For free quality healthcare for all through socialized medicine!
Snakes Bite: Healthcare in Capitalist America Kills
In July of 2015, a San Diego man was bitten by a rattlesnake and racked up a $153,000 medical bill. The cost for the antivenin was a whopping $83,000. In May of 2015, a Missouri man that suffered a venomous snakebite died in his sleep, refusing to get treatment because he couldn’t afford the bill. These cases detail the enormous cost of healthcare in capitalist America and the life or death questions faced by the working class. The United States, the only major industrialized nation without universal healthcare, has the highest healthcare spending compared to its Gross Domestic Product (GDP). As summed up in a 2015 quasi-government report:
“Health care spending in the U.S. far exceeds that of other high-income countries, though spending growth has slowed in the U.S. and in most other countries in recent years. Even though the U.S. is the only country without a publicly financed universal health system, it still spends more public dollars on health care than all but two of the other countries. Americans have relatively few hospital admissions and physician visits, but are greater users of expensive technologies like magnetic resonance imaging (MRI) machines. Available cross-national pricing data suggest that prices for health care are notably higher in the U.S., potentially explaining a large part of the higher health spending. In contrast, the U.S. devotes a relatively small share of its economy to social services, such as housing assistance, employment programs, disability benefits, and food security. Finally, despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions. Mortality rates from cancer are low and have fallen more quickly in the U.S. than in other countries, but the reverse is true for mortality from ischemic heart disease.”
– Commonwealth Fund, “U.S. Health Care from a Global Perspective”, October, 2015
With the 2016 election of Trump and the ushering in of social reaction, the ruling class is going all out to undo Obama’s Affordable Care Act (ACA) and replace it with the Trump/Ryan American Health Care Act (AHCA). The AHCA guts protections for pre-existing conditions, cuts Medicaid and kills Medicaid expansion, defunds Planned Parenthood, and will cause millions of Americans to lose insurance. The L.A. Times called it a “tax cut for the rich.” This continues the assault on decades of social gains, of labor and abortion rights.
Our position is that Obamacare was never going to be a viable method of providing quality and affordable health care for all. It was always a limited reform, being principally a benefit for insurance companies and these companies much prefer to make a higher rate of profit on fewer covered people paying higher premiums. This caused some companies to drop out of the insurance provider pools in most states. Obamacare never provided sufficient premium protection for chronic conditions, nor against soaring prescription costs. Socialized medicine would not permit any of these costs to go uncontrolled, as the firms would be worker-controlled. Profit would be removed from the equation and healthcare would be recognized as a human right.
The political question of universal healthcare has taken center-stage once again. John Conyers (D) has introduced H.R. 676 into the House, a “Medicare for All” bill. This bill as written would create a single-payer universal healthcare system building on the existing Medicare system. It would leave the private health sector alone and would be financed through payroll and income taxes and “taxing the rich”. One problem with this bill is that by the time the Democratic and Republican parties got done with it in the House and Senate, even assuming it had any chance of passing, you can bet it would end up like a Dr. Frankenstein monster with the working-class paying a whole lot for a lot less than promised in the initial version of the bill.
Medicare is not free healthcare insurance. Workers pay for it throughout their lives in payroll taxes and despite that are best advised to buy supplemental insurance. And there are additional costs. A retired couple can expect to pay thousands of dollars on healthcare every year at a time when they are on a fixed income and their health is more at risk. See Med City News, “Medicare Is Not Free, As Many Would Believe”..,
Medicare for all is also what Bernie Sanders says he will support in a “companion bill” to H.R. 676. Either way it would not most likely not be free and in a capitalist system where the drive to maximize the rate of profit rules, it would not be quality.
“Medicare for All” or “Single-Payer Universal” healthcare demands are all calls for a refurbished, for-profit, capitalist healthcare system. While liberal reformist demands can be supportable depending on the circumstances (and Medicare, Medicaid and Social Security are defensible gains), we of the Communist Workers Group (CWG-USA) do not subordinate the working class political program of transitional demands for socialist revolution to liberal reformist demands. We always advance our Marxist program and we support even minimal demands, employing and teaching militant, class struggle methods, thus extending Medicare as a universal healthcare system is also a limited gain, a plus so long as labor and the oppressed build an independent workers’ movement for socialized medicine as part of a socialist program. But the devil is in the details and most reforms are partial wins or even a double-edged sword designed to buy class peace. And right now, the only “mass movement” raising the demand for “Medicare for All” is the movement by the Democratic Party hacks, the class collaborationist union bureaucrats and the fake-socialist misleaders like DSA trying get the Democrats back into office. The “struggle” for them is at the Democratic Party rallies, the “moral suasion” pressure politics of street marches, political lobbying and the ballot box.
In contrast, what is necessary is for the working class to fight for our objective interests, and free, quality healthcare for all can only happen through the nationalization without compensation of the healthcare, pharmaceutical and medical technology industries under workers control. Quality in healthcare can only happen through production and services for social needs not profit. Only rational centralized-planning in a collectivized socialist economy can realize this.
Healthcare under a capitalist system, even a universal healthcare system, will still be driven by the laws of the capitalist system to maximize the rate of profit. Britain’s National Health Service public healthcare suffers from staff shortages and cuts (see The Guardian, “Staff shortages are threatening the NHS”, February 2017). The Canadian healthcare system, like the United States, has wait times due to rationing: “In 1966, Canada implemented a single-payer health care system, which is also known as Medicare. Since then, as a country, Canadians have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times (PNHP, “5 Myths About Canada’s Health Care System“, June 2012).”
Scarcity and rationing can only be solved through rational planning by the working class, determining social needs and allocating resources to fulfill those needs. U.S. healthcare is also experiencing shortages of medical staff. A planned economy would seek to train the next generation of medical workers. This ties into education and training, which is why free, quality education for all is necessary for quality healthcare also. Quality education can only come about by eliminating the poverty and exploitation in society, tearing down the racist economic segregation of the inner cities. This poverty is a permanent feature of an economy that feeds the military-industrial-complex the capitalists require to maintain their world empire. Feeding it to the tune of almost a Trillion dollars denies monies to every human need satisfying endeavor. Capital’s proposed remedy of privatizing everything is more religion than reason, having ceased to be progressive more than a century ago, their declining rate of profits drives competing imperialisms to world war.
Reformist Socialist Tag-Tails of the Democrats
Along with elections, healthcare is always a pretty good litmus test for Bolshevism vs. Menshevism in America among the ostensible socialist organizations. Socialist Alternative (Soc Alt) and the Democratic Socialists of America (DSA), for example, call for either “Medicare for All” or “Single-Payer Universal” healthcare. These are the same demands raised by the Democratic Party liberals for many years. Soc Alt and DSA abandon the Marxist political program of free, quality healthcare for all and play the tag tail of the Democratic Party liberals. These “socialists” seek to be the best builders and most consistent advocates of the politics of the liberal bourgeoisie, be it healthcare or advocating a sub-living $15 poverty minimum wage.
The political method of these organizations, like most of what calls itself the “Left” in America, is to pressure the capitalist state for legislative reforms, notably trying to pressure the Democratic Party to the left. They are ‘desperately seeking a progressive wing of the capitalist ruling class’ that doesn’t exist and that will never exist. This method is very well expressed by Noam Chomsky’s political children who like to quote Howard Zinn: “The really critical thing isn’t who is sitting in the White House, but who is sitting in–in the streets, in the cafeterias, in the halls of government, in the factories. Who is protesting, who is occupying offices and demonstrating–those are the things that determine what happens.” That struggle gets the goods is true, but for Marxists, it also does matter who is sitting in the White House, or rather, which social class holds state power. We don’t want anyone sitting in the White House and instead we seek to organize and mobilize the workers as a class-conscious class for itself to establish workers power. Endless protests, divorced from a perspective of a politically independent workers’ movement armed with an historic workers’ political program of transitional demands that build a bridge to the socialist revolution, are reducing socialist revolution to a form of “left” activists’ political lobbying for minimal demands, for mere reforms!
Soc Alt and Kshama Sawant, supporters of the capitalist Green Party (itself a pressure group on the Democrats), were cheerleaders and prominent builders of social imperialist Sanders’ campaign rallies, even at the same time denying that they formally advanced political support to his campaign for nomination. They are currently parroting Sanders and his call for “Medicare for All” and continue to cheer him (see Socialist Alternative, “Democratic Leadership Under Pressure – Which Way Forward for the Left?”) after even many of his supporters saw him for what he was, a bourgeois politician for the Democratic Party. Sanders recently toured the country with DNC Chair Perez on their unity tour to rebuild the Democrats for 2018 and also recently signed a pro-Israel Senate letter, thumbing his nose at the Palestinian struggle.
DSA has been growing dramatically, riding the momentum of a renewed interest in socialism and the popularity of the Sanders’ campaign. That well-meaning workers and youth subjectively wanting to fight for socialism are joining DSA is undeniable. The leadership of DSA, which is where it counts politically, are little better than the left flank of the Democratic Party. “Democratic”, as in Democratic Party, is a very appropriate title for DSA, but they miss the mark by a wide margin on the “Socialists” part. DSA has their origins in the Cold War anti-communist, social imperialism of the Socialist Party (who supported the U.S. in the Vietnam War), which split eventually into the DSA led by Michael Harrington in the early 1970s. Part of the social democratic Socialist International, the political step-child of the Second International, DSA has been entrenched in the Democratic Party from the start, supporting Mondale, Jackson, Kerry, Sanders and Obama through the decades of exploitation, war, racism and poverty. DSA never let such things as imperialist bombings by Democratic Party administrations (Clinton, Obama) or cutting welfare (Clinton) interrupt their support for the Democrats. Harrington quite clearly stated his politics and those of the DSA: “I share an immediate program with liberals in this country because the best liberalism leads toward socialism…. I want to be on the left wing of the possible (New York Times, “Michael Harrington, Socialist and Author, Is Dead”, August 1989).” Harrington saw that “the left wing of realism is found today in the Democratic Party (Newsletter of the Democratic Left, March 1973, p. 5).”
Today you can see the DSA in action as they organize what are Democratic Party electoral rallies. For example, in Iowa City and in five other Iowa cities, DSA and “Our Revolution” organized a “Medicare for All” rally on May 20th with a whole slew of local and state Democratic Party politicians as speakers. This is the first thing that the sellout labor bureaucrats do in every labor struggle. Find a Democratic Party politician to stand on stage and tell workers and youth to vote in the next election. This is DSA’s method for winning healthcare reform that takes a flight from political reality and into fantasyland. Even if the Democratic Party were to support such reforms as Medicare for All, they cannot even defend social gains they do support such as abortion and labor rights, much less advance new significant reforms. Right-wing social reaction cannot be fought through the Democratic Party. The trade union bureaucracy has been playing this game for decades and it has resulted in the labor movement being brought to the brink.
DSA serves to prop up working class illusions in the Democratic Party of U.S. imperialism; the party of Hiroshima/Nagasaki, Bay of Pigs, Vietnam, and the current MENA wars; a political party of exploitation, war, poverty and racism. DSA is providing a left cover for a political party of the ruling capitalist class under the banner of ‘socialism’ and are a political obstacle to building a class struggle workers’ movement and a class conscious working class. DSA bolsters illusions in electoral politics, reinforces pro-capitalist ideology within the workers’ movement and promotes liberal bourgeois reformist politics at the expense of a working class political program that points the way towards workers rule.
Revolutionary Marxism draws a political picket line between the working class and the capitalist parties: Democrats, Republicans, Greens. And just like the labor bureaucracy which has supported the Democrats for decades, what can be said for a ‘socialist’ (or labor) leadership that does not even recognize who the enemy social class is and who the enemy political parties are? A leadership that supports such political parties, who sides with the enemy social class? And to top it off, in the midst of a class war that the working class is losing?!!!
Karl Marx’s International Workingman’s Association, the First International, was very clear on the question of working class independence from capitalist parties:
“Against the collective power of the propertied classes the working class cannot act, as a class, except by constituting itself into a political party, distinct from, and opposed to, all old parties formed by the propertied classes.”
– International Workingmen’s Association, Hague Congress, “Resolution on the establishment of working-class parties”, July 1872
“However, our politics must be working-class politics. The workers’ party must never be the tagtail of any bourgeois party; it must be independent and have its goal and its own policy.”
– International Workingmen’s Association, “Apropos Of Working-Class Political Action”, September 1871
It is a common understanding among leftists that the Democratic Party is the ‘graveyard of social and class struggles’, that that is where social movements go to die. Last year, trade unionists in Portland Oregon IUPAT (Painters) Local 10 passed a resolution calling for “the labor movement to break from the Democratic Party, and build a class- struggle workers party.”
These trade unionists represent a class-conscious section of the working class, standing for a politically independent workers movement as opposed to those fake-socialist misleaders, the “tagtails” of the Democrats like DSA, who say “we are not a separate party” (from the Democrats) and who seek to “strengthen the [Democratic] party’s left wing, represented by the Congressional Progressive Caucus.” (DSA, “Aren’t you a party that’s in competition with the Democratic Party for votes and support?”)
For a class struggle workers movement!
Social Security and other gains that came out of the 1930’s were a product of social and class struggles, not a gift from Roosevelt’s New Deal. The militant organizing drives and labor struggles such as the 1934 Minneapolis Teamsters strike, the Toledo Autolite strike and the San Francisco Longshoremen’s general strike, were all led by ostensible Reds. Militant class struggle is what forced the capitalist ruling class to make concessions. 1937 saw over 1000 sit-down strikes across the U.S. in the wake of the famous Flint plant occupation by auto-workers. Medicare and Medicaid were passed during the period of colonial/semi-colonial social revolutions (China, Cuba, Vietnam), the social struggles of the Civil Rights Movement and the anti-war protests against the U.S. imperialist Vietnam War prosecuted by the Democratic Party Johnson administration. The U.S. ruling class was caught in their contradiction of waging an anti-communist Cold War in the name of so-called democracy, while poverty and Jim Crow segregation existed at home. They at least had to go through the motions of prettifying racist capitalist America with a minimal social safety net and abolishing formal, legal segregation.
European social democracy existed as an anti-communist bulwark post-WW II against the bureaucratically degenerated Soviet and Eastern European workers’ states. Social democracy was propped up by European Capital through the super-exploitation and plunder of their colonies and semi-colonies. It was also a product of class struggles and of a class conscious working class that were organized into working class parties, albeit bourgeois workers’ parties with pro-capitalist, class-collaborationist leaderships. The Democratic Party in America serves the same role as social democracy, but as an outright capitalist party. A poor substitute even for decrepit social democracy. The American working class, divided by racism and a “pull up by your bootstraps” false bourgeois ideology of social advancement, never developed an advanced class consciousness. The U.S. never had a mass working class party and stands as the only major industrialized country without universal healthcare. Even Canada, which has a universal healthcare system, had a workers party, if just barely, in the New Democratic Party (NDP).
The ruling class is not going to grant any significant reforms now absent mass working class struggle. World capitalism has not recovered from the 2007-08 crash and Capital is still seeking to restore their lost rate of profit and they are doing that partially through attacking the social gains of the past and by waging war on the working class. Given the dearth of working class leadership and the absence of class struggle in the United States, they can do this without the unnecessary overhead of social democracy. The time is long overdue for the working class and oppressed to start building the fighting organizations of the working class: the factory, worksite and trade union committees, the workers and oppressed assemblies and the labor, black and brown self-defense guards. And above all to build the working-class political party based on an historic class struggle workers political program of transitional demands that mobilizes the working class to cross the bridge from today’s demands for such things as healthcare, jobs, education and housing to the whole program of the socialist revolution.
“The revolutionaries always consider that the reforms and acquisitions are only a by-product of the revolutionary struggle. If we say that we will only demand what they can give, the ruling class will give only one-tenth or none of what we demand. When we demand more and can impose our demands, the capitalists are compelled to give the maximum. The more extended and militant the spirit of the workers, the more is demanded and won. They are not sterile slogans; they are means of pressure on the bourgeoisie, and will give the greatest possible material results immediately.”
– Leon Trotsky, “The Political Backwardness of American Workers“, May 1940
Defend Medicare, Medicaid and Social Security!
ACA Stinks, but ‘Nothing Care’ Stinks Worse! Nationalize the Healthcare, Pharmaceutical & Medical Technology Industries Under Workers Control with No Compensation to the Major Shareholders!
For Free Quality Healthcare for All Through Socialized Medicine to Include Free Abortion on Demand and Full Reproductive Services! For Free Quality Education for All to Train and Educate the Next Generation of Healthcare Workers!
Build a Class Struggle Workers Movement!
For Labor Political Strikes and General Strikes to Win Workers’ Demands!
For a Rational, Centrally-Planned, Collectivized Socialist Economy Under Workers Control with Production for Social Needs, Not Profit!
Break with All Capitalist Parties: Democrats, Republicans and Greens! Build a Fighting, Multi-Racial, Internationalist, Workers/Labor Party to Fight for a Workers Government Based on Workers Councils and a Workers Militia! For Workers Rule!
For World Socialism, the Last, Best and Only Hope for Humanity’s Future!