Healthcare has been on everyone’s mind recently, and with good reason. With the previous administration’s signature policy achievement, the Affordable Care Act, on the chopping block, the public discourse has turned to what we expect from a healthcare system and the importance of both access to and quality of care. Health and the ability to maintain it is one of the foundations of a society. An ill and dying population is in no position to make decisions that are good for themselves, their government, their culture, the environment, and the future. As such, making access to healthcare subject to the capitalist market and private interest is not only immoral and unethical, but is inefficient. This is why, while we will defend the hugely inadequate status quo that exists with the ACA, as socialists we do this only to demand the next step: full public healthcare, equally accessible to all regardless of income, age, gender, orientation, or immigration status.
Just defending the status quo is bad politics, but worse than that, it’s a dead end. In 2017, after years of ACA implementation, we have 27 million people without health insurance. Over 30 million are underinsured and can’t afford their premiums, so counting them as insured serves only to conceal the reality of the situation. This is unacceptable. Instead of accepting a system designed by the reactionary Heritage Foundation that props up insurance conglomerates like Cigna or Aetna, socialists want to take the beneficial parts of the ACA, such as Medicare expansion, and continue to expand them until we have a universal healthcare system. Dozens of political scientists, pundits, and healthcare specialists have written at length about the economic feasibility of this plan, and all you have to do is look it up if you’re interested. But just know that in the US, we spend more than any other country on healthcare, and our health outcomes are significantly worse than other “developed” countries, many of whom already have universal healthcare. We can do better. We deserve better.
Denying health care to a person is violence. Lack of access to quality care has a real human cost, and that cost is in death, suffering, and pain. If you live under the threat of capitalism, you or your loved ones becoming injured or sick limits your opportunities and your sense of being in the world. Conversely, if you have health, you are more free. You have more life. A system such as capitalism that distributes goods and resources that does not have this goal in mind is immoral.
But for a significant portion of those who not only grudgingly accept capitalism but extol its virtues, what’s appealing about it to them aren’t the things they pretend to appreciate: “it creates wealth” or “it’s free of coercion” or “it’s efficient.” (None of these things are true.) They like capitalism because it punishes “the weak.” People don’t have insurance or don’t have enough insurance or are in crippling debt because they don’t have enough money. This is because they made poor decisions or, honestly, just weren’t born in the right way, as the right class or race or nationality or gender. This is what any argument for private healthcare is: some deserve healthcare and some don’t, and the way we distribute it is through who has money. This gets right to the heart of why the choice we’re faced with is either socialism or barbarism: we can distribute our resources and our opportunities in ways that make us all better, or we can allow capitalism to elevate a few at the expense of the many.