By Billy Wharton

March 24, 2010 -- Americans desperately need healthcare. The need is so desperate that many are buying into a “something is better than nothing” philosophy to support a healthcare bill that actively works against their own interests. The bill that US President Barack Obama plans to sign into law is being dubbed a “reform”, but actually amounts to a corporate restructuring that will solidify the reliance on the same private insurance companies that have caused the crisis in the nation’s healthcare system.

As single-payer heathcare activist Dr. Margaret Flowers stated, “The Democratic Party has now moved so far to the right that they have just passed a Republican health bill.” This is no surprise, private insurers and pharmaceutical companies have flooded the electoral system with money in order to guarantee their continued ability to accumulate profits.

[In the United States, "single-payer healthcare" refers to universal public health insurance schemes similar to Canada's scheme and Australia's Medicare.]

Junk healthcare plans and the race to the bottom

At nearly 2500 pages, the bill contains a myriad of loop holes that will allow insurance companies to continue nearly all of the immoral practices that have, according to a Harvard University study, resulted in more than 40,000 deaths per year due to treatable conditions. In fact, private insurers will now receive taxpayer funds to subsidise the sale of junk healthcare plans that the group Physicians for a National Health Program estimates will only cover 70% of people’s medical needs. This will likely spark a race-to-the-bottom as employers look to provide the minimum amount of coverage possible, insurers grab ever-increasing chunks of public money and people continue to face the prospect of soaring out-of-pocket costs, deep medical debts and death from treatable illnesses.

However, Americans have adjusted to profit-driven healthcare by avoiding it. A study by the Kaiser Family Foundation found that 6 out of 10 Americans had deferred or delayed what they understood as necessary medical treatment. To close this option, the healthcare bill lends the coercive power of government to private health insurers. For the first time in US history, citizens will be forced to purchase health insurance or face stiff annual fines. Such a mandate guarantees that millions of people will be herded into the new “health insurance exchanges”, an idea created by the right-wing Heritage Foundation, in order to fork over their money to private insurers. Estimates are that this will produce more than 20 million new customers for abusive insurance corporations such as Humana, Oxford and Aetna.

When corporations own democracy

The bill is a remarkably clear demonstration of the power of corporate money and influence in US politics. Health insurance corporations spent an average of US$600,000 a day in lobbying during the first six months of 2009. Lobbyists had a seat at the table during all parts of the writing, debate and approval of the bill. When single-payer advocates from the Physicians for a National Health Program and Healthcare-NOW attempted to participate in proceedings at the Senate Finance Committee, they were first denied a seat at the table and then arrested. All along, the insurance lobby followed the basic strategy they have employed since the 1990s – either prevent any reform or stick people with a bad reform. Welcome to the bad reform.

The fix was in from the beginning. This was clear as Democrats stumbled through “town hall meetings” during the summer of 2009. Most could not explain the details of the plan and relied on vague appeals to the obvious fact that people needed access to healthcare. Most Democrat legislators had already taken hefty campaign contributions from the insurance and pharmaceutical industries.

Meanwhile, the bill grew in size and in pro-corporate credentials. Republicans added more than 100 amendments, Democrats negotiated away any even vaguely progressive language and the insurance industry opened profit-rich loopholes. Along the way, Obama made anti-abortion pledges and immigrants were thrown out of the legislation. Gone was Obama’s campaign pledge to create “universal healthcare” it was replaced by the neoliberal slogan of “choice and competition”.

Democrats: For sale or lease

A few Democrats put up symbolic resistance. House Representative Anthony Weiner cashed-in politically by running a slick public relations campaign nominally in support of single-payer healthcare before fading back into line with Obama. Senator Bernie Sanders, an independent, tried the insider route, attempting to carve out provisions that would allow state-by-state single-payer systems and that would create a public option. This failed and Sanders withdrew, choosing to go-along-to-get-along.

Dennis Kucinich was held up as a “last honest man” figure. Kucinich has serious single-payer credentials and seemed fearless in his criticism of both the content and process of the bill. He correctly surmised that the bill "would put the government in the role of accelerating the privatization of health care” and voted No during the first round in the House of Representatives. Yet, as the clunky pro-corporate bill lumbered toward a final vote, Democratic Party leadership broke Kucinich, squeezing a "Yes" vote out of him, presumably by threatening to run a well-financed candidate against him in future elections. In a scene more reminiscent of an Orwellian dystopia, a defeated Kucinich held a press conference to describe why he was going to vote for a bill that he opposes.

Along the way, the Democrats received a wonderful political gift – the Tea Partiers. Both the conservative and liberal media focused in on tea-party demonstrations in order to craft them as the face of the opposition to the bill. A reactionary motley crew of racists, gun lovers and right-wing libertarian yahoos provided pro-corporate Democrats with the chance to appear as the rational defenders of the people. Single-payer advocates were unable to break this embargo despite a variety of tactics ranging from civil disobedience to letter writing. Ultimately, the Obama administration was able to present the struggle as one between healthcare “reformers” and far-right whackos looking to wreck his presidency. All this was done in the service of protecting the insurance companies from the serious critique offered by single-payer healthcare.

A medical `cash-for-clunkers'

The healthcare bill fits smoothly into the Obama administration’s now clearly established economic strategy. Unlike the Bush administration, which attempted to use jumbled down-home rhetoric to cover class war from above, Obama has created a grotesque form of lemon socialism disguised by the language of reform. Under lemon socialism, financial losses are laid on the public while private corporations retain the profits. Consider this bill as the healthcare version of "cash-for-clunkers". Public money that could be used for the social good will be sent to bankroll abusive, inefficient and anti-human private corporations. Just as with the bank bailout, the war economy and education policy. The administration speaks the language of reform, but enacts the policies of neoliberal privatisation, no matter what the cost to the public in terms of funds or lives.

There are simple lessons to be learned from all of this – the market and corporations have no role to play in either healthcare or politics. Insurance companies merely disrupt the relationship between doctors and patients. They add nothing to the healthcare system and suck off profits by limiting or denying access to care. These profits are then re-deployed in the political system to buy both Democratic and Republican politicians through a corrupting system of lobbying and campaign contributions. Now that the US Supreme Court has provided corporations with an unlimited ability to donate money to candidates, these trends are sure to increase.

Democracy or the rich?

Now is the time to put an end to this process. On healthcare, we need to re-build the single-payer movement, rooting it in poor and working-class communities, winning over our trade unions and growing into a mass movement whose demands can neither be denied nor ignored as utopian. Single-payer healthcare can open the door for a fully socialised medical system in which healthcare is finally recognised as a guaranteed human right.

Such a movement will be one part of a broader upsurge for democracy from below that seeks to address the fact that 5% of the population in the United States controls 85% of the wealth. As the reformer Justice Louis Brandeis once wrote, “We can have democracy in this country or we can have great wealth in the hands of a few, but we can’t have both.” We can accomplish this by voting for green and red candidates who support single-payer healthcare and in the streets by creating an uncompromising social movement that puts human needs first and aims to relegate the insurance companies, the banks and the multinationals to the position they so rightly deserve – the dustbin of history.

[Billy Wharton is a writer and activist whose articles have appeared in the Washington Post, Counterpunch, Common Dreams, Dissident Voice, the NYC Indypendent, Links International Journal of Socialist Renewal, Spectrezine and the Monthly Review Zine. He is co-chair of the Socialist Party (USA).]