Health care decays in the ‘Rust Belt’

Excerpts from a talk given by Bev Hiestand at the WWP National Conference, Nov. 15-16.

Decades of decline in the living conditions of the working class in this country are now being followed by a severe crash of the capitalist economic system, the worst since the Great Depression of the 1930s. There is little disagreement that if the ruling class has its way, this next period will be devastating for our class.

Bev Hiestand WW photo: Gary Wilson

The Rust Belt city of Buffalo, N.Y., has already experienced unabated decline for the last several decades. Today Buffalo is the third poorest mid-sized city in the country. Once a center in steel production, almost all of that is gone, along with all the other industries associated with it, including parts businesses. The future of the remaining Ford and GM auto plants located outside the city limits is very bleak.

The result of this economic devastation has been totally shaped by institutional racism. Racist redlining by the banks and suburbanization have emptied the city of much of the white population. The majority of investment in businesses, jobs, housing, the university, new schools and shopping malls has been outside the city. Left behind is a city that is now 60 percent people of color—African Americans, Latinos and Latinas, small Arab and Yemini communities and a smaller number of recent African immigrants.

The only investment in the city has been for gentrification—building expensive condos for the rich along the waterfront. There is no urban renewal, only bulldozing hundreds of the 10,000 city-owned abandoned homes. Needless to say, there was no housing bubble in Buffalo, even in the suburbs.

Heating bills cost as much as housing. The schools are in terrible shape. Buffalo’s subway system travels back and forth along a Main Street of banks, state and federal buildings, empty stores and social service agencies, and a small portion of neighborhoods. A recent study of the poverty within the city has noted that the lack of a good mass transit system has left the poor and unemployed who live within the city unable to access jobs that are mostly in the suburbs. And yet, once again, there is an effort to raise the cost of bus fare. The only way to maintain such oppressive conditions is police brutality and a control board that takes more and more tax money from the workers, cutting the services we need and giving that money to the banks and developers.

The largest employer in the city is the health care industry. Over the last decade the health care unions have had to fight to preserve even these jobs as health care institutions have been repeatedly cut back. Several hospitals have been closed in a forced merger by the state. Now they are facing large cutbacks in state Medicaid and eventually Medicare funding.

As the best-paying steel and auto jobs have disappeared, the number of workers who can afford health care has diminished. Most health care insurance has been employer-based. As people lose jobs, they lose health care coverage. If GM closes or merges, thousands could lose their jobs. Already local health insurance companies have been greatly affected by GM’s announcement that it will no longer provide retiree health care coverage.

Health care advocates have been working for years on proposals that improve access to care but fall short of guaranteeing all people the right to free, quality health care. During the presidential election the candidates proposed that more people be included in existing plans—but these plans are now cutting services or excluding coverage for some existing health conditions. In addition, there are no attempts to cut the profits of the pharmaceutical companies.

It is clear that the health care crises will be at the top of both the capitalists’ agenda and the agenda of poor, working and unemployed workers.

What the ruling class has done to Buffalo is what they have planned for all the cities—to leave our class feeling hopeless and defenseless. However, now there are signs of change. The Barack Obama presidential campaign has raised the hopes of our class to think that it is possible for people to make great changes to improve their lives. Even in Buffalo, it has created enormous energy and optimism. It has also created an organization.

And so the contradiction exists between a ruling class that will do anything to keep its exploitive economic system from collapsing and the awakening masses who are now organizing to build a new society that can meet their needs. Change is also coming from the ruling class, but it will not be what people need. It will not make it possible for us to survive until we fight back.

As leaders in the struggle we have to understand this contradiction and decide: “What do we do?” Can we provide an analysis of capitalism that will help to offer a new path of struggle for all the people who want to fight? Can we provide leadership in the struggle for the things we need?