[Peace-discuss] Health Care in America: Where is the Socialist Solution?

[David Johnson]

July 13, 2017 

 
<https://www.counterpunch.org/2017/07/13/health-care-in-america-where-is-the
-socialist-solution/> Health Care in America: Where is the Socialist
Solution?

by  <https://www.counterpunch.org/author/cuxere/> Ajamu Baraka 

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The introduction of the Republican legislation to "repeal and replace"
Obamacare is no more than latest scrimmage in the ongoing one-sided war
against the poor and working class. The "Affordable Care Act" (ACA, better
known as Obamacare) proved to be both unaffordable and unable to provide
comprehensive care for millions. Nevertheless, with the ACA being one of the
only tangible "victories" Democrats could claim for an administration with a
dismal record of noteworthy accomplishments, neoliberal Democrats and the
party's liberal base led by Bernie Sanders are now coalesced around the ACA
and have vowed to defend it to the bitter end.

Yet, camouflaged by the hot rhetoric of confrontation and the diversionary
struggle of the duopoly, the common agenda and objective interests being
protected in this healthcare battle are quite clear. No matter what version
of the healthcare bill passes or if the ACA remains in place, it will be a
win for the market-based, for-profit beneficiaries of the U.S. system. As
long as healthcare remains privatized, the real winners of healthcare reform
will continue to be the insurance companies, hospital corporations and
pharmaceutical and medical device companies.

That commitment to the interests of the insurance/medical complex ensures
that the interests of healthcare consumers, the uninsured, the elderly and
the sick will continue to be sacrificed to maintain a healthcare delivery
system in which thousands suffer premature deaths from inadequate
preventative treatment, millions are unable to afford coverage and millions
who have private insurance fear using it because of prohibitive co-pays and
deductibles.

That is why during the current debate the insurance companies have been
largely silent. There is no need to engage in public debate because having
largely written the ACA they are again deeply involved in the construction
of the current legislation. Their interests will be protected even if it
means forcing Republicans to embrace policies that are at odds with their
professed philosophies - like including government subsidies for low-income
people to purchase insurance. In fact, the only comments from insurance
companies in this debate were related to their supposed concern that the
Senate bill might not provide enough assistance to those who need help to
pay for healthcare. They want what is being called a "stabilization fund" to
reduce the numbers of people who might opt out of coverage because they
can't afford it.

The Senate bill provides those funds, but they are temporary and are
scheduled to end after 2019. Which means that people will be forced to make
an unpalatable decision after that - purchasing insurance with higher
out-of-pocket costs like $10,000 deductibles or electing to go without
insurance altogether. If history is a guide, many will opt out. In fact, the
Congressional Budget Office predicts that the current bill will push 22
million people back into the ranks of the uninsured with the potential loss
of millions of customers and potential profits for healthcare corporations.

But the companies have a plan should those funds prove inadequate to hold
substantial numbers in the system: Increase individual premiums by at least
20 percent more than the double-digit increases
<https://www.nytimes.com/2017/06/23/health/senate-health-plan-costs.html?act
ion=click&contentCollection=us&module=NextInCollection&region=Footer&pgtype=
article&version=newsevent&rref=collection%2Fnews-event%2Fahca-american-healt
h-care-act-repeal-obamacare> already under consideration.

Coming to the aid of the Insurance/Medical complex: Ted Cruz and the
Consumer Freedom Amendment

Insurers need large numbers of healthy people on the rolls, as their
premiums help defray the cost of care for those who are sick. Because
insurance companies are for-profit operations they set rates based on the
risk pool in a market. With the potential loss of customers if the
government does not provide adequate long-term subsidies, middle-class
consumers who earn too much to qualify for temporary premium assistance will
bear the brunt of any premium increases.

The Cruz amendment to the legislation has a solution to the possible
increase in premiums and healthcare costs in general. The so-called
<https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/07
/10/the-health-202-cruz-picks-government-health-care-subsidies-as-lesser-of-
two-evils/59611958e9b69b7071abcae4/?utm_term=.8c65c3c21edf> "Consumer
Freedom Amendment" represents the typical extreme individualism and
anti-social sentiments of the right wing. It essentially advocates for
reducing the burden on healthy consumers paying into system to help cover
higher-risk fellow citizens.

The Washington Post's analysis of the Cruz amendment
<https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/07
/10/the-health-202-cruz-picks-government-health-care-subsidies-as-lesser-of-
two-evils/59611958e9b69b7071abcae4/?utm_term=.597e109b6324> suggests:

"Under Senator Cruz's plan, insurers could sell cheaper, stripped-down plans
free of Obamacare coverage requirements like essential health benefits or
even a guarantee of coverage. These sparser plans would appeal to the
healthiest Americans, who would gladly exchange fewer benefits for lower
monthly premiums.

But insurers would also have to sell one ACA-compliant plan. The sickest
patients would flock to these more expansive and expensive plans because
they need more care and medications covered on a day-to-day basis. As a
result, premiums for people with expensive and serious medical conditions
like diabetes or cancer would skyrocket because all those with such serious
conditions would be pooled together."

And how would the elderly and people with pre-existing conditions pay for
the increased premiums that they would face under the current Senate bill
and Cruz's amendment?
<https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/07
/10/the-health-202-cruz-picks-government-health-care-subsidies-as-lesser-of-
two-evils/59611958e9b69b7071abcae4/?utm_term=.597e109b6324> "The $100
billion stabilization fund for states could help cover costs for the
resulting pricier coverage for those with preexisting conditions under this
amendment."

In an ironic twist that both exposes the class interests of this initiative
and its hypocritical approach to the question of the role of the government,
Cruz's amendment affirms that role in the form of subsidies for the sickest
citizens and calls for an expansion of government resources to cover them.

The Cruz plan would segment the insurance market into healthier and
higher-risk segments. High risk individuals along with the already-sick and
the elderly would be pushed out of the market because those premiums would
soar even with state subsidies, since insurance companies would still set
premium rates to maximize profits.

Given the lose-lose options for consumers now being debated in Congress, the
only rational objective for the majority of the people in the U.S. is to
move toward the complete elimination of the for-profit healthcare system.

Socialization of Healthcare: The Only Solution

The ideological and political opposition to state-provided healthcare is
reflected in the ACA and the various repeal-and-replace scenarios. Through
mandates, coercion and the transfer of public funds to the insurance
industry, the ACA delivered millions of customers to the private sector in
what was probably the biggest insurance shams in the history of private
capital. And that gift to the insurance companies is only one part of the
story. The public monies transferred to the private sector amounted to
subsidies for healthcare providers, hospital chains, group physician
practices, drug companies and medical device companies and labs as well.

The Republican alternatives to the ACA variably supplement the corporate
handouts with more taxpayer-funded giveaways. And once the private sector
gains access to billions of dollars provided by the state, they and their
elected water-carriers fiercely resist any efforts to roll those subsidies
back.

The subsidies coupled with the mergers and acquisitions of hospital
corporations and insurance providers over last few years and a general trend
toward consolidation of healthcare services in fewer and fewer hands
underscored the iron logic of centralization and concentration of capital
represented by the ACA and was a welcome development for the biggest players
in the healthcare sector. The movement
<https://popularresistance.org/time-to-fight-health-care-monopolization/>
toward a monopolization of the American health-care market means that rather
than the reduction in healthcare costs that is supposed to be the result of
repeal and replace, the public can instead expect those costs to escalate.

Many on the left have called for a single-payer system similar to those that
work well (if not perfectly) in Britain, the Netherlands, Finland and
elsewhere in Europe. But even with an "improved Medicare for all"
single-payer system, costs will continue to increase in the U.S. because
they cannot be completely controlled when all of the linkages in the
healthcare system are still firmly in the hands of private capital.

The only way to control the cost of healthcare and provide universal
coverage is to eliminate for-profit, market-based healthcare. Take insurance
companies completely out of the mix and bring medical device companies, the
pharmaceuticals companies and hospitals chains under public control.

The ideological implications of the Cruz amendment are that it reflects a
growing public perception both domestically and internationally that
healthcare should be viewed as a human right.

Putting people at the center instead of profit results in healthcare systems
that can realize healthcare as a human right. This is the lesson of Cuba
where the
<http://www.huffingtonpost.com/salim-lamrani/cubas-health-care-system-_b_564
9968.html> United Nations World Health Organization declared that Cuba's
health care system was an example for all countries of the world.

That is the socialist option, the only option that makes sense and the one
that eventually will prevail when the people are ready to fight for it.

More articles by: <https://www.counterpunch.org/author/cuxere/> Ajamu Baraka

Ajamu Baraka is the national organizer of the Black Alliance for Peace and
was the 2016 candidate for vice president on the Green Party ticket. He is
an editor and contributing columnist for the Black Agenda Report and
contributing columnist for Counterpunch magazine.  

 

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