The Supreme Court upheld most provisions of the Obama administration’s Affordable Care Act on June 28. Most notably, the court upheld the individual mandate that requires everybody to purchase insurance or pay a fine. The only part of the law that was not upheld was the requirement to expand Medicaid to serve more poor people.
This decision is being hailed as a victory for President Obama and for the cause of health care reform. A complete overturn of the law would have been a setback for workers and poor people, as the ACA includes many popular provisions that have increased access to medical insurance, such as the eventual elimination of insurance companies’ ability to deny coverage on the basis of “prior conditions” and the already implemented provision allowing children to stay on their parents’ plan until age 26. The law also eliminates discrimination against women through higher insurance premiums, and mandates coverage of women’s preventative care including birth control.
However, this decision to uphold the “individual mandate” while rejecting the expansion of a publicly funded program to serve the poor highlights the shortcomings of the capitalist so-called health care system, in which preventing and treating illness is a commodity and an individual responsibility instead of a human right and a societal responsibility.
There are currently 49.9 million people in the U.S. with zero health insurance of any kind. Many of those who are insured are either underinsured, or have high co-pay and prescriptions costs and still have trouble paying for needed medical treatments.
The biggest flaw of the health care law is that it attempts to plug the “holes” in a system based on the idea that health care is just another commodity to be bought and sold on the so-called “free market.” Despite what the conservatives in the Republican Party might say, the ACA was clearly not written up by a socialist who believes health care should be a human right.
The ACA leaves health care right where the billionaires on Wall Street want it to be, in the hands of the tiny group of health care and hospital capitalists who profit from the billion-dollar health care industry. Similar to what goes on in the housing and education industries, health care decisions are made not on the basis of individual or social needs but for the pursuit of bigger “profit margins” and “rates of return.”
While Wall Street has become synonymous with corporate greed, health care CEOs are in fact the highest paid on average compared to any industry, including finance. The median annual compensation for the top health care CEOs was $12.4 million, two-thirds higher than your average CEO on Wall Street.
ACA guarantees profits for health ‘care’ industry
Instead of eliminating the role of insurance companies, the ACA leaves the insurance, drug and medical technology companies alone. Indeed, it greatly expands their customer base. It is estimated that the U.S. spends $2.4 trillion on health care every year, 50 percent more per person than any other industrialized nation on Earth. These trillions of dollars translate into massive profits for the few capitalists who control the health care industry.
The insurance companies, private hospitals and drug companies deny medicine and medical attention to as many people as possible, and sure enough the profits roll right on in. Under capitalism, withholding health care from someone who needs it becomes a legal “right” of the hospital owner.
By far the most egregious source of profits built into the U.S. health care system is the health insurance industry. Since the insurance companies actually perform no medical service whatsoever, they are in reality just parasitic administrative middlemen. Insurance companies like Aetna, Humana, Cigna and United Health Group do nothing but divert resources and billions of dollars away from actual health care and into the pockets of their shareholders.
Studies have shown that by just cutting out the unnecessary “administrative middlemen,” the health care industry would save $350 billion, enough to provide medical coverage for the nearly 50 million residents of the U.S. who are currently uninsured.
The so-called “individual mandate” is a perfect example of the inability of capitalist elites to challenge the profit motive and provide health care for all. While the ACA attempts to “control prices,” it offers insurance companies a massive subsidy by increasing the pool of those who must buy health insurance.
While the Obama administration argues that those within 100 percent to 400 percent of the poverty line will be eligible for subsidies to mitigate the costs of insurance, this still leaves a large hole. The Supreme Court decision allows states to reject an expansion of Medicaid, which means that many of those under 100 percent of the poverty line will also not be eligible for expanded Medicaid, and thus still be unable to afford health insurance on the private market.
Single payer an improvement but still not enough
Many progressive political parties like the Green Party advocate for a “single payer” health care system where insurance companies are eliminated as the answer to the demand for universal quality health care.
“Medicare for All,” as the single payer system is referred to by its advocates, would undoubtedly be a big step forward and far more comprehensive than the ACA. However, the single payer health care system leaves important sectors of the health care economy—such as the pharmaceutical industry and the medical technology sector—in the hands of profit-making giants. Like Medicare, it would most likely be financed through a non-progressive payroll tax.
In addition, a simple expansion of Medicare would leave out over 12 million undocumented workers, as residents without documentation are currently not able to receive benefits under these programs.
“Medicare for All” would replace most for-profit health care coverage with publicly funded insurance. The “mandatory private insurance” program now being implemented remains entirely within the bounds of the profit system. We will not be able to build the powerful movement we need for universal health care if we shoot ourselves in the foot from the start by recognizing the right of the country’s biggest banks and corporations to profit from people who are ill.
Point two of the Lindsay/Osorio Party for Socialism and Liberations’s Presidential Campaign’s program would make housing, health care and education constitutional rights for every working person regardless of sex, age, sexual orientation, income or “legal status.”
Health care needs to be reorganized on the basis of people’s needs, not the profit of a few.
The giant pharmaceutical and health care corporations have proven unable to meet the needs of the vast majority of people. The insurance companies that profit only from misery need to be abolished, with their vast resources turned over to a general fund dedicated to providing free health care for all.
Health care—from top to bottom, including the pharmaceutical giants and health care corporations—should be nationalized.
This is what the Party for Socialism and Liberation fights for, and if you believe that health care should be nothing less than a human right, then join us in our fight as well. Vote PSL!