As the politicians in Washington, D.C. debate over how large a band-aid to stick onto the corpse of our for-profit U.S. health care system, millions of working people stand dumbfounded. Why is the obvious solution – a single-payer system – simply declared “off the table?”

The United States spends twice as much on healthcare as any other advanced industrialized country yet 47 million Americans are without health insurance. For those fortunate enough to have coverage, they are slowly being crushed beneath exorbitant monthly premiums.

Yet Americans have a lower life expectancy and higher infant mortality rates than any other industrialized nation.

The U.S. healthcare system is a monumental testament to the lies of pro-capitalist ideologues who preach that private industry is more efficient than publicly-run programs. A major study by researchers at Harvard Medical School and Public Citizen found that bureaucratic overhead accounts for 31% of U.S. healthcare costs, compared to 16.7% in Canada.

The study estimated that under a U.S. national health insurance system $286 billion annually could be saved in administrative costs alone. Just half these savings, $133 billion, would be enough to cover all the uninsured and all out-of-pocket prescription drug costs.

To any serious thinking person not steeped in free-market fundamentalism and not paid-off by the health care industry (admittedly, that excludes most politicians and media corporations!), the case for a free, high-quality single payer health system is absolutely clear.

Beyond Single Payer
But the problem isn’t limited to the insurance companies, which a single payer system would replace. Hospitals and clinics are mostly in private hands and run on a for-profit basis. This is behind the outrageous trend of hospitals shutting down in low-income areas, or simply getting rid of essential services like emergency rooms in favor of more profitable services.

Then there’s the parasitical role played by the pharmaceutical industry. In 1997 Democratic President Bill Clinton’s Food and Drug Administration allowed them to market drugs directly to consumers for the first time, bypassing physicians. Such direct advertising increased fivefold in the following seven years, filling the airwaves with ads urging patients to pop away their problems with the latest brightly-colored pill.

Scandalously, a 2007 study showed Big Pharma spends almost $60 billion a year promoting their drugs, double what they spend on research and development! (ScienceDaily 1/7/08).

This has allowed the profit rates of the drug companies to dramatically expand over the last decade, making the industry among the most lucrative. The top three drug companies alone made over $30 billion profit in 2006.

They now command a powerful army of lobbyists in Washington and disperse millions in campaign contributions to ensure any reforms put their profits over social priorities.

Rather than squandering billions on advertising, CEO profits, or producing copy-cat versions of trivial but profitable drugs like cold medicines, we could use these giant companies’ resources to address pressing medical problems such as cancer research, diabetes, and preparing for potential pandemics.

Socialized Medicine
The HMOs, insurance companies, hospitals, pharmaceutical companies, medical device makers, and other healthcare companies should be taken into public ownership to eliminate the profit motive from all aspects of healthcare.

In their place we should establish a publicly owned, democratically controlled, integrated healthcare system providing free quality service to all.

Under such a system, patients and health professionals could make medical decisions based on patients’ needs, not wealthy shareholders’ profits. With payment for healthcare guaranteed by the government, workers would not be pushed to take certain jobs or intimidated from organizing in their workplace for fear of losing their health benefits.

A national system would also free spouses and children from dependence on “primary breadwinners,” whereas employer-based insurance reinforces sexism and discrimination against same-sex couples.

For a publicly owned health system to be run efficiently and justly, it needs to be democratically controlled and managed from below, at the local and national levels, by elected representatives of healthcare workers and the general public, not appointed government bureaucrats.

The Rule of Profit Corrupts More Than Healthcare
We Need a Socialist Economy!

The basic goal of the capitalist owners of health insurance companies is no different from the goals of Ford, Nike, or Exxon-Mobil. Their aim is not to provide quality medical care, cars, shoes, or fuel. Instead, to survive within capitalism, corporations must completely fixate on their profit margin at the expense of workers, consumers, and the environment.

If it makes sense to take the profit motive out of the healthcare industry and put it under public, democratic ownership and control, then why not the big oil and car companies who are blocking the transition to a renewable energy economy and fully developed mass transit systems?

Why not take big agribusiness into public democratic control to ensure safe food, sustainable farming methods, and an end to the malnutrition and hunger which affects one in four U.S. children?

Is there any major industry where workers, consumers, and the wider society couldn’t elect management teams and cooperatively decide production priorities, investment, and wage scales? Socialists argue that we should take the top 500 U.S. corporations and put them under democratic workers’ control.

Public ownership of the “commanding heights” of the U.S. economy would allow, for the first time, real democratic control over the direction of our society. Instead of the profit-driven insanity of the market, with its boom and bust cycles, democratic economic planning and resource distribution would allow us to end class divisions, poverty, homelessness, unemployment, and much more.

The U.S. is the richest nation in history. There is plenty of wealth to solve our pressing social problems. But until working people own and democratically control the goods and services we produce, the big business elite, and the political parties they control, will continue to direct society toward their narrow interests.

Let’s fight for a free, quality single-payer health service, linking that campaign to the wider struggle for genuine democratic socialism.