Republican health-care plan: Dead on arrival

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In an early test for the Trump admin­ istration, the pledge to “repeal and re­ place Obamacare” was developed into a legislative proposal that was withdrawn before its anticipated defeat in Congress. The full support of the president and a major push by Speaker of the House Paul Ryan came to nothing.

The failure also highlighted the lack of competence in a president who has tout­ ed his business acumen and negotiating skills. Despite, persuasion, pressure, and ultimatums, President Trump could not generate enough support within his own party to do what the opponents of Obam­ acare have been vowing to do since the Affordable Care Act was first adopted in 2010.

This dead-end legislation resulted from factional warfare within the GOP. Repub­ licans have begun governing by the pro­ verbial circular firing squad. To draft a new health-care bill, they aimed assault rifles at each other and began blasting away, with predictable results. As his fa­ tally wounded plan lay dying, President Trump chose to blame the Democrats.

For a bill to have been approved in Congress, party and faction compromise would have been necessary, but despite concessions to both Republican group­ ings, the pieces could not be made to fit. No coalition formed, not even a tempo­ rary one.

Democrats would have no part of the Republican plan. The GOP centrists or moderates were too few. The 30 to 40-member hard-right House Freedom Caucus would not budge from its de­ mands, even with the result of preserv­ ing Obamacare. This group, like all the others, was too small to pass a bill but large enough to block one. Stalemate meant failure.

A socialist leader once said, “The art of politics consists in knowing what to do next.” By that measure, the president who loudly claims to have mastered the art of the deal has clearly not mastered the art of politics.

That Americans deserve and need bet­ ter than what Obamacare has offered is hardly in doubt. That President Trump and his business buddies will provide better is definitely in doubt. In fact, it is becoming increasingly clear that any Re­ publican replacement plan will certainly provide less coverage to fewer people at higher cost—and with higher corporate profits—despite claims to the contrary from GOP leaders.

All of the health-care plans and pro­ posals emanating from the WashingtonWall Street nexus, from ACA/Obamacare to the eventual Republican plan, suffer from the same fatal flaw. They are all in­ tended, in the first place, to create exorbi­ tant corporate profits, and, in the second place, to provide some measure of “good medicine.” These two goals—money and health—are inevitably in conflict.

Capitalist America places the greater value on the health of business rather than on the health of people. The latter is simply a byproduct of the former.

Despite the recent debacle, battles over quality health care are far from conclud­ ed. Before facing voters again, Repub­ licans will have to try to make good on their promises. Eventually, Republican Healthcare 2.0 will be released to Con­ gress—that is, another bill that takes away from the poorest, the oldest, the neediest, and gives to the wealthiest. At this point, though, Republicans are still reeling from their defeat: no future plans or timelines have been announced.

Americans will need to see through the right-wing fog of rhetoric in order to go beyond the Republican plan, beyond Obamacare, and towards a universal health-care program with access for all. Until then, Obamacare, a flawed system whose insurance costs are still too high for too many, remains in place.

What should be on the public agenda now is a serious discussion about pro­ posals for national health-care and single-payer plans. This sentiment was brought forward repeatedly in speeches and interviews at the annual convention of Students for a National Health Pro­ gram, meeting in March in Philadelphia. Matthew Moy, a fellow at the American Medical Student Association, told the Philadelphia Inquirer at the gathering, “When you believe that health care is a human right, the only way to adequately and efficiently provide for everybody is through a single-payer system, which won’t waste money with a middleman insurance company telling you where you need to go.” n SOCIALIST ACTION APRIL 2017 3

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Joe Brusky of such a technology. Between brackets, this is further evidence that science is not neutral and objective, especially when it comes to making social-economic projections.

It is important to note that the fact that the carbon budget for 1.5° will be exceeded and that the 2°C budget will most likely be quickly exceeded too, does not mean that we should accept capitalist technologies as a lesser evil. On the contrary. The situation is extremely se­ rious, the fact is that reducing and cancelling carbon emissions won”t suffice.

Saving the climate requires removing carbon from the atmosphere. But this objective can be better achieved without resorting to BECCS or other dangerous technologies. The reason cap­ italism opts for technologies such as BECCS is that they suit the race for profit.

The alternative is to develop and generalize a peasant organic agriculture and careful for­ est and land management, respectful of Indig­ enous peoples. In this way, it will be possible to remove great amounts of carbon from the atmosphere and to store it in the soil, while fostering biodiversity and providing good food to everybody.

But this option means a fierce anticapitalist battle against agribusiness and landowners. In other words: the solution will not be found in the technological field, but in the political