“Reform” Wall Street Can Believe In

Democrats’ Health Care Scam

For Free, Quality Health Care, Including for All Immigrants!

For Free Abortion on Demand!

One would think that it would be impossible to pass a health reform that did not offer something to someone. But the Democrats have managed to come close. To be sure, 30 million people now without health care are eventually supposed to be covered. But 23 million people are projected to remain uninsured by 2019. Children seem likely to be covered for pre-existing conditions at a cost to be negotiated with the insurance company vampires, a benefit to be extended in 2014 to all others. Older Americans can expect to pay even more usurious fees for such coverage.

While Barack Obama and the Democrats pat themselves on the back for passing this “historic” legislation, undocumented immigrants are proscribed from receiving benefits from this “reform.” In most states, even those with legal papers will have to be residents for five years to be eligible for such assistance as Medicaid. And women in need of an abortion, which is becoming next to impossible to get access to, need not apply. Obama went out of his way to sign an executive order reaffirming the Hyde Amendment, which bans federal funding for abortions. His bill allocates some $250 million for “abstinence only education.”

There is supposed to be some more money for community health clinics, which are themselves minuscule in scope. But if your employer doesn’t insure you or you’re not on Medicare, you’ll have to buy coverage from the very insurance giants that have made U.S. health costs the highest on the planet, while most U.S. citizens, in comparison to those in other industrial nations, receive the poorest health care. The insurance companies are the same parasites that regularly deny people coverage on the basis of “pre-existing conditions.” In Texas last month, a baby born with a rare heart defect was denied coverage by Blue Cross because he was considered to have a “pre-existing condition” (sensing a PR disaster, the insurance company eventually covered the child, though at a higher premium).

There are no guarantees of affordable premiums or decent coverage. But if you don’t buy insurance, you could be penalized up to $695 per adult (or $2,085 per family), or 2.5 percent of your household income, whichever is higher. And you can be sure that the insurance companies will do everything to get around the pre-existing conditions clause.

As we warned in “For Socialized Medicine!” (WV No. 943, 25 September 2009), “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.” The spectre of this country’s impoverished and uninsured masses is being wielded as a battering ram against unionized workers and the elderly. Some $500 billion are to be slashed from Medicare. And beginning in 2018, the costs for this “reform” will in part be paid by taxing the “Cadillac” health plans held by not a few organized workers.

In a recent issue of CounterPunch (29 March), columnist Kevin Zeese gives the following grim prognosis:

“The new law forces Americans to buy a corporate product that is overpriced and flawed. Americans could be required to pay up to 9.5 percent of their income on insurance that only covers an average of 70 percent of their medical expenses. In addition, insurance is allowed to deny care with no court review of that decision. As a result, someone with insurance, paying an expensive premium, could find themselves in bankruptcy as a result of this law. The major cause of bankruptcy before this bill was a health care crisis and a majority of those people had insurance. That will remain true under the new law.”

Those bankruptcies are hardly an accident. For decades, employers, in the process of slashing their payroll costs, have been raising the out-of-pocket expenses for the health coverage they provide. In this period of historically low strike activity, the few strikes that have erupted have largely been over health care. This is exactly the kind of reform bill that Wall Street wanted, with “progressive” tycoons like Warren Buffet even willing to pay a little extra in taxes for the cause of containing soaring health expenses in the U.S.

Liberal Democrats regret the absence of what was always meant to be a dwarfed “public option,” and the trade-union tops are not pleased with the tax on “Cadillac” plans—but “hey,” as they now say, “it’s a start.” But in fact, the new law is a creature that the labor bureaucrats helped to create. Notably, SEIU service workers union leader Dennis Rivera served as Obama’s point man for the reform, gaining kudos for helping to forge a coalition of insurance and drug companies, along with the American Medical Association and the American Hospital Association and their lobbyists, that determined the bill’s real contours. These corporate foxes now not only control the chicken coop, but also, with access to abortion being even further constrained, the government has taken on the role of a priest in ensuring that the hens pay the price for their sexual “sins.”

In the aftermath of the bill’s passage, many liberals and leftists are today expressing dismay at the paucity of its benefits. These are, virtually to a man, the same gaggle who promoted Obama’s election as the road to progress after years of Republican reaction and who more recently begged him to hold tough on the public option. Yesterday, trade-union bureaucrats like AFL-CIO head Richard Trumka drew lines in the sand around the issue of the public option, while threatening to withdraw support if union-negotiated health policies were taxed. But no longer. Now they downplay the tax on these supposedly opulent union health benefits. After all, 2018 is a long way away. But the 2010 midterm elections are just around the corner. Union bureaucrats now plan to campaign strongly against those Democrats who voted against the bill and redouble their search for really, truly “progressive” Democrats, while holding Obama’s feet to the flame of popular pressure. This quest is similar to Ponce de Leon’s search for the fountain of youth.

For Socialized Medicine

In contrast to what is available in the United States, health care in the European “welfare states” seems luxurious. This is no accident. These benefits were ceded, mostly after the Second World War, to placate working-class militancy in societies where the advanced layers of the proletariat were not averse to entertaining thoughts of socialist revolution. Such thoughts and aspirations were inspired by the 1917 October Revolution in Russia. Even with the degeneration of the Soviet Union under the Stalinist bureaucratic usurpation of political power beginning in 1923-24, the planned economy that survived provided all with a job, health care, education and housing. It is similarly no accident that the capitalist counterrevolution in the USSR in 1991-92 was followed by havoc and precipitous societal decline there, with life expectancy plummeting. Today, as a result of this world-historic defeat, the consciousness of workers around the world has been thrown back, albeit unevenly, to the point where politically advanced workers no longer identify their struggles with the goals of socialism. And the benefits that were once wrested from the various ruling classes of Europe are under attack.

At home, the American bourgeoisie has faced no such challenge to its rule. America’s rulers have very successfully wielded anti-black racism, anti-immigrant nativism and sexual bigotry to preserve their class rule. The giant class battles that led to the formation of the CIO in the 1930s and the social struggles of the 1950s and ’60s did not result in the formation of a mass proletarian party of even reformist dimensions. And the reforms that issued from these conflagrations—whether health care concessions from the bosses or governmental reforms such as Social Security and Medicare—were correspondingly modest, but gains nevertheless. Today, in the absence of any significant working-class struggle, the current health care reform has more in common with the gutting of retirement benefits, the slashing of educational opportunities and the disappearance of the good, or any, job that now face poor and working people.

That the U.S. is the only major industrialized country on the face of the planet without a national health care program is, in large part, testament to how the race-caste oppression of black people has been used by America’s rulers to divide and weaken the working class. Cries against “big government” have long been synonymous with axing social programs such as health care and welfare, with these painted as a drain on the tax dollars of “hard-working folks” to benefit the ghetto poor.

We say that all must have access to medical care at no cost, including access to abortion and contraception. We are for socialized medicine—the expropriation of the parasitic health care and drug companies, which are an immediate threat to the well-being of just about everyone in this country. We call for full citizenship rights for all immigrants and free abortion on demand. As we wrote in WV No. 943:

“Free, quality medical care for all should be an elementary right. But achieving that will require a genuine socialist assault by the multiracial working class to rip the ‘health’ industry out of the hands of the profit-gorged insurance giants and drug companies. Only with the destruction of this entire capitalist system of exploitation, which measures human life in dollars, can the wealth generated by those who labor be committed to providing the highest level of medical care for all and eradicating the poverty and hunger that condemn countless millions to a life of misery, disease and early death.”

America Needs Workers Revolution

Such health care benefits as the multiracial working class has won have been the product of militant class struggle against the bosses. The dearth of strikes over the past decades helped pave the way for the exploiters to butcher health care, pensions and other union gains with impunity. And they have gotten away with it thanks to the acquiescence of the union misleaders, who share the bosses’ concern of maintaining the profitability of American capitalism.

There is plenty of justified fear and apprehension, especially among unionized workers and the elderly, over the health care “reform.” But with the labor movement on its back and the trade-union bureaucrats actively collaborating with the Obama administration, opposition to the bill has served as a boon to the Republicans and far right.

Today’s “militants” are the racist militiamen and reactionary Christian fundamentalist types who have been mobilized by the Tea Party movement, which is supposedly anti-tax although there have been no tax increases of significance in years. Mistakenly believing that the black man who now occupies the White House is interested in significantly improving the lot of working people, blacks and the poor, these yahoos now rise in defense of a testosterone-dominated “white America” that is threatened not by what they ludicrously claim is a “socialist Obama” but merely by demographic realities.

Obama is seen as one of “them” by the racist Tea Party types. In fact, he is the Commander-in-Chief of the most vicious, racist and powerful imperialist power on the planet. The usual Democratic hype of “justice” and “reform” for working and black people, who are the base constituency of this other party of the bosses, is laid aside once the votes are counted. With that party’s most recent ascension to dominance in Congress and most statehouses and major city administrations, immigrants face increasing victimization and the right of women to abortion is further threatened, with abortion providers murdered and clinics closing. Meanwhile, the focus of U.S. imperialism’s unending wars, which are designed to preserve America’s dominance as its economic strength declines, has been shifted from Iraq to Afghanistan. Working people and the oppressed—not the fat-cat bankers and Wall Street hustlers—are the ones who are paying and will continue to pay for this most recent eruption of capitalism’s anarchy and decay.

The social debris that constitutes the Tea Party movement would be confronted by a revival of labor struggle. Programmatically, any such revival must link the struggle against all exploitation and injustice with the fight for black equality. This in turn demands the forging of a revolutionary proletarian party committed to the overturn of American imperialism through socialist revolution. All of this cannot go forward unless the pro-capitalist bureaucrats who control the trade unions in this country are driven from their positions of power and replaced by class-struggle militants who understand that the bosses and the workers share no common interest.

The normal rejoinder to this Marxist perspective by those leftists who would reform this decaying capitalist order is that one begins with a small step to the “left,” like Obama’s election. Then when the Democrats disappoint, those who elected them will take another step to the left. By the reformists’ lights, Obama and the Democrats have disappointed, and so it is time for another step to the left. Don’t hold your breath.

A cogently articulated variant of this perspective is provided by Workers World Party, complete with references to “the class struggle” (but not socialist revolution). Writing on the health care legislation, Workers World (24 March) declared:

“The Democratic Party leadership has given in all along the line. The workers, oppressed communities, students and youth all have a stake in this struggle. It can be united with the struggle for jobs, against the budget cuts and foreclosures, and to save public education. All these fronts in the class struggle form the basis to come together in People’s Assemblies or other organs of popular power to unite to launch a powerful, anti-capitalist movement.”

The “fight the right” perspective of the International Socialist Organization (ISO) is even more anodyne. In a 24 March article, Socialist Worker online complains, “What a twisted outcome to the opportunity that greeted Barack Obama and the Democrats a year ago—massive public sentiment in favor of transforming the dysfunctional health care system.” The ISO’s answer to this “twisted outcome” is provided in a 31 March article:

“For many people who are sick and tired of conservatives getting their way, the bill’s passage signaled a potential shift in the political winds in Washington. So after months when it appeared that the right was making a big comeback, the health care reform could translate into a growing confidence that working people can make real progress today after all….

“We deserve much better. To get it, we have to build independent organizations and movements that take on pro-business, anti-worker policies—whether they’re put forward by Republicans or Democrats.”

Here, there are not even the words “class struggle,” let alone the suggestion that capitalist rule itself is inherently “pro-business” and “anti-worker.”

In spelling out its program of pushing the Democrats to fight against the Republicans’ “Fascist Agenda,” the Maoist Revolutionary Communist Party (RCP) goes so far as to make common cause with America’s slaveowning “founding fathers.” The RCP writes in Revolution online (4 April):

“The Republicans are for tearing up and rewriting the social contract forged by the founders of the United States in the U.S. Constitution—and in particular, the concept of the U.S. as a secular nation.

“The Democrats are convinced that this agenda—for a Christian fundamentalist theocracy based on extreme individualism and brutal repression—is not a viable way to maintain the U.S. as the world’s dominant superpower. Nor do they see this as a viable way to re-cohere domestic social stability of the U.S….

“As conflict between rival sections of the ruling class intensifies, and even breaks out into open clashes [guess which side the RCP is on], the legitimacy of the entire old order could be called into question” (emphasis in original).

All these reformists argue that it is disruptive to their slog toward goodness for us to expose their (sometimes implicit, sometimes explicit) support to “democratic” American imperialism, as this supposedly divides the “movement.” The reality is that working people’s lives are being savaged. Their children’s futures are turning to dust. In all quarters it is realized that the path will continue to go downhill, albeit with occasional feeble upside pulsations. The anger of working people is both deep and just. The problem is that they see no alternative to imperialism’s decay. Against the reformists and the trade-union bureaucrats they tail, we underline that the 1917 Bolshevik Revolution remains the beacon of progress for all humanity.

The various would-be reformers of the capitalist order are in one way or another adamantly opposed to the path of international proletarian revolution that was the banner of that historic victory. Thus, they lull the working class with pipe dreams as a way forward. The only successful proletarian overturn of capitalist rule to date occurred because the Bolshevik Party convinced the working masses, through its relentless exposure of the treachery of the reformists, that the only way forward was to smash the bourgeois order through proletarian revolution. The perspective of the International Communist League and its U.S. section, the Spartacist League, is to forge revolutionary working-class parties that fight for new Octobers.