives” as Franklin Delano Roosevelt, Harry Truman and Lyndon Johnson. These efforts to resurrect the halcyon days when the Democratic Party was the putative champion of the working class and poor are but camouflage for perpetuating the rule of decaying U.S. imperialism. From World War II, which established the military and economic dominance of the American empire, through the Korean and Vietnam wars and the more recent occupations of Iraq and Afghanistan—these Democratic Party “progressives” have engaged in whatever savagery was deemed necessary to maintain the supremacy of U.S. imperialism.

Reforms enacted under their regimes—from FDR’s “New Deal” to LBJ’s “Great Society” programs—had nothing to do with the virtues attributed to the Democratic Party. On the contrary, they were the by-products of mass social struggles, from the class battles of the 1930s that forged the industrial trade unions and the giant strike wave following World War II to the civil rights and Vietnam antiwar movements.

Although modest in scope, these were nevertheless real gains for the working class, black people and the poor. Not so the Affordable Care Act. With its individual mandate requiring those not insured by their employers or qualifying for Medicare or Medicaid to buy health insurance or pay a substantial fine, the biggest beneficiaries of this “health care” bill will be the profit-gouging health insurance giants and pharmaceutical companies. The medical profession and hospitals will also be enlisted as the overseers of “cost containment.” The Hyde Amendment denying federal monies for abortion was reaffirmed by an executive order issued by Obama. In the bill, undocumented immigrants are proscribed from receiving any of the act’s benefits. Union workers with so-called “Cadillac” health plans will shoulder a portion of the costs of this “reform” through proposed new taxes.

The poorest layers of society were supposed to receive coverage under this law through an expansion of Medicaid. Now state governments, beginning with Florida and South Carolina, have announced that they will opt out of this expansion after the Supreme Court ruled that they cannot be penalized for doing so. It is no coincidence that this revolt begins in the states of the former Confederacy. The very fact that the U.S. is the only major industrial country on the face of the planet without a national health system is testament to the brutal racial oppression of black people.

The color bar has historically served to divide and weaken the working class, impeding the development of class consciousness and the formation of even a reformist workers party. The existence of such parties in Europe, together with the militant struggles and socialist aspirations of advanced layers of the proletariat, led to the creation of nationwide health care, pensions and other programs. In contrast, in the U.S. many such benefits were the product of individual union battles. Correspondingly, the dearth of strikes in recent decades has led to the butchering of health care, pensions and other union gains by the bosses. They have overwhelmingly gotten away with it thanks to the acquiescence of the trade-union bureaucrats, who are committed to preserving the “competitiveness” of American capitalism.

Private-sector unions having been ravaged, including much of what existed of guaranteed health and pension benefits, Democrats and Republicans alike are carrying out wholesale attacks on such remaining plans for public workers unions. The capitalist politicians are whipping up a public outcry against these workers for supposedly living high off the hog at the taxpayers’ expense. In racist capitalist America, the reactionary myth that social programs are merely a drain on the income of hard-working people has long been wielded to shred benefits for the ghetto and barrio poor. Now these guns are being turned on what benefits remain for the working class as a whole.

Republicans promote the idea that the answer to societal decay is to further increase the massive transfer of wealth and income to the 0.01 percent of the population that constitutes America’s ruling class. The Democrats propose to put lipstick on the pig of social decay by “reforming,” i.e., decreasing, benefits available through such social programs as continue to exist. In either case, the result is the same: the continuing erosion of the living standards, and the very ability to live, of working and poor people in the U.S.

Free, quality health care for all is a burning need for the mass of the population. To win this demand would require a revival of working-class struggle. Such will not be forthcoming from the misleaders sitting atop the unions. Following the Supreme Court decision, AFL-CIO president Richard Trumka saluted Obama’s stand “for fairness and for working men and women,” declaring “the election this November provides a clear choice.” Subordinating the interests of the workers to their capitalist masters as represented by the Democratic Party has long been the name of the game for the union bureaucrats.

Last year, it was played to contain protest by tens of thousands of unionists, youth and others who had rallied in defense of Wisconsin’s public worker unions against Republican governor Scott Walker’s union-busting assault. Diverting this militancy into a recall campaign, the bureaucrats were handed a stinging rebuke when Walker beat his Democratic Party opponent for a second time. With union membership among Wisconsin state workers slashed by at least half since last year, Trumka declared that Walker’s “divisive agenda has been stopped cold”!

The workers would find plenty of allies if they waged some hard class struggle for health care, for black and immigrant rights and access to free abortion and contraception. But to wage such a battle means replacing the present sellouts—who peddle the lie that the workers have interests in common with their exploiters—with a leadership committed to mobilizing labor’s power in opposition to the capitalist class enemy. The workers need their own party, a multiracial revolutionary workers party that will fight to expropriate the health care industries as part of a fight to overturn the rotting American imperialist order through socialist revolution.