Vote YES on ONE this November 6th!
This article is based on remarks given by Worcester Socialist Alternative members at a series of joint meetings with the Safe Patients Limits Campaign.
Healthcare Under Capitalism
Nothing reveals the mounting racial and class inequalities under capitalism like the growing for-profit-healthcare disaster. Lack of insurance is the 7th leading cause of death in America. The U.S. healthcare system is totally dysfunctional and the crisis goes far beyond the uninsured.
Tens of millions more are under-insured and under-serviced by companies that often refuse care for pre-existing conditions or serious illnesses. The Rand Corporation found that 60% of the care delivered in the U.S. is substandard, yet Americans spend two times more than any other country per capita on healthcare while millions go uninsured.
For those fortunate enough to have coverage, we are slowly being crushed beneath exorbitant monthly premiums. 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 (administrative costs) in the U.S. insurance industry, both for-profit, and even the non-profit, accounts for 31% of all its money, double the amount spent per person in Canada. In other words, almost a third of your money spent on health insurance goes to hiring the people who then make the decision to deny you care and services.
Health insurance companies make billions in profits every year by systematically denying adequate health coverage. These are profits made on top of enormous administrative overhead and advertising, which could be eliminated by a single government-run health insurance agency, or single-payer system. A Harvard study in 2007 found that more than half of all personal bankruptcies were due to medical bills and three-quarters of them were insured. And costs are still rising.
In today’s dire economic climate, healthcare is getting even farther out of reach for millions of people. Health benefits are attached to people’s jobs, and the newly unemployed are or will soon become the newly uninsured. Not to mention that most jobs created since the 2008 crisis have been in the gig or service economy where benefits aren’t even an option for most workers. Big business’s answer to the crisis is to close down hospitals and ration services for the poor and workers in the name of market efficiency.
Meanwhile, the few public health clinics and hospitals – the only alternative for the poor and uninsured – have been steadily starved of funds, and the current shortfall in most states budgets means cuts in public services with devastating effects on patients. Just look at the closing of the Plumley Village clinic here in Worcester! A non-profit hospital receiving public funds shut down the low-income health clinic which it opened 30 years ago as a part of its “payment in lieu of taxes” – while also distinctly not paying taxes or replacing the community service! The question of healthcare has become a key issue in virtually all recent union contract negotiations, from the hotel workers to the teachers and gas workers strikes, as big business attempts to take back benefits won by the labor movement.
The U.S. healthcare crisis won’t be fundamentally fixed as long as profit is to be made by over-working hospital workers of all types, overcharging patients and Medicare (and ultimately taxpayers), and denying people with health problems coverage. The Harvard 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. The rest of the $133 billion? Could easily be spent on proper staffing levels – and that would hardly cause a dent!
These companies claim reform would lead to inefficiency and poor care, but the reality is that their system is the most wasteful in the industrialized world. 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, patients, and the environment.
Medicare for All Movement
10 years ago Obama stood on the campaign trail and told us he would pass Medicare for All. He discussed what the movement was demanding – single payer healthcare where the government takes the place of for-profit insurers. Yet after years of a Democrat super majority in Congress, we are no closer to equitable healthcare in this country. We need fundamental change within all aspects of the healthcare system.
Safe Patient Limits are an incredibly positive step in that direction. Private hospitals are known for shutting down in low-income areas and even cutting crucial services like emergency care because it is not profitable. Hospitals are mainly funded through battles with various insurers over thousands of itemized bills. It’s a costly system that requires loads of administration. Some hospitals have more billing clerks than nurses! With Safe Patient Limits we can change the game. But this would mean challenging the very foundation of the existing private health industry, something the Democrats spent the last 10 years proving they are not willing to do. They are too tied to these corporate interests to put up a real fight. And a real fight is what winning Safe Patient Limits will take!
10 years of betrayal in the Massachusetts legislature is why the nurses are taking this question to us – the voters! Unions, health care advocacy organizations, and working people need to wage a battle for a better kind of healthcare, independent of the Democrats and Republicans, putting forward the first steps towards building a fighting movement. The unions and health care advocates have the resources to organize mass demonstrations across the state and across the US, to demonstrate loud and clear that working people want Safe Patient Limits and an end to the domination of the insurance companies and hospital corporations.
Relying on politicians gave us the Commonwealth Care model, where all Massachusetts residents are required to purchase a health insurance policy or face fines. This strategy is not universal healthcare, it is private health insurance forced on the poor. Before this plan, it was possible to walk into community care facilities and receive care without any insurance. Now, they won’t even look at you without it. In other words, what was once provided by the state to the poorest Massachusetts residents is now only provided if the private insurance companies can take a cut. The Safe Patient Limits campaign is taking place in the context of the worst economic inequality since the 1930s. Given the absence of a mass left-wing anti-corporate alternative to the establishment parties, health insurance companies and conservative forces have been able to whip up divisive sentiments and direct them against any attempts to restrict their huge profits.
How Do We Win?
So then how did they pass Safe Patient Limits in California? Why do so many other countries across the globe have higher-quality yet more affordable healthcare? Other countries with better healthcare systems got them because ordinary working people fought for them. There can be no shortcuts, and nobody will do it for us. The welfare state in western Europe was won because strong unions were built and because working people organized their own political parties rather than depending on the parties of corporations. Only when the capitalist class feels their rule threatened by a mass movement will they grant reforms.
Who Says YES?
The Yes on One campaign has united nurses, patients, unions, community, and all who care about our health and well-being under its banner. The Massachusetts Nurses’ Association has stood up fearlessly to build the movement and to lead the fight to pass the referendum. Because have no illusions – it will take a movement. The nurses’ union was key in passing the first Safe Patient Limits nationwide in California. The MNA has advocated for improved hospital conditions for over 20 years but the Democrats in power in our state have consistently ignored people’s needs in exchange for lobbyist money. So this year the nurses and activists are bringing it to the voters! Ordinary Americans who have to navigate, suffer under, and sometimes die under this inhuman healthcare system.
Who Says NO?
We’re seeing real money mobilized against the Safe Patient Limits campaign. $20 million, in fact. Hospital executives – CEO’s – are hiding behind management nurses in TV ads who might wear scrubs but whose job is to keep the business moving forward profitably. This pits our opponents against labor and patients who are equally exploited in the for-profit capitalist healthcare model. Hospital execs and lobbyists have spent almost $20 million dollars against the referendum, which is well-spent pocket change to protect their $915 million in offshore profits! I’m sure they call that a great return on investment! These profits and multi-million dollar CEO salaries are clearly standing in opposition to nurse well-being, patient health, care quality and affordability, and a society that puts people ahead of profit! No on One has demonstrated no scruples in spreading misinformation and outright lies to protect their interests.
We must remember that every progressive step forward in this country has been the result of mass struggles by ordinary Americans. Voting rights for women, workplace rights, and civil rights were not handed to us by the good will of a few politicians. They were concessions delivered as a result of an increasingly politicized, organized and mobilized population. And no historic gains are won forever under capitalism. That is why we must fight for the issues of today – including, full-heartedly, Safe Patient Limits – but realize that our battle must go all the way, for a world where people are no longer subjugated to profit.
And Unions are key.
We saw the power of workers and unions organizing with the victories of the West Virginia Teacher’s Strike! The only way a national healthcare system can become a reality is by organizing a massive campaign to defeat healthcare cuts and concessions in benefits, and linking that struggle to the need to take profit out of healthcare. The trade union movement can play a leading role in such a campaign. The unions still have millions of members and the resources to organize teach-ins and demonstrations
in all major cities. In this way, the labor movement can show that it will fight to defend the interests of all workers, immigrants, the unemployed, patients, students, etc. That is why I am proud to stand up here today with the MNA who have made the commitment to bring this crucial legislature to the ballot as a referendum because it’s the most democratic tool we have, under the imperfect system. And workers – voters – want the quality of care that Safe Patient Limits means.
SA Stands in Complete Solidarity with our nurses, the nurse’s union, and Safe Patient Limits!
We are proud to have hosted joint meetings with the campaign and to be a part of building the movement. We’ve enjoyed the chance to be boots on the ground for the campaign, to talk with voters at the door and show the clear class lines that underlie this issue – between ordinary people and profiteers. We encourage other organizations to join campaign! Mobilize your members to stand in solidarity with the campaign and help us win this November. For you Massachusetts voters in the crowd – go vote Yes on One November 6th! I’m finally registered in MA and I’m so proud I’ll have the opportunity to vote YES to Safe patient limits and YES to transgender anti-discrimination protections. We will fight for Safe Patient Limits up to the minute the polls close on November 6. And after that we will continue to build the movement for healthcare workers and patients by campaigning for universal healthcare, regardless of ability to pay.
Writing our legislators has not stopped the attacks against workers over the last period. We need walkouts, strikes, building occupations, and a determination not to back down until the attacks are reversed. We need to create broad progressive coalitions to involve all individuals and organizations interested in joining the struggle for real gains. We must rely instead on ourselves – own numbers, our organization, and determination. We need to take to the streets in an ever-expanding movement to defend our public services and jobs. And the unions need to take a lead role due to their power and the numbers they can mobilize.
We can force the politicians to cave if, instead of rallying support for the Democrats, we boldly expose the big business character of both parties and run our own candidates against them on a clear pro-single-payer, anti-corporate, pro-worker platform. Ultimately, a free, universal, quality healthcare system will only be conceded to us if we get out there and protest. A majority of working class people support single payer health care. We need to use our massive numbers and power to politically challenge both parties of big business, both in the streets and at the ballot. We need to organize protests with a clear demand for free, quality healthcare for all. We also need to start running our own candidates and ultimately build our own party, not as another electoral machine, but as a fighting party of working people, youth and the poor.
However we must have no illusions in our political system. Politicians of both parties will likely mobilize to block or overturn a successful referendum. Capitalist politicians, from California, to DC, to Minneapolis have proven that they are willing to overturn voter initiatives that are not in the interest of the corporate elite. Even if we win this vote, the legislation could be repealed if corporate interests put enough pressure on politicians, like with the recent Amazon Tax betrayal in Seattle and the repeal of DC’s $15 an hour minimum wage. That’s why we will need to defend and extend this fight. From Safe Patient Limits we must boldly stand for Medicare for All. Finally, we cannot leave politics to the two corporate parties. We need to run independent candidates from our movements who will not water down our demands, not bow down to corporate interests, nor get sucked into the Democratic Party machine.
By learning from the experience of workers across the world and arming ourselves with a socialist, class-struggle strategy and program, we in the U.S. can not only win Safe Patient Limits and universal healthcare but free public education, child care, affordable housing, and other major reforms for working people. But only by workers taking democratic control of the economy and government can we hope to keep what we’ve won. We must fight for a new kind of world, a socialist world! So join the Yes on One campaign, join broader movements, join SA, and join a fighting movement for a better world!