Questions and Answers on Health Care for Activists

What principle should guide our thinking as we approach the health care debate?

We believe that health care is a human right. We believe that all human beings everywhere have the right to health care, no matter whether they are young or old, sick or well, employed or unemployed, men or women. The right to health care means the right to preventive care, to medical attention, to prescriptions, to hospitalization, to therapies of all sorts, and to hospice care if necessary. The quality of medical care that one receives should not depend on a person’s ability to pay.

What do you see as the source of our current health care problems?

First, health insurance companies are the principal source of our problems, since they exist to make money, not to provide health care. To make money, insurance companies attempt to exclude those who are most likely to need health care, for example, the elderly, the sick, people with “pre-existing conditions.” To protect their profits, they attempt to restrict or cut off medical care to their customers when they become sick or are injured.

Second, many hospitals, medical centers, clinics, and physicians’ offices also operate as for-profit businesses. In many cases, these institutions and organizations work to drive up costs through exorbitant fees, fabulous salaries and bonuses, recommendations for unnecessary procedures or lab work. While most physicians may be devoted to their patients, some have become ruthless business people, at the same time others find themselves caught in the existing set of economic pressures and demands.

So, we need to get the profit motive out of health care. First, by eliminating the health insurance companies’ role and, second, by regulating or eliminating the for-profit health care institutions. We need a health care system which is democratically controlled by our society in the interests of us all.

How would you pay for this health care?

We believe that our country, our society has the wealth to make health care available to all. To do so, we would have to increase the level of taxation on banks, corporations, and the very wealthy. We might also make other changes in our national economic priorities, such as ending the wars in Iraq and Afghanistan, closing U.S. military bases around the world, and cutting the military budget.

Where do you stand on the current call for health care reform? What is your position on issues such as “single-payer” and on President Obama’s call for a “public option.”

We join with and support all of those who are working for health care reform, that is, working to provide health for all of those in our society who do not now enjoy it. We believe that in reforming the health system, the most important thing is to create a national system that covers everyone living in the United States.

We already have government payment for health care in the form of Medicare, for residents over 65, and Medicaid, children, pregnant women, and the disabled, as well as the State Children’s Health Insurance Program (CHIP) for low-income children not qualified for Medicaid. We believe health care reform might be brought about, in part, by unifying and extending government coverage to all.

We believe that single-payer might be one way to create a more inclusive and equitable system, if not the perfect system. Single-payer means a system where the government or some government-backed organization provides the financing which pays for medical care. A single-payer system, such as exists in Australia and Canada, pays the hospitals, clinics, laboratories and pharmacies and the doctors who treat patients. Thus profit is eliminated from health insurance, but not from health care. The public might find itself being taxed to pay private hospitals and physicians, and to insure their profits.

The “public option” which President Obama had proposed but then dropped—and which is now being championed by Democratic Party head Howard Dean--would create a government-funded insurance company to compete with private insurance companies. Proposed as an alternative to eliminating the health insurance companies or to government regulation of them, the public option give people an alternative to the private insurance companies, theoretically acting as a check on insurance company practices.

We believe that single-payer, which would eliminate private health insurance companies altogether, would be superior to the public option.

Are your proposing “socialized medicine”? And what do you think of that idea?

“Socialized medicine” is often used to describe the state-run system that exists in England. We also have such systems in the United States, such as the Veterans Hospital and the Indian Health Service. We think that in many respects, such a system would be a great step forward if it covered everyone in the United States. Such a system would provide health care for all without cost. We think that is right, is just.

A big problem is that such systems exist within the broader crisis-prone capitalist economy with its economic booms and busts, so that economic crisis can lead to cutbacks in health care. This has happened to some state-run health care systems in Latin America, for example.

Another problem is that political agendas and government bureaucracies can distort such systems and divert them from the goal of providing health care for all. So, while we can see advantages in socialized medicine, we think that health workers, communities, and patients need to have a large role to make such a system work.

What do you see as the ideal alternative?

We believe that the profit motive should be eliminated from health care altogether by creating a democratically controlled social system of health care. We think that the public should set the general priorities, while health care workers—physicians, nurses, technicians, etc.—working with communities and patients should work out the best way to deliver care.

How do you ever see that coming about? How do we get there?

We believe that we have to do several things. First, we have to develop the critique of the profit system—capitalism—and a vision of an alternative—democratic socialism. So part of our work is intellectual and political: to understand and to pose options.

Second, we have to build a movement with the numbers and the power to transform our capitalist society into a democratic socialist society. We believe that working people, those who work for wages as factory or service workers, as teachers, nurses or social workers, will be at the center of such a movement. By a movement we mean those committed to go to planning meetings, to attend demonstrations, and in the future to join in protests and strikes.

Third, we think that we will have to build a political party, a party of working people and all those who face injustice and unfairness in our society. We believe that both the Republicans and the Democrats, including the Barack Obama administration, serve the banks and corporations, and serve the government, politicians, and the military, rather than serving the people.

Ultimately, though, we think we will need to build a powerful political movement to carry out a revolutionary transformation of our society, to eliminate profit not only from insurance and health care, but from every aspect of our society. We need a society based on the concepts of justice, equality, and fairness.

So does that mean we can’t do anything now? Do we have to wait for the right movement, political party, or for a revolution?

No, we can accomplish a lot now, by supporting health care reform and raising the single-payer option. Working within the movement, we can join with other activists to begin to build the movement that we need both to win reform now and to bring about revolutionary change in the future.

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