The ruling by the U.S. Supreme Court to uphold the core provisions of President Barack Obama’s health care reform is no victory for the working class. The mandate forcing people to buy insurance on a for-profit basis is a bonanza for the insurance companies and health maintenance organizations (HMOs). These companies will now have tens of millions of new customers from whom to reap enormous profits. The same is true for the pharmaceutical and hospital industries that will continue to rob the general population with over-priced drugs and tests, many of them unnecessary. The more money they rake in, the less workers will have for basic needs.
The money to pay for health reform will, in effect, come from a tax on the entire working class. This was the basis for the rulers’ new hero, Chief Justice John Roberts, to become the deciding vote in declaring Obamacare constitutional. Congress has the power to tax, he said, and tax it will. Not everyone will be covered by the reformed health care system, of course. Twelve million undocumented workers and their children will remain unprotected, facing Obama’s policy of mass deportations, upwards of 1.4 million and counting.
Workers Have No Stake in Elections
The main beneficiaries of the Supreme Court’s decision may be Obama, whose bid to retain the White House in this November’s election gained a needed boost, and the finance capitalists who back him as their imperialist and international assassin of choice. But whether the Democrats or Mitt Romney and the Republicans come out on top, workers have no stake in either of these ruling-class candidates or in capitalism’s electoral process. The bosses’ election circus is designed to enforce the profit system that heaps only mass unemployment, racism, sexism, poverty and war on the backs of the working class. No doubt the medical industrial complex will use this reform to squeeze workers even more, with mergers swallowing smaller competitors and leading to even more layoffs.
Racist discrimination imposes a special burden on black and Latino workers, who suffer from either a doubly high rate of joblessness and lower wages for those who manage to find work. Racism enables the bosses to reap hundreds of billions of dollars from these wage and job differentials, while dividing and weakening the working class’s efforts in trying to fight these attacks. Capitalists need us only healthy enough to create profits, fight their imperialist wars for them, and bear the children the bosses can exploit in the future. These are the narrow limits of Obama’s concern for the masses’ well-being.
U.S. Bosses in Dogfight
Obamacare’s troubled progress and narrow 5-4 margin in the Supreme Court reflects sharpening conflict among U.S. bosses. The needs of U.S. imperialists who must deal with sharpening global rivalry are not always aligned with the needs of the drug, insurance and HMO bosses, who make their profits primarily from domestic exploitation rather than imperialist wars.
At the top of Obama’s imperialist agenda is his need to rein in runaway medical expenditures and thereby fund his masters’ war efforts. Second is the imposition of fascist discipline on all capitalists, great and small. Third is fostering patriotism by making workers dependent upon and loyal to a “benevolent” U.S. government.
This isn’t the first time the liberal imperialist wing has tried to advance health care reform as a political strategy. Ted Kennedy made it the centerpiece of his aborted 1980 White House bid. Bill and Hillary Clinton pushed hard for it in Clinton’s first term but were thwarted by the insurance and drug companies. Today it’s the politicians fronting for the domestically oriented bosses who balk at the more centralized control that Obamacare represents. And despite the Supreme Court ruling, the bosses’ internal fight is far from over.
Obama’s inability to rally broad unity for his mandates is a disappointment to liberal, imperialist Brookings Institute think-tankers, who shed crocodile tears for the uninsured while exposing the fact that Obamacare is not all what it seems:
[B]eneath the surface, the ruling is less liberal than it looks....First, the Medicaid ruling limits the power of the federal government to encourage states to extend medical care. This gives states the authority to resist national efforts to expand health insurance....Second, although Chief Justice Roberts supported the constitutionality of the individual mandate, his opinion limited the ability of the federal government to regulate interstate commerce through tactics other than taxes. This part of the decision will restrict the ability of future Congresses to regulate commerce.... The ultimate result of this decision will be that fewer uninsured will be covered than thought by health care reformers (Brookings website, 6/29/12).
The liberal reformers touting Obamacare may deceive some into thinking the U.S. is on the road to a single-payer healthcare system, a la Canada, which seems to be less costly and more efficient. In reality, however, Canada’s system is paid for by higher taxes on the working class as a whole — not so different from Obamacare, with the difference that U.S. workers have the added burden of paying for the profits of the drug, insurance, and hospital corporations.
Only Communism Can Provide for Workers’ Health
Only a communist system, one that puts workers’ needs first, can provide health care that benefits the whole working class. Without bosses and profits, workers — who produce all value in society — can allocate that value to their class’s collective health. Without a parasitic ruling class, health care will be distributed on a communist basis: from each according to their commitment to the social good, and to each according to their need. This is what Progressive Labor Party fights for in organizing for a communist revolution. Join us!