Democrats’ quick fix is no solution for workers

Voters will go to the polls in November desperate for change and with high hopes that the next president will pass and sign universal health care for everyone living in the United States.

The hopes and expectations for meaningful change are perfectly understandable. The crisis in U.S. health care has left 50 million people uninsured and another 25 million underinsured.

The lack of government investment has contributed to massive public hospital closures. According to the American Hospital Association there were approximately 1,800 public hospitals in the United States in 1980. By 2006 almost 700 of these hospitals had closed. Public hospitals are medical providers of last resort for the uninsured and handle disproportionately more cases of abuse, trauma, drug addiction, alcoholism and AIDS than their private counterparts. The closures leave many poor and working-class patients without access to the life-saving treatments they desperately need.

Despite the severity of the health-care crisis, it is unlikely the next president will pass a truly universal health-care bill. The political system of U.S. capitalism is heavily stacked against all reformers—inside and outside of government. The corporations and billionaires who profit from the health-care crisis will do everything in their power to prevent universal health care from being signed into law. Neither major party has signaled a willingness to propose and fight for a universal health-care system.

The Republican Party and its presidential candidate John McCain are not even pretending to offer solutions to the very real crisis facing workers in this country. McCain’s proposal would actually exacerbate the health-care crisis by expanding market-based competition and shifting more of the burden for coverage onto individual workers.

Voters have, however, projected much of their hope for health-care justice onto the Democratic Party in general and its presidential nominee Barack Obama in particular.

The Democrats realized this early on and have claimed the mantle of reform in their campaigns for president and Congress.

Much of the Democratic presidential primary was spent on mind-numbing debate over the details of the top contenders’ “universal” health-care plans. Senator Hillary Rodham Clinton led the charge that Obama’s plan was not truly universal because it did not contain a mandate requiring everyone to purchase insurance.

Senator Obama, meanwhile, counter-charged that Clinton’s plan unfairly penalized poor and working adults who may not be able to afford even subsidized insurance.

The fact is that both Obama and Clinton were correct in their respective critiques and neither candidate’s plan offers truly universal coverage. As Dr. Steffie Woolhandler, professor of medicine at Harvard University and co-founder of Physicians for a National Health Plan, points out: “Hillary and Obama are both right. Hillary’s individual mandates would, as Obama charges, financially punish uninsured families. Obama’s plan contains no individual mandate, but would, as Hillary charges, fail to cover 15 million or more Americans.”

Obama has promised that by the end of his first term in office the U.S. will have universal health insurance. Obama’s health-care plan, however well-intended it may be, fails to deliver on this promise.

Obama’s plan essentially prohibits private insurers from denying anyone coverage, regardless of medical history, and provides subsidies to help low-income workers purchase health insurance. The plan also allows people to buy into government insurance instead of purchasing private coverage. Obama’s proposal mandates parents to purchase coverage for their children, but otherwise has no individual requirement to buy insurance.

The fatal flaw with the Democratic health-care proposals is that the wasteful and profit-driven private insurance system is left intact. This makes it very difficult to increase coverage without incurring extraordinary costs both for the government and for individual workers who will not be able to afford the coverage with or without a mandate.

Rose Ann DeMoro, executive director of the California Nurses Association, contends that “you cannot reform health care by selling insurance. Expanding the reach of the insurance industry—which is at the center of all the [major] candidates’ plans—is not universal health care and it will not control costs. Forcing people to buy insurance, especially while insurers can continue to charge as much as they want and still deny needed medical care, further entrenches a broken system, and it’s not humane.”

The Democrats’ health-care models of expanded private insurance have already been attempted in Massachusetts, where former Republican Governor Mitt Romney signed a bill requiring every adult to purchase insurance or face penalties. The group Physicians for a National Health Plan estimates that prohibitive costs have prevented at least 250,000 of the state’s uninsured from purchasing private insurance despite the threat of year-end financial penalties. A national health plan based on this model will likely have even greater difficulty providing affordable insurance to every single person living in the United States.

Next: Single-payer reform as an immediate demand.