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Issue #1803      November 15, 2017

Taking Issue – Rob Gowland

Medicare or Money Care

It is the mark of a civilised society that it takes care of the health and welfare of its members. The sick and injured, the aged and infirm are looked after by that society’s system of government because it is the humane thing to do. Not to do it would be uncivilised.

Such civilised behaviour, however, runs counter to the basic tenets of capitalism, which is primarily concerned with increasing the profits of a privileged few at the expense of the majority. That privileged few deeply resent any expenditure by government on the care and welfare of the less affluent members of society, regarding it as theft of what is rightfully theirs.

When capitalism was developing and reaching its ascendancy, it needed firstly to build a skilled workforce – so it introduced free universal education – and secondly to allow that workforce to be renewed, so it yielded (reluctantly) to the workers’ struggle for shorter hours and better wages and conditions. Publicly-provided pensions and healthcare were part of that struggle.

In the 19th century, wounded soldiers and sailors who were no longer of use in building up the empire were simply tossed aside, as were the numerous factory workers and mill hands injured in the course of their employment. They were left to beg, dependent on charity or the evil malevolence of the work-house.

As workers combined to defend their interests, they were able to force employers – or their capitalist governments – to provide pensions for the old, the injured and the otherwise dependent. But that was then. Now, capitalism is once again on the offensive, determined to take back all the “benefits” workers won through 200 years of often bitter struggle.

At the same time, they seek to boost corporate profits by slashing company tax, denying governments the wherewithal to pay for social programs and services. Now, capitalist governments protest that they cannot afford to continue paying pensions and other forms of welfare. They tell the workers that they are “living beyond their means”, must accept grim “austerity” measures and must “tighten their belts”.

Modern technology has greatly increased the productivity of labour. Under Capitalism however, that means the system now has many more workers available to it than it has work for. Capitalism no longer has a need to assist workers to renew their labour power. The provision of housing, pensions, unemployment benefits or health care is no longer a priority of the social system.

In a throwback to the 19th century, charities are once again stretched to the limit trying to cope with the number of people unable to feed their families or provide them with shelter. At the same time, capitalist governments, having cut their own income, are desperate to reduce their costs and look to eliminating or privatising social services. And top of their list for privatisation or the chop is health care.

Ever since Medicare was introduced by the Whitlam Labor government, successive Australian governments – Labor as well as Liberal – have been whittling away at it, trying to convince the Australian people to accept the notion that it should be offloaded to private enterprise. Almost alone among developed capitalist countries, the USA has a for-profit health system, and the rest of the world watches in horror as Americans struggle to cope with hideous costs of a trip to hospital or even a visit to the doctor.

Medicare in Australia introduced the concept of bulk billing. When it was introduced it was universal but it has been cut back to the point where now it is becoming hard to find a doctor who bulk bills, certainly one who bulk bills people who are not pensioners.

One of my sons had the unpleasant experience recently of attending a doctor’s practice where bulk bill patients were moved to the back of the queue, with other patients moved in ahead of them. He waited in the surgery’s waiting room for over four hours before he was seen. They made no attempt to disguise what was being done to the queue: instead, it was presented as normal, as right and proper that people who are not being bulk-billed should take precedence.

This is nothing less than the imposition of a two-tier health system, where the well-to-do get treated ahead of the “charity” patients. It is the exact opposite of what Medicare was supposed to be. But we know that both Libs and Labor would like to get rid of Medicare altogether and instead have a US-style for-profit health care system in Australia. Under that type of system, health care is just another opportunity for making money, a fact which appeals strongly to capitalists and the politicians who are in their pockets.

The American documentary film Sicko by Michael Moore contrasted the profit-driven US system with that prevailing in neighbouring Canada, and also with the systems operating in France and Britain. Like the US, all three are also developed capitalist countries but their approach to health care is very different to that of the US.

In the US, a stay in hospital can bankrupt a family. It is now well known that many Americans do not bother to get their doctor’s prescriptions filled for the simple reason that they cannot afford to. Protest demonstrations against the high cost of health care are commonplace. The high cost of health care contrasted with constant government attempts to cut back on health care and related services in order to reduce the cost to the government while constantly increasing military spending has even been the subject of a movie, Article 99 which starred Kiefer Sutherland as a doctor in a veteran’s hospital who discovers that even US war veterans find access to health care a nightmare.

That’s because health care under capitalism is a constant struggle between those concerned with providing an essential service and those whose interest is in making a profit. In Britain, the Tory government is trying to abolish the much-praised National Health Service, introduced after WW2, but public opposition to such a move is fierce.

Capitalists everywhere, however, have their greedy eyes on the provision of health care: it is an essential service and everyone needs it at some stage. As an opportunity for profit-making, it is unparalleled.

In the US, Donald Trump and the far Right of the Republican Party are busy trying to dismantle Obamacare, the very tentative health insurance scheme introduced by his predecessor.

Fortunately, leading Republican John McCain has protested against this policy and thrown his considerable weight behind the retention of Obamacare. This fight is far from over.

Next article – Job cuts and tax dodgers

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