The Spark

the Voice of
The Communist League of Revolutionary Workers–Internationalist

“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx

What’s in the Reform?

Nov 9, 2009

The Democrats’ health “reform” bill is winding its way through Congress, with one version having passed the Senate Finance Committee, another version having passed the Senate Health committee, and still a third version having just passed the House of Representatives.

The medical system of this country certainly needs a drastic reform. The situation is nothing short of a disaster. The U.S. spends twice as much per person as many other countries, and yet provides much less medical care. Forty-seven million people are left without any kind of coverage at all. Another 168 million people have what’s called “inadequate” coverage–meaning if you have a serious illness or operation, it can wipe out all your savings or drive you into bankruptcy.

So, what will this reform do? The details are not clear. But the main outlines of the “reform” can be seen.

Central to every version of this reform is the mandate requiring all individuals to have medical insurance. Either your employer buys it from a private insurance company or you do–or you pay a penalty. In the Senate bill, the penalty is $1500 each year for a family.

Oh, yes, people can be exempted from paying the fine if they can’t find a policy whose premiums cost less than 8% to 12% of their gross income. But you’ll still have the same problem: you won’t have any insurance.

If you do find a policy with a cheap premium–say $3,000 or $4,000 a year in premiums for a family–you then have to pay high deductibles, co-pays and uncovered costs. You can easily double your total expense for health care.

Nothing in these bills gets rid of this outrageous pricing for medical care.

You can get onto Medicaid if your family income is close to the government’s poverty level. But the fact that you are on Medicaid doesn’t mean you can get medical care. No doctor or hospital or laboratory is mandated by this “reform” to accept Medicaid payments or to treat you. Today, less than a third of all primary doctors and obstetricians/gynecologists accept Medicaid. Only about one-quarter of all dentists accept it. Some states are slashing back coverage, eliminating dental care, eye care, eyeglasses, hearing, podiatry. And the House version allows states to charge the very poor up to 20% of Medicaid’s costs.

If you have just a little bit more income–up to 400% of poverty, you can get tax credits to cover part of the medical insurance. BUT those credits won’t begin to pay the costs of even the cheapest premiums, not to mention the monstrous deductibles and co-pays. AND you have to file an income tax return to get those credits, AND wait until next year to get them. Who has the luxury of waiting until next year to be repaid for what you put out this year? Not the working poor!

And the Congressional Budget Office estimates the most likely version of the bill still leaves 25 million people uninsured.

As for the 168 million people whose insurance is today inadequate, it will remain inadequate. Nothing in the bill even touches that question.

They dare call this a “reform”?