As we enter a new time of cutback threats and attacks on economic rights, one of the most discussed measures is the proposed defunding of the “Patient Protection and Affordable Care Act,” more commonly known as “Obamacare.” Liberals and some leftists have been rushing to the law’s defense, claiming that it is crucially progressive and its repeal would be a catastrophe for poor and working people. Reactionaries call it a waste of resources and an acceleration of “Taxmageddon,” as well as an attack on religious freedoms.
As the political games go on, it is important to recognize the actual provisions and limitations of the law. One of the far right’s favorite ways of demonizing the PPACA has been to call it “socialist.” We have seen the terms “socialist” and “communist” slung around as bogey-words by conservatives for many years. The reality, however, is that the PPACA comes nowhere close to the provisions that would be in place under a workers’ government, which would provide free health care for all.
Many liberals have lauded the bill as a step to a single-payer system that would eliminate health care profiteering by private insurance companies. That is a dubious claim, to say the least. As has been the trend with the few ostensibly progressive reforms passed under the Obama administration, Democratic politicians and their sympathizers have been quick to categorize this reform as crucial and groundbreaking.
Expanding the customer base
The provisions in the act, however, are mainly aimed not towards providing health care for all but expanding the customer base of the health insurance companies. Instead of using available government resources to fund free, quality health care for all, the PPACA mandates the purchase of health care insurance for sectors of the population not classified as “poor” that previously did not have coverage, or else pay a sizable fine. While this expands coverage for those who can afford to buy health insurance, a large sector of poor and working people will still have to rely on Medicaid and other similar programs that have themselves been cut back.
The only entity whose “health” has improved in a major way under the PPACA is insurance, pharmaceutical and medical equipment companies, all of whom played a major role in drafting its provisions. With a broader base of “customers” to market to, these groups of capitalists are eying a new revival of their profits. Bargaining sessions between the Obama administration and the right wing leading up the passage of the law resulted in yet another profit-oriented bill masked as a groundbreaking progressive reform.
When polled prior to legislation, a vast majority of U.S. working people made clear their preference for a single-payer health care system—essentially Medicare for all. However, at the very beginning of the legislative process in 2009, the Obama administration voluntarily took single-payer off the table so as to not threaten insurance companies’ profits.
As an additional gift to the profiteers, most of the law is not slated to go into effect until 2014. This has allowed health care providers to raise whatever costs they can in anticipation of restrictions the law imposes, which could bring many poor and working people back to square one—unable to pay for their health care or forced to purchase highly priced insurance packages in fear of getting ill and not receiving treatment. These moves are observable in rising co-pays for many basic services, particularly with regard to women’s reproductive health.
While the PPACA is far from the progressive relief liberals claim it is, it is important to note that the loss of some of its provisions already in effect will be severely felt if the law is repealed. These include the ban on the ability of insurers to drop policyholders if they become sick, the ban on price discrimination based on pre-existing conditions or gender, and allowing children and dependents to remain on their parents’ insurance plan until their 26th birthday.
The last component has been particularly helpful for students trying to survive while paying back their loans and trying to find work in a stagnating economy. The first two potentially help everyone relying on insurance coverage, while the second provision could somewhat lessen discrimination against poor and female policyholders.
However, the negative sides of the PPACA, and the grim reality of the profit system upon which it is based, outweigh these small concessions. In a country run almost entirely on the basis of corporate profit, the provisions against discrimination and extreme overcharging will likely be ignored or circumvented by both the health care providers and the insurance companies. And the cost to working-class families for health care will continue to rise, one way or another.
Free health care for all possible
It is criminal to ignore the needs of working people and use this country’s vast resources and federal power to secure the profits of capitalists instead of providing the care everyone needs for free. While Obamacare is hardly “socialist,” historical experience has shown that free medical care for all is, in fact, possible.
In the Soviet Union, for example, free health care was a constitutional right. All women had a guaranteed 112 days of maternity leave at full pay. During and after this period, maternity health specialists were dispatched to women’s homes to provide advice on caring for babies and proactive aid to the mothers, as well as deliver any necessary supplements the family needed. Whether a patient had a cold or cancer, they were given treatment and medication free of charge for an unlimited period of time.
In socialist Cuba, where free health care is a constitutional right as well, medicine is one of the most rapidly growing fields. Because the state places so much importance on the proper education of doctors and nurses and the furthering of medical science, students flock from all over the world to study for free under Cuban medical professors. In 2011, Cuba announced the discovery of the world’s first lung cancer vaccine. While the U.S. government answers to health care profiteers, in Cuba it is a crime to hold sick people hostage for the sake of profit.
There are other countries with progressive policies that include single-payer health care. Ironically, former Congresswoman Cynthia McKinney recently paid a visit to Syria—the nation headed by a bourgeois-nationalist government currently targeted by the U.S. war machine—and had nothing but praise for its health care system. Unfortunately, this system, along with much of the rest of the country, is being systematically devastated by a civil war unleashed by reactionary U.S.-backed rebel forces, whose most pro-imperialist elements now complain that the Obama administration failed to follow through with its threats to bomb their country.
Both the USSR and Cuba started out with almost non-existent health care systems at the time of their revolutions. Both countries struggled under great scarcity and technological backwardness, not to mention imperialist and imperialist-sponsored invasions and economic blockades, but still managed to build systems guaranteeing free health care to all. In the U.S., the richest country in the world, with vast technological and scientific potential, there is no objective barrier for denying people the same.
We need to go beyond Obamacare. The productivity of U.S. working people, the enormous wealth of this country, and the demonstrated achievements of our brothers and sisters internationally demand nothing less than a complete overhaul of our for-profit health care system. We can and need to attain the inalienable right to free, quality health care for all.
