Despite defiant declarations to fight on, it’s clear Obama and the Democratic Party’s signature domestic legislation, health care reform – and the hopes of millions for guaranteed health care – are in dire straits.

Most of the sorely needed reforms have been removed from any bill and the emaciated Senate version now being debated faces a tough road ahead. We need to ask ourselves what happened to the health care reform we were promised?

The health care bill negotiated in the Senate failed to provide a universal health care system that was promised. It leaves the insurance companies in charge of health care, and the majority of Americans are stuck with their rotten health care plans. In fact, it offers tens of billions of new customers to the private health care industry. Rather than pay for health care by repealing Bush’s tax cuts as Obama had promised, it is working-class people who are paying, with proposed cuts in Medicare and a tax on quality health care plans enjoyed by many workers.

From the start of the process the Democrats put the private, for-profit industries at the heart of the reform bill. Early on, deals were made with the pharmaceutical companies to deny the federal government the right to negotiate lower drug prices. Also, the positions held by the insurance companies were never threatened, with the single payer option never coming to the table.

Single Payer Rejected
The Democrats have steadfastly refused to consider implementing a “single payer,” “Medicare for all” system which could have provided guaranteed quality health care for all. By removing the parasitical insurance companies, this system would not only have cost less, but would have created a surplus. This is despite a majority of the public supporting such a system.

The Democrats, despite the gravity of the issue and the intense popularity of reform, unfortunately will not deliver the sort of change needed. The reason lies in the fundamentally pro-corporate character of the Democratic Party.

It is no wonder that the public turned against this bill. A recent ABC/Washington Post poll (1/12/10) finds that a majority of Americans do not support Obama’s handling of health care reform (52%) or the reform thus far (52%). Moreover, on how to pay for the health care reform a majority do not support a “Cadillac” tax (22%) but DO support a tax on the wealthy (58%) – an approach Obama has rejected!

In rejecting a single-payer health care system, or even a strong public option, Obama and the Democrats claimed they needed to pursue “realistic” and popular policies. In fact, their health care position has proven to be widely unpopular and open to right-wing attack. This is the result of the big-business, free-market approach and the conservative political strategy of Obama and the Democrats.

Health Care “Deform”
Does the loss of popular support for Obama’s health care reform and the growth of the Tea Parties indicate that the majority of Americans are right-wing and against significant government intervention in health care? Or can the answers, and their true meaning, be found in the approach Obama and the Democrats took to achieve health care reform?

Now that the Democrats have lost their filibuster-proof majority in the Senate, Obama and the Democrats claim that they must shift more to the center to court the moderates in the Republican Party and to hold the conservative Blue Dog Democrats in their camp. However, when the Democrats did enjoy majorities in Congress, not to mention majorities in state legislatures, and amongst state governors and city mayors, what they produced was a series of compromises, mandates, and taxes on working people.

Regrettably, the blame for a diluted “reform” bill or the failure to pass any bill that can be honestly considered a reform does not lie solely with the Democrats. Union leaderships, with few exceptions, and other leaders of progressive movements, who ostensibly represent the interests of working people, did not robustly demand the Democrats pass the significant reform needed.

Rather, they accepted the excuse that we needed to be “practical” and get something passed. Unfortunately, this is the price of lesser-evilism. When movements strap themselves to the Democratic Party, they are ultimately forced to water down their demands to what is politically palatable to their “friends” in office. The unions and other progressive groups could have marshaled their great resources and organized rallies, forums, and pickets to demand a single payer health care system. Instead it was the right wing that brought pressure to bear!

Sadly, it is difficult to expect anything less. It was the Democratic majority who supported and passed bailouts for the big banks and Wall Street, who recently approved the largest military budget in human history, and who have done little to nothing to help the foreclosed, the unemployed, and cash strapped state budgets.

If we want to break the hold corporations have over health care, if we want to insure quality, plentiful, and free medical care for all, the bitter lesson of Obama’s health care reform makes clear that we must break from the big-business Democratic Party and build a mass movement for single payer.