The Current U.S. Health-Care Debate and the Fight for Workers Power


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Today, in the USA, forty-six million people have no health-care coverage at all. Tens of millions more are “underinsured.” Half of all the personal bankruptcies in the USA today are caused by expenses due to illness. Under the impetus of the U.S.-led global capitalist economic crisis, the rapidly growing ranks of the unemployed will lead to far greater numbers of men, women and children with no health-care. Already, twenty thousand deaths per year are directly attributable to the lack of medical care caused by the wretched state of the U.S. health-care system.
Yet the current health-care debate has not been driven by a popular or working class mobilization, but by the strategic interests of the U.S. monopoly capitalist and imperialist ruling class.
Health-care reform is the most controversial political issue in the USA today because the sector of monopoly capitalists that makes up the “medical-industrial complex” is in opposition to the stake of the U.S. ruling class in general, as well as to the interests of the U.S. people, in improving the delivery of health-care in the USA. The filthy rich and criminal insurance industry and their even richer and more criminal partner, the pharmaceutical industry, have provided millions of dollars to corrupt Democratic and Republican Party politicians and operatives and to corrupt the mass media in order to defeat any pro-people health-care reform.
In defense of their obscene billions in profits, these powerful monopoly medical-industrial corporations have shrewdly pushed the right buttons of a large section of the U.S. population that, after sixty years of U.S. Empire, is gullible, ignorant, selfish and chauvinistic. The result, thus far, has been to beat back the half-hearted and heavily compromised attempts of the Obama-Biden Administration and the Democratic Congress, on behalf of the U.S. monopoly capitalist and imperialist ruling class, to improve the system of health-care of the people of the USA.
No wonder New York Times columnist, Paul Krugman has written: “At this point, all that stands in the way of universal health-care in America are the greed of the medical-industrial complex, the lies of the right wing propaganda machine and the gullibility of voters who believe those lies.” (8-18-09)

More than six decades after U.S. imperialism emerged from World War II as the hegemonic imperialist power, the USA is the only developed, advanced capitalist country in the world that does not provide universal health-care coverage for all its citizens. Clearly, these two facts are interconnected.
Two years ago, before the current U.S. health-care debate and before the U.S.-led global economic crisis and the bankruptcy of two of the big three U.S. automakers, we observed: “The almost unchallenged domination of U.S. society by the U.S. monopoly capitalist ruling class for so long has weakened the ability of the U.S. economy to compete in the increasingly competitive global market. The ability of this ruling class, over the past several generations, to steamroller any internal class resistance to its rule has resulted, for example, in a chaotic and inefficient private healthcare system unlike that in any other advanced capitalist country. The obscene mega-profits of the U.S. pharmaceutical industry, connected with this anarchic healthcare system, dwarf even the super-profits of the oil cartel war-mongers. The lack of universal healthcare in the USA has, in turn, resulted in a situation where important U.S. employers such as the Big Three automakers have closed huge factories in the USA and shifted the work abroad because of the runaway cost of healthcare coverage for U.S. workers.” (Ray O. Light Newsletter Number 45, July-August 2007)
Now, according to Fareed Zakaria, Editor of Newsweek International and one of the foremost bourgeois experts on the United States today, “The U.S. health-care system is on an unsustainable path. If current trends continue … health care will consume 40 percent of the national economy by 2050. … Costs are rising so fast that every day, more that 10,000 Americans lose their insurance coverage.” Zakaria also observed: “Americans do worse on almost every health measure than most advanced industrial countries, which spend about half as much on health care per person and have proportionally more elderly people.” (“Americas Fatal Flaw,” Newsweek, 8/24-8/31/09 issue) Under the pressure of the current world capitalist crisis, such an anarchic health-care system renders the U.S. economy all the more weak and vulnerable to being outstripped by its imperialist partner-rivals and thus threatens to help topple the U.S. Empire.
Hence, it is in the strategic interest of the U.S. monopoly capitalist and imperialist ruling class to establish a more efficient health-care system. While the Obama presidential campaign had promised the voters much needed health-care reform and this need resonated with many voters, the main source of this reform “movement,” with its focus on the U.S. Congress, has been the needs of U.S. imperialism itself. And the Obama-Biden Administration has been assigned the task of ushering in such reform.
However, Obamas great abilities as a “communicator” and all the Democratic Congress people who seek “modest reform” have been no match for the millions of dollars that the insurance industry and the pharmaceutical industry (“Big Pharma”) have used to dominate the health-care “debate” thus far. In line with the Obama-Biden Administration, Newsweek, in an attempt to serve the U.S. ruling class in general, has attempted to bring reason to the debate. Thus, the August 24-August 31 issue features three articles on health-care in addition to the authoritative column by Newsweek executive Zakaria. The appearance of four different articles and columns dealing with the same question from the same perspective in one issue of a magazine representing the U.S. imperialist bourgeoisie seems unprecedented.
In a column, provocatively titled, “Socialism is the best medicine,” Commonwealth Fund president Karen Davis is quoted as follows, “America ranks last overall in the funds comparative studies, which consider access, equity, cost, quality, and efficiency measures across select developed countries.” In yet another Newsweek column, Jonathan Alter notes that many of those who have health insurance are indifferent to those who do not. In this economic climate, says Alter, they could easily join the ranks of those who do not, and this should be argued as a reason for those with insurance to support extending coverage to everyone else. (“Health Care as a Civil Right,” ibid.)
Finally, the same Newsweek issue contains a major article by Sharon Begley dealing with “the truth behind the health-care hysteria.” Ms. Begley exposes a number of “the lies, damned lies, and misleading statistics” which “flourish” in the current “debate” on U.S. health-care.
What she and her bourgeois journalist Newsweek colleagues fail to point out is the fact that this debate is being dominated by millions of dollars which Big Pharma and the insurance companies are using to bribe the Washington politicians of both parties as well as the mass media. While right wing Republicans apparently got most of the 2008 campaign funds from the medical-industrial complex, Jonathan Alter lightly touches upon the fact that President Obamas Chief of staff, Rahm Emanuel, promised Big Pharma, that any Obama-Democratic Party health-care reform would not threaten the obscene profits of the pharmaceutical industry. Also, former Senate Democratic leader Tom Daschle, Obamas first choice for the cabinet post of Secretary of Health and Human Services, is now “a paid advisor to clients in the pharmaceutical, hospital, and insurance industry.” (The Christian Science Monitor, 9-6-09) Not surprisingly, Daschle is now a proponent of universal insurance coverage, not universal health-care! Not surprisingly, too, the few politicians in Congress not compromised by big pharma and the insurance companies are no match for the army of Republican and Democratic politicians that are.
The profits of the pharmaceutical companies and the insurance companies are so massive and have made them so powerful that these corporations have been able to dominate “both sides” of the debate. They have kept the whole question of a single-payer plan, nationalizing or socializing health-care in the USA, from even coming up for consideration. Their achievement is all the more remarkable because of the great success of nationalized health-care in neighboring countries such as Canada and Cuba and the oldest U.S. ally, Great Britain, as well as all of Western Europe. Michael Moores recent documentary film, “Sicko” brings this point home loud and clear.
Barack Obamas former physician for twenty-two years, Dr. David Scheiner, joined 3500 physicians and medical students in urging the president to embrace a national single-payer healthcare system. Dr. Scheiner points out, “There are multiple problems with the present Congressional health reform proposals, but allowing private insurance to continue being involved is the most egregious.” A “Medicare for all” solution has gotten such short shrift that Scheiner asks, “Is the single-payer message so dangerous that it cannot even be discussed by Congress and the administration?” (“A Vote on Single-Payer,” The Nation, August 31/September 7, 2009)
Clearly, if the Obama-Biden Administration and the Democratic Party (as well as their loyal followers at the top of the U.S. labor movement) were genuinely interested in helping the masses of the U.S. population obtain decent health-care, they would be raising up the banner of the single-payer health-care system instead of helping the right wing reactionaries of both major capitalist parties, as well as big pharma and the insurance companies, bury single-payer.

The Big Lie and the Fascist Mobilization in the Health-Care Debate

Big Pharma and the insurance industry have used the “big lie technique” very successfully against a non-existent liberal or “socialist” or “government” health-care plan. Various ideas that have been proposed in Congress have been taken out of context, sliced, diced and spinned to fan the flames of ignorance and chauvinism. Among the main features of this big lie are the following:
1. The government will set up “death panels” which will decide how long you live. Popularized by Sarah Palin, this lie is so blatant that Palin is called out by Newsweek columnist Sharon Begley. Palins death panels is actually a reference to the idea of providing health coverage for an optional consultation with doctors around end of life issues. Patients currently have to pay for such a consultation out of pocket.
2. The government will tell you what doctor to use. In reality, in the USA today, tens of millions of uninsured have no doctor at all. And current private health insurance plans routinely penalize patients if they do not use doctors affiliated with their plan. By contrast, the Canadian universal single-payer system provides personal choice of physician.
3. Taxpayers will be forced to pay for abortions. There has been no proposal to this effect; and a significant proposal in the House of Representatives has raised continuing the specific exclusion of federal monies for so-called “elective abortions.”
4. Universal Health Coverage will threaten Medicare. Senior citizens, nervous about the already limited medical coverage they have, are being told that, if the current millions of people without health-care gain coverage, it will come out of Seniors Medicare. In reality, the biggest threat to Medicare is the drive to maintain and extend the privatization of health-care. The strongest basis for defending and expanding Medicare coverage for the elderly is, as anti-war heroine Cindy Sheehan has expressed it, “All for Medicare and Medicare for All!”
5. “Illegal” immigrants will get free health insurance. Even under current law, everyone in the USA is supposed to receive emergency medical coverage. The House bill provides no one with free health-care. By the way, even the libertarian Cato Institute has issued a report asserting that the U.S. economy benefits from immigrants; and Newsweek states that “even the least skilled more than repay their costs in schools and health care.” (Ibid.)
Notice the buttons that the stooges for the insurance company and big pharma monopolists employ: Point #1 deals with the widespread fear of death. Points #1 and #2 both deal with fear of the government interfering in our most private decisions. Point #3 is a religious/ethical issue. Point #4 plays on the vulnerability of senior citizens around health-care and the fear of losing ones share of the pie. It is just another version of divide and conquer. It pits the old against the young and encourages us to be selfish. And Point #5 pushes the button of great nation chauvinism. U.S. “natives” are taught from birth that we are better than other people. “We” deserve health-care; “they” dont.
The monopoly capitalists of the medical-industrial complex wrap these and other dangerous elements of the “big lie” all together with the two biggest ideological pillars of U.S. monopoly capitalism and imperialism: white supremacy and anti-communism.
The medical-industrial complex monopolists raise the specter of “socialized medicine,” nationalized health-care, even the “public option,” pushing the anti-communist button, the unprecedentedly deep seated fear of socialism or communism among the U.S. population. The truth about Soviet health-care in the past (and “socialized medicine” in the rest of the developed world today) exposes the fact that workers of the world and especially in the USA, rather than fear “socialized medicine,” should embrace it!
In 1932, Sir Arthur Newsholme, former principal medical officer of the Local Government Board of England and Wales, and John Adams Kingsbury, former commissioner of public charities for the city of New York, took a trip to the Soviet Union where the working class, led by its Communist Party and great leader Joseph Stalin, held power. In their report, “Red Medicine: Socialized Health in Soviet Russia,” published in 1933, Newsholme and Kingsbury stated: “The Soviet Union is the one nation in the world which has undertaken to set up and operate a complete organization designed to provide preventive and curative medical care for every man, woman and child within its borders.” (“Soviet medicine – a workers health plan,” David Hoskins, Workers World, 9-3-09) This was at the height of the Great Depression in the capitalist world where workers suffered from mass unemployment, homelessness and disease.*
*Since the formal dissolution of the Soviet Union and the victory of capitalism in Russia in 1991, the Russian people have experienced a health-care crisis and a drastic lowering of life expectancy worse than any other country in modern history. No wonder the vast majority of Russians desires a return to socialism.
Following World War II and the historic defeat of world fascism, led by the Soviet Union, imperialist countries throughout Western Europe, including Great Britain and France, implemented major concessions to the aroused and inspired working class, including “socialized health-care,” as part of an effort to prevent the workers in these countries from taking power and building socialism. The largely positive health-care systems in the advanced capitalist countries today (with the notable exception of the USA) are largely a tribute to the struggle of the Soviet people and to the superiority of socialism over capitalism for the working class and people of the world.
Even in the USA, the post World War II Truman Administration attempted to establish universal health-care. While the U.S. monopoly capitalist and imperialist ruling class was strong enough to survive without providing “socialized medicine” to the U.S. working class at the time, less than twenty years later, President Johnson invited Truman to the White House for the signing of the bill introducing Medicare, i.e. “socialized medicine for the elderly” who then made up 8% of the U.S. population.
Finally, the use of white supremacy to defend medical-industrial complex mega-profits is especially insidious. The insurance companies and big pharma have identified health-care reform with President Obama, taking advantage of the fact that the President is a man of color and tapping into the deep-seated white supremacy of the vast majority of U.S. citizens to galvanize opposition to any real reform of health-care. The mobilization of irrational and hysterical white supremacist mobs to the town-hall meetings has been key to the success of the big lie in the health-care debate. These mobs also represent a new source of recruits for the mounting drive toward fascism in the United States.

The use of the anti-communist and white supremacist tactics in conjunction with the “big lie,” has been so successful that the monopolists of the medical-industrial complex have become recklessly arrogant. They have made a few notable gaffes and suffered a record-breaking fine, none of which, however, has thus far hurt or slowed down their successful campaign. In what Newsweeks Sharon Begley described as “one of this summers iconic moments,” an irate senior taxpayer at a South Carolina “town-hall meeting” demanded from his Congressman: “keep your government hands off my Medicare!” As Begley observed: “appeals to fear, anger and hate really gain traction when ignorance is wide and deep … [as] when some portion of the citizenry is ignorant of the fact that Medicare is run by the government.”
Begley and other commentators also reported a significant gaffe made by Investors Business Daily in a 7-31-09 editorial. According to Begley, this business journal “warned that health care reform would produce a system like Britains, where the government decides who gets medical treatment based on whether your life is considered worth saving … People such as Stephen Hawking [who has been paralyzed with Lou Gehrigs disease for decades] wouldnt have a chance in the U.K. But Hawking lives in the U.K. and regularly gets expensive care – because the U.K. doesnt do anything like the editorial claimed.” (Newsweek, 8/24-8/31/09)*
*Stephen Hawking is a remarkable and world renowned physicist.
Despite these gaffes, the “big lie” express train, featuring Medicare recipients denouncing government involvement in health-care and the demonization of the British national health-care system, which is considered a proud national treasure by almost every British citizen, keeps running full speed ahead.
Perhaps even more significant for the health-care debate, on September 2nd, the worlds largest producer of pharmaceutical drugs, Pfizer, was given a $1.2 billion criminal fine by the U.S. Justice Department, the largest ever in any U.S. criminal case! Federal prosecutors called Pfizer a “repeating corporate cheat for illegal drug promotions that plied doctors with free golf, massages and resort junkets … [in the] marketing of 13 different drugs.” Authorities noted that Pfizer is a “repeat offender”; this was Pfizers fourth settlement of government charges in the past decade! On this basis, Pfizers total fine is a record-breaking $2.3 billion in this case. “Mike Loucks, the U.S. attorney in Massachusetts, said that even as Pfizer was negotiating deals on misconduct, they were continuing to violate the very same laws with other drugs. To prevent backsliding this time, Pfizers conduct will be specially monitored by the Health and Human Service Department inspector general for five years.” (Associated Press, 9/3/09)
Obviously, to Pfizer and Big Pharma as well as the insurance companies, the fine is just part of the cost of doing business; they are a law unto themselves.
U.S. Workers need to Fight for a Single-payer Health-Care System – on the Road of Struggle for Workers Power and Socialism

This article documents the fact that the HEALTH-CARE SECTOR of the U.S. RULING CLASS – the insurance companies and big pharma – those with the most direct stake in the debate, are prevailing over the general interest of the U.S. monopoly capitalist and imperialist ruling class as a whole. Despite the fact that the primitive and barbaric for-profit U.S. health-care system is “an Achilles heel” that may prove fatal for the U.S. Empire, they have driven single-payer out of the debate. Even a “public option” has almost become a “non-starter.” The insurance companies actually like many of the proposed reforms that have survived their “debate” thus far. For example, one proposal would establish a legal requirement that every family purchase insurance or suffer a tax penalty. What windfall profits this “reform” would bring the insurance corporate giants!
Earlier this year, writing in The Atlantic magazine (April 09), Simon Johnson, the former chief economist for the International Monetary Fund (IMF), wrote that the U.S. government had been captured by the financial oligarchy. Johnson argued that at least a sector of the ruling class has to be sacrificed so that the failing system can survive. Johnson shared the fact that the IMF would not provide the desperately needed loans to failing economies until a sector of the ruling class was offered up for sacrifice. Despite Johnsons appeal, U.S. finance capital, the chief culprit in the financial collapse of the U.S. and then the global economy, sacrificed not at all. Instead, finance capital has been the recipient of several trillion dollars in U.S. government largess. Today the medical-industrial complex monopoly capitalists are just as unwilling to be the sector that is sacrificed to the interests of the system of monopoly capitalism and imperialism as a whole, just as the financial oligarchy was unwilling to play that role.
The absolute domination of the current health-care debate in the USA by the monopolists of the insurance industry and big pharma reflects the fact that the greed and strivings for maximum profits by the monopolists of the affected industry (e.g. health-care) generally trumps the interests of the U.S. monopoly capitalist and imperialist ruling class as a whole, until this ruling class is overthrown. One conclusion the proletarian vanguard needs to share with the workers and the masses of the USA today is that the U.S. monopoly capitalist and imperialist ruling class will not “give” us and our families quality health-care. It is up to us to organize and fight for universal single-payer health-care against the fascist big lie movement sponsored by the medical-industrial complex. Those of us who harbor no illusions about the “good intentions” of the Obama-Biden Administration and/or the Democratic Party need to rally and unite with those who continue to have such bourgeois democratic illusions in order to build the organized power of the proletarian vanguard, our class and the masses to the point where we can demand and win universal single-payer health-care from Obama and the Democrats. Coalition work should be carried out with groups such as Labor for Health Care and Jobs with Justice and with progressive unions, including the new National Union of Health Care Workers (NUHW), the California Nurses Association, and others.
Financed by the monopoly capitalists of the insurance companies and big pharma, the one-sided reactionary anti-people side is winning the health-care debate in the USA today. It is a reflection of how little political power the workers and oppressed nationalities within the U.S. multi-national state possess. Our challenge as proletarian revolutionaries, as militant workers and concerned community activists is to get involved, get serious, stay involved and struggle until we win socialized medicine and then socialism.
“For the proletariat needs the truth and there is nothing so harmful to its cause as plausible, respectable petty-bourgeois lies.”
V.I. Lenin
Selected Works, Vol. X, p. 41

The Current U.S. Health-Care Debate and the Fight for Workers Power