The Greatest Obstacle to Single-Payer Health Care: The Democratic Party

California Single Payer Activists
Single-payer advocates march in downtown Los Angeles, March 26, 2017, in support of a bill that would create a national health care system in the state of California.

Regardless of the fate of the Senate’s barbaric health care bill — which, according to the Congressional Budget Office would throw 22 million Americans off of their insurance —the left should seize on the renewed health care debate to push for a universal, single-payer program.

The United States stands alone among wealthy democracies in not treating health care as a basic human right, guaranteed to all citizens. Instead, we have a for-profit, pay-or-die system.

Can’t afford health insurance…? Well, as Democratic Rep. Alan Grayson sardonically put it: “Die quickly.”

But, then, that is capitalism for you. It is a perverse economic system that treats everything — including human lives and the ecosystem that supports all life on the planet — as a commodity.

As famed consumer-advocate and three-time independent presidential candidate, Ralph Nader wrote in an open letter to House Minority Leader Nancy Pelosi, earlier this year:

“Obamacare, without a public option, has been a complex patchwork in so many ways —including forcing individuals to purchase inadequate insurance from private insurance companies — insurance that carries with it high premiums, deductibles, co-pays and forces narrow networks.”

“For many,” Nader adds, “Obamacare is quasi-catastrophic insurance with limited choice of doctor and hospital.”

Nader goes on to urge Pelosi and the Democrats to push for “single payer Medicare for All — everyone in, nobody out, free choice of doctor and hospital, no medical bankruptcies, no coercive co-pays or deductibles … and no more deaths due to lack of health insurance.”

Sadly, I fear Nader’s exhortation will fall on deaf ears — assuming, that is, Pelosi even reads his letter in the first place.

For one thing, the Democratic Party has regarded Nader as a pariah ever since he “spoiled” the 2000 presidential election for Al Gore — a baseless accusation completely undermined by the fact that Gore won the popular vote and would have won the Electoral College if the Florida re-count had been allowed to take place. It was the right-wing Supreme Court that stole the election from Gore — not Nader.

But, beyond the Democrats’ abject hatred for Nader (as well as more recent Green Party standard-bearer, Jill Stein), the biggest reason the Democrats are unlikely to push for a single-payer bill, now or anytime in the near future, is because they are adamantly opposed to it.

Sure, the prospect of a universal health care program has long been a staple of the Democrats’ campaign rhetoric dating back to President Johnson’s administration. But when push comes to shove, and the Dems are actually in a position to implement single-payer, party leaders suddenly come up with all sorts of excuses why such a national health care program could “never work” here in America, or is “politically impossible” because they simply “don’t have the votes.”

During the Democratic Congress’s crafting of the Affordable Care Act, single-payer was “off the table” from the get-go. In fact, when single-payer activists peacefully interrupted an early White House public hearing on health care, Democratic Sen. Max Baucus (MT) promptly called security and had them arrested. Baucus and his colleagues glibly laughed as the protesters were, one by one, removed from the room.

And the Democrats have only become more forthright in their opposition to single-payer in recent years.

Last year, Pelosi publicly rebuked Sen. Bernie Sanders’ single-payer campaign platform — specifically, his intent to raise taxes on the wealthy in order to fund the program. “We’re not running on any platform of raising taxes,” Pelosi said during a Jan 27, 2016 press conference.

Regarding single-payer, Pelosi added, “It’s no use having a conversation about something that is not going to happen.”

Speaking of Sanders, now would be a prime moment for him to submit his long-promised Medicare-for-all bill in the U.S. Senate. Yet, according to an article by single-payer activist, Dr. Margaret Flowers, Sanders has instead opted to join his Democratic colleagues in fighting to save — and later improve upon — the ACA. Flowers criticizes Sanders for having his “priorities backwards,” accusing him of having “greater allegiance to the Democratic Party than he has to the supporters of Medicare for All, his base.”

But then, the nominally “independent” Vermont senator has always been a de facto member of the Democratic Party, as evidenced by his role as “sheepdog” for Hillary Clinton in the 2016 presidential campaign.

And Democratic legislators in California recently killed a bill that would have implemented a single-payer system in the state. California Assembly Speaker Anthony Rendon announced June 23 he was putting the bill, SB 562, on “hold,” effectively leaving it stranded in legislative limbo. The bill passed the State Senate, 23-14, earlier this month.

All of this is further evidence that the Democratic Party is perhaps the greatest obstacle to achieving universal health care, nationally or even at the state level. As the Bay Area chapter of Socialist Alternative writes of the Dems’ betrayal on SB 562, on their website:

California Senator Diane Feinstein, House Minority Leader Nancy Pelosi and Governor Jerry Brown are united. They want to kill off the whole idea of single-payer. … Once again they [the Democrats] aim for a corporate-friendly “centrist” policy when the left is the popular place to be. Despite the progress that Obamacare represents, it and Trumpcare are both market-based plans that do not challenge the big health insurance companies’ parasitic role in health care.

Little wonder then, that Kevin Phillips, a former strategist for Richard Nixon, once referred to the Democrats as “history’s second most enthusiastic capitalist party.”

Pelosi seemed to concede as much during a CNN town hall-style debate, earlier this year. When a young man in the audience asked Pelosi about the Democrats’ failure to move further to the left on economic issues in accordance with a growing majority of young people, Pelosi responded, “Well, I thank you for your question. But I have to say, we’re capitalist and that’s just the way it is.”

Well, there you have it. Straight from the donkey’s mouth.

But despite the Democrats’ professed anxieties about the “difficulty” of funding a single-payer system (*cough* Tax the rich! *cough*), it is really not complicated at all. Currently, our pay-or-die health care system wastes $375 billion a year on health insurance paperwork alone — most of which is billing-related. This accounts for roughly 15 percent of overall national health care spending.

And while single-payer has always had broad popular support among Americans, that support is currently at its highest level in decades. A recent Pew Research Center survey finds 60 percent of Americans support “a single-payer approach to health insurance.” Likewise, a majority of respondents believe it is the “federal government’s responsibility to make sure all Americans have health care coverage.”

The Republicans’ stalled efforts to “repeal and replace” Obamacare have, understandably, put leftists in a difficult position. They are scrambling to defend a health care reform that, while certainly better than any barbaric, “free-market” alternative the GOP has in mind, is still significantly flawed.

Thus, there has never been a better time to push for single-payer. The left’s job should not be to defend the “lesser evil” of an untenable status quo. Rather, we should be unafraid to offer bold, radical alternatives to our racist, sexist, xenophobic capitalist society. This includes an unapologetic recognition that abortion is a form of health care which all women should have free and unhindered access to without shame or stigma.

Sadly, Planned Parenthood and the Democratic Party will not make these demands for us. Only the working class can bring about its own emancipation. This is yet another reason why the working class needs its own revolutionary political party.

As Democracy Now! host, Amy Goodman, and Dennis Moynihan observe in a recent column titled, “Medicare for All: A Prescription for What Ails Us”:

“Single-payer is already in practice in the U.S. and is immensely popular. It’s called Medicare, the tax-payer funded program that guarantees health care for seniors and people with permanent disabilities.”

They continue:

… Currently, 57 million seniors and people with disabilities are on Medicare, out of a U.S. population of 320 million. There is no rational reason why Medicare couldn’t be expanded to cover all Americans, regardless of age, from birth to death. … The savings [from a Medicare for All system] would be extraordinary, and the system would most likely be as popular as Medicare is today.

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Capitalism will never grant Americans the universal health care we deserve

Single Payer Now!

Donald Trump, who was elected president largely based on his ability to portray himself as an “average” working-class American, continues with his every utterance to reveal just how completely out of touch with working-class concerns he truly is.

Last month for instance, Trump, in addressing the myriad complexities in following through on his pledge to repeal Obamacare, groaned to reporters, “Nobody knew that health care could be so complicated.”

Actually, I would wager most working-class Americans who have struggled with lousy, overpriced health insurance that does not actually cover anything, outrageous premiums and co-pays, unreadable, jargon-laden insurance disclaimers, and the criminal dilemma of having to choose between paying for prescription medication, or rent from month to month, are painfully familiar with how unfathomably complicated–and inhumane–the U.S. for-profit health care system is.

Trump–a wealthy elite who has never had to worry about paying for a hospital visit in his life–is only now realizing this. Must be nice.

As bad as Obamacare is, the Republican Congress’ “plan” will be even worse. (I put “plan” in quotation marks because the GOP proposal is not an alternative to the Affordable Care Act, at all. It is merely a retooling of it.)

In the absence of the ACA’s most integral feature, the individual mandate, health care costs will no longer be defrayed by the large pool of insurance purchasers. This leaves health care corporations like UnitedHealth Group (2014 net sales: $130.5 billion), Anthem ($74 billion), and Aetna ($58 billion) free to rack up coverage costs. The Republicans’ retooled plan also grants massive tax cuts to the wealthy, while increasing costs on the poor and elderly.

In other words, the Republicans’ actual health care plan is basically the same as former U.S. Rep. Alan Grayson’s (D-FL) sardonic characterization of it during a biting Sept. 29, 2009 House floor speech.

“It’s a very simple plan,” Grayson said of the then-minority Republicans’ opposition to the ACA. “… Don’t get sick … And if you do get sick, here’s what the Republicans want you to do … Die quickly!”

To paraphrase Arnaud Amalric’s famous saying, “Privatize it all and let The Market sort ‘em out.”

As if to add insult to injury, congressional Republicans are now resorting to their standard Ayn Randian, blame-the-victim logic in defense of claims that health insurance will become more expensive under “Trumpcare.”

Rep. Justin Chaffetz (R-UT), in a March 8 interview on CNN, suggested people need to “invest in their own health care,” rather than “getting that new iPhone.” Chaffetz went on to insist that Americans “have choices,” under capitalism, and they “have to make a choice” about how to spend their money.

But this advice is cynically disingenuous at best–cruelly dishonest, at worst. The only “choice” capitalism offers workers–who by definition, do not own the means of production–is to either sell their labor-power to an exploitative employer in order to survive, or to starve to death. That is not a choice, at all. It’s extortion.

As Stephen Pimpare points out in a rebuttal to Chaffetz in the Washington Post, “most American adults who are poor are not poor from lack of effort, but despite it.”

Limited as the ACA is, it has granted health insurance to some 20 million Americans who were previously unable to afford it. And aspects of the law such as allowing young adults to remain on their parents’ plan until the age of 26, and prohibiting insurance companies from denying claims based on so-called “pre-existing conditions,” are admittedly steps in the right direction. Certainly, the revocation of these benefits is nothing for leftist critics of Obamacare to celebrate.

But we must be clear about the ACA’s formidable shortcomings.

The ACA is built on a conservative idea developed by the Heritage Foundation. It is essentially a bailout for the for-profit health insurance industry—one which it did not even need.

President Barack Obama and the Democratic Congress never gave serious consideration to the alternative proposal for a government-run “public option” that would have competed with the corporate insurance providers. And the public option plan was already a watered-down Plan B from instituting a single-payer, universal health care system, which citizens in nearly every other industrial democracy throughout the world enjoy.

Indeed, the U.S. ranks 50 out of 55 countries according to a 2014 Bloomberg survey that calculates “life expectancy, health-care spending per capita and relative spending as a share of gross domestic product.” The survey found the United States’ for-profit health care system among the “least efficient in the world.”

Single-payer was “off the table,” from the start of the health care debate. In fact, when single-payer activists interrupted an early White House health care public hearing, Democratic Sen. Max Baucus (MT) promptly called security and had them arrested. Baucus and his colleagues glibly laughed as the protesters were, one by one, escorted out of the room.

And the Democratic Party has only become more forthright in its opposition to universal health care.

Last year, House Minority Leader Nancy Pelosi rebuked Sen. Bernie Sanders’ single-payer campaign platform—specifically, his intent to raise taxes in order to fund the program. “We’re not running on any platform of raising taxes,” Pelosi said during a Jan. 27, 2016 press conference.

Regarding single-payer, Pelosi added, “It’s no use having a conversation about something that is not going to happen.”

Earlier this year, Pelosi conceded during a CNN town hall-style Q&A that the Democratic Party is “capitalist, and that’s just the way it is.”

I must say, Pelosi’s newfound candidness, though infuriating to many liberals, is rather refreshing. Now that workers know exactly where the Democrats stand in the class war, perhaps we can finally abandon the party for good, and start our own.

Despite the Democrats’ opposition, transitioning to single-payer would go a long way to simplifying our complicated, pay-or-die health care system. Indeed, the U.S. currently wastes $375 billion a year on health insurance paperwork, alone—roughly 15 percent of overall national health care spending. Kinda gives a new meaning to the phrase, “Death by a thousand paper-cuts,” doesn’t it?

“Many people with curable ailments have died for lack of care,” writes veteran investigative reporter, Dave Lindorff, in his submission to the 2014 essay-collection, Imagine: Living in a Socialist USA“That’s what happened to a teenage boy brought to a hospital by police in Chicago. He died on the sidewalk as the cops stood by helplessly: the hospital wouldn’t admit him because he had no insurance.”

Lindorff goes on to observe that the United States is “the only modern industrial nation in the world that does this to its people.”

But as long as we live under capitalism–a system that treats everything, including human lives and the environment, as a commodity–this unconscionable attitude toward the poor and uninsured will continue. The basic necessities of life–health care, housing, and food–will remain out of reach for working-class people. A more efficient and humane way of organizing our economy would treat these human needs as universal rights–not commodities no different than toothpaste.

Abortion, likewise, is a form of health care and should be recognized as such. Women should have access to free abortion on demand and without apology. Indeed, I have long found it curious that the right-wing, “pro-life” zealots who espouse the “sanctity of life,” are completely absent from the fight for universal health care–and, for that matter, the anti-war movement.

(“Trumpcare” will, of course, strip all federal funding from Planned Parenthood.)

“In a socialist society,” Lindorff writes, “a parent with a sick baby could go straight to the doctor, or in an emergency, to the hospital. The baby wouldn’t be at risk of suffering through something potentially life-threatening, and the parents wouldn’t have to face the financial anxiety of deciding to see a doctor–or suffer the guilt of not seeing one.”

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From Hope to Hopeless: Reflections on Obama’s Legacy of Corporatism and Militarism

barack-obama

Barack Obama’s farewell address last Tuesday highlighted, one last time, the conflicting disparity between the president’s rhetoric and the actual policies he has pursued throughout the last eight years.

It was, as always, a rousing speech–even if it was completely detached from the material reality working-class Americans endure. (Say what you will about the president, but the man remains an impressive orator. George W. Bush, on the other hand, struggled just to correctly pronounce the word “nuclear.”)

Obama assumed office just as the 2008 Great Recession, the worst economic crisis since the Great Depression, was unfolding. He handily defeated Republican John McCain, on a marketing-savvy (if, ultimately, vacuous) platform of “hope” and “change.” And congressional Democrats rode Obama’s campaign coattails to victory, enlarging their already solid majority in the House and Senate.

The message from voters was clear: Americans were fed up with eight years of Bush’s unpopular wars, shredding of constitutional liberties, torture and spying programs, and the ever widening gap between the wealthy one percent and the working class. President Obama and the Democrats had a clear mandate to enact sweeping progressive changes on the level of FDR’s New Deal.

Eight years later, those unpopular wars have not only continued but been expanded. The NSA’s surveillance program is far more widespread than we originally imagined. The U.S. no longer tortures its enemies–it murders them, without charge, warrant or trial, via unmanned predator drones. The once discredited Republican Party has retaken control of Congress and the White House along with 67 state legislatures.

And the economy remains stagnant–the much lauded “economic recovery,” a cruel joke. Wall Street not only weathered the recession, but emerged richer and more influential than when taxpayers were forced to bail out the floundering Lehman Brothers and AIG at the height of the recession.

What the hell happened…?

For starters, Obama’s roughly $800 billion stimulus fell far short of the type of robust stimulus package many economists–including New York Times columnist, Paul Krugman–believed was necessary. (Krugman would later reveal the true limits to his supposed Keynesian economic populism in his intense opposition to democratic socialist, Bernie Sanders during the 2016 Democratic presidential primary.)

In fact, the stimulus contained limited money for job-creation and, according to the Socialist Worker‘s Lance Selfa, “explicitly ruled out direct government jobs programs modeled on the 1930s-era Works Progress Administration. It dedicated upwards of 40 percent of the stimulus bill to tax cuts and credits to individuals and business that were useless in creating jobs.”

But then, it seems that Obama–who described himself on the campaign trail as a “free-market guy,” and cited Ronald Reagan as a political inspiration–was always more committed to serving Wall Street than Main Street.

Investigative journalist, Ron Suskind, in his book, The Confidence Men, reported on a March 27, 2009 meeting between the president and a group of the most influential Wall Street CEOs. Despite Obama’s warning the billionaires that, “My administration is the only thing standing between you and the pitchforks,” he and then-Treasury Secretary Timothy Geithner nonetheless assured them they would not interfere with business-as-usual in Wall Street.

Suskind quotes one of the attending CEOs:

The sense of everyone after the big meeting was relief… The president had as us at a moment of real vulnerability. At that point, he could have ordered us to do just about anything, and we would have rolled over. But he didn’t. He mostly wanted to help us out, to quell the mob.

The list of botched opportunities and unfulfilled promises goes on.

The health insurance giveaway known as the Affordable Care Act is based on a right-wing proposal and is a far cry from the single-payer, universal health care program left activists have long called for. The former community organizer who frequently invokes the language and rhetoric of nonviolent civil disobedience used the brute force of the NYPD to violently crush Occupy Wall Street.

Obama has deported more immigrants than any other president in history. (And you thought Trump’s xenophobia was bad!) He has, likewise, created a repressive, chilling atmosphere toward journalists, prosecuting more whistleblowers under the Espionage Act than all other previous administrations combined.

And, while the historic significance of a nation founded and built on slavery electing its first African American president should not be undermined, Obama did precious little to address the deeply-embedded, institutional racism that remains a pernicious presence in our supposedly “post-racial” country. Indeed, black Americans have lost ground in every economic category during the last eight years.

By the 2010 midterm elections, liberal voters were understandably underwhelmed and unimpressed. They stayed home on Election Day, allowing the conservative Tea Party “movement” to sweep Republicans back into the House of Representatives. The Democrats barely hung on to their majority in the Senate–a situation which would eventually by reversed after the GOP won big gains in the 2014 and 2016 elections.

As Selfa writes of Obama’s first two years in office, “This was a time when Obama and the Democrats held almost all the levers of political power in Washington. And they squandered it.”

He later adds,

“Obama’s penchant to reach for compromise and ‘bipartisanship’ was exactly the opposite of what the dire situation he inherited required–and what the American populace was ready for.”

But I think the biggest gap between President Obama’s rhetoric and his actions is demonstrated in the area of foreign policy, where the Nobel Peace Prize winner has proved himself to be a greater warmonger than Bush.

Obama ramped-up the nebulous war in Afghanistan, making it the longest war in U.S. history. He has dropped bombs on Pakistan, Yemen, Libya, Syria, and Somalia. In fact, according to anti-war activist and Code Pink co-founder, Medea Benjamin, the U.S. dropped 26,171 bombs in 2016 alone. And the U.S. maintains a military presence in Iraq, a nation both Bush and Obama have all but ravaged, paving the way for the massive refugee crisis and the creation of the Islamic State in Iraq and Syria (ISIS).

“What does the administration have to show for eight years of fighting on so many fronts?” writes Benjamin. “Terrorism has spread, no wars have been ‘won’ and the Middle East is consumed by more chaos and divisions than when candidate Barack Obama declared his opposition to the invasion of Iraq.”

Additionally, Obama has codified and normalized the use of unmanned predator drones. Contrary to his insistence, these robotic death machines do not allow for more selective, precisely targeted killings. Obama is also the first sitting president to claim for himself the right to assassinate, at will, any person based on the slightest suspicion of connections to terrorism. Targets are selected for assassination based on Obama’s secret “kill list”—a list which includes American citizens.

And on Jan. 20—five days from this writing—Donald Trump will inherit all of this awesome, unprecedented military power and extrajudicial authority. Yeah, I’m fucking scared, too.

To that end, perhaps Obama’s greatest achievement has been his ability to get progressives to passively go along with policies they never would have supported under a Republican president.

Glenn Greenwald observed this phenomenon during Congress’s debate in 2011 on raising the federal debt-ceiling in order to avoid a government shutdown. As part of Obama’s “Grand Bargain” with the Republicans he offered up deep cuts to Medicare, Medicaid, and Social Security, the crown jewels of New Deal liberalism.

As Greenwald wrote in The Guardian at the time:

Therein lies one of the most enduring attributes of Obama’s legacy: in many crucial areas, he has done more to subvert and weaken the left’s political agenda than a GOP president could have dreamed of achieving. So potent, so overarching, are tribal loyalties in American politics that partisans will support, or at least tolerate, any and all policies their party’s leader endorses–even if those policies are ones they long claimed to loathe.

In the end, Obama’s true legacy may be that he was not the “lesser evil,” but in the words of Black Agenda Report’s Glen Ford, the more “effective evil.”

Going forward, as Obama exits the White House and we look down the barrel of Trump’s administration of swamp monsters, it is worth remembering a quote from left-wing historian, Howard Zinn.

“What matters most is not who is sitting in the White House,” Zinn wrote in A People’s History of the United States, “but who is ‘sitting in’–and who is marching outside the White House, pushing for change.”

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