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Examining, analyzing and drawing political conclusions about the most critical issues facing the revolutionary movement in the U.S. today

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The Fight for Healthcare for All

There have been over 70 unsuccessful attempts to repeal “Obamacare’ – the Affordable Care Act (ACA) – including 2 trips to the US Supreme Court. Trump and the Republicans, upon capturing the presidency, felt they needed to repeal the ACA in order to finance their proposed 2017 tax cuts, to enrich themselves and the billionaires. When this failed, the Republicans went ahead and passed the 2017 tax cut bill anyway, adding to the national debt to the tune of a whopping $2.2 trillion, and then used this to attack the ACA.

In a shrewd maneuver, they reduced the Individual Mandate tax penalty within the ACA to zero. This rendered it no longer a tax, whereby Congress would have no authority under the auspices of the US Commerce Clause, which could supposedly eliminate the Individual Mandate and the ACA. No sooner than the tax cut law was passed, 20 Republican state attorneys general, (once again) sued to challenge the ACA, and on December 14, 2018, in a surprise decision, Texas U.S. District Judge Reed O’Connor ruled that tax reform eliminated the individual mandate and consequently made the ACA “invalid as a whole.”

While the appeals process is underway, this represents another attack in the struggle for Single Payer, H.R. 676 – Expanded and Improved Medicare for All (Everybody in, Nobody out), and threatens to push back further the availability of healthcare for all residents of the United States and its territories. The struggle for single payer has gone through all types of twists and turns, and throughout the process, the ruling class has narrowed the fight down to the fight for the ACA. It’s now a fight to maintain coverage for pre-existing conditions, allowing offspring to be covered up to age 26 on their parents coverage, expanding Medicaid, and subsidies for low income and the disabled. All of this will be gone if this ruling is upheld. All the while, the ruling class points out the futility of “Medicare for All,” while the struggle for H.R. 676 is disconnected and isolated from the ongoing healthcare struggles and the coalescing of the revolutionaries around the approaching revolution for the basic necessities of life.

This fight around healthcare has caused all types of splits in the political process, and once again the Democrats have used it to their political advantage. Even though they used healthcare to recapture the U.S. House in the 2018 mid-term elections, the split in the Democratic Party between those who support single payer and those that don’t has intensified. Right now, in the U.S. Congress, there are 123 co-sponsors of H.R. 676. It has the highest number of co-sponsors of any pending healthcare legislation. Yet, the Bernie “Medicare for All” caucus has arisen in the House, where over half of the H.R. 676 co-sponsors have joined, and where one of the co-chairs, Representative Pramila Jayapal (D. Washington) wants to introduce a new bill.

Single Payer, Expanded and Improved Medicare For All, H.R. 676, is no longer some pipe-dream of the left. It never was. It was only the denial on the part of the ruling capitalist class, in their drive to produce maximum profits at the expense of the people, that has kept comprehensive healthcare from being provided to all the people of the United States. Healthcare today is the most profitable sector of the U.S. economy. Healthcare stocks have stood up better than any other “equities” on the U.S. stock exchanges. Consequently, it has never been about providing healthcare to all the people, and the struggle around Medicare/Medicaid has been a political football to be tossed about, all the while moving the goal posts and diverting the movement, depending upon where the struggle was at any moment.

At the height of the Civil Rights movement, when Medicare/Medicaid were being born, “Medicare for All” could have been provided, but Wall Street and the for-profit healthcare industry wasn’t having any of it. Nor was the “Solid South,” through which Wall Street controlled the country. At that time the struggle for Medicare, among other things, boiled down to a question of age. Since the life expectancy for African Americans was less than 64 years of age and for Black males it was under 61 years, the final compromise settled at the ripe old age of 65.

In the released taped phone conversations of President Lyndon Johnson (LBJ), a piece in the June 25, 2011 commentary by Thomas G. Donlan of Barron’s describes LBJ talking to Democratic U.S. congressman Wilbur Mills of Arkansas, Chairman of the House Ways and Means Committee. Mills tells LBJ, ”I think we’ve got you something that we won’t only run on in ‘66,’ but we’ll run on from hereafter.” The intent of passing Medicare in 1965 was to get out the vote and get Democrats elected. Prior to becoming president, Barack Obama proclaimed, “If it was up to me, I would go with single payer.” Instead, here we are: as they push the goal posts back again, we find ourselves under the threat of not even receiving “Obamacare.”

Why is it that countries all over the world, especially the so-called “developed” countries, can guarantee a modicum of healthcare to all, achieve decent, and in some cases superior health results, at a lower cost, but we can’t? Unless of course, you have the money, and even then, if you have some insurance, you can still be denied healthcare. It is a testament to the strangle-hold that the capitalist class has over the economy and politics of the country, that there is austerity and scarcity in healthcare. Making money from people’s suffering is sick and disgusting.

It’s no secret that the U.S. spends more money on healthcare than any other country on the face of the Earth. Yet our mortality rate ranks number 32 in the world. Spending on all healthcare increased 3.9% last year to $3.5 trillion. healthcare spending as a share of U.S. Gross Domestic Product is 17.9%. More than 1/6 of our economy is related to healthcare. More than enough for a single payer, universal, comprehensive, “Medicare for All,” public healthcare system – from the day you’re born to the day you die. “Everybody in, Nobody out!” We’re already paying for it.

We’re just not getting it! And why? Because we don’t have the political power.

The Democratic Party is a part of a two party system of rule, along with the Republicans, that the ruling capitalist class uses to trick us, exploit us, and oppress us. They have the political power to deny us. But suffice it to say that by hook or crook, by any means necessary, we are going to get our Improved Medicare for All, H.R. 676, call it what you may. Healthcare is a right, and rights are fought for. Only with a society of the people, by the people, and for the people, where ownership of the social means of production, including the healthcare industry, is public property owned by society, are we going to solve this conundrum in healthcare, along with all the other basic demands for the necessities of life.

Single Payer, H.R. 676 points the way.

March/April 2019 Vol29.Ed2
This article originated in Rally, Comrades
P.O. Box 477113 Chicago, IL 60647 rally@lrna.org
Free to reproduce unless otherwise marked.
Please include this message with any reproduction.

Photo of Protest

30,000 March in Support of
Chicago Teachers Union Strike
Photo by Ryan L Williams
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The age-old vision of a world without scarcity, without exploitation, class domination, organized violence, and stultifying labor has been the dream of millenia. The new completely socialized labor-eliminating means of production ... sets the basis for its realization. Now human history can begin, the light of the individual shining in the full brightness of liberated life, that can only be realized within true equality and cooperation: communism, a cooperative society.

'Without Vision, the People Perish'
Rally, Comrades ! May/June 2011

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Rally, Comrades! is the political paper of the League of Revolutionaries for a New America. If you are one of the thousands of revolutionaries around the country looking for a perspective on the problems we face today, and for a political strategy to achieve the goal of a world free from exploitation and poverty, then Rally, Comrades! is for you.

Rally, Comrades! examines and analyzes the real problems of the revolutionary movement, and draws political conclusions for the tasks of revolutionaries at each stage of the revolutionary process. We reach out to revolutionaries wherever they may be to engage in debate and discussion, and to provide a forum for these discussions. Rally, Comrades! provides a strategic outlook for revolutionaries by indicating and illuminating the line of march of the revolutionary process.

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