Obama claims that the reforms would widen access to medical care. But with or without them, millions of working people will be forced to shoulder more of the skyrocketing costs, face cuts to previously won social programs, and deal with a deteriorating medical system as the worldwide capitalist crisis continues to take its toll.
The health-care proposal passed the Senate in a 60 to 39 vote. The Obama administration hopes to have a compromise between the Senate and House of Representatives versions early in the 2010 session. Not a single Republican voted for the Senate bill.
The legislation approved by the Senate December 24 is similar to one approved by the House in November. It includes a mandate that would force most people in the United States to buy health insurance or pay a fine. The bill sets a $95 per uninsured person fine in 2014; $350 in 2015; and $750 or 2 percent of a households income, whichever is greater, in 2016 and beyond. Some federal subsidies to buy insurance would be provided to those with income up to four times the official poverty level.
The mandate would give windfall profits to insurance companies, which would collect on an estimated 31 million additional people obligated to buy plans over the next 10 years.
Proponents of the bill claim that 14 million people would be added to Medicaid rolls, a government-run health insurance program for those with low income. But the reform proposals project major cuts to Medicaid and to Medicare, the government-run medical program for those 65 and older. These programs were won by working people in 1965 as a result of the mass, working-class-led struggles for Black rights in the 1950s and 60s. The two programs were an extension of the social wage won in the 1930s during the upsurge of the labor movement.
The Senate bill cuts $483 billion from the costs of Medicare and other federal programs over 10 years, including $118 billion in federal subsidies to privately offered Medicare Advantage plans.
The Senate bill also limits a womans right to choose abortion. Those who receive federal subsidies to pay for health insurance would have to make separate payments: one for abortion coverage and another for the rest of the insurance. The House version of the bill outright bans those who receive subsidies from choosing a health plan that covers abortion.
Both the House and Senate bills prohibit undocumented immigrant workers from receiving federal subsidies to pay for insurance. The Senate bill would also prevent undocumented workers from purchasing coverage offered through state-run insurance marketplaces.
Hospitals cut back on services
As the capitalist crisis takes its toll, both private and government-run hospitals are cutting back on services.
Recently, Jackson Memorial Hospital in Miami cut off kidney dialysis treatment to some 175 patients who cannot afford insurance.
In October, Grady Memorial Hospital in Atlanta shut down its dialysis clinic, affecting more than 60 undocumented immigrant workers who depend on its services for survival. Hospital officials offered to ship the patients off to their countries of origin or other states, and to pay for just three more months of dialysis at a private clinic.
Three former Grady dialysis patients have died since the clinics closing, though a hospital spokesman told the New York Times none were the result of insufficient dialysis.
In Pennsylvania at least seven hospitals and medical centers closed in 2009. Fifteen acute-care hospitals have closed in New Jersey since 1997.
In Queens, a borough of New York City, 3,000 workers were laid off when two major hospitals declared bankruptcy and closed in March 2009.
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