The Affordable Care Attack

Source: Max Fraser, New Labor Forum, Vol. 23 no. 1, Winter 2014
(subscription required)

“A national health insurance plan on a compulsory basis,” the UAW argued at the end of World War II, “is necessary to provide all of the people with necessary medical care.” The private insurance industry has waged a seventy-years war against such initiatives that has left the United States with the most expensive and least effective health care system of its peer nations. Industry lobbyists have worked overtime convincing American legislators that this wildly costly and inefficient system, which leaves decisions about who receives care to businessmen rather than doctors, is in the public’s best interest, or at least in those legislators’ best electoral interests.

And why not? The market for health care experienced astronomical growth over the second half of the twentieth century: Americans covered by employer-provided medical insurance increased from 3 million to more than 150 million, while their per capita health expenditures grew by more than 2,000 percent. Today, overall spending on health services accounts for roughly 18 percent of GDP—up from less than 4 percent in 1950—and corporate profits in the health sector have swelled to nearly $900 billion annually. In the meantime, health care premiums have increased three times faster than wages over the last decade, even as the number of people denied coverage because of pre-existing medical conditions has grown by nearly 50 percent. In 2007, nearly two-thirds of all household bankruptcies were coming as a result of unaffordable health care costs.

The 2010 Affordable Care Act, otherwise known as “Obamacare,” was supposed to fix all that, by finally installing a version of the comprehensive reform program the UAW had called for in 1945. But from the outset, when the Act was first being formulated, the commercial insurance industry has strategized to guarantee that would not happen. As the January 1, 2014 deadline for the launch of the new state exchanges looms, it is becoming even clearer that Obamacare is a “national health insurance plan on a compulsory basis” that only an insurance company executive could love. In fact, rather than a fix-all, the ACA is beginning to look more like the private insurance industry’s coup de grace. …