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Vol. 77/No. 43      December 2, 2013

‘Obamacare’ rollout highlights
health care crisis for working class
(lead article)
The botched rollout of the Affordable Care Act has created a political crisis for the Barack Obama administration, the Democratic Party and the capitalist rulers, who above all are seeking a way to protect the massive profits reaped from the health care “industry.” At the same time, they pursue the antagonistic goal of placating dissatisfaction among working people over the declining quality and access to medical services.

Hailed as the signature accomplishment of the Obama administration, “Obamacare” was enacted in 2010 with the backing of substantial sections of the propertied rulers. Its main function is to subsidize the giant health insurance companies, among the key props of finance capital. And it helps some bosses to continue shedding costs of providing employee insurance.

Rather than addressing the problem of declining health care for the vast majority, the act is geared toward reversing the declining number of working people without health insurance. And rather than move toward a government-funded health care system, it creates a massive government bureaucracy to administer the capitalist insurance market and foists the burden on millions of individuals to find and purchase insurance.

Under Obamacare you’re “not getting healthcare from the government,” writes financial analyst Jonathan Tepper. You’re “being forced to buy from private companies that have pricing power and market dominance.”

The rollout of Obamacare’s complex federal and state insurance exchanges, which opened Oct. 1, has been marked by chaos, confusion and computer shutdowns. Over its first month and a half, only about 100,000 signed up on government websites.

The president also promised that anyone who wanted to would keep their previous insurance policy under Obamacare. But the market decided otherwise, and at least 3.5 million people received notices of cancelation from insurance companies seeking higher profits under the new scheme, according to Associated Press.

Obama went on television to apologize. More than three dozen Democrats in the House voted with Republicans for legislation authorizing renewal of the canceled health insurance policies.

Roots of capitalist ‘health care’ crisis

The way the health care crisis for working people is unfolding in the U.S. today has roots in the failure of the labor movement to fight for the broad interests of the working class over decades, explains Jack Barnes, national secretary of the Socialist Workers Party, in The Changing Face of U.S. Politics: Working-Class Politics and the Trade Unions:

“For 25 years, beginning in the second half of the 1940s, prolonged capitalist economic expansion made it possible for broad layers of U.S. working people to wrest significant concessions from the exploiters,” wrote Barnes in 1985. “That quarter century, however, was also marked by the institutionalization of the class-collaborationist methods of the union bureaucracy, and a political retreat of the labor movement. The result was a terrible weakening of the unions. But this fact was hidden, since workers were able to continue wresting gains from the employers despite the obstacles of the class-collaborationist policies followed by the union misleaders. …

“The bureaucracy turned its back on any fight for nationwide government health care and improved retirement benefits for the working population as a whole. Instead, it sought to negotiate industry-by-industry ‘fringe benefits,’ more and more tied to the profits of individual industries and companies.”

“It’s almost like a march back toward feudalism,” Barnes writes in another section of the book. “These fringes are good in good times — for workers who have them — because they’re a substantial addition to everything else industrial workers can count on. But when the squeeze comes, this all begins to fall apart.”

The percentage of workers with employer-sponsored health insurance coverage has continued to decline, dropping to 59.5 percent in 2011, a 10 percent drop from 11 years earlier. And the number of uninsured with no health coverage rose to 48 million in 2012, according to the Census Bureau.

The rulers have decided in their majority to deal with this development by mandating everyone purchase policies, or pay fines — more than $2,000 per family by 2016. And to foist greater insurance costs on those younger and healthier, to even out prices.

According to a Nov. 5 Manhattan Institute report, insurance premiums on the exchanges are going up an average of 41 percent in 49 states, with only New York seeing a decline. And the plans often have restricted coverage with higher deductibles.

In the short term, Obamacare will likely be better for some and worse for others. But maintaining profit as the force behind the organization of health care ensures that as the crisis of capitalism deepens, the quality of medical care for the working class will continue to decline. And it is becoming clearer the new scheme poses new problems of its own.

For younger workers, premiums are rising the most — nearly 100 percent for young men and about 60 percent for younger women, according to Department of Health and Human Services figures.

Of the 2,500 counties served by federal exchanges, 58 percent have plans offered by just one or two insurance companies. In some 530 of them, only a single insurance company sets rates and coverage.

Millions of low-wage workers face a crisis in obtaining health insurance as their income levels are above those qualifying for Medicaid but too low to qualify for subsidies.

And because of a provision that allows employers to opt out of providing insurance or paying a $2,000 fine for those working less than 30 hours a week, many employers are slashing workers’ hours, leaving them with less income and no coverage.
Related articles:
Fight for universal health care!
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