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Socialists: HCR Will Kill Employer Insurance

From the World Socialist Website:

Trotsky, Lenin, and Kamenev at the second Communist Party Congress in 1919.

Obama advisor champions rationed health care

By Kate Randall
15 September 2009

Ezekiel J. Emanuel is a close advisor to the Obama administration on issues of health care policy. He currently serves as a special advisor on health policy to the director of the White House’s Office of Management and Budget and is the chair of the Department of Bioethics at the Clinical Center of the National Institutes of Health.

He has authored several books, including most recently Healthcare Guaranteed: A Simple, Secure Solution for America, which elaborates his plan for restructuring the US health care system. [1]

In March, Emanuel, a breast oncologist, was appointed to the Federal Coordinating Council for Comparative Effectiveness Research. The 15-member body was authorized by Obama’s American Recovery and Reinvestment Act (ARRA) to provide “information on the relative strengths and weaknesses of various medical interventions” in relation to federal programs.

Obama has pledged to slash more than $600 billion from Medicare and Medicaid as part of his health care plan. Utilizing comparative effectiveness research (CER), this council will recommend cuts—in the form of cost-cutting “efficiencies”—to these federal programs for the elderly, disabled and poor. The cuts are central to Obama’s overhaul of the health care system and are supported by all versions of legislation currently under consideration in Congress.

For decades, efforts to slash Medicare benefits have been frustrated by political opposition, particularly from the working class and senior citizens. The appointment of this body is a thoroughly anti-democratic effort to ride roughshod over this popular opposition to implement deep cuts that will severely impact the health and lives of millions of Americans.

In his advisory capacities, Ezekiel Emanuel—the brother of White House Chief of Staff Rahm Emanuel—has been placed in a strategic position to influence the Obama administration on these policies. An examination of Emanuel’s vision of health care restructuring reveals that Obama’s proposals have been informed by many of its guiding principles. Key among them are the defense of a health system based on private profit and the delivery of class-based, rationed medical care for the majority of Americans.

Opponents of Obama’s health care initiatives have attacked Emanuel for writings in which he advocates rationing care, particularly for the elderly, infants and those with mental or physical disabilities. He argues that this is necessary to ensure access to finite health care resources to what he deems to be more “participating” and productive segments of society.

Many of the attacks on Emanuel have come from the right, including Republicans who are masquerading as defenders of health care for ordinary Americans. However, these right-wing opponents of Obama’s proposals are seizing on aspects of Emanuel’s theories that are, in fact, deeply reactionary.

His recommendations about who will and will not receive certain health care services proceed from the premise that health care must remain subordinated to private profit and that “reform” must be geared to cutting the cost of health care for corporations and the government.

To give some examples, in a piece published in the November-December 1996 Hastings Center Report, Emanuel writes that “services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.” …

In all of these scenarios, Emanuel presents the necessity of rationing as if scarcity of medical services and technologies were a natural occurrence, rather than the result of the organization of society on a capitalist basis.

In reality, there are already vast resources that could be devoted to providing quality health care for all members of society, and all the objective prerequisites for exponentially increasing these resources.

However, in a society where the richest 1 percent controls more of wealth that the bottom 95 percent combined, these resources are squandered in the interest of private profit. Emanuel’s insistence that scarcity is the starting point for social policy is both intellectually dishonest and politically reactionary.

In the Hastings Center Report cited above, Emanuel puts forward what he considers to be the criteria for deciding how health care should be distributed under conditions where it is limited by the workings of the “free-market.” It is instructive to quote his exposition at some length, as it reveals the class basis of his supposedly ethical justification

In other words, the majority of the population would be relegated to a basic minimum level of care, while those with the financial resources would be able to purchase the finest medical services and take advantage of the latest technologies

Emanuel argues that medical services must be restricted for the general population—unless, of course, the individual can pay extra for them

Emanuel supports scrapping the traditional “fee-for-service” payment system, in which health care providers are reimbursed for each patient visit and procedure, and replacing it with a system where doctors and hospitals are compensated for services performed over a period of time. Obama has spoken in favor of phasing out fee-for-service, which would inevitably lead to rationing of care, imposing dollar limits on health care for working people.

In his 2008 book, Healthcare, Guaranteed: A Simple, Secure Solution for America, Emanuel elaborates in more detail the health care system he would like to see implemented—the Guaranteed Healthcare Access Plan.

Under this plan, every citizen would receive a “health care certificate.” This health care coverage would be portable and permanent, would not be dependent upon employment status or pre-existing conditions and would provide an unspecified range of basic benefits.

The plan would be financed through a dedicated 10 percent Value Added Tax, or VAT, on purchases and services. Emanuel claims such a tax is egalitarian. VAT is, in fact, a highly regressive form of taxation, disproportionately effecting lower-income people. Health care expenditures would be capped according to the amount of revenue raised by the VAT, unless Congress authorized an increase in the VAT rate.

Emanuel also calls for an outright end to employer-based health care provision, which would eliminate any responsibility for businesses to provide medical insurance for their employees. Among unionized workers, health care coverage was won in the course of decades of bitter struggle. Emanuel proposes to scrap these benefits and replace them with his universal plan, providing “standard benefits” across the board

Obama’s proposals go a long way toward dismantling employer-provided health care. Under the Senate Finance Committee plan that Obama suggested he would support in his speech to Congress last week, and which is generally considered to be the model for an eventual health care “reform” bill, employers who fail to provide medical insurance, or who eliminate existing coverage, will only be required to pay a nominal penalty (a fraction of the cost of premiums). It will be in companies’ financial interest to pay the fee and drop coverage, giving the lie to Obama’s claims that “if you like your insurance, you can keep it.”

Under Emanuel’s plan, while everyone will have the same “standard” plan, the wealthy would be able to purchase additional care. He justifies this with the following: “We are used to being able to spend our money on what we want. If we want a fancier car, a smaller, faster computer with more memory, or a luxury vacation, we can pay the extra cost for such things and skimp somewhere else if necessary. The key is that it is our decision.” [10]

He calls this the “choice” aspect of his plan. Needless to say, such freedom to choose is not available to the vast majority of working class families, the unemployed and the poor. In fact, under Obama’s plan, a significant portion of the population will likely choose to pay the penalty for being uninsured—at an estimated average of upwards of $1,000—rather than pay the premiums charged by the private insurance companies, because they cannot afford them.

One of the most insidious features of Emanuel’s plan is the proposal to scrap Medicare, Medicaid and the State Children’s Health Insurance Program (SCHIP). He writes: “Current enrollees will have the option of joining the Guaranteed Healthcare Access Plan. Over a period of about fifteen years, these programs will be phased out.” [11] His vision of universal health care therefore eliminates the only government administered health care programs.

Overseeing health care expenditures would be the Institute for Technology and Outcomes Assessment. It would review “research studies and data on the effectiveness and cost of various drugs, devices, diagnostic tests, and new technologies—thus insuring that we spend money only on those healthcare tests and treatments that truly improve the quality and length of life.” [12] This body would decide what treatments would be available to patients on the standard plan and what services are “unnecessary.”

The American ruling class cannot tolerate—under today’s prevailing conditions of economic decline—the principle that all elderly people, regardless of economic status, should be entitled to health care roughly equivalent to that of the rich. Rather, they now demand that health care—like education and other aspects of social life—be placed more directly on a class basis to bring it more in accordance with the vast growth of social inequality and the de facto dictatorship of the financial aristocracy.

While not adopting Emanuel’s Guaranteed Healthcare Access Plan in its entirety, Obama has incorporated its fundamental principles in his proposals. These policies are part of a restructuring of American capitalism and class relations in the US that is taking place under the pretext of addressing the economic crisis—in the case of health care, the necessity to craft “deficit neutral” legislation. Their implementation poses a sharp and permanent lowering of the living standards of the working class.


*Footnotes at link.

For the record, here is how the ‘World Socialists’ describe themselves:

About the World Socialist Web Site

The World Socialist Web Site is published by the International Committee of the Fourth International, the leadership of the of the world socialist movement, the Fourth International founded by Leon Trotsky in 1938.

The WSWS aims to meet the need, felt widely today, for an intelligent appraisal of the problems of contemporary society. It addresses itself to the masses of people who are dissatisfied with the present state of social life, as well as its cynical and reactionary treatment by the establishment media.

Our web site provides a source of political perspective to those troubled by the monstrous level of social inequality, which has produced an ever-widening chasm between the wealthy few and the mass of the world’s people. As great events, from financial crises to eruptions of militarism and war, break up the present state of class relations, the WSWS will provide a political orientation for the growing ranks of working people thrown into struggle…

As we have often noted, they have been hitherto the staunchest supporters of Messrs Obama and Biden.

And we suspect this is just cover fire to make it seem like Mr. Obama’s healthcare reform plans are not nearly as radical as they seem – or might be.

But who can doubt that this would be the next step in the process, once the camel’s nose is under the tent.

Still, there are a few salient points made in the piece, such as:

Obama has pledged to slash more than $600 billion from Medicare and Medicaid as part of his health care plan.


Obama’s proposals go a long way toward dismantling employer-provided health care.


These policies are part of a restructuring of American capitalism and class relations in the US that is taking place under the pretext of addressing the economic crisis—in the case of health care…

Proving that sometimes the truth can be found in the strangest places.

This article was posted by Steve on Tuesday, September 15th, 2009. Comments are currently closed.

6 Responses to “Socialists: HCR Will Kill Employer Insurance”

  1. proreason says:

    Anything strange going on here?

    Conservatives have been savaged in the msm for calling the Moron’s administration fascist and for making comparisons to Communism and National Socialism.

    Why you would almost think that the cabal in the White House is just your normal administration. Nothing strange with that crew, right?

    Well consider this partial list of activities that HAVE NEVER HAPPENED IN OUR COUNTRY BEFORE:
    • A by-design, unaccountable, secret executive branch with 30+ “czars”, of whom none has been vetted by anybody except the White House
    • Overturning settled law by fiat (GM and Chrysler bond-holders contractual rights)
    • Government takeover of private businesses (auto industry, banks)
    • Quadrupling of the National Debt in 6 months (proposed, of course. It hasn’t happened yet)
    • Increase in the portion of the economy controlled by government from mid 20%’s to high 40%’s (if Health Care Destruction is passed)
    • Unauthorized usages of Federal budget (TARP funds, Cash for Clunkers, etc.)
    • Massive unauthorized expansion of the money supply
    • Denigration of this country and its traditions (non-stop in every speech)
    • White House directly attacking private citizens (Rush, Palin, AIG CEO’s, etc.)
    • White House directly attacking dissenters (Fox News, Talk Radio, Tea Parties, 9/12 march, etc.)
    • White House calling political opponents liars
    • White House directly threatening Americans (“call you out”, “hit back with twice the force”, etc.)
    • White House establishing a means to “report” citizens who dissent
    • Blatant political payoffs (Stimulus Bill, 10 billion to unions in Health Destruction bill, billions to Acorn, etc.)
    • Abandonment of traditional allies (WSJ says US is “pushing Israel toward war”)
    • Snubbing of traditional allies (the UK, others)
    • Alignment with 3rd world thug dictators
    • Rejection of a democratic form of in favor of a dictatorship (Nicaragua)
    • Declared intent to negotiate with foreign enemies without pre-conditions
    • A president continually referencing himself instead of the office or the country (50+ times in many speeches)
    • Big Brother media presence (111+ speeches, Pressers, Addresses to Congress, suffocating presence on talk shows)
    • Attacks on the ECONOMIC SYSTEM not just the economy (profits, unfair, greedy)
    • Private iconography

    • proreason says:

      And consider this partial list of activities that HAVE RARELY IF EVER HAPPENED in our country before:
      • Unprecedented corruption at every level of government
      • Unprecedented alliance with an unquestioning press
      • Outright lies (impact of Stimulus, success of the Stimulus, “job losses prevented”, many statements about the Health Care Destruction, many more)
      • Scope and pace of major government action during peacetime
      • Regal actions during a near depression (Date nights, vacations, exorbitant use of Air Force 1, flying chefs to the White House, etc.)
      • Outright irresponsible behavior (Professor Gates, attempt to propagandize children, etc.)
      • Racism (Prof Gates, “cowards”, appointment of black radicals, denigration of Tea Parties, etc.)
      • Two-sided comments (decrying lack of bi-partisenship while issuing blatant partisan attacks, demonization of opponents, obvious word games with policy issues)
      • Witch hunts (CIA, Bush Administration)
      • Release of criminals and terrorists
      • Dismantling of proven methods to protect National Security

    • proreason says:

      And that doesn’t include countless extreme behaviors by this president and administration before and after seizing power:
      • The NYC fly-over
      • Snubbing the heroes of 9/11
      • Appointment of the racist Sotomeyer
      • Inflexibility on every position
      • Allegiance to Saul Alinsky’s methods
      • Adolescent declarations (“I won”)
      • Unfilled formal government posts
      • Adherence to philosophies rejected by a clear majority of Americans (Global Warming, Abortion, scorn for patriotism, opposition to religion, denial of the sanctity of Families, Income Redistribution, “flawed” Constitution)
      • Adherence to an agenda and priorities clearly rejected by a majority of Americans (Fascism, Socialism, Taxes, Income Redistribution, foreign policy, Abortion, Support for Card Check (i.e. NOT secret ballots)
      • The associations (Wright, Ayers, Farrakhan, Van Jones, etc., etc., etc.)
      • Lies about personal history and biography
      • Refusal to release or publish information about his past that is highly relevant to his political philosophy and fitness for office.
      • Refusal to act to prevent Nuclear proliferation
      • Ill-conceived closing of Gitmo

  2. Tater Salad says:

    I do believe that Jimmy Buffet has is right with the video below:


  3. MinnesotaRush says:

    This is another “must see” .. it’s great!!! The good old days!

    http://spinpolitico.com/forum/topics/a-50-year-old-cartoon-from (cut & paste)

  4. Reality Bytes says:

    Wow SG! Love the photo. Who are those community organizers with?

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