Barack Obama is calling for affordable healthcare for all. While appearing progressive, a closer look reveals that his plan is barely a bandaid. Obama is not calling for universal healthcare. Even if he were, universal healthcare never means equal healthcare under capitalism. The following just touches the surface of his “reform.”

In 2007, PBS compared U.S. healthcare statistics to Japan, the UK, Germany and Switzerland.(1) The U.S. spends more on healthcare (15.8% of its Gross Domestic Product) than any of the above. But the increased costs don’t produce better care. The report shows that, in comparison, people here have a shorter life expectancy and higher infant mortality rate. The extra costs go into the profit coffers of insurance and drug companies. The other countries boast a “socialized medicine,” “national health insurance” or “social insurance” model. In these countries, everyone has healthcare (although it’s not free for everyone). However, as of 2006, 47 million people in the U.S. had no health coverage.(2)

The U.S. actually ranks 41st in life-expectancy statistics compared to other countries. Mainstream media often cites obesity and racial disparities as the main cause.(3) But without a class analysis, this seems to blame the problem on individuals, for being fat or black, instead of the system.

WILL OBAMA FIX THIS PROBLEM?

Myth #1: Under Obama’s plan everyone will receive free healthcare.

Reality: Those who don’t qualify for Medicaid or State Children Health Insurance Plan (an income of $20,614 for a family of four in 2006), will be expected to buy into the new plan, or purchase private healthcare coverage, with an income-related federal subsidy, if their employer does not offer health insurance.(4) This implies universal access to a health plan, but not government-mandated universal coverage (compared to other countries).  

Myth #2: Catastrophic illness medical bills will be covered.

Reality: Catastrophic illnesses are those that incur major expenses such as lengthy hospital stays and financial losses, including loss of work. Heart attacks and cancer are examples of catastrophic illness. A high percentage of U.S. workers, 40% for example in California, hold jobs that do not offer sick days, and therefore lose a day’s pay for each day they’re out sick. Obama’s plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold.(5) The only people able to go to top hospitals for cancer or surgery would be those who could afford it, the way it is now.

Myth #3: Obama’s plan will cover long-term care for the elderly.

Reality: People over 80 are the fastest growing segment of the population. Most need some kind of assistant care. Currently, in a nursing home, Medicare pays only for short-term rehabilitation immediately following a hospitalization. After that, people must pay out of their pockets until all their money is gone and they’re eligible for Medicaid. Obama says he’ll “work to” improve the choices, the quality of care and to reform the financing of long-term care. Beyond that, nothing more specific.

Myth #4: The Obama campaign says he would finance his health plan costs by allowing expiration of tax cuts adopted in 2001 and 2003 for families making over $250,000. (New England Journal of Medicine, (8/21/2008)

Reality: In its projections, the Congressional Budget Office has already assumed this extra money coming from the ending of the tax cuts.

Myth #5: Taken from his website: “Obama will tackle the root causes of health disparities by addressing differences in access to health coverage.”(6)

Reality: This is impossible for Obama, or anyone else, to fix under capitalism. In its drive for profit, capitalism creates poverty and racism, which causes these disparities in healthcare. “Blacks with diabetes or vascular disease are nearly five times more likely than whites to have a leg amputated” and “women in Mississippi are far less likely to have mammograms than those in Maine.”(7)

Worldwide, a woman in Sweden or Japan will typically live past 80 years, while the average woman in Swaziland does not live to see her 30th birthday. Without noting that disparities in U.S. healthcare (and healthcare worldwide) stem from poverty and racism — inherent under capitalism — these problems won’t disappear.

While many workers believe Obama’s healthcare reform is in their interest, the truth is Obama only represents the interests of the capitalist class. But Obama and McCain and the bosses they serve face a major contradiction: On the one hand, they need more physically-fit soldiers to fight in their endless wars against their imperialist rivals, but on the other hand they need to cut the costs of all social services including healthcare, to pay for that very military and for their current fiscal meltdown. No doubt they will try to solve this contradiction on the backs of the working class.

1. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/)

2. (http://public.cq.com/docs/cqt/news110-000002575515.html)

3. (http://www.cnn.com/2007/HEALTH/08/13/life.expectancy.ap/index.html)

4. (http://www.barackobama.com/issues/healthcare/).

5. ibid.

6. ibid

7.http://www.nytimes.com/2008/06/05/health/research/05disparities.html