The ruling class is staring down the barrel of a ballooning debt crisis. Federal debt sits at approximately $36.56 trillion and rising. Interest payments have crept higher than the military budget, making up 13% of federal spending, at $881 billion in 2024.

Following World War II, America subsidized Western Europe’s military spending to secure control over the region and use it in their struggle against the Soviet Union. This freed up money for Europeans to develop a strong social safety net.

This wasn’t the case at home. Instead, the government provided tax benefits to companies for providing private health insurance to their employees. The ruling class relied on wages being high enough that a significant layer of the working class could afford to pay insurance premiums and enjoy cheap consumer goods—buying relative class peace.

Vicious austerity is coming

Now the anomalous postwar boom is long gone, importation of cheap consumer goods is under threat, and the national debt is out of control. In the 2008 crisis, the European ruling class launched vicious austerity measures, taking aim at social spending. Eventually, the American ruling class will be forced to make cuts or risk defaulting on its debts—and because there’s not much social spending to begin with, there isn’t much fat to cut.

Take a look at figures from the 2023 federal budget. The top three spending categories, excluding interest payments, were:

• Healthcare, including Medicare and Medicaid, at 24% of the budget
• Social Security at 21%
• So-called “defense” at 13%

Billions are wasted every year on military equipment, which Ted Grant aptly described as “the production of expensive scrap metal.” Money squandered bombing faraway places in the interests of American imperialism could instead be put to socially useful purposes. But the capitalists and their representatives in Congress won’t willingly slash the war machine. Indeed, after promising cuts, Trump and Hegseth want a trillion-dollar military budget this year.

That leaves them with two major targets: healthcare and Social Security. What would serious cuts to Medicare and Social Security look like? Retirement will become a pipedream for even more workers. A NerdWallet report shows that a third of Americans expect to retire exclusively on Social Security—they don’t have any retirement savings. 90% of retirees rely on Medicare. Cuts to these programs mean that more workers will be forced to drag themselves to work until they drop dead. This will also impact the wallets and psychology of younger generations, who have aging relatives. Many young people already can’t see a future under capitalism.

Drowning in medical debt

American workers are already suffocated by medical debt. One in 12 adults have medical debt, but if you take into account medical debt put on credit cards or owed to family members, that figure rises to a whopping 41%.

This debt was amassed even though most Americans have health insurance. Imagine how that number will balloon if millions have their coverage hacked away or yanked entirely? In 2023, Medicare covered an estimated 18.9% of the US population. Medicaid provides health care coverage to one in five Americans—more than 70 million people—including 40% of children and 60% of nursing home residents.

If Medicare and Medicaid are slashed, rural hospitals across the country, which rely heavily on these programs, will go bankrupt and close their doors. This, in a country where medical deserts—places with seriously limited or nonexistent access to medical care—affect 80% of all counties. As a consequence, more workers will die—either because they can’t afford care or they can’t survive the trek to the nearest hospital.

Deep hatred

With Medicare and Medicaid on the chopping block, the question will be posed: how can everyone receive quality healthcare? Interest in a nationalized healthcare service is sure to rise. However, cuts and privatization of such services in Europe show that, even if we win a Medicare-for-all system on a capitalist basis, it will eventually come under attack.

85% of people oppose cutting Medicare, 81% oppose cutting Medicaid, and 79% say Social Security benefits should not be reduced in any way. But this overwhelming public opinion cannot be effectively mobilized without strong working-class organization.

The shooting of Brian Thompson revealed deep hatred for the private healthcare industry. With social explosions on the horizon, there is an urgent need to build the forces of the RCA. A mass movement against austerity must aim its fire against the cause of both the debt crisis and the abysmal state of healthcare in the US: the profit motive, private ownership of the means of production, and the capitalist system as a whole.