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The new US health care bill – a betrayal of working people and women

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Many are hailing the new Healthcare bill in the US, but there are serious problems, reports Simon Hardy

With the passing of the Affordable Health Care for America Act in the US House of Representatives by a narrow 219-212 majority, the Democrats are now arguing that Obama has fulfilled one of his main campaign pledges. On the surface, the bill is an advance on what came before. As of March 23rd 2010, an extra 32 million US citizens now have health insurance, insurance can no longer be refused based on medical histories, and there is a sizeable increase of Medicare coverage for people on low incomes.

But most healthcare campaigners are highly critical about the new bill and the way it was arrived at. The bill will still leave 23 million Americans uninsured. The new law will force middle income earners to buy insurance, costing as much as 9.5 per cent of their income, which would still only cover about 70% of medical expenses. To cap it all off, the already incredibly powerful insurance companies will be given an extra $450 million a year in public money to subsidise their insurance packages, handing over more money to the private sector.

In short, this Act does nothing to really challenge the profit-driven stranglehold of the insurance companies over healthcare in the US. Many Americans will not see any benefit until 2014 when all the measures of the bill finally come into force, and by then the insurance companies could have increased their premiums substantially. Physicians for a National Health Program likened the new bill to “using an aspirin to treat cancer.”

Right up to the last minute, concession after concession was made to the Republican (and Democrat) opponents of universal healthcare entitlement. Under the new law, thanks to Democrat Senator Bart Stupak, an agent of the Catholic Bishops’ Conference, women will have to pay for insurance cover on abortions “100% out of their own pocket”. “Pro-choice” activists expressed concern that, if insurance for abortions has to be paid separately to the health care companies, some might drop it as an option.

A further problem in the provision of healthcare for women is that, although the bill bans using gender as a factor when costing premiums (currently many women have to pay more for the same insurance package as a man, and workplaces with a majority female workforce have to pay more insurance) these provisions will not come fully into force until 2017. No wonder the National Organisation of Women referred to the bill as a “a giant leap backward for women”.

Many of his supporters are enraged that Obama caved in on so many key points of the Act as it made its way through the congress. The problem stems from two points, the first is that the Democrat party, wedded to capitalism and heavily funded by the health insurance companies, did not want too radical a reform bill. The second point, related to the first, is that Obama refused to use his campaigning base to establish more support for a radical version of the bill. The right mobilised significant pressure from its base, with demonstrations and protests across the country, designed to put pressure on wavering politicians to oppose the legislation, or fight for it to be further watered down. The right wing populist Tea Party movement, organised a protest on Capitol Hill the day before the act was passed where Democrat politicians were harassed, some were called “niggers” and “faggots” and even subjected to physical abuse, reported the Huffington Post.

The language from the Republican politicians themselves was designed to provoke emotional and irrational anger, “a little bit of freedom dies here today” declared Marsha Blackburn. “Will we choose the path of individual liberty or will we choose the path of government tyranny” asked Ted Poe, using the popular buzzwords from the Tea Party campaigners demanding that the tree of liberty be watered with the blood of tyrants. And when John Shadegg said that the bill was destroying freedom in the US, he was clearly referring to the total freedom of the insurance companies to make money from people’s illnesses.

For their part, Obama and the Democrats purposefully kept a lid on the activist base, clearly concerned that, if they mobilised such forces, the expectations of the movement would far outstrip anything that the Democrats were willing to offer in congress. This is because the Democrats cannot actually provide what so many people want and need, fully funded, free healthcare available at the point of demand.

The choice was over a continuation of the appalling free market system, which has ruled health care for generations, or some modest government intervention which would help paper over the cracks of healthcare provision in the US, whilst maintaining the profit system for the insurance companies. When stripped down to its bare essentials, this is a reform package which does not slay the beast of market profits in healthcare, but tries to tame it.

Now the battle is on to destroy even what has been achieved so far. The Republicans will be running in the mid term elections in the Autumn under a “repeal the Bill” ticket, no doubt accusing the Obama administration of “socialism” and “government take over of healthcare”. The Democrats are promising to defeat the Republicans but they have a track record of caving in under pressure and conceding strategic ground to the populist right on such issues. Of course, many Democrats themselves (the so called blue-dog Democrats) opposed the bill and act as a fifth column within their own party ranks on the health care issue. Currently, the Republicans stand united on their hatred of the healthcare reforms.

This highlights the problem of the reformist logic. Making concessions to the Republicans did not lead to any increase in bipartisan support, instead it resulted in a watered down bill and an entrenched opposition. The “public option” government health insurance provision as an alternative to the private pension schemes was unceremoniously dropped. If this is the best reform that can be brought about through the mechanisms of the US government, then it is clear that a more radical route is needed – “Power to the (Working) People!” Working people in the US, who most desperately needed, and still need, a genuine free health care system, should bear in mind Lenin's words “reforms are the by-product of the revolutionary struggle”, and that is what is lacking in the US today.