In the present situation of bitter recriminations between the Democrats and Republicans over the partial shutdown of the government and the Republican threat of forcing a US government debt default, it is easy to forget what their policies have in common.
Both have intervened to protect the interests of the capitalist class as a whole in the aftermath of the Great Recession at the expense of the working class. This is indisputable given the reality that profits are soaring while real wages are declining. Both parties have implemented policies that cut the social wage for workers.
That said, there are real differences between them. The Republicans have been captured by extreme rightists, who are intent on slashing the social wage drastically, while the Democrats fear this will cause social unrest.
The immediate issue in dispute is the Republican drive to defund the Patient Protection and Affordable Care Act, known as “Obamacare”. The Republicans control the House of Representatives, which is responsible for initiating government spending.
The Republicans refused to approve a budget for the government unless Obamacare was not funded, and threaten to do the same for government borrowing. Obama and the Democrats, who control the Senate, would not agree, so there was a partial shutdown of the government beginning 1 October.
The brunt of the shutdown is being borne by workers, including 800,000 government workers who are laid off and many more who are working without pay. Many millions who rely on social services are facing dire circumstances.
A US default due to a failure of Congress to raise the ceiling on the federal debt would be catastrophic. The deadline when the government would run out of money to pay its debts without taking out further loans is around 17 October.
If the default were allowed to happen, US securities would begin to lose their convertibility to US dollars. This would cause huge banks runs, including in the US. Credit would dry up, interest rates would soar, industrial production would drop and world trade grind down.
This would be a crisis on the scale of 2008 or greater. But this time it would not have been the result of the workings of the capitalist system itself, but of a policy failure.
For this reason such a default is quite unlikely. I won’t say impossible, because capitalist politicians have been known to make irrational decisions.
Obamacare
To understand the issue of Obamacare, we have to look at the state of the US health care system. Martin Wolf, writing in the pro-business British Financial Times, says, “The Republicans are doing all this in order to impede a modest improvement in the worst healthcare system of any high-income country … US spending per head is almost 100 percent more than in Canada and 150 percent more than in the U.K. What does the US get in return? Life expectancy at birth is the lowest [of the imperialist countries], while infant mortality is the highest.”Australia spends 9.3 percent of its GDP on health, about one-half of what the US does, and has a much lower infant mortality rate and higher life expectancy, two universally recognised indicators of the quality of a health care system.
This disparity puts the US at a disadvantage with its imperialist competitors. There are 40 to 50 million people in the US with no health insurance. Obamacare seeks to extend coverage to many of those presently not covered.
The aim is to check runaway medical insurance costs, which would make it easier to hold down workers’ money wages and result in a healthier and more productive workforce.
Obamacare from the beginning excluded national universal government provided health care, like Medicare in Australia.
In fact, the idea behind Obamacare originated in a right wing think tank, the American Heritage Foundation, as an alternative to national health insurance. The idea was to lock in the hold of the private insurance companies.
When Mitt Romney, the Republican presidential candidate in 2012, was governor of Massachusetts, he implemented such a plan. The fact that he ran against his own policy in 2012 is an indication of how far to the right Republicans have moved. An idea originating in a rightist think tank is now denounced by the Republicans as “socialism”.
But it is not only that the Republicans have moved to the far right. In their wake come the Democrats, also moving right but not as far or as fast.
It is ironic, but the day of the partial government shutdown, 1 October, was the day when the major part of Obamacare went into effect. Moreover, because of how it is funded technically, the partial shutdown didn’t affect it.
A quite popular aspect of Obamacare is that the children of insured parents are themselves covered up to age 26. This has already gone into effect. Another popular provision is that insurance companies can no long deny coverage to people who have already existing medical problems.
A major defect in Obamacare is that it relies on employers to provide most medical insurance plans for their employees. This makes it more difficult for workers to change jobs. Moreover, in the current economic situation, employers are looking for ways to cut back on their contributions to employee plans.
The Obamacare law is a bureaucratic mess – more than 2,000 pages, in order to accommodate all the demands of the insurance industry. It won’t work if millions of healthy young Americans don’t sign up for it. That’s why it contains a provision to fine them if they don’t.
The healthy young not covered by their employers must buy private insurance to make the system work because if they don’t, the insurance sharks will raise the cost of insurance for the rest.
There is another problem. While Obamacare will provide subsidies to lower income people to help them buy private insurance, it relies on the states to increase the coverage for the very poor to cover the millions of uninsured in this category, under a program called Medicaid.
The federal government is set to give the states the money to increase Medicaid enough to provide insurance for these people, who are the ones most in need. But in 27 states the Republicans have control of the state governments, and many have rejected the federal funds in order to sabotage Obamacare. These are the states with the greatest extreme poverty rates.
There are all kinds of problems with Obamacare, including different plans with different coverage. In all the private insurance plans that Obamacare rests upon, there are costs that individuals must cough up.
None of these problems would exist with universal Medicare. The profits of the insurance companies, which are pure waste and contribute zero to health care, would be eliminated, and medical costs would go down.
But even with all of its problems, when it became possible beginning 1 October for the uninsured to sign up for Obamacare, millions rushed to do so, and the computer systems broke down. This fact underscores the dire needs not being met in the US medical system.