The US healthcare system is infamous worldwide for being an absolute travesty. The everyday stories of working class people facing traumatic choices about whether to seek medical aid or pay rent are shocking for those who hear it for the first time. Americans spend about $4.3 trillion in healthcare costs per year (roughly 17% of GDP) – roughly twice that of similar countries – yet we live shorter lives and infants are more likely to die than in those places. 

So where does the money go? It lines the pockets of insurance companies, big pharma, and the entire racketeering for-profit system erected around them. During the height of the pandemic when people were dying and suffering in droves, these companies reported record profits. 

A recent development has brought into focus again how deeply destructive and fragile the US healthcare model actually is. Due to a cyberattack in late February, a division of UnitedHealth Group (which recorded $22 billion in profits in 2023, the most profitable in the US health industry and among the top 25 of ALL companies), had to shut down its massive and sprawling system of electronic healthcare payments which processes up to 15 billion transactions annually. The knock-on effect of this is still being felt weeks later as medical facilities from small clinics to gigantic hospital networks are unable to pay bills (with places like urgent care facilities facing the prospect of shutting down all together), process insurance, provide critical care, or fill prescriptions potentially leaving millions without any safety against illness and disease as the problem lingers. 

The government has intervened to front some of the payments and “request” the private insurance companies to relax their rules to deal with the crisis but it’s unlikely that this will be able to fill the massive gap. This is coming at the same time where, unless a funding deal is reached, the ending of COVID-era pandemic rules around Medicaid threates the collapse of healthcare facilities across the country that provide services for up to 30 million mainly low-income people.

Repackaging Failed Solutions

Given the scale of the crisis growing deeper by the day, one would think that the two frontrunner presidential candidates would have some solutions. But neither Biden nor Trump offers any fundamental alternative to the exploitative system that currently exists. Despite every day introducing new elements bringing the healthcare system closer to complete collapse, it’s deja vu with the two main parties.

Democrats and Republicans, this time in the form of Biden and Trump, are warring not over massive overhauls to fix the fundamentally broken system but in a scene that could’ve been directly lifted from a decade ago (the Republicans tried to repeal parts or all of it 50 times by 2014), the main point of contention is the Affordable Care Act. A repeat of the same fight that reemerges every few years while we pay the price for a broken system. While we should oppose Trump’s attempts to take away access to insurance from millions of working people, Biden’s effort to continue to apply the same band-aid solution to an ever gaping wound will not heal us. 

The historic level of ACA enrollment for 2024 of 21.3 million people does not reflect confidence in it but rather desperation as COVID has made people desire some health coverage versus none at all – reflected in the rates of uninsured dropping over that time but still making up over 26 million people in 2022. But none of this will solve the innate crisis embedded in a privatized healthcare system dominated by oligopolies like UnitedHealth. Only by a mass working class struggle for a true, universal and free at point of use system of Medicare for All can begin to reverse the tide of disease and despair.