The US government is facing its deepest-ever debt crisis. Roughly 27% of federal expenditure is on healthcare, making it a prime target for austerity. Some 24 million Americans rely on Affordable Care Act subsidies for health insurance. Cutting the subsidies will double premiums on average nationally. Five million people will lose their health insurance entirely. The impact will be catastrophic.

Trump has attempted to justify this very unpopular attack on living standards by calling Obamacare a “disaster,” saying he wants to “repeal it, replace it and get something great.” He recently unveiled “The Great Healthcare Plan,” a vague outline with empty promises of lower and more “transparent” drug and insurance prices. The crux of it is to replace federal subsidies with direct payments (of unknown quantity) to individuals’ Health Savings Accounts, which “consumers” can spend on private insurance. This solves nothing.

For their part, leading Democrats blame the Republicans for “assaulting” the healthcare system. They cynically hope to benefit from anger over healthcare costs at the Midterm elections. When you separate words from deeds, however, it’s clear that Obama-Biden’s party is equally to blame for the private healthcare disaster ruining the lives of millions.

The “Obamacare” swindle

The Democrats sold “Obamacare” as a supposed “reform” to make healthcare more fair and affordable. However, instead of providing publicly funded and administered healthcare for all, free at the point of service, it uses public money to subsidize private insurance plans, guaranteeing fat profits and millions of customers.

In practice, the Affordable Care Act amounts to taxing one layer of the working class to give a handout to the insurance corporations. In the ten years after Obama signed it into law in 2010, the five biggest private insurance companies saw their profits triple.

Over that same period, 66% of personal bankruptcies involved medical bills and illness-related income loss. More than 40% of US adults remain underinsured, with many delaying care because they can’t afford it. Headaches become heart attacks, and a $100 check up becomes a $95,000 emergency operation, further driving up overall healthcare costs.

This is the same system that 70% of Americans say is in crisis or has major problems, with 80% dissatisfied with costs. These are the conditions that led millions of Americans to sympathize with the killer of UnitedHealthcare’s CEO. This is the for-profit healthcare system that the Democrats (and Republicans) have created and maintained.

Instead of providing publicly funded and administered healthcare for all, free at the point of service, “Obamacare” uses public money to subsidize private insurance plans, guaranteeing fat profits and millions of customers. / Image: public domain

Fight for free, universal healthcare

Private health insurance is a deeply sinister system that, to maximize profit, charges people as much as possible while covering as little as they can get away with. It employs armies of administrators performing socially useless tasks, the costs of which are passed back to “consumers” through deductibles, copays, and premiums.

Despite spending nearly twice as much per capita on healthcare as other wealthy countries, the US has lower capacity and fewer physicians per capita. Americans also have worse health outcomes than in other high-income nations, including life expectancy, maternal mortality, chronic disease rates, etc. Scandalously, 75% of all healthcare spending is related to conditions that are largely preventable.

A universal, socialized healthcare system would save $600 billion a year in administrative costs alone. Instead of having to navigate the hellish medical insurance landscape, healthcare workers would be freed up to perform actual useful labor, treating patients and improving preventative care.

But this would require going against private property and the profits of the capitalists. The healthcare sector represents the largest portion of the US economy, accounting for 18% of US GDP. The Democratic Party is US capitalism’s party par excellence, and the main political arm of the healthcare industry. Like the Republican Party, it exists to manage American capitalism and ensure the billionaires’ profits.

The healthcare industry is the single largest Democratic Party lobby. In the 2024 election cycle, Democrats received 75% more donations from the big hospital, pharmaceutical, and insurance monopolies than Republicans. Nearly one-third of all Department of Health and Human Services political appointees leave government to work for the very companies they once “regulated”—a revolving door that turns policy into paychecks, and vice versa.

So, although the big-business Democrats cynically lament that the healthcare system is being “broken,” they are part of the system!

This is why the working class needs a party representing its own interests, with no ties to the private health industry and the capitalist class that owns it. Workers have the power to transform society, using all that wealth to build a new system that works for our health, not to line the billionaires’ pockets through our suffering.
A workers’ government would abolish health insurance. It would nationalize the medical industries and hospital networks, and integrate them into a democratically administered public health provider offering world-class services to all.