Health Care Reform and Labor: How to Fight

Sanidad universal by Daquella manera. Union members across the country are rallying to defend health care reform at Congressional Town Hall meetings.  The right-wing populists are doing everything in their power to stop the discussion and shout down Congress members who have shown any sign of support for even moderate changes in the health care industry.  A few hours squaring off with the screeching paranoids of the Limbaugh persuasion tends to sharpen one’s thoughts on the issue.

In his entry on this website about the Employee Choice Act,  T. Shelton urged us not to forget how important fights for reforms that matter to workers’ lives are for revolutionary Marxists.  He pointed out that even a compromised Employee Free Choice Act, if it is passed, would be the most important and positive labor legislation since the Depression.  

We agree.

The health care debate poses similar problems for revolutionaries.  Virtually the entire left supports a “single payer solution”  to the health care crisis.  This would create a Medicare-type federal program which would eliminate or reduce the inefficiency and profiteering of the insurance industry and drug companies and hospitals.  Some type of single payer system is in place in most advanced industrial countries already. 

President Obama’s incredible shrinking health care reform efforts would create a “public plan” to compete with the insurance agencies—and also include many other reforms to regulate the insurance companies.  Whether the public plan will be big enough or free of restrictions to the degree that it can actually compete with the private plans or grow into a single payer system is subject to considerable debate.  Critics like Kip Sullivan of the Physicians for National Health Care argue that the current Democratic House Bill 3200 is not the public option we were promised, and is already wired to fail.    

But House Bill 3200 also contains a number of important  reforms that would make it hard to oppose even if the public plan is crippled.  It would extend coverage for children up to 26, offer some form of Medicare at age 55 (which would be huge for unions and other trying to negotiate early retirement), reduce and eventually eliminate the “donut hole” in prescription coverage for seniors, and prevent insurance companies from refusing coverage to people with pre-existing conditions, which will save lives.  Applying the logic of Shelton’s article on the Employee Free Choice Act, we have to support this bill (at least as it stands now—it may well get worse before any possible final vote) if we are going to “win as much as possible for the people,” one of Freedom Road’s  guiding tenets of mass work.

The key is this, as Shelton mentions: “If we do this work well there will be new layers of fighters deeply committed to and politicized by the fight,” who go from “trade union consciousness” to “working class consciousness” in the course of the campaign.  
Vermont Human Right To Healthcare Rally_0085 by NESRI.
To do that in the context of the Health Care Reform fight, we have to be constantly identifying the class interests of the insurance companies, drug companies, the hospital industry and others who benefit from the status quo.  There’s hardly a better place to talk about the inability of private capital to meet the needs of the people—even some free market economists will grant that health care is a “market failure.”

There is ample opportunity to get into other issues that arise in the health care debate as well.  Take immigration, a critical lightning rod of race and chauvinism by the right.  Despite the fact the current House bill does not cover undocumented workers (unfortunately), the right says it does.  So you can get into education and agitation about immigration, from “if an immigrant kid gets swine flu at school, you think your kid is immune?” Or on a broader level, “Let’s talk about why Guatemalans come here in the first place….” There are endless possibilities of radical and revolutionary agitation that will build consciousness among the advanced cores we need to consolidate as part of the revolutionary struggle.

This means how you organize is as important—maybe more so—than how pure you are on taking a “single-payer or nothing” line.  The single payer movement has gained considerable ground in this campaign, becoming stronger even as the Democratic compromises have become weaker.  Support has grown through countless forums and discussions, and now includes many local Democratic Party organizations and the Progressive Democrats, not to mention a hundred and thirty Central Labor Councils and thirty-nine state AFL-CIO federations.

But some of the single payer crowd has missed the boat.  Rather than pointing their agitation toward capitalism and its faults, they insist on attacking any compromise on health care, even if it included reforms that meet the needs of our people.   At some Congressional Town Hall meetings  we have attended, some of the single-payer folks gave long professorial lectures that drove even their supporters mad.  This is not only an intellectual discussion, this is combat.

An anti-corporate agitational focus is also the only way to defeat the right wing populists.  These folks are funded by billionaires, to be sure, but they also have a significant base.   The wing-nuts at the Town Hall meetings  we’ve  attended weren’t mostly Brooks Brothers types as liberals have alleged, not by appearances.  Many are working class and small business whites, yelling about not just health care but the entire right-wing litany from abortion to guns to tort reform to immigration.  They cheered wildly when a guy introduced himself as a retired Marine Corp veteran, then booed angrily thirty seconds later when the same man said he supported reform.  They turned on a woman whose son had been saved by the VA system when he came back butchered from the war in Iraq because she said the government health program had done ok.  When someone mentioned that end of life counseling by a doctor is helpful (the right’s imaginary  “death panel” that will force insurance companies to cover a doctor’s time to speak to you when your loved one is facing a terminal illness), the fear-mongers insisted that Obama’s after your mama.  They booed when someone mentioned France or Canada, never mind Cuba.  They refused to sign in, seeing it as a government plot—or not wanting to admit they were from out of state.  They were explicitly anti-union, complaining about “subsidizing the United Auto Workers” and “the people in the purple shirts.” “If you want health care, get a job”, they shouted.  And many were explicit market fundamentalists, demanding that nothing stand in the way of completely unfettered capitalism.
Vermont Human Right To Healthcare Rally_0088 by NESRI.
They had signs calling Obama Hitler, and saying the plan would euthanize the elderly.  Their determination to believe the weirdest shit (“the SEIU beat up a black gentleman in St. Louis who was passing out American flags” was a particular crowd pleaser) against all obvious facts is reason to check your own weapons.  Someone is definitely going to get hurt by these folks, and soon.  These are some confused, ugly folks, and there are more than few of them.  Some union activists say the hard core amounts to 5% of the population, but 35% or more of the population feels some kinship to their ranting.  

Part of the reason unions have pulled together some folks to go to the Town Hall health care meetings was to defend the simple process of discussion—you could call it a “Democracy Brigade.” And make no mistake about it, simple discussion is under threat.  As Sara Robinson points out, it is not new that such groups exist.  But today most of the Republican Party leadership is unapologetically identifying with these groups.  The open alliance between rural fascist tendencies and what Robinson calls the “Conservative elite” and corporate funding is something new and dangerous. 

And race, as always, lurks behind the debate.  I have yet to see a single person of color at the right-wing rallies.  One alleged description of the “Obamacare” they distribute contains repeated references to the “Civil Rights Division,” language counseling, etc.  The anti-immigrant rants draw the loudest angry boos of the day at the Town Hall meetings.  It was a deafening rage.  The same folks blasting Obama’s “socialist” health care reforms are calling him a “racist” and an “angry Black man.” (It makes you wonder exactly what a Black man has to do to be non-threatening to these folks as they await Armageddon?)  They will fan every incident like the one with Professor Gates at Harvard.  

Getting into the middle of the health care reform fight as it actually exists does make for some messy problems, as left critics contend.  Most frustrating is that if you aren’t careful, you end up positioned as the defenders of the corrupt, corporate-dominated government that we probably like even less than the wingnuts do.  The key is to keep the focus on the corporations, not the politicians as most of the movement (both Obama-inspired and single payer wings) have done until now.  Expose the corporate funding of the Right.  Don’t defend the sins of the government where they exist.  It’s not that we believe in the government, we believe in ourselves as an aroused, informed people and our ability to wring reforms from the government.  If the state was as clear a class tool as the Russian Tsar during Lenin’s time this would be simpler—but today the state, even more than in Russia at the turn of the last century,  is also a complex arena of class struggle.  Still, we would argue its essential nature—a tool with which one class rules another—hasn’t changed in a hundred years.  

Learning to fight for reforms in a revolutionary manner is the work of a lifetime.  It’s easy to fall into being an apologist for the mainstream liberals or being a purist who misses the opportunities to dive in and mix it up, create left poles and activists and socialist organization in the midst of “fighting to win all that can be won for the people.”

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