Healthcare in America: Right or Privilege?

Scan page 10

The following is an edited and abridged version of a talk given by Chris Bieler at a Feb. 7 Socialist Action forum in New York City titled: "The Crisis in Healthcare.

Increasingly there is a two-tier system for healthcare in this country. The rich, who live in their pristine enclaves, receive state-of-the-art healthcare. They have access to the most advanced medical research and technology in the world.

Meanwhile, working people, the unemployed, and the poor are receiving less healthcare; less in quantity; less in quality. More than one-third of pregnant Black women and one-fifth of pregnant white women receive inadequate prenatal care. The infant mortality rate in some parts of New York City is higher than some of the poorest countries in Latin America.

Over 36 million Americans have no health insurance coverage at all, and the number is growing. These are not just the unemployed or the homeless; millions of them are the working poor, who receive no medical benefits.

There are 53 million Americans who, although they have some form of health insurance, have no coverage in the event of a catastrophic illness. Americans over the age of 65 on average pay 50 percent of their medical costs out of their own pockets. Around half of all personal bankruptcies in the United States are the result of financial problems caused by the high cost of illness.

But there certainly is no crisis in the medical insurance industry, whose bottom line is profits. The chief executives of healthcare and medical insurance companies have the highest median income of any corporate CEOs, averaging almost $1.5 million each. The medical insurance comChemical and Atomic Workers Union (OCAW) disclosed that while only 30 percent of those who responded would support a healthcare program that would only benefit the uninsured, a whopping 73 percent supported a national healthcare system that would benefit everybody.

Currently, six bills for healthcare "reform" have already been introduced in Congress. Virtually all of them are limited to making "improvements" in the current market-based health insurance system.

President Bush's proposal—by far, the most useless—is to give tax credits of up to $3600 per family for health insurance coverage. Such so-called "credits" don't even come close to covering the average family's health insurance costs and in no way do they provide coverage for catastrophic illness. The Democrats, on the other hand, have proposed a "play or pay" plan, the Mitchell Bill, which would require employers to insure their workers or pay a 7 percent payroll tax toward a government health fund. All of these proposals are no more than a band-aid on an already cancer-ridden system.

Typically, the AFL-CIO trade-union bureaucracy is lending its support to the Mitchell Bill. The bureaucrats echo the opinion of a large section of the capitalist class, like Lee Iacocca and the president of General Motors, who that say some kind of national healthcare is needed so that the cost to them is eliminated, thus making the American capitalists more competitive with the Japanese, who already have a national healthcare system.

Who should pay?

But as long as healthcare is tied into the health insurance industry, which is privately owned and interested only in profits, there will be no fundamental change. For years, they have functioned, together with the American Medical Association (AMA), as a trade cartel. They routinely serve on each others' boards of directors, encourage inflated costs and fees, and collaborate on raising the costs of premiums.

The other side of the coin is: Who will pay for national healthcare? The rich or working people?

In Canada, medical coverage is provided by a single payer, a national health insurance agency. Its strongest feature is that all treatment is free, with universal access to all—young and old, employed and unemployed. At the same time, the middlemen of the health insurance industry have been eliminated.

But national healthcare in Canada is in a tenuous situation. Their system leaves untouched the "fee for service" system, which allows doctors, hospitals, and other medical treatment institutions to charge the government whatever price they want for services. None of these institutions are accountable to working people or the communities they serve.

In fact, today in Canada health costs are rising and some government-owned healthcare facilities are being reprivatized. The U.S.-Canada Free Trade Agreement removes restrictions placed on y.s. corpo-