Amid Rightwing Terror, Congress Adopts Health ‘Reform’

AFTER NINE MONTHS of discussion and debate, several revisions and compromises, and the emergence of a seemingly irreconcilable polarization, President Barack Obama’s health insurance “reform” measure finally passed through Congress in the early morning hours of Monday.

The vote came after two days of increased violence against Democratic Party offices and officials by supporters of the Tea Party Nativist movement. Bricks were thrown through the windows of Democratic Party offices in New York and Kansas. An unknown Nativist used a bat or pipe to smash in the window of a Democratic Congresswoman in Tuscon, Arizona, and another hurled a rock through the window of the Democratic Party offices in Cincinnati, Ohio. Other Democratic officials received anonymous death threats in response to their positions.

On Saturday, Tea Party Nativists gathered outside the Capitol attacked several Congressional Democrats, including African American Congressmen Emmanuel Cleaver (spit on and called “ni**er”) and James Clyburn (called “ni**er), and openly gay Representative Barney Frank (called “fa**ot”).

Regardless, in spite of this wave of rightwing terrorism from the Nativists, members of the House not only succeeded in holding a vote, but also passing both the bill and a series of “fixes” to be adopted through the “reconciliation” rules for approving budgets.

The bill that passed the House by the narrowest of margins was the one passed by the Senate at the end of last year. Gone is the so-called “public option” and all meaningful attempts at providing “universal coverage.” In its place we have the personal mandate and a tax on those who cannot afford to buy health insurance, another tax on so-called “Cadillac plans” that unionized workers fought years and decades to gain, cuts to Medicaid and Medicare in the guise of “eliminating waste,” and massive corporate welfare to the insurance and drug companies.

The largest piece of corporate welfare comes from the so-called abolition of “pre-existing condition” restrictions. Millions of mostly poor and working people will be prey to the health insurance corporations, who will be able to charge them exorbitant rates (due to an absence of price controls or caps).

While not claiming “universal coverage,” the structure set up by the “reform” bill is being hailed as establishing a “universal system” that can be “improved” over time.

FOLLOWING THEIR VOTE, the Democrats made a real push to declare that their bill established a “universal system” for the first time in the U.S. In and of itself, there is truth to the statement. But it leaves out an important fact: the new “universal system,” for the first time in American history, establishes a class-based multi-tier health care system that mandates sub-standard health coverage for poor and working people.

On one end, you have the cuts to Medicaid and Medicare. According to the Democrats, these are being made to areas like Medicare Advantage programs (the private health insurance that spans the “gap” between what Medicare provides and what people need) and “overpayments” in both programs. However, since the oversight panels can make cuts to Medicaid and Medicare without Congressional approval, and Congress would need a supermajority to override what this group of appointed officials does, the end result will be reduced quality of care for Medicaid and Medicare recipients.

On the other end, you have the tax on the so-called “Cadillac plans” that mostly unionized workers fought for over the last five decades. The tax is a downward pressure on the quality of those health insurance plans; bosses will begin looking to cut costs by switching from comprehensive to PPO to HMO plans in order to come in under the tax threshold. The effect of the tax will be to establish lower-quality health insurance plans for all workers, since neither bosses nor workers will want to have to pay it.

In between these two ends you have the personal mandate and the penalties against the uninsured. The ending of pre-existing condition nullification means millions of new customers, most of them part of the working poor, who will be forced to buy insurance, either through their employer or on their own. If they don’t, the fines, which are regulated by the Internal Revenue Service, will be levied. In order to “help” these working poor, the health insurance companies will create brand new “sub-prime” health insurance plans (and make billions on their own credit default swaps!) for their fresh meat.

So, what you end up with are three tiers of health care: Medicaid/Medicare for the working poor, elderly and disabled; “sub-prime” health insurance that are stripped down to avoid the “Cadillac tax” for the rest of the working class (and some of the lowest layers of the “middle class”) that doesn’t qualify for Medicaid/Medicare; and quality health plans for the capitalists and “middle class,” who can afford the “Cadillac tax.”

And as a bonus, the Democrats get to divide the working class and pit it against itself, with workers getting “sub-prime” insurance being set against the working poor getting Medicaid/Medicare, and vice versa.

THOSE WHO CALL this bill anything other than what it is, a piece of brutal class warfare that condemns millions of workers to substandard health coverage, is either unaware of the facts or lying.

In the coming months and years, the reality of this “reform” will be laid bare for all to see. Millions will be subject to the health care tax that is part of the personal mandate, and of them, thousands will face prosecution by the IRS for “willful tax evasion.” A whole layer of poor and working people will be criminalized because they cannot even afford the “sub-prime” insurance plans that their fellow workers are forced to purchase.

The Workers Party is committed to help organize a working-class movement against the personal mandate and the associated tax. We believe that no working person, who has sacrificed their body and their life on the altar of capitalism, should now be forced by the capitalists’ government to pay a very real “death tax” if they do not agree to further subsidize private health insurance companies.

If we do not do this, the growing dissatisfaction with the current “reform” will create a vacuum that will inevitably be filled by the Tea Party Nativists, who will use that expanded base to attack not only the current health care system, but also to attempt to privatize Medicare and Medicaid programs.

We fight to move the health care battle forward, toward real universal coverage and real freedom for patients and medical workers. A meaningful reform, like a single-payer health system, would be a good start. But the change we believe in is workers’ control of health care, as part of a society that works for working people — a workers’ republic.

If You Want Decent Reform, Then Fight for Single Payer!
It You Want Real Change, Then Fight for Workers’ Control!