How the Democrats Lost Control of Health Care


How far the debate has come from 1954, when President Truman called for the creation of a national health insurance fund to be run by the federal government! For sixty years the Democrats have failed to deliver on this promise. Truman’s program —a single payer system- is essentially off the table. As a result we see enormous loss of life. On average, 20,000 people a year die in the United States due to lack of adequate coverage, including those who die due to caps on lifetime treatment for chronic and debilitating conditions. Another result of the American way of health care delivery is that nearly 62% of bankruptcies stem from medical bills, and this also encompasses people with health insurance who face financial disaster if they experience a serious illness. Health insurance costs alone are the fastest growing expense for employers, to the point that employer-based health insurance costs overtook profits in 2008. The gap, absent remediation will continue to grow unchecked. It is a tribute to the lemming like idiocy of American business, increasingly held hostage to the health care industry, that it has not demanded government relief from the stranglehold of the health insurance sector. That the Republicans are absolutely indifferent to the health care crisis should surprise no one. That they are ruthless and unprincipled in their hostility to the well–being of average Americans is standard fare. Where Republican political representation is weak, individuals are encouraged to organize in the streets on an ad hoc basis in the form of mobs or near mobs solely for the purpose of counteracting all collective, and social programs that seek to address inequalities. The “townhall” disruptions are the intersection of the tea baggers, the birthers (those who believe Obama to be a non-American born Manchurian candidate planted by evil one worlders, possibly with roots in the Illuminati) and those for whom the election of a Black president, the selection of a female head of the state department and a Latina supreme court judge is simply a world gone mad. Still the Democrats essentially conceded the debate at the outset by preemptively removing the single payer option and deciding, as they habitually do, to “govern from the center.” Had the Democrats proposed a Medicare for All program, they might have won the public over to their side and taken command of the issue. It is simple, has a proven track record, contains realistic cost control—by eliminating the quest for profits, vastly reducing administrative overheads and obscene CEO compensation packages—and it could have been easily explained. Medicare, along with social security, is a hugely popular program that has virtually eliminated the problem of health coverage and poverty for the aged, previously a major constituency to this unfortunate category. Had the administration argued that socialized care does indeed exist for military veterans and that their care is considered superior to that offered by the private sector, he may have made some inroads. But Obama was only able to make the case for universal health coverage by promising a boondoggle of additional enrollment for private insurers, in effect, mandating what will be, in the context of unchecked premium growth, a regressive tax on wage earners. It is true that the Obama plan will prevent coverage from being withheld for preexisting conditions, or caps being placed on lifetime coverage, or portability of insurance being tied to employment. These would be real advances. But comprehensive coverage under a hybrid plan will, down the line, prove to be unaffordable, which is why an additional federal tax on the health care benefits of covered workers is still not off the administration’s agenda. Obama has backtracked even further in the direction of corporate America, and away from cost control, by negotiating a truly repulsive deal with the pharmaceutical industry–a promise not to use government bargaining power to bring down drug prices. And Obama’s hybrid plan foregoes hundreds of billions in administrative savings, because the multiplicity of insurers requires a corresponding army of administrators and billing clerks to negotiate between doctors, hospitals, pharmacies and insurance companies. Even the modified public option, which at this time may be sacrificed in the further interests of feckless bipartisanship, would quickly fail to control health care costs, as Joanne Landy explains ( The US trade union movement has acquiesced to this pale version of reform, for risk of ruining Obama’s presidency by calling him out on this. The Democrats are so timid at being identified with their base that they risk near lynch mob venom, rather than holding their townhall meetings in union halls or black churches, where such behavior would be overwhelmed from the floor. If the AFL-CIO shows some militancy in the end to preserve the public option as left-leaning Democratic representatives are now threatening to do, it will simply be too little, too late. Real health care reform that also provides true economic security for the American worker will again have to wait for another day. * A fuller version of this article appears in “Solidarity Magazine,”… .

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