The Senate Democrats have mustered up a fragile compromise on health reform, defeating a filibuster and moving one step closer to passing the first comprehensive health legislation in decades. But is there anything for working people to celebrate after months of givebacks to the right wing and Wall Street-backed insurance companies?

From the outset, President Obama and the Democrats never intended to provide guaranteed health care for all. This could not be done without first replacing the private insurance companies that dominate the system with a “single-payer,” government-run system. Instead, they sought to tweak the dysfunctional for-profit system, relying on new regulations, taxes, subsidies, and mandates.

Some pain from the crisis-ridden system will be relieved. But, on balance, the proposals are totally inadequate and will serve to prolong the health care crisis for years to come. The source of the crisis – the way the system is organized for the profits of Wall Street and corporations – remains fully intact. Meanwhile, the public option has been dropped.

People or Profit?
The problems with profit-driven health care are painfully clear. It is wasteful, inefficient, and expensive. The U.S. spends twice as much per person on health care as any other industrialized country, yet the outcomes are worse (www.pnhp.org).

Forty-five million people lack insurance and have no way to pay for health care, but the “universal health care” proposal from the Democrats is a total sham. It’s simply an “individual mandate” that requires us to buy insurance or face a tax penalty. Health insurance is not health care. Physicians for a National Health Program (PNHP), an organization of 17,000 U.S. doctors that supports single payer, points out that an individual mandate “forces us to buy a defective product.”

In an open letter opposing the Senate legislation, PNHP further explained that instead of reigning in the corrupt insurance corporations, the individual mandate “would reinforce private insurers’ stranglehold on care.”

“Those who dislike their current employer-sponsored coverage would be forced to keep it. Those without insurance would be forced to pay private insurers’ inflated premiums, often for coverage so skimpy that serious illness would bankrupt them. And the $476 billion in new public funds for premium subsidies would all go to insurance firms, buttressing their financial and political power, and rendering future reform all the more difficult” (www.pnhp.org).

New subsidies to help people buy insurance are slightly positive but still wholly inadequate. “According to the Congressional Budget Office, a family of four earning $54,000 in 2016, when the health legislation is fully in effect [in 2016!], would be eligible for a subsidy of $10,100 to help defray the cost of insurance under the health legislation being debated by the Senate. By then, one of the most popular federal plans, a nationwide Blue Cross and Blue Shield policy, is projected to cost more than $20,000” (NY Times, 12/11/09).

With the passage of the final bill, the health care crisis will not only continue, it will deepen as their demands for large profits continue to drive up costs.

The Public Option
Shamefully, the Senate Democrats dropped the “public option” (a government-run insurance program to compete with private insurers) in early December, unable to take a firm stand even on this extremely limited reform. The public option was not too “radical,” as polls consistently showed a majority of the population supported it (pollingreport.com).

But Wall Street-backed insurance companies viewed it as unwanted competition. When the public option was axed, the stock index for health insurers rose 1.6% compared to a 0.6% fall for the broader index of all companies on the same day (Democracy Now!, 12/10/09).

Meanwhile, a recent study by Northwestern University found a “revolving door” between congressional aides in both parties and health care lobbying firms. 166 former congressional aides – including six aides of the “liberal” Senator Ted Kennedy – helped health care corporations channel more than $635 million to both parties in the past two years (Chicago Tribune, 12/20/09).

Lessons of the 2009 Health Care Debate
For-profit health care must go, and only a massive grassroots movement of working people organizing independently of both parties can make it happen. As a first step, we should support the fight for a single-payer national health care system. This would replace the “multi-payer” system of more than 1,000 private insurers with a “single payer,” the government, thus breaking the power of the parasitic insurance companies and eliminating more than $400 billion in waste, according to Harvard researchers (www.pnhp.org).

Widespread support exists for single payer amongst progressives and in unions. According to Labor Notes, over 550 resolutions supporting it have been passed by various labor bodies. But this support was held in check in 2009 by the “lesser-evil” approach of supporting the Democrats. With the left demobilized, the right wing had more room to exploit the massive anger at the politicians.

Some progressives argued that the public option would be a step toward single payer. In reality, by focusing on the public option and supporting the Democrats, a huge opportunity was lost to broaden support for single payer. Unions and progressive groups poured enormous resources into the public option campaign – and in the end we got nothing!

A massive, independent movement of ordinary people campaigning against big business, insurance companies, the right wing, and both corporate parties could have dramatically changed the terms of the debate. In the fight for the change we need, we must break with the Democrats once and for all.