Comrade Chairman Bernie Sanders and the Secretary of the CitiBank Comintern Chuck Schumer pulled off a major publicity blitz with coordinated protests nationwide in the name of “saving” the Affordable Care Act over this past weekend. What is so astounding is how gullible people are falling en masse for such a con rather than demanding the Old Bolshevik Teddy Kennedy’s single payer Medicare for All, a policy move which would make the United States a bit more humane and civil and bring us up to the same level with the rest of the industrialized world.
My astonishment comes from two places.
First, the Affordable Care Act was not magically put under dire threat the day after the election because of the selection of Donald Trump. In fact, it was on the verge of implosion the day before a ballot was cast owing to the massive fiasco known as the Aetna-Humana merger.
At the end of the summer of 2016, two major mergers by insurance giants Aetna-Humana and Anthem-Cigna were highlighted in coverage by International Business Times. When the federal government stepped in and sued to prevent these monopolistic industrial coagulations, Aetna turned around and said that they would withdraw from the ACA healthcare exchanges. This is equivalent to a spoiled child giving you the middle finger after you shower him with presents on his birthday because, if you have not heard, the ACA had always been nothing but a massive bail-out for Big Pharma and its hustlers in the insurance industry. There was no penalty or repercussion given Aetna for this ballsy move because, hey, it’s a free market! This in turn sent a massive ripple across the entire system. If Aetna could get away without a consequence for throwing such a tantrum, any of the insurers could!
And on top of that, the grace period of the ACA’s implementation was about to end anyways. The so-called Cadillac Tax was set to roll out in a year. Economist Dean Baker wrote in October 2015 (https://www.counterpunch.org/2015/10/22/jeb-bushs-health-plan-only-the-healthy-need-apply/):
Beginning in 2018, the ACA imposes a “Cadillac tax” on healthcare plans that cost more than $10,200 a year for a single individual. The intention of the tax is to discourage plans that cost a lot up front but don’t make patients contribute much at the point of service — through copays and the like… There are two problems with the logic of this tax. First, the reason most expensive plans are expensive is not the generosity of the benefits; it is the health condition of the participants. Most of the plans that would be subject to the tax have a disproportionate share of older workers with higher medical expenses. So the tax won’t primarily punish executives with luxurious, cushy plans; it will punish older workers who are more likely to have health issues. The other problem with the tax…is that it assumes people would seek out more cost-efficient care if they paid for it out of pocket. But new evidence…indicates that when people have to pay at the point of service, they often ignore necessary care. They don’t just skip frivolous or purely optional treatments; they choose their wallets over their well-being.
This is a massive flaw that, if anything, would have led to a rightward midterm upset had Clinton won the election. In other words, Trump and his bizarre government can and should be seen as a kind of stop-gap for a further rightward shift in our politics that would have continued otherwise due to a tax hike that disproportionately targets the elderly and middle class, particularly small business owners and so-called ‘gig economy’ workers.
At the end of his life, Edward Kennedy laid out in his book America Back on Track his logic and reasoning for creating a single-payer healthcare system. His argument was that Medicare could merely reduce the enrollment age to birth and almost instantaneously a federal program that is highly lauded would be able to provide healthcare for millions of uninsured Americans. As it stands right now, the insurance companies already make out fine with Medicare, they act as facilitators for payment of taxpayer funds and have booming business providing primary payer care for the elderly. Health insurance scholar and retired medical school professor Dr. John Geyman recently wrote (http://www.truth-out.org/speakout/item/39570-how-the-gop-can-avoid-the-trap-of-repealing-the-aca) “If the GOP pursues its claimed conservative principles, such as maximizing efficiency and choice, enhancing value, lowering costs, and reining in excess bureaucracy, another alternative is in plain sight, which supports these principles — single-payer national health insurance (NHI).”
The obvious question is why then they would oppose single-payer?
The issue is simple, healthcare is a major impediment to wider labor mobility in the job market. Under the ACA, people are restricted by large income caps. If they go over the income cap, they are slammed with huge copays and deductibles. As such, the law incentivizes living below the poverty line until one finds a full-time employer with a decent benefits package. This gives the employer the upper hand in any instance when they sit across the table from the workers. The ACA is nothing more than part and parcel of a larger system of control, created in collaboration between the private and public sectors, to restrict workers in their demands for higher wages and better quality of life. A single payer health plan would enable the type of labor mobility that would be a genuine benefit for working people nationwide. Even the desirable anti-discrimination clauses in the ACA, which quite admirably ended decades of industrial practices that targeted women and those with pre-existing conditions, are nothing but band-aids on a massive gash in the social safety net. The fact Bernie Sanders continues to support this diabolical system is nothing but wretched.
It is time for the resistance to Trump to purge itself of the neoliberals within their ranks. Neoliberalism as a system of control is just as racist as Trump’s white nationalist tendencies, if not more so due to the accommodation given such policies by thoughtless progressives who should know better. Whether it was the ACA or the destruction of Welfare in the form of block grants or NAFTA/TPP/TISA/TTIP trade deals, neoliberal Democratic Party politicians have enabled massive harm to the poor and minorities in the name of a corporate Washington consensus that has led to the rise of outright neo-Nazis within some sectors of the Republican Party. Whether it was Ronald Reagan launching his 1980 campaign from Oxford, Mississippi advocating states rights, Newt Gingrich cleaning up with the midterm Clinton elections, the Tea Party, or now the alt-right, corporate Democrats like Jimmy Carter, Bill Clinton, and Barack Obama have used American tax policy to wage a war on the white working class which in turn causes them to vote for chauvinist Republicans that promise relief before turning around and implementing more austerity and misery. For all the analogies made with Weimar Germany of late, no one seems to remember the reason the Nazis actually took power was because the mainstream political parties, including Sanders-style Social Democrats, implemented similar austerity policies upon the German people so to finance the odious reparations mandated by the Treaty of Versailles. That is the real lesson that history should be giving us at this moment.
The cancer of neo-fascism, neoliberalism, and accommodation is only going to be eradicated finally with a full-throated set of demands that includes single-payer healthcare. Anything less will only enable a further slide in our socio-political discourse towards reaction.