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May 09th, 2013

5/9/2013

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GET INVOLVED WITH YOUR STATE'S UNIVERSAL HEALTH CARE MOVEMENT....WE NEED NATIONAL HEALTH CARE TO CORRECT THIS PRIVATIZATION PUSH!!!


Third Way democrats pushed health care reform to the front not to make it more affordable as the bill would have you believe, but to make it more profitable. That's why insurance mandates and co-pays that keep people from accessing care are front and center in the reform. Entitlements have been gutted even as you listen to your Third Way corporate democrats pretend to be fighting for them. Medicaid is gone....it is now a public health program and Medicare is heading that way as seniors become poorer because of the massive corporate fraud and ever declining Social Security. They can't afford access. THAT IS THE POINT TO HEALTH CARE REFORM.

RUN AND VOTE FOR LABOR AND JUSTICE NEXT ELECTIONS....WE CAN REVERSE THESE POLICIES!!



Regarding health care reform in Maryland and the US:

As you read what is just this month's snapshot of health care in Maryland remember this......health care fraud, especially entitlement fraud has taken almost half of entitlement expenditures for these few decades.....trillions of dollars that need to come back to the Trusts. Payroll taxes that fund SS and entitlements have been sent to the Treasury rather than the Trusts and need to come back to the Trusts....trillions of dollars. Corporations have illegally categorized workers as 'independent contractors' to shed payroll deduction requirements for these few decades involving tens of millions of workers......losses of trillions of dollars to health care Trusts. THE RECURRING THEME.....WE NEED TO RECOVER TRILLIONS OF DOLLARS...PERHAPS TENS OF TRILLIONS BACK TO THE HEALTH CARE TRUSTS AND GOVERNMENT COFFERS TO FULLY FUND HEALTH CARE.

THERE IS NOT HEALTH CARE COST CRISIS.....WE ONLY HAVE CROOKED LEADERS IN OUR JUSTICE AND THIRD WAY CORPORATE POLICY AGENCIES!!!

Here are just a few disturbing facts I collect as I talk to Maryland citizens about health care:

1) Just with one hospital chain....the fastest growing Med Star and just these past few weeks I hear stories

of patients near death from after-infections from surgical procedures as cost-cutting compromises sterile environments.

patients being treated as in third world clinics when they come in with Medicaid or are uninsured. Setting serious bone fractures and dislocated joints without Xrays and suspension of blood tests so as to protect these departments from financial losses with no ability for followup at Medstar. Using surgery techniques of installing metal plates on fractures that do not meet the guidelines for surgery... (think heart stints).

patients rushed out on discharge when not stable, whether a patient is still compromised by anesthesia (get a home health care person they are told) or a new mother that dies from a botched delivery that leaves placenta in the womb sent home too early for observation.

parents distressed that the school dental program and the community child dentistry businesses are doing copious and needless procedures 'just to bill for them'. Indeed, I spent all last year writing and publicly admonishing health department officials over the presence of these national dental chains that are charged across the country for fraud and malfeasance.....but I only get the usual retort in Maryland.....THERE IS NO FRAUD AND MALFEASANCE!

patients who are now denied cancer treatment and other chronic illness treatments as a result of being sent to the Maryland Insurance Plan are dying simply from lack of access to care.

hospitals are now calling the state out on cuts to government payments to hospitals that will have labor and quality of service greatly compromised. Already hospital employees just like Federal employees and teachers are seeing their middle-class wages and benefits starved from year to year.


VOTE YOUR THIRD WAY CORPORATE DEMOCRAT OUT OF OFFICE!!!!
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Let's remember that this policy to lessen SS payments coincides with Medicare funding cuts that move more costs to seniors who then can't afford care.  It is a back-door way to end entitlements for most!



AFL-CIO Now

'Chained CPI Not a Tweak: It’s a Cut to Social Security,' Alliance Members Tell Congress

05/08/2013

Mike Hall

After Medicare deductions, Marty Alvarado has about $950 left in her monthly Social Security check. The Alliance for Retired Americans members from Dallas told a Capitol Hill Hands Off Social Security summit of Alliance members, lawmakers, senior activists and Social Security advocates:

As you might imagine that’s very difficult to live on. I cannot afford to lose any of my benefits due to the chained CPI cut in benefits. This is especially important to me as a woman. Women represent 57% of all Social Security beneficiaries. Chained CPI would hit female beneficiaries especially hard because we tend to live longer.

Click here to see full coverage of the summit by WeActRadio DC.

Chained CPI would change the way cost-of-living adjustments are calculated for Social Security, veterans and other federal benefits. Sen. Bernie Sanders (I-Vt.) told the summit that Republicans and some Democrats have described chained CPI as “a minor tweak.” But, he said:

Let’s be clear: for millions of seniors living on fixed incomes and disabled veterans, the chained CPI is not a minor tweak. It is a significant benefit cut that will make it harder for permanently disabled veterans and the elderly to make ends meet.

Alliance Executive Director Ed Coyle said that a study by the group Social Security Works shows that under this proposal someone retiring at age 65 would lose nearly $5,000 in benefits by age 75. By age 85, they would lose almost $10,000. If they lived until 95, they would lose more than $15,000.

The average Social Security check is only slightly more than $1,000 per month. For many retirees, this is their only source of income. I can’t imagine how seniors could get by on anything less.


Alliance members also spoke out against proposed changes to Medicare, including raising the eligibility age. Jody Weinrich is a 63-year-old retired garment worker who receives about $800 a month in Social Security and $105 from a small pension.

Every month, I spend $500 on health insurance—well over half of my monthly income. I barely have any money to cover my other expenses. The biggest thing that gives me hope is that in a year and a half, when I turn 65, I will finally be eligible for Medicare. For me and the millions of other Americans in similar circumstances, raising the Medicare age to 67 would be a disaster.

After the summit, Alliance members visited lawmakers’ offices and urged them to support Senate and House resolutions to protect Social Security, Medicare, Medicaid and veterans' benefits.




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Make no mistake, defunding hospitals is a back-door intent of limiting access and lowering labor costs rather than funding health care with universal health care that will set health care fees and with recovery of trillions of dollars in health fraud.  THESE TWO POLICIES ARE THE DEMOCRATIC APPROACH TO HEALTH CARE REFORM.  THE AFFORDABLE CARE ACT DOES THE OPPOSITE.

Maryland health reform is driven by Johns Hopkins and their intent is to grow global health institutions that make billions in profit at the expense of patient access.  THIS IS A POLICY!




Md. hospitals say rate vote means jobs cuts Decision comes after state commission votes against increasing hospital rates
  • By Andrea K. Walker, The Baltimore Sun 11:41 a.m. EDT, May 2, 2013



Maryland hospitals said they will need to cut jobs and patient services after a state panel voted Wednesday to keep hospital rates flat, despite a 2 percent cut in Medicare payments required by federal sequestration.

"There are significant job cuts literally on the near-term horizon," Robert A. Chrencik, CEO of the University of Maryland Medical System told commissioners during a hearing before the vote. "I think folks need to be aware of that."

The 5-1 vote by the Health Services Cost Review Commission, which sets the state's hospital rates, effectively forces the hospitals to absorb the cut in Medicare reimbursement at a time when hospital margins are razor-thin. Hospital representatives who filled a hearing room to lobby for a rate increase criticized the decision, saying it will further hurt the already financially strapped industry.

Hospitals sought a rate increase for the remainder of the 2013 fiscal year, which ends June 30, to help offset the Medicare cuts. Now, the state's hospitals will collectively lose about $7 million to $8 million a month in April, May and June, the commission estimated.

The Maryland Hospital Association released a report Friday that said 1,450 Maryland jobs would be lost for every 1 percent drop in total hospital revenue. The job losses would come from hospitals and from firms related to the hospital industry. Hospitals in Maryland employ nearly 100,000 people, according to the report.

Chrencik, who said after the vote that he was "disappointed" in the decision, predicted a failure to increase rates also could affect hospitals' access to capital and hurt their ability to fund community services.

He also said access to care could be harmed. Many hospitals have already cut services because hospital rate increases have not kept pace with inflation, hospital executives said. For example, the University of Maryland system cut the obstetrics program at its Chester River Health System in eastern Maryland.

"People are now traveling a longer distance to get routine obstetrics care," Chrencik said. "The economics of that just weren't feasible."

The Medicare cuts are part of the $85 billion in across-the-board federal spending reductions known as sequestration. The U.S. Department of Health and Human Services plans to cut $15.5 billion under the plan, with much of it coming from Medicare.

Medicare patients will not face reductions in benefits under sequestration. Instead, the federal government specifies that cuts should be made to payments to hospitals and doctors and to monthly payments made to private plans that administer parts of Medicare.

Commissioners said they will account for the impact of sequestration as they decide hospital rates for fiscal year 2014, starting July 1. They added a provision to their decision Wednesday requiring the commission staff to develop a proposal on new rates in the next 30 days. That provided little comfort to the hospital industry, which worried that commissioners might lose sight of the Medicare cuts as they debate new rates.

"It's possible the sequestration gets lost in the breadth of the larger discussion," said Carmela Coyle, president and CEO of the state hospital association, which represents 46 acute-care hospitals in the state.

Commissioners said they sympathized with the hospitals' concerns, but felt other issues outweighed them.

Specifically, they worried how raising rates would affect the state's Medicare waiver, an agreement with the federal government unique to Maryland that allows the state to set hospital rates. Insurers, including CareFirst BlueCross BlueShield and UnitedHealthcare, also favored keeping rates flat because of the waiver.

The state must pass a test to maintain the waiver. Maryland keeps the waiver if its average cost per hospital admission rises no faster than in other states. The state, which is in the process of negotiating a new waiver test with the federal government, worried that a rate increase might disrupt those talks.

"I think we should keep our eye on the bigger ball, which is retention of the waiver," said Dr. Bernadette C. Loftus, a commission member who is also associate executive director of the Permanente Medical Group.

Thomas R. Mullen, president and CEO of Mercy Medical Center in Baltimore, was the only commissioner to vote against keeping rates flat. He said the option of increasing rates 0.16 percent for three months was small enough that the commission should consider implementing it, given the financial condition of hospitals.

"Putting in something for three months … would not be a deal breaker," he said.

Maintaining hospital rates was one of three options considered by the commission staff. The option supported by hospitals would have treated revenue lost from sequestration as a one-time "unusual expense," and rates would have risen to compensate. Hospital rates would have increased 0.16 percent for the last three months of the fiscal year.

Another plan would have split the impact between insurers and hospitals. Half of the sequestered revenue would have been treated as a one-time expense and hospitals would have gotten a 0.08 percent increase in rates until the end of the fiscal year.

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Here in Maryland and especially Baltimore we are seeing the same massive fraud in dental care as is happening across the country.  It is happening with the schools dentistry being sent to our public schools for goodness sake.  I have notified the State Health and Hygiene executives personally, I have notified Baltimore City Public health executives personally, I have sent all this information to the Attorney General Gansler and all media and yet, children and the poor are still being abused for purposes of billing fraudulently.

Maryland and Baltimore, all of our democratic politicians support this abuse by their silence!!!


Texas tries to crack down on dental chains that put profits ahead of patients
By David Heathemail 5:12 pm, January 7, 2013 Center for Public Integrity

Kool Smiles in the largest dental chain serving kids on Medicaid, with about 2 million patients. But the chain has been criticized by regulators in three states for allegedly doing unnecessary procedures on children. The company denies this, saying it provides quality care to children in need. Frontline Slideshow: High costs of dental care 1234567891011 There are 43 million American kids eligible for Medicaid or similar coverage, but finding a dentist willing to accept the program’s lower rates for dental care can be tough. 

Frontline

Dollars and Dentists Dental care can be a matter of life and death. Yet millions of Americans can’t afford a visit to the dentist. FRONTLINE and the Center for Public Integrity investigate the flaws in our dental system and nascent proposals to fix them.

A leading Republican in the Texas legislature, who says she’s outraged by allegations that corporate dental chains put profits ahead of patients, has introduced a bill that would allow the state to regulate chains and forbid them from forcing dentists to meet revenue quotas.

A joint investigation by the Center for Public Integrity and PBS Frontline last summer found that two of the largest dental chains owned by private-equity firms, Aspen Dental Management and Kool Smiles, put pressure on its dentists to meet production goals, prompting complaints of overbilling and unnecessary treatments.

Both companies deny this. And a coalition of dental chains in Texas contends that their dentists have total control over patient care. But the chief sponsor of the bill remains skeptical.

“Several reports, including the Frontline program, have uncovered outrageous activities involving the illegal enticement of patients, especially among our Medicaid providers and often involving dental service organizations,” said Republican Sen. Jane Nelson, who chairs the Senate’s Health & Human Services committee.

Nelson did not name a specific chain. Aspen Dental does not accept Medicaid and has no offices in Texas. But Kool Smiles has clinics throughout Texas, and public records show that the state Attorney General has been investigating Kool Smiles for Medicaid fraud.

Texas has been embroiled in a Medicaid fraud scandal for the past couple of years. The initial focus was on overbilling Medicaid for unnecessary braces on children. But the scandal has since widened. State authorities said last October that beyond braces, they’ve identified 89 dental providers they suspect of overbilling Medicaid by $154 million.

The state hasn’t identified those providers, but a spokeswoman for the state Health and Human Services Commission said that because chains bill Medicaid the most, they were more likely to be scrutinized.

Most states outlaw anyone but a dentist from owning a dental clinic. Corporate dental chains are often owned by private-equity firms, but they contend that dentists own the actual practice. The chains say they merely provide those owner dentists services under contract.

But in many cases, the chains open the clinics, own the equipment, hire the dentists, employ the staff, and control the business strategy, which might include specializing in dentures or Medicaid patients. And our investigation found that Aspen Dental and Kool Smiles set revenue targets for each clinic.

The push to boost corporate profits has led to allegations that dentists are pressured to bill more than they might otherwise. Regulators in Georgia, Connecticut and Massachusetts concluded that dentists at Kool Smiles were routinely doing unnecessary procedures, including using  more expensive stainless steel crowns on cavities when a simple filling would do.

The executive director of the Texas dental board, Glenn Parker, wrote legislators last October that he had no power to monitor chains to assure that dentists were free to treat patients as they saw fit.

“The dental board and staff are aware of the many media stories concerning the allegations of Medicaid fraud and patient abuse,” Parker wrote. “We are appalled by stories indicating that some dentists have over-treated young patients by placing unnecessary crowns, fillings or braces on those children.”

Nelson’s bill would require dental chains to register with the Texas State Board of Dental Examiners and forbid them from influencing treatments or setting quotas for a particular dental procedure.

The Texas Coalition of Dental Support Organizations, recently formed by a group of dental chains, opposes new regulation, saying laws on the books are already adequate.

“It is a felony to practice dentistry without a license, including by influencing, controlling or interfering with a dentist’s professional judgment,” the group says on its Web site. “The Attorney General is specifically empowered to prosecute violators of the Texas dental statutes and bring the full force of law down on anyone who would endanger patient safety by attempting to interfere with dentists’ clinical judgment or by practicing dentistry without a license.”

But without some way to track dental chain’s behavior, the Attorney General has no way of knowing whether they may be interfering in patient care, said Dr. Richard Black, an El Paso orthodontist who handles legislative matters for the Texas Dental Association. The state dental association supports the bill.

“There’s nothing sinister about this. We’re not interested in punishing anybody,” he said. “If they feel that they are doing everything exactly right then I don’t think they should feel at all put out by registering and being part of our state system.”


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IF YOU LOOK AT MASSACHUSETTS, THE STATE THAT MODELED THE AFFORDABLE CARE ACT, THE COVERAGE FOR CITIZENS IS TIERED TO A GREAT DEGREE.  MOST PEOPLE FALL INTO THE CATEGORY OF INSURED SO MINIMALLY AS TO BE FORCED TO AVOID HEALTH CARE....WHICH IS THE POINT.

Whether state insurance, medicaid, or high-deductibles 80% of people can no longer access the level of care we all did just a few years ago.  You know how catastrophic auto coverage works....well, there is far less likelihood of dying from and auto accident then having a health incident.......AND CATASTROPHIC HEALTH COVERAGE IS WHAT MOST PEOPLE ARE CHOOSING BECAUSE THEY CANNOT AFFORD PRIVATE INSURANCE.
  All of this is why financial analysts have declared health institutions as profitable as ever......THE AFFORDABLE CARE ACT AND THIRD WAY DEMOCRATS!!



Many opt for high-deductible health plans despite risks Plans offering low monthly premiums but requiring high upfront payments when care is needed can be a poor choice for those without a lot of cash on hand.

To save money, Alice Marie Francis of Burbank opted for a high-deductible plan and uses the Web to help in her care. “I self-diagnose all the time,” she said. (Lawrence K. Ho, Los Angeles Times / May 2, 2013)

By Lisa Zamosky May 5, 2013

Alice Marie Francis believes it's important to have health insurance, but finding a plan that fit her budget was no easy task. "Money is tight," says the 50-year-old Burbank mother of two, whose children are insured by their father's work-based policy.

To make sure she had coverage that didn't break the bank, she opted for a high-deductible health plan — an increasingly popular option with lower monthly premiums but high upfront costs before most insurance payments kick in.

High-deductible plans are typically recommended for younger policyholders who are in good health and have less need for doctor visits and prescription drugs, and for people with incomes high enough to cover the cost of routine medical care.

But patients like Francis opt for it anyway, despite the risks. She pays just $123 a month, but if she gets sick she'll have to shell out $3,300 to meet her deductible before insurance helps her pay the bills.

As a result, Francis says she does whatever she can to avoid the doctor. "I ensure that I take very good care of myself," she says.

For people like Francis who don't have a lot of cash on hand, these policies can be a poor choice. Often, they hesitate to seek care when they become ill or injured.


Be careful if you move to a higher-deductible plan from one with a lower deductible, says Linda Blumberg, an economist and senior fellow at the Urban Institute, a Washington think tank.

"You've got to be putting away money as you go along so if something bad happens you're prepared and you're not in a situation where you can't access the care you need."

For Francis — and others with high-deductible policies — experts have plenty of advice on ways to access needed medical care and manage costs. It's advice that can benefit everyone.

•Know your plan. Francis hasn't had a mammogram or a routine checkup in years. She didn't realize that despite her $3,300 deductible, she can get many preventive services at no cost.

"There is a required list of preventative services that have to be free under the Affordable Care Act," says Cheryl Fish-Parcham, deputy director of health policy for Families USA, a healthcare advocacy organization in Washington. You can see the full list of covered services at HealthCare.gov.

Blumberg of the Urban Institute also suggests taking time to understand other basics of your plan, such as what services are included and excluded from coverage, and which doctors and hospitals are in the insurer's provider network.

"Get as much information as you can about what services count toward the deductible and what counts toward out-of-pocket maximums," she says.

•Stay in network. Getting care from your insurer's network of doctors, clinics and hospitals will be less expensive than care received outside the network.

"Most of the time when you go to a physician or hospital in network, the cost of that service, while subject to a deductible, will still be at a discounted rate," says Martin Rosen, an executive vice president of Health Advocate, a patient advocacy organization based in Plymouth Meeting, Pa.

•Sign up for a health savings account to set aside money for medical expenses. These HSAs are investment accounts that can be opened by anyone enrolled in a qualified health insurance plan. For 2013, a single person can sock away as much as $3,250 annually and a family can set aside as much as $6,450. If you're 55 or older, you're allowed to kick in an additional $1,000 each year.

The money you deposit goes in as a before-tax contribution and, as with a 401(k) account, accumulates tax free from year to year. The money can also be withdrawn tax free as long as it's spent on qualified healthcare costs, such as dental care, doctor and hospital visits, eyeglasses and prescription drugs. Check out IRS Publication 502 for a list of qualified expenses.

•Shop for the best price and negotiate. The prices of medical procedures vary widely from one healthcare provider to another, even among those contracted with the same insurance company. For example, a study conducted last year for Catalyst for Payment Reform, a nonprofit organization working to improve how health services are paid for, found that the price for colonoscopies varied from one provider to another by as much as 1,000%.

For that reason it pays to shop around. Though healthcare prices are notoriously hard to pin down, Rosen suggests starting with a ballpark figure and then negotiating with providers, especially for elective procedures. Most health insurers offer a price comparison tool, as do many employers. In addition, websites such as FairHealthConsumer.org enable you to estimate potential costs for medical care in your area.

Francis still relies on her own methods for maintaining her health and saving money.

"I self-diagnose all the time," she says. "The Internet is my best friend."

business@latimes.com

Zamosky writes about healthcare and health insurance.


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AS THIRD WAY PRETEND TO BE PROTECTING ENTITLEMENTS AND SOCIAL SECURITY EACH BILL THAT COMES FROM CONGRESS AND EACH BUDGET CUT IS SLOWLY KILLING ALL THESE PROGRAMS.
The drive to dismantle Medicare

1 April 2013

Following the imposition of “sequestration” budget cuts that will amount to $1.2 trillion over the next decade, Obama and the Republicans are quickly turning their attention to slashing and ultimately dismantling Medicare, the government health insurance program for the elderly in the United States.

The New York Times published an article last week detailing ongoing closed-door negotiations between the Obama administration and congressional Republicans, pointing to broad agreement between the Democrats and Republicans on a deal to cut Medicare costs.

According to the Times, “The president told House Republicans that he was open to combining Medicare’s coverage for hospitals and doctor services. That would create a single deductible that could increase out-of-pocket costs for many future beneficiaries…”

The proposal would have devastating and almost immediate consequences for millions of people. Obama and the Republicans are proposing to merge Medicare Part A, which covers hospital care, and Part B, which covers outpatient care, such as doctor visits, tests and medical procedures.

The deductible for Part A, which is used by only 20 percent of Medicare recipients in a given year, is relatively high, at around $1,200, while the deductible for Part B is intentionally set far lower, at $147, in keeping with the mission of Medicare to enable the elderly to afford the minimum level of medical care required to stay healthy and live longer.

Combining Parts A and B would increase the amount of money that elderly people have to pay for doctor visits, a move that would sharply increase out-of-pocket costs for routine care.


For the ruling class, the structure of the Medicare system is intolerable because the elderly are not “incentivized” to limit treatments and medications. Under the terms of the program, they are able to go to the doctor as many times as they and their doctor feel is necessary, without significant additional expense. Large sections of the bourgeoisie consider this an outrage, because elderly people are spending money to maintain their health that could otherwise be funneled into the stock market portfolios and bank accounts of the financial elite.

In the anodyne words of the Times, echoing the language of the Obama administration, “The goal is to discourage people from seeking unneeded treatments, shrink health spending and offset the costs of a cap on beneficiaries’ total out-of-pocket costs.”

Who determines what treatments are needed or “unneeded,” and on the basis of what criteria? In any rational and humane system, such decisions should be made by individuals and their doctors. Obama, the Times, and both the Republicans and Democrats want such decisions to be dictated by the profit interests of the pharmaceutical and insurance companies.

Those conspiring to impose these changes are well aware that they will shorten the life span and vastly erode the economic conditions and quality of life of the majority of Americans. Medicare “reform” will send older Americans to their graves sooner and reduce the overall life expectancy of working people. That, however, is the desired outcome, as far as the financial aristocracy that really rules America is concerned. Why waste potential profits and bonuses on keeping people alive and relatively healthy who produce no surplus value for the capitalists?

The Times, the chief organ of the liberal establishment, politically and ideologically allied with the Obama administration, has been spearheading the campaign to ration health care and deny treatments to the “mob” ever since Obama took office. For years, the newspaper has been carrying politically motivated and dishonest articles arguing that much of preventative medical care, particularly that received by the elderly, is “unnecessary” and even harmful.

The aim is to create an even more heavily class-based health care system, in which the rich have access to the full panoply of treatments and tests, while workers and the vast majority of elderly people are relegated to substandard care. Obama’s 2010 health care “reform,” presented as a “progressive” measure, was, in fact, a major step in this direction.

Obama is now seeking to present his push to increase Medicare recipients’ out-of-pocket costs as a “compromise” position with the Republicans, who earlier this month put forward a budget that would transform Medicare into a voucher program for the purchase of private insurance. As always, Obama is playing a good-cop/bad-cop routine with the Republicans, seeking to present brutal cuts to vital social programs as a reasonable middle ground.

Behind this dog and pony show, the two parties are agreed on the basic strategy. In the words of Democratic Senator Mark Warner, quoted in the Times, “We don’t really like what [Republican Paul] Ryan has done—premium support—but we want systemic reform.”

The proposals currently under discussion would signal a massive retrogression in the conditions of life for the majority of people in the United States. The implementation of Medicare in 1965, along with the expansion of Social Security benefits, helped to sharply decrease poverty among the elderly, from about 30 percent in 1965 to under 10 percent now.

Even with Medicare and Medicaid (the federal-state health insurance program for the poor) in place, the lack of affordable medical care in the United States is disastrous. Some 45,000 people die every year in the US because they lack access to affordable health care, according to a 2009 study by Harvard Medical School. This is more than those killed by drunk driving and homicide combined. The more than 45 million uninsured people in the United States have a 40 percent higher risk of death than those who are insured.

If the ruling class has its way, the situation will become far worse.

The creation of Medicare and Medicaid in 1965 as part of Johnson’s Great Society program was the last gasp of American liberal reform. These reforms came in response to the mass upsurge of the working class in the 1930s and the ongoing militancy of workers through the ‘50s and ‘60s, together with the explosive upheavals associated with the civil rights movement.

At the time of its creation, progressive public opinion in the United States saw Medicare as the bare minimum in health care, to be rapidly superseded by a system of universal health care, as in Canada and Europe.

For the ruling class, these and other social programs were seen as temporary concessions to be eliminated as soon as possible. The corporate and financial elite is now using the crisis created by the 2008 economic collapse as an opportunity to radically weaken and ultimately dismantle them.

Medicare and Medicaid, far from being beneficent gifts of the US ruling class, were extracted as a result of mass struggles. These struggles, however, were kept within the framework of the profit system and aborted, primarily through their being channeled behind the Democratic Party. This is what has made the past gains of the working class vulnerable to being continually chipped away at and eventually destroyed.

A new mass movement of the working class is the only means for defending what remains of past social gains and extending them to secure the basic social right to quality health care for all. This time, however, the movement must be armed with an independent program in opposition to both parties of big business and the capitalist system they defend.

What is required is the political mobilization of the working class on the basis of a socialist perspective, including the nationalization and public ownership of the banks and corporations and the reorganization of society on the basis of social need, not private profit.

Andre Damon





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    Cindy Walsh is a lifelong political activist and academic living in Baltimore, Maryland.

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