Health care reform: they're all wrong

Two trends have emerged since the passage of the health care reform.

One denigrates the reform, calling it "worse than nothing" and bleakly prognosticating that the "fake" reform has blocked any chance for "real" reform in the next decade. Examples of this view can be found in The Socialist Worker, CounterPunch, MRZine, and other left venues.

The other trend is to play up the bill. It is "historic," "a big f___ deal," "a major people's victory," and so on. This view is mostly advanced by Democrats and their puppet pundits, but can also be seen on the left.

Both of the takes on health care are wrong.

As for the first, it can only be said that it thinks too highly of bourgeois democracy in the world's leading imperialist power. Bourgeois democracy in the world's leading imperialist power is never going to make the "real" reform they want.

The idea that the victory of "fake" reform has blocked the chance of "real" reform going forward is also dubious. The last time major health care reform was tried, in Clinton's first term, it failed, and no further battle was fought until the present. Win or fail, health care reform is not going to be dealt with again by bourgeois democracy for a decade or more.

Calling the reform "worse than nothing" because it entrenches the insurance industry is another blunder. The insurance industry will not be dismantled by the bourgeois democracy of the world's leading imperialist power. It will take a socialist revolution.

They dismiss the bill because it does not do enough, but that is like telling a starving man to refuse a crust of bread, because it alone will not end his hunger. The error is obvious, and can only remain hidden to those whose bellies have always been full and don't know what real hunger feels like.

The second view, that the legislation is a big people's victory, is about as wrong as the first. Usually the people don't offer specifics of why this is so, when they do they're often not right.

"No more pre-existing conditions," they say, when in reality there will be such things for four more years until the changes kick in, and even then the insurers will, though not be able to deny coverage, be able to manipulate premiums to make customers with health problems pay much more.

"Subsidies so insurance can be had by all," but even within the official predictions, 23 million will remain uninsured.

"Keep health care affordable," but again under the plan's predictions, premiums will continue to rise. Families will feel increasing pressure, and if they do fail to pay, they will be fined.

The Medicare drain, the numerous loopholes, the restrictive abortion provisions, etc. can also be mentioned. To call this a "people's victory" and a "historic achievement" is to mock people's victories and historic achievements.

Both views are wrong. The underlying problem is that both views caricature bourgeois democracy. Because bourgeois democracy cannot deliver a strong people-first program, the "worse than nothing crowd" take the view that it cannot ever deliver anything at all. Because they see some value in the health care reform, the "historic triumph" people decide that bourgeois democracy can and has delivered a strong people-first program. Both are wrong!

The health care reform is capital-compromised, but it is a gain. It is an ideological gain and a material gain. It is not a large gain, but it is about the largest the bourgeois democracy of the world's leading imperialist power can produce. It should be so viewed.

To say either that it is "worse than nothing" or that is is a "monumental achievement" is to mislead and misrepresent. Basing a political program on these kinds of distortions can only lead to failure.