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“Sicko is Boffo!” screamed the Daily News. Michael Moore’s latest
film – an acute dissection of the U.S. health-care “system” – is taking
the country by storm. Not only because it’s one of his best efforts as
a director, but also because once again he’s struck a raw nerve, in
this case the anger over care denied in order to keep medical
profiteers wealthy.
Conservative critics of course panned the
film, claiming it was naïve at best – “Americans want choice in their
healthcare,” they insist (as if choice can exist in a system dominated by
profits) and treasonous at worst – i.e., for Moore’s admiration of
national healthcare systems elsewhere, especially in Cuba.
Liberals present a more dangerous critique.
They criticize Moore for not mentioning the snake oil panaceas being
peddled by Democratic Party candidates. (See the articles in this
pamphlet for analyses of these “universal” proposals.)
Typical of this approach is New Yorker film critic David
Denby’s review of the film. Denby is so outraged by Moore’s politics
that the director’s typical “gee whiz” ironic stance goes completely
over his head (or at least that’s the pose Denby strikes). What’s
worse, Denby trots out the tired old lies about waiting times in Canada
and England, and complains that Moore ignores the “reform” plans put forward
by “major Democratic Presidential candidates.” Denby ends by claiming
that a “shift to the left” in the country in favor of health-care
reform has “rendered his latest film almost superfluous.”
In fact Moore’s advocacy of single-payer puts
him squarely in synch with the mood of the millions of U.S. workers and
retirees who’ve been stripped of their health benefits and those still
with benefits who can’t afford the premiums nor get the kind of care
they need. And it leaves both Moore and these workers firmly to the
left of the typical Democratic candidate, whose “universal” reform
would force workers to pay more and get less.
The key to answering Moore’s question, “Why
can’t we do better,” depends, as Lenny Bruce’s Tonto knew full well, on
just who you mean by “we.”
If in that we you include our ruling class,
forget it. They will never have an interest in providing for workers’
health care needs – any more than they care about provision of other
basic needs such as food, housing, decent retirement, etc. And they
know yielding on health-care leads inevitably to battles over other
basic needs.
If by we, on the other hand, you mean workers
and those disproportionately impacted by the lack of decent health
care, and suffering from the underlying conditions that sicken and kill
us every day, then that’s an entirely different diagnosis of the
problem.
At showings of his film Moore has appeared
with single-payer advocates such as the California Nurses Association
to advocate passage of bills such as H.R. 676 (the Conyers bill; see
the articles in this pamphlet for details). CNA recently affiliated
with the AFL-CIO, and part of the agreement for doing so was that the
union federation would adopt its pro-single payer position (which it
has done, although in fairly vague wording). CNA’s militant advocacy of
single-payer in the political arena, has been coupled in a number of
instances with militancy over workplace issues. It has been involved in
numerous heated organizing and contract battles in recent years. At the
same time there are signs of brewing discontent within the country’s
largest health-care union. In May, California affiliates of the Service
Employees International Union forced their national leadership to end a
sweetheart deal with nursing home managers signed at the expense of,
and without the vote of, SEIU nursing home workers.
These battles are important for two reasons.
First, the vast majority of healthcare workers in this country are
unorganized. This means they not only lack the wages and benefits they
need, but with no say over their working conditions they can’t care for
their patients the way they would like to (nurse staffing ratios, for
instance, is the most hotly contested issue in health-care workplaces).
To fully organize this sector, militant, democratic and politically
independent unions are required (it’s worth noting that CNA was a key
promoter of the Labor Party formed in the 1990s). Once such unions are
built and/or rebuilt we can be sure they will be in the vanguard of the
fight for important reforms such as single-payer.
What’s more, with adequate leadership such
militant unions won’t stop there. They’ll ask Michael Moore’s question
– “Why can’t we do better?” – on an even larger scale. They won’t stop
at single payer, but will ask, “Why can’t we socialize the entire
health care system, and tax the rich to pay for it?” which in turn will
lead to the question of all questions: “Why can’t we socialize the
system itself, and end a state of affairs which condemns millions to
illness and death in order to secure profits for the few?”
In this fight they’ll be eagerly joined by
the millions of auto, steel, garment and other workers who agree with
Moore that our system is truly “Sicko”!
Bush’s ‘Free-Market’ Health Care Plan Pushes Cost Onto Workers
by Andrew Pollack
From the February 2007 issue of Socialist
Action Newspaper
In his State of the Union speech on Jan. 23,
George Bush proposed a plan to gut the country's employment-based
health insurance system. In an attempt to force workers to buy their
own cheaper and less comprehensive coverage, it would provide tax
breaks up to $7500 for individuals and $15,000 for families. And
workers with employer-provided insurance would have to pay taxes on any
coverage over $15,000.
Some bosses will dump their plans and force
workers to buy individual coverage, while those keeping their plans can
push the cost onto workers. Funding for the plan will also come from
cuts to hospitals serving the poor. The Employee Benefit Research Institute
said the proposal "would mean the end of employer-based benefits.”
Bush claims the "gold-plated" plans
he would tax encourage overuse of health care. But high costs are due
not to overuse of routine care, but rather bureaucratic waste, profits,
and high-tech care for serious or critical conditions. Combined with
geographic and demographic factors, even a run-of-the-mill plan can
easily exceed the $15,000 limit.
In fact, rather than being profligate
consumers, workers have been paying ever more for ever less care as
bosses have cut back on benefits. They started by cutting or
eliminating coverage for retirees—the group most in need of care—and by
hiking copays, deductibles, and premiums for current employees.
By 1993 only 36 percent of firms with 200 or
more workers provided retiree insurance, down from 66 percent in 1988.
The accounting rule change used as an excuse for these cuts will soon
be extended to the public sector.
A recent survey of large firms showed 70
percent increased retiree premiums and two-thirds had caps on firm
contributions. In 2004, just 20 percent offered coverage to those over
65. Since late 2005, several companies—including GM, Ford, Chrysler,
Nissan, Verizon, and Sears—have announced cuts to retiree benefits.
These cuts often affect seniors who've lost their pension plans and can
least afford their own medical care.
Current employees face the same dismal
picture. The percentage of workers required to pay all or part of their
premiums rose from 46% in 1980 to 78% in 1995. Bosses have been
twisting workers' arms to enroll in Health Savings Accounts, which
shift the financial burden to employees.
Almost half the 47 million uninsured work
full-time. Medical bills contribute to half of personal bankruptcies,
even though 75 percent of those in debt had coverage. Lack of insurance
is estimated to cause 18,000 deaths a year. Of course, the most
oppressed workers—Blacks, Latinos, and immigrants—get the worst care
while paying the highest relative cost.
Some of the soldiers in Iraq joined the
military to get health insurance. One woman told an antiwar rally how
her son, killed in Iraq, had enrolled because his daughter had
congenital heart defects and he couldn’t find a job with health
insurance.
Health care has been a prominent issue in
every recent strike, and will once again be a key item in this year’s
auto talks, with GM demanding more cuts to retiree benefits.
Now Bush wants to give auto and other bosses
a class-wide solution. In an article titled “U.S. Car Makers Stand to
Gain From Bush Plans,” the Wall Street Journal reported, "White
House aides hope [the plan] will boost the ailing American auto
industry.”
Health Affairs says employers are calling for
an "exit strategy" from their obligations. So Bush's plan—and
others analyzed below—is welcome news to the ruling class, who will no
longer have to cut health care one company at a time.
Bush's plan will also take money from
hospitals to subsidize private insurance, and his 2008 budget will
further slash Medicare, primarily through cuts to hospitals and
doctors.
Bush's plan would cover at most three to five
million of the 47 million uninsured. The plan also will encourage
younger workers to desert employer-provided plans, leaving them with
older and sicker people to cover—thus pushing even more over the
$15,000 limit.
Deborah Burger, president of the California
Nurses Association/National Nurses Organizing Committee, said the kind
of plans that Bush wants workers to buy encourage people to avoid
preventive care, leading to more serious illness later.
The "free market" slant of Bush's
plan is finding an echo in plans being pushed by both parties in D.C.
and in state legislatures.
In April, 2006, Massachusetts passed a
"universal" coverage bill. But the plan is only universal in that
it forces every resident to buy private insurance or face steep
penalties. Money provided for subsidies (to low-income workers only) is
not enough to buy decent coverage. And as in the Bush plan, that money
is taken from funds for care now given to hospitals and doctors.
The bill was passed without any estimates of
cost. Nine months later, those who predicted workers wouldn't be able
to afford its coverage were proven correct. The cheapest plan would
cost about $360 a month, and workers would pay up to $5000 for
individuals or about $8750 for families in out-of-pocket expenses. Even
these numbers are just guidelines for insurers, who can charge what
they want. Not surprisingly, a survey showed most bosses in the state
favor the plan.
On Jan. 8, California Gov. Arnold
Schwarzenegger put forward a similar plan mandating purchase of private
insurance. He had earlier vetoed a bill to replace private insurance
with a statewide trust fund.
Insurer UnitedHealth said that
Schwarzenegger's plan would "present real possibilities for our
business." While still making billions in profits, new enrollment
for insurers has slowed. Thus, said the Wall Street Journal,
Schwarzenegger’s plan was welcome relief, as it would “expand the
market to four to five million uninsured Californians.”
Consumers would have to pay up to $10,000 for
a family out-of-pocket, and again hospitals and doctors would be taxed
to pay for the plan.
Adding insult to injury, Schwarzenegger
demanded "personal responsibility," saying "the trim and
fit" should be treated differently from the "obese and
inactive." Companies nationwide have used such rhetoric to deny
coverage to those who smoke, can't lose weight, etc. Some are even
fired before they can use benefits: Last year Wal-Mart told its managers
to get rid of overweight, elderly, and injured workers.
Schwarzenegger's announcement came the same
month as a series in the Los Angeles Times exposing how California
insurers were denying coverage to individuals with routine ailments or
in certain occupations, denying payment for covered children with
cancer, etc., while giving executives billions in stock options (often
illegally backdated).
These are the insurers bosses expect us to
find coverage from!
The CNA said the plan wouldn’t provide comprehensive
or affordable coverage, and would limit employers' responsibility but
not insurers' profits. But Andy Stern, head of the Service Employees
International Union, praised Schwarzenegger for his
"leadership" in "expanding coverage and making quality
care more affordable.”
A dozen other states are considering similar
plans to mandate insurance purchase, typically without subsidy for
anyone on an average working-class income. And most will likewise cut
payment for care. Said the expert crafting the New Jersey plan, the
state should stop “paying for care” and instead “empower” individuals.
A bill before Congress encourages each state
to come up with its own pro-business plan. Meanwhile, Oregon Senator
Ron Wyden's Healthy Americans Act would establish a “centrally financed
system of private health insurance.” Its expressed goal—only implicit
in Bush’s plan—is to destroy the employer-sponsored coverage system.
Employers would have to terminate their
health plans and pay the amount saved to workers in tax-deductible
wages. Workers would not be allowed to buy coverage worth more than a
pre-set limit. Wyden estimates his plan will save bosses $310 billion
of the $429 billion they now spend on health care. Backing Wyden are
Families USA, Safeway CEO Steve Burd—and SEIU’s Stern.
The architects of the Massachusetts and
similar plans have done studies showing that government-provided
insurance would be far more equitable and efficient, yet in every case
have opted for private mandates citing "political feasibility."
The week before Bush’s speech a coalition of insurers, doctor and
hospital groups, drug companies, the Chamber of Commerce, and AARP came
out for tax credits for individual insurance purchases.
According to the Wall Street Journal,
insurers have lost business as employers cut benefits to save money,
and so insurers have been scrambling for new revenue. Now they've found
it.
At a January press conference, the head of
the Business Roundtable (representing the country's 160 largest corporations
and banks), stood alongside Stern and the head of AARP. Their joint
message, said the Washington Post: “We stand ready to give you the
political cover you need for a centrist, bipartisan fix for a broken
health-care system.”
Hailing the “new partnership,” Stern said,
“America needs a plan. Not a Democratic or Republican plan, a business
or labor plan. An American plan.” Hailing the Massachusetts and
California plans, he thanked corporate America: “Today we stand united
by our love for this country and our desire to see it prosper.”
The day after Bush’s speech, a press
conference was held to show support for HR 676, Rep. John Conyers'
single-payer bill, which is backed by Physicians for a National Health
Program and 225 labor organizations. Speakers denounced the
state-by-state giveaways to insurers, as well as the Wyden bill.
However, the mainstream Democratic Party
approach is clear: "I think Democrats are concerned lest they seem
too radical," said Rep. Pete Stark, chair of the House health subcommittee.
"We've got to win again in 2008, and we don't want to talk about
universal coverage or anything that sounds like socialized
medicine."
Meanwhile, the new Democratic majority just
handed Big Pharma a huge gift. While allowing Medicare to bargain for
the first time for lower drug prices, it will have no enforcement
power, as no drug will be excluded from the program for costing too
much.
In a future article we’ll look in more detail
at the roots of the health-care crisis, the difference between
solutions such as single-payer and socialized medicine, and what labor
is doing on this front.
SEIU joins bosses, politicians calling for health care ‘reform’
by Andrew Pollack
From the March 2007 issue of Socialist Action
Newspaper
On Feb. 7, the head of the biggest
health-care workers’ union in the U.S. stood side by side with its most
notorious denier of health care at a press conference to pledge their
commitment to health-care "reform."
This love-fest united Andy Stern, head of the
Service Employees International Union (SEIU), with Wal-Mart CEO H. Lee
Scott. It followed previous appearances by Stern with other business
moguls and politicians mouthing empty phrases about
"universal" health care—mostly wrapped around plans to force
individuals to buy their own insurance (see article in the February
Socialist Action).
Wal-Mart used to stay away from business
appeals for "solutions" to the health-care crisis, which is
not surprising, because it solves its own crisis by refusing to cover
the vast majority of its workers, charging exorbitant amounts to the
few covered, and trying to force out those most likely to need health
care.
This has been a key plank of anti-Wal-Mart
activists, and has led to local legislation mandating employers over a
certain size to provide coverage—bills clearly aimed at Wal-Mart. So
for Wal-Mart, saying it's for "universal" health care with no
specifics—and saying explicitly it has no intention of offering more
coverage to its own employees—is a cheap way of trying to rebut critics.
Joining Stern and Scott were AT&T, Intel,
Kelly Services, the Communications Workers of America, and various
mainstream policy groups. They talked vaguely of universal coverage, of
getting more value for the buck, and demanded individuals take more
responsibility for their own health and its costs.
Stern, repeating his mantra that
"employer-based health care is dead—a relic of the industrial
economy," complained that his corporate friends "cannot
compete in the new global economy" and that health care "is a
major drag on American competitiveness." "Business by
2008," he said, "will pay more for health care than they will
make in profits. That is untenable." What Stern ignores is that
the increased productivity of industry long ago provided enough surplus
value to pay for free health care for all.
Gerald Shea, the AFL-CIO's head of health
policy, derided the event as just talk. And Stern's embrace of Wal-Mart
was too much even for some of his labor allies, drawing an angry rebuttal
from the head of one of the biggest affiliates of Stern's union
federation, Change to Win.
Joe Hansen of the United Food and Commercial
Workers issued a letter saying, "It's not appropriate to take the
stage with a company that refuses to remedy its mistreatment of
workers. Wal-Mart is actually decreasing health-care coverage to
employees. The company has become a proponent of health care for
everyone—as long as Wal-Mart doesn't have to deal with the needs of its
own employees."
Members of UFCW-backed Wake-Up Wal-Mart
handed out fliers at the Stern-Scott press conference denouncing the
company, and its director also took a swipe at Stern: "Why
Wal-Mart would want to look for a partner to cover up its health-care
crisis is obvious. Why anybody would decide to give a disingenuous
player that stage is unconscionable."
Simultaneous with his embrace of Wal-Mart
came Stern's promotion of Dennis Rivera, head of 1199 SEIU United
Healthcare Workers East, to national chief of the union's health-care
division, which represents a million health-care workers. Rivera will
be in charge of pushing Stern's vision of "universal"
coverage, and, says the New York Daily News, is already touring the
country to build "an alliance of unions and corporations opposed
to the rising cost of health insurance."
Rivera was a perfect choice for the post,
having worked hand in hand with New York hospital bosses to lobby
politicians for more money. Rivera oversaw a massive expansion of the
union's dues rolls, but he often sidestepped battles over wages, jobs,
and benefits—fighting instead for job retraining funds.
And in December Rivera refused to fight the
state's plan to close hospitals. Rivera also refused to fight the
conversion of the state's Blue Cross and Blue Shield into for-profits,
instead cutting a deal so some of the sale price went into one-time
contract gains.
There are, in contrast, a number of local and
state union bodies fighting for single-payer health care. Under
single-payer, often referred to as Medicare for All, the federal
government would pay all health-care bills, eliminating the role of
insurers.
Representative John Conyers of Michigan
introduced a bill in 2003 (HR 676) to cover every person in the U.S.
for inpatient and outpatient services; drugs, primary and preventive
care; dental, mental, and home health; physical therapy and
rehabilitation; eye and hearing care; long-term care; etc. There would
be no deductibles or co-pays—but part of the funding would come from a
payroll tax.
The bill has been endorsed by hundreds of
locals and dozens of city and state union bodies. The All Unions
Committee For Single Payer Health Care, headed by RN Kay Tillow,
encourages and publicizes endorsements. And Leo Gerard, a Canadian who
heads the United Steelworkers of America (USWA), has made frequent
statements in favor of single-payer.
Conyers' bill is similar to proposals by
Physicians for a National Health Program and the Labor Party's Just
Health Care Campaign (except that Conyers makes no provision for jobs
for laid-off insurance company workers). Single-payer advocates point
to the huge waste in dollars from insurance companies' profits, as well
as the money spent finding ways to deny care. Even the paperwork for
care provided is unnecessarily costly because of its spread among
numerous competing entities.
Private insurers devote 20 percent of their
premiums to administrative costs and profit, compared to about 3
percent for Medicare's administrative costs. Physicians and hospitals
consume another 12 percent of private insurance premiums on billing and
insurance related functions.
A single-payer system would also seek to
negotiate with drug companies and other providers of goods and services
for lower prices (but would still leave them in private hands).
Single-payer would theoretically allow
redirection of resources to primary and preventive care, which would
save billions more by stopping many acute and chronic conditions from
developing.
What it would not do, however, would be to
stop hospitals or drug or equipment companies from spending billions on
one of the biggest sources of high costs: high-tech care of critical
conditions near the end of life.
Single-payer advocates say this too could be
subject to negotiation, but without socializing provision of care as well
there would be inherent limits to such negotiations.
Single-payer deals primarily with the
financing of care but not its provision. Doing so would require
socialization of medicine, i.e., having care provided by public
institutions and their staffs—as is already the practice at Veterans
Administration hospitals and clinics.
Paul Krugman, a liberal economist and
prominent backer of single-payer, has pointed to the efficiencies
available to the VA because of its nationwide scope, with patients and
information about them part of a single, life-long system. And he
points to the efficiencies of care provided by system employees rather
than entrepreneurial clinicians in private practice.
In the last decade such efficiencies allowed
the VA to transform the rat and filth-infested facilities described in
Vietnam vet Ron Kovic's "Born on the Fourth of July" into the
envy of the rest of the "industry." Of course, the U.S. only
grudgingly financed this exercise in objective socialization.
A Newsweek article last year promoting the
VA's successes was met with embarrassed silence by the Bush
administration. And cuts to the VA budgets, combined with the rapid
influx of seriously wounded vets from the war in Iraq, have led to a
resurgence of the Vietnam-era conditions: a Washington Post exposé
published Feb. 19 showed that rats and filth are on their way back.
This mirrors the way Britain starved its
National Health Service for funds as a prelude to privatizing parts of
it, the lesson being that even a socialized medicine sector is never
secure until workers take over society as a whole.
This brings us to the peculiar nature of our
market-based health-care system. Despite crocodile tears about record
numbers of the uninsured or poor quality, the real reason for the flurry
of new plans is that health-care costs are cutting into profits of the
bosses as a whole.
The U.S. pays far more for health care than
any other country but gets far less in care and quality. Wasted dollars
are due not only to private financing, but also from the profits and
exorbitant salaries going to for-profit hospital chains, Big Pharma,
equipment makers, and medical specialists.
More significantly, its very structure
mirrors the combination of competitive anarchy and oligopolized
collaboration of other "industries." Our health-care system
consists of hundreds of thousands of private doctors and thousands of
hospitals (increasingly grouped in networks), some for-profit and some
not-for-profit. But even the latter are forced to compete with each other
to take affluent or well-insured patients (and the doctors who treat
them) away from other hospitals—and to do so by pushing the highest-cost procedures.
Compounding this anarchy is the
commodification of medical services. As manufacturing productivity
soared but profits declined, employers looked for new places to invest.
They did so by converting services previously provided by government
bodies, charities, or households into commodities to be bought and
sold. Thus, markets were created for food and entertainment services,
education—and health care.
Ironically, once this happened, even the
federal government's creation of the mammoth Medicare and Medicaid
programs created new huge markets for private firms selling goods and
services to hospitals and doctors providing care billed to those
programs. The same dynamic would continue to exist even under a
single-payer program.
The current health-care crisis is an example
of the costs of such commodification, as a plethora of drugs,
diagnostic machines, and types of surgery based on advanced technology
are pushed on patients for ever-diminishing return in extended
longevity or quality of life. And the money devoted to these high-tech
"cures" comes at the expense of primary and preventive care.
But as profitable as this process has been
for health-care profiteers, bosses in other sectors are sick of paying
the tab—especially with the long-term decline in the rate of
profitability, which has dovetailed with the country's loss of global
economic dominance.
In the September 2003 Monthly Review, radical
health-care author Vicente Navarro described the class nature of health
care in the U.S. He pointed to the ruling-class figures who dominate
hospital boards of trustees. And more fundamentally, he noted how the
growth of coverage under union contracts after World War II coincided
with the passage of the Taft-Hartley Act, which restricted use of the
very strike weapon which other countries' labor movements had used to
fight for public health care.
Instead, the Act brought a common structure
to the firm-by-firm coverage that was evolving. This in turn made
workers fearful of standing up to bosses for fear of losing their
source of health-care coverage.
U.S. labor has been taking it on the chin over
health care in almost every contract settled in the last two decades,
and is getting set for even more bargaining setbacks. While the
individual insurance mandates being pushed by both parties would get
bosses off the hook, they're not waiting for any of these bills to
pass.
After forcing retirees to pay more of their
own costs in October 2005, GM is looking in this year's negotiations
for even more massive cuts—or even to dump their responsibilities
completely. Ironically, auto bosses see their opportunity in a
dangerous precedent set by the USWA. Despite Gerard's single-payer
rhetoric, he helped his own employers violate their promises to
retirees, and automakers have convinced the UAW to consider a similar
deal.
In January, Goodyear dumped its $1.2 billion
health-care liability onto a fund co-managed by the USWA and itself in
exchange for a one-time payment of $1 billion. This fund was originally
set up to provide partial benefits for some of the more than 200,000
retirees dumped during bankruptcy proceedings by LTV, Bethlehem, and
National Steel.
Now it is union officials who have to tell
retirees they have to pay higher premiums or can't have certain
benefits. Union "control" of such funds means the right to
say "no" to members' needs.
The Wall Street Journal described the typical
day of one such official, who receives calls from retirees and widows
who can't afford drugs or care. To please everybody, he says,
"we'd be out of money in a matter of months."
The trust is $200 million short of estimated
future retiree medical costs. There are precedents for union-run or
joint union-management-run multi-employer health plans. But they had
traditionally been based on employer contributions negotiated at each
contract, and even these funds have been prone to benefit cuts stemming
from stock declines or theft, as well as from management cries of
poverty.
The Steelworkers' fund started on an even
rockier foundation: providing benefits for retirees of bankrupt
companies that had simply walked away from their promises. Creation of
the fund itself was a favor to billionaire investor Wilbur Ross, who
claimed he would save jobs by buying the bankrupt steelmakers but
wouldn't assume "legacy costs." So the union suggested the
trust fund.
In the first years the Steelworkers’ fund
didn't even have enough cash to pay any benefits. Given the massive
loss of benefits for its retirees, its not surprising that the USWA has
said more than most on single-payer. It has also joined rallies and
conferences of groups like PNHP and Healthcare-NOW, and in 2003 forged
an alliance with the California Nurses Association, an even more
vigorous advocate of single-payer (and a critic of sell-out contracts by SEIU).
But the Steelworkers, while mobilizing
retirees for legislative protection, hasn't done much to mobilize
members on the broader issue—a lack of action flowing from its
preoccupation with its bosses' profits, expressed by Gerard as
repeatedly, if not as obnoxiously, as Stern.
For instance, in testimony to Congress,
Gerard complained, like Stern, that because of health-care costs, steel
bosses were losing profits and global
market share. His solution was not single-payer, but increased
benefits and tax credits for his members—and subsidies to the
companies.
Meanwhile, Democratic presidential candidates
continue their duplicitous ways. At a January campaign event, Hillary
Clinton asked those in attendance what type of health-care system they
wanted. Almost every hand went up for extending Medicare to all. Forget
it, said Clinton. "We need to build consensus first," she
said, in favor of "politically feasible" solutions.
Presidential candidate John Edwards has
proposed setting up a competition between private plans and regional
single-payer plans—which would still be run through private insurers.
A recent article in Health Affairs pointed
out that drastic change in nations' health-care systems often comes
along with such crises such as war and depression. So it's worth noting
that the debate over who will pay for ballooning health care costs
coincides with the trillions of dollars spent (and the hundreds of
thousands of lives lost) in Washington's imperialist adventures.
Thus, Deborah Burger, president of CNA, wrote
that uppermost in voters' minds in the last elections were the Iraq War
and health care: "More than ever, the two issues seem linked. With
record budget deficits inflated by war spending, resources for health
care and other critical domestic needs are increasingly starved."
Burger noted that on the very same day Bush
proposed hundreds of billions more for war and hundreds of millions in
cuts for public health spending. She also pointed to "the
horrifying, long-term costs of caring for our nation's war
wounded," estimated to cost over $600 billion over the next 40
years for tens of thousands of injured veterans," including large
numbers of "amputees, the blinded and brain damaged, who will
require extensive social support."
Meanwhile, the VA is increasingly denying
coverage to soldiers just back from the war. The U.S. spends two or
three times more on health care per person than other industrialized
countries while getting far less.
There's one country that spends about four
percent of what the U.S. does—yet has life expectancy and infant
mortality rates that, says the BBC, "are pretty much the
same" as those of the United States and has doctor-to-patient
ratios that "stand comparison to any country in Western
Europe."
That country is Cuba—which not only
socialized medicine, but also expropriated a ruling class that, left to
its own devices, seeks to continually re-infest every possible niche in
the economy, including health care. Having eliminated these parasites,
Cuba was able to focus resources on preventive and primary care, and
even train enough doctors to get volunteers to help dozens of other
countries (while the U.S. can't even train enough nurses to meet
patient needs).
There's much talk in the U.S. these days
about the need for stricter infection-control practices in hospitals.
The same can be said about the need to rid us of the social infection
ravaging our health-care system.
The labor movement in the U.S. could take a
small but significant step toward that goal by uniting its forces on
picket lines in defense of any group of workers battling to save their
company-provided health care. At the same time, it should enroll them
in a militant campaign of action—not just rhetoric—for health care that
is publicly financed and provided, and worker-controlled.
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