Obamacare, Now Trumpcare, An Attack on Workers

The Donald Trump administration’s move to replace Obamacare is a move to replace a severely weakened and inadequate healthcare system with an even worse one. The inability of the wealthiest country in the history of capitalism to provide healthcare for the working class exposes that healthcare for profit is incompatible with providing for the needs of the working class.
Healthcare, A Profit Industry
Health insurance cannot be both comprehensive and profitable. The health insurance companies make money by signing up young healthy people to buy policies, while limiting the costs they spend on care for the sick who require more services. This formula has been extremely profitable. United Health, one of the five largest insurers in the country, announced it was pulling out of the Obamacare plans because they made less money than anticipated. Their profits for the year were “only” $11 billion, record breaking, but $850 million less than expected, with the bulk of the difference coming from losses associated with policies linked to the Obamacare plans. (Consumer Affairs, 11/1 2016).
If a company making that much profit won’t provide care to people, it is futile to expect health insurers to provide comprehensive healthcare to the working class.
Healthcare Was a Hard Fought Gain
A system of employer-paid health coverage emerged in the U.S. out of mass struggles. As the working class fought to build unions, healthcare became part of the struggle. Union membership in the U.S. reached its peak in 1954 with about 35 percent of the workforce unionized. In the late 1950s and into the 60s, the ruling class attacked the unions, mainly using anti-communist McCarthyism to divide and terrorize workers.
The trend to de-unionize the workforce was accelerated under Carter and then Reagan to the point where now only about 10 percent of the U.S. working class is unionized (Bureau of Labor Statistics 1/26).
Ruling Class Smash Unions and Healthcare
The percent of people having health insurance rose and fell in an almost identical way as the rate of unionization. Health coverage reached a peak of about 80 percent in 1968. It remained stable until 1980 when it began a steady drop. What was needed was a plan to provide bare-bones coverage and place the cost on the backs of the working class. An imperialist power needs its part of its population to receive enough healthcare to fight wars. That’s when Obamacare came in.
A combination of moving more people onto Medicaid and forcing young healthy people to buy expensive insurance with high deductibles increased the amount of people with insurance. This year, the average cost of the Obamacare Bronze plan (the cheapest) is $311/month for an individual 30 year old. The plan includes over $6000/year in deductible or out of pocket costs. Which means if you are sick, you will be paying thousands more on top of your premiums (Healthpocket.com 10/26/2016). This high cost, low coverage health insurance is nothing like the virtually free coverage unionized workers fought for at the height of the union movement. Obamacare was part of the thrust of reversing social gains won by the working class in the course of more than a century of struggle. This is indicative of how important it is to build a mass fighting movement against capitalism, and to build a society based on need and commitment rather than money and exploitation.
Further Decay
As expensive as Obamacare is, it is scheduled to get worse next year with increases in premiums and more out-of-pocket costs. But the deterioration of healthcare under the Obamacare plan is not fast enough for some members of the ruling class.
The United States empire is weaker than at any time since World War II. Healthcare is one arena of struggle that reflects this weakness. The Trump administration is now fronting for the insurance companies and the faction of bosses who want to attack the working class even faster. The new healthcare bill “would eliminate the mandate for most [people] in favor of a new system of tax credits to induce people to buy insurance on the open market. It would also eventually roll back the expansion of Medicaid that has provided coverage to more than 10 million people in 31 states” (NY Times, 3/7). Medicaid serves the poorest section of the U.S. working-class children and parents, as well as many older and disabled workers.
The race to the bottom in healthcare coverage is a symptom of a profit system that cannot provide livable existence for the working class.