Right-wing hysteria has dominated the political debate about health care reform in the US.
The Republican right wing has gained renewed traction with their bizarre claims that public health care would mean “rations care” and “death boards” for the disabled and elderly. Some have even gone as far as to rage against “state-sponsored euthanasia”.
Disturbing reports of assaults, lynching of Obama effigies and even death threats have emerged; one right-winger even brought a gun to a Town Hall meeting in Arizona. This and slogans like “Reclaim America” expose an undercurrent of racism in the protests.
Liberal commentators have pointed to the fact that the protests have been led by known lobbyists for big healthcare corporations. But the protests can’t be purely attributed to this “astroturf” strategy. Obama’s popularity ratings have sunk to their lowest levels since his election.
Lost in this hysteria is the debate over what kind of health care reform is really needed. 
US healthcare is a system in crisis. There is no generally available public care. It is a system dominated by private health insurance companies—whether you receive care or not relies on your ability to pay. The single biggest cause of death in the US is lack of insurance. Even those with coverage have no guarantees; around 20 per cent of Americans with health insurance have been refused the care recommended by their doctors.
As unemployment continues to grow, many will lose the insurance they receive through their jobs. 
Despite being the most expensive system in the world—costs per capita are more than double those of Australia’s health system—it is one of the most inefficient. Over 50 per cent of personal bankruptcies in the US are due to health expenses. As a US registered nurse explained to socialistworker.org:
“People without insurance will wait months, and sometimes years, to be seen for their health problems. When I ask how long someone has had abdominal pain, they will often respond that it has been many months… the profit-driven component of our health care system has given us nothing but overpriced drugs, denied claims and understaffed hospitals. Profit should have no place in health care, any more than it should have in fighting house fires.”
Healthcare is big business—it is worth over $2.4 trillion a year in the US economy and 18 per cent of gross domestic product. Health care companies gave over $90 million in donations to Obama’s election campaign. Getting a better health care system in the US will mean an open challenge to their interests. 
But instead of mobilising his campaign support base to rally for reform, Obama has looked to bipartisanship with the Republicans and health corporations. The result is a plan that will do relatively little to change the situation.
Democrats encouraged industry representatives to help draft bills in an attempt to neutralise opposition. Health insurance companies have used their influence to lobby congressional staffers, and have consequently assured themselves a major role in determining both the problems that health care reform should address and the solutions that are being proposed.

Obama’s plans for health care
The central plank of Obama’s plan is to make it compulsory for all US residents to take out private health insurance—with the government paying the fees of those who could not afford it.
So Obama is guaranteeing the profits of health insurance companies, not undermining them. The costs will by made up by cuts to Medicare, a government program for the elderly. There will still be no restrictions on what companies can charge or price controls on drugs.
Obama originally proposed a “public option”—a public insurance scheme designed to “compete” with private insurers, supposedly to keep them in check. But even this halfway measure looks set to be dropped in the face the right-wing backlash.
Glaringly absent from the debate are the masses that backed up Obama for President. His election campaign was a testament to the desire for change—health care reform was key demand of the movement that brought him to power.
But the fact that Obama’s plan contains no substantial change has not only failed to capture the imagination of the majority of Americans who want government funded health care—it has allowed the right to gain ascendency in the debate. Mobilising that movement in support of health care for all is the only way to pose an effective challenge to the vested interests that want to block change, and to force Obama into real action. By Amy Thomas

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