The Worker (Update), May 30, 2014
Published by the Workers Party, USA
P.O. Box 25716, Chicago, IL 60625

Deepening Health Care Crisis

Nationally, our country's health care system is undergoing rapid corporatization.

The restructuring of health care along the lines of managed care puts the drive for corporate profits ahead of the health and well-being of the people. Under managed care, health care providers are paid a fixed premium for each person enrolled. And since the aim of these corporate providers is to maximize profit, the managed care system has a built-in incentive for the provider to minimize the care available. Hospital stays are arbitrarily shortened, referrals to specialists are put off and needed procedures denied.

The government is accelerating this corporatization of health care by increasingly contracting out Medicaid and Medicare recipients to managed care networks. Federal regulations which allow states to opt for mandatory Medicaid managed care without federal waivers, have led many states to privatize Medicaid services and more are expected to follow. So too, Medicare is being privatized with a large percentage of beneficiaries already enrolled in managed care plans. In this way, billions of dollars of public monies, formerly earmarked for the health of the population, are being turned over to the private sector and converted into profits. Privatizing Medicare and Medicaid undermines the entitlement status of these programs, taking the delivery of health care for the poor and elderly out of the public domain. Under managed care, millions of recipients find themselves shunted aside and denied needed services.

With the profit motive in command, hospitals are understaffed because the owners seek to maximize profits by cutting back on employees which in turn endangers the quality of care. There are many disastrous consequences. For example, many emergency medical facilities are already so overcrowded that some patients go untreated while others suffer severe complications as a result of long waits. So too, some hospitals have developed a two-tier delivery system. Private, for-pay patients receive quality care while the under-insured find that vital procedures, access to specialists, follow-up care, etc. are delayed or denied altogether.

The privatization and corporatization of health care across the country confronts the people with a serious challenge. In our country, which has created a modern health care infrastructure, growing numbers of people find themselves paying more and more for health coverage but receiving less care. The "Affordable Health Care Act" will accelerate the process of corporatization as it guarantees a market for health care providers who will continue to have a built-in incentive to minimize the care available in order to maximize profits. Furthermore, more Medicaid and Medicare recipients will be contracted out to managed care networks. And obviously, with the profit motive in command, health care costs will continue to rise.

We say that a fundamental change is needed. We must no longer allow our country's health care infrastructure to be used to maximize profit.

Health care is a right belonging to every human being. We must put our country's vast health care sector in service of the people so that this right is guaranteed, free of charge, for everyone.

Draft Program of the Working Class

The Working Class Must Lead the Way Out of the Crisis and Open the Path for the Progress of Society


1. Capitalism in the U.S. has reached its final stage, the stage of monopoly capitalism and imperialism.

The severity and unresolvable nature of the crisis of the monopoly capitalist system is sharply reflected in the fact that today, even in the periods of so-called economic recovery – that is, during the boom phase of the recurring economic cycles – the capitalist economy is unable to provide jobs for growing numbers of workers, and the capitalists continue to demand wage and benefit concessions from the workers. The program of "increasing the productivity and international competitiveness of U.S. capitalism" is a program for further shifting the burden onto the workers, increasing their exploitation. Reality proves that today, capitalism cannot utilize aspects of the scientific-technological revolution except through the further destruction of the productive forces. This is reflected, for example, in the on-going processes of corporate downsizing and economic restructuring, which are destroying the livelihoods and economic security of tens of millions.

The root problem is that monopoly capitalism has brought to the bursting point the basic contradiction inherent in capitalism (the contradiction between the socialized productive forces and the capitalist social relations based on private ownership of the means of production). Today, the capitalist social relations stand as a roadblock to the development of the productive forces and the all-around progress of society.

The crisis of the monopoly capitalist system in the U.S. is part of the general, world-wide crisis of capitalism. The U.S. monopoly capitalists also seek to escape the crisis by shifting the burden onto the peoples of other countries. This intensifies the contradictions both between U.S. imperialism and the peoples as well as between the U.S. and rival imperialist powers. This is the source of the aggressive U.S. foreign policy and presents the American working class and people, and the peoples of the whole world, with the grave danger of new imperialist wars.

With the unresolvable economic crisis at the base, the monopoly capitalist class is attempting to save itself and its profit-margins by imposing retrogression on the whole of society. This is expressed in the governmental economic program of stripping away any and every guarantee of workers' and people's rights, of sacrificing needed investments in social programs and the well-being of the people in order to rob the people, so as to maintain and increase the profits of the big monopoly groups. The insistence on "free market economics" is really the program of monopoly capital for removing any and every roadblock to its unbridled exploitation of the workers. The demand that every individual must fend for herself or himself is simultaneously the demand that only monopoly capital can make claims on society; it represents the attempt of the capitalist class and its government to deny any concept of social responsibility and to impose the social-Darwinist law of the jungle on society.

Like feudal lords, the monopoly capitalists seek tribute from the whole of society, bringing into sharp relief the question of whether society is going to guarantee the inviolable rights of the people, including, for example, the right to a secure job and livelihood, to education, health care, pensions and so forth, or protect the privileges of the private capitalist owners.

2. In order to fortify the capitalist relations based on exploitation of the working class, the monopolists have entrenched a system of political privilege which insures their domination over the state.

While the formal shell of universal franchise exists, the current system of representative democracy does not place sovereignty with the people themselves but rather with the government, which is free to carry out its policies without regard for the will of the people, and which has placed itself above society, unaccountable to the people.

The system of Party government through which the big political parties are given, in law and in fact, a monopoly over the selection and nomination of candidates for office further guards the political power of the capitalist class, undercutting the right to vote and disenfranchising the people from their right to nominate and select government officials as well as from any direct role in governance.

The real political power resides in the Executive branch of government, including the bureaucracy, the police and military forces under the command of the Executive. This executive power, in the manner of the feudal monarchs, acts as an absolute and arbitrary power over the masses of people and is, in reality, the class power of monopoly capital. This class power stands in irreconcilable opposition to democracy – to rule by the people – and relies, in the final analysis, on violence to maintain the system of private property in the means of production and to impose class exploitation and oppression on the workers and broad masses of people.

3. Thus, while wealth and power accumulate at one pole of the society in the hands of a tiny minority of monopoly capitalists, misery, poverty and powerlessness grow at the other pole amongst the great mass of the society. The working class – the class which has no way to live except to sell its labor-power day in and day out to the capitalist owners – is the special product of modern industry and constitutes the overwhelming majority of the society.

The domination of the capitalist class rests secure only so far and so long as it can maintain competition amongst the workers. But the entire history of the working class shows that it overcomes the competition fostered in its ranks through common organization and collective struggle, coming out as a class for itself to fight for its emancipation. As a class for itself, the working class puts forward its own program, including both immediate and long-range objectives, as the basis for uniting its ranks as well as for leading the whole society out of the crisis of capitalism and onto the path of social progress.

Program of the Working Class

4. The working class, deprived of all private property in the means of production and representing the advanced, socialized productive forces of society, cannot create conditions for its emancipation except by abolishing the system of exploitation of human beings. Thus the program of the working class is for socialism. The socialist economic system, based on the social ownership of the means of production, will insure the uninterrupted development of the productive forces based on a conscious plan which places the well-being of the people at the center.

In order to carry out the socialist transformation of society, the working class and broad masses of people must win the battle for democracy. The current state, which represents the class power of monopoly capital, must be replaced by a new political power which arises from and is wielded by the working class and broad masses of people themselves.

The immediate program of the working class aims at opening the path for the progress of society and creating conditions for the realization of the strategic program.

The immediate program of the working class includes:

Guarantying the Economic and Other Inviolable Rights of the People

Every human being has certain inviolable rights simply by dint of being human, and it is the elementary responsibility of society to provide guarantees for these rights. They include the right to a secure job or livelihood at the highest possible standard commensurate with the level of development of society, the right to comprehensive and free medical care, the right to secure pensions and for retired workers to live in dignity, the right to free and equal education at all levels (including child care and university education), the right to housing, shelter and food.

In addition to these rights which belong to everyone simply by virtue of being human, the workers, women, the youth, senior citizens, and the members of various nationalities all have rights which arise from their position in the society. The people have the right to work and live in a safe and healthy environment. All these rights also must by recognized and guaranteed.

One immediate step in terms of guarantying these rights is for the government to stop bankrupting the public treasury and dislocating the country's economy in order to guarantee privileges for the big capitalists. Instead, the government must make the needed investments in such vital programs as education, health care and so forth.

Democratic Renewal

The working class strives for the democratic renewal of the political process and political system so that the decision-making power is placed in the hands of the people.

The program of democratic renewal demands the abolition of any and all political privileges and the creation of mechanisms which guarantee the masses of the people the right to participate fully and directly in the political process and in governance.

Political parties must be denied the privilege to nominate and select candidates for public office and this right must be returned to the people. The electorate must also retain the right to recall elected officials at any time.

Further, the chasm between the legislative and executive branches of government must be overcome and the arbitrary power of the executive branch must be broken. The entire operation of government must remain under the direct supervision of the people. Any power not expressly delegated by the people to the government remains with the people themselves.

Constituency committees comprising all citizens must be organized in workplaces, communities and wherever the people are concentrated. Such committees will have the right to nominate and select candidates, to hold elected officials accountable, to set the agenda of government, and to participate directly in governance.

The program of democratic renewal recognizes the right to self-determination, up to and including the right to secession, for the Native peoples, the people of Puerto Rico and other oppressed nations.

The program of democratic renewal demands equality – equal rights and duties – for all regardless of race, national origin, sex, etc. This includes the right for all nationalities to develop their own culture,
language, etc. Most importantly, equality means that everyone has the right to participate fully in the political process and governance, to take part as decision-makers in exercising control of their lives.

Democratic Foreign Policy

The working class strives for a democratic foreign policy. The working class demands the immediate withdrawal of all U.S. troops abroad, the withdrawal of the U.S. from all aggressive military pacts and alliances, such as NATO, an end to the militarization of U.S. society and an end to U.S. interference and intervention against other countries in any form – economic, diplomatic, political, military, etc.

A democratic foreign policy demands an end to Big Power interference and intervention against sovereign nations, and the democratization of international relations on the basis of recognizing the inviolable right of every nation to determine its own affairs. Every nation must be recognized as equal.

The working class is an international class. The U.S. working class, while carrying forward its short-term and long-term program, necessarily supports the struggle for emancipation of the workers of all countries.

Strategy, Tactics and Organization

5. In order to carry forward its immediate and long-range program, the working class relies on its own consciousness and organization.

The working class cannot win victory if it allows its movement for emancipation to develop spontaneously, nor can it implement its short-term and long-term program on a haphazard, hit-or-miss, basis. On the contrary, the decisive factor is for the workers to equip themselves with consciousness and organization so that the movement can advance in a planned and systematic way to achieve the aims the workers have set for themselves. In addition, the working class must wage a continuous struggle against the pressure of bourgeois ideology, which is exerted against the workers' movement with the aim of getting the workers to give up their role to lead society out of the crisis and onto the path of progress. The key factor in strengthening the consciousness and organization of the working class is for the workers to build their own political party, the Workers Party.

The Workers Party leads the work of popularizing and elaborating the short-term and long-term program of the working class, taking this program to all sections of the class, as well as to the middle stratum in order to rally it under the leadership of the working class. Elaborating and popularizing the program of the working class involves intensive and extensive theoretical and ideological work. This work is necessary both to continually strengthen the conviction of the workers about the conditions which they must create in order to emancipate themselves, as well as to defeat the attempts of the capitalists to sidetrack the movement.

Uniting the entire working class and rallying the middle stratum behind the program of the working class necessarily requires a struggle against all attempts to create division and competition in the workers' ranks, as well as a struggle to isolate the forces calling for compromise with and reliance on the capitalist class. In other words, the strategy of the working class is based on directing the main blow against the labor aristocracy and the political forces which work to liquidate the class independence of the workers by creating illusions in the capitalist system and the capitalist political parties.

The tactics (methods of struggle), as well as the forms of organization employed by the working class may and do vary depending on various conditions. But, at all times, the tactics and forms of organization are developed in a planned way and with the same aim – the aim of advancing the workers' struggle for their short-term and long-range objectives as embodied in the program.

(from the "Draft Program for the Working Class", published by the Workers Party, U.S.A. on October 30, 1994)

The Struggle Over Health Care

In the U.S., monopoly capital is imposing a thoroughly reactionary, anti-social agenda on the country as a whole – imposing new and more intense forms of exploitation on the workers, slashing social investments in education, in health care, in income-support programs, in Social Security, etc., etc., privatizing the public infrastructure and stripping away any guarantees for the economic and human rights of the people. This anti-social agenda offers no other project or future except putting our entire country at the disposal of the capitalist monopolies.

To impose this agenda on the people, the government rules by the most arbitrary methods and the people are completely excluded from the political power.

The new health care law is an excellent case in point. The so-called "Affordable Health Care Act" keeps the profit motive in health care intact even while putting billions of dollars in taxpayer's monies at the disposal of the insurance companies.

The Democratic and Republican parties imposed this pre-set "solution" on the people. While the Democrats and Republicans put on a show and played a real con game on the public by pretending to "argue" over the agenda, both "sides" of the "debate" remained within the limits set by the needs of monopoly capital.

Thus, the Republicans demanded the all-around privatization of the health care safety net while the Democrats advertised their program of partial privatization not merely as a "lesser evil" but as a real victory for the people. In other words, the Democratic and Republican politicians refused to even discuss the need for fundamental change. Rather the capitalist politicians were determined to protect the for-profit system and to continue to slash social investments in health care.

This pre-set agenda completely excluded the overwhelming majority of the people who remain more concerned than ever about the failure of our country to guarantee comprehensive health care for everyone or to solve the other pressing economic, social and political problems facing the people.

* * * * *

Fundamental reform of our country's health care system is a problem which must be solved. The battle lines are clearly drawn. On one side stand the overwhelming majority of the people demanding their right to health care while, on the other side, the capitalist class and its politicians are blocking the necessary changes and denying the rights of the people.

The people can only claim their right to health care by coming into the political arena on an independent basis and organizing a political struggle which aims at creating a universal, comprehensive and free health care system.

The immediate steps to push forward this struggle include: 1) organizing a big campaign to popularize the right to health care; 2) joining in the many on-going struggles – the contract battles of the workers, the movement of senior citizens and others – which fight to extend health care coverage; and 3) demanding that the government STOP PAYING THE RICH and make all the investments needed to guarantee everyone's right to health care.