Health care under capitalism is not a right, as it should be, but an industry, a lucrative one at that. The quest for profits and the "bottom line" are what drive the decisions of corporations that run hospitals and clinics, produce and distribute drugs, manufacture and sell equipment, and control other aspects of health care. Health insurance, medical visits, emergency room treatment, and home care become enormous bureaucratic exercises where working people are more likely to end up in miles of red tape than with a cure. Nurses and health-care workers have been forced on strike as they resist company attempts -- even by so-called "not-for-profit" corporations -- to increase working hours, decrease staffing levels, and cut wages.

More and more health-care responsibilities get pushed on family, friends, or individual sick people as hospitals push patients out the door in record time, funds for home nursing dry up, and medical facilities, especially in rural areas, are closed down as unprofitable. More and more working people use emergency rooms as the only option for last-resort medical attention as the number of people with no medical insurance remains at persistently high levels.

Officials of HMOs state matter-of-factly that they are withdrawing from the "Medicare market" because government payments have not kept up with rising prices charged by hospitals and other companies. A million more people were left without health insurance each year since 1987 under a bipartisan offensive at the federal and state level. The Clinton administration together with the Republican-controlled Congress deepened the assault by eliminating "welfare as we know it," as the White House proudly claims. Pushed off Aid to Families with Dependent Children, millions of working people were left without health-care coverage.

Combined with these moves, many companies have targeted union health-care and pension plans. Fighting back against such concession demands has been a hallmark of a growing number of strikes by unionists over the past several years.

Rather than leave this as an individual problem or something that local unions have to thrash out with the bosses, the labor movement needs to fight to pose the right to government-financed cradle-to-grave health care as a social question, one that is essential for defending the lives and living conditions of all. Labor can take the lead in combating the ruling-class "solution" of imposing on the individual family the responsibility for social services that should be taken care of by society--care of the young, the elderly, the sick and disabled. Such a fight can also push aside the practice, grown up with the agreement of the labor officialdom over the past decades, of tying health-care plans to the profitability of individual employers. This avoided a fight against the capitalist rulers to demand health care for all in exchange for "fringe benefits" and individual retirement plans for some -- benefits that then came under attack when the "good times" ended.

Ninety miles from the shores of the United States, the people of Cuba have set an example of social solidarity and demonstrated the capacities of humanity. By making a socialist revolution, workers and farmers in Cuba have shown it is possible for even a relatively poor and underdeveloped country to make health care, education, and care of the young, elderly, and disabled a universal right. Life expectancy, levels of child mortality, incidences of death through lack of basic medical services rival the most economically advanced countries in the world.

The worries and hassles of forms, insurance, and other obstacles have been replaced with neighborhood clinics staffed by doctors and nurses and medical personnel who are in the profession to make people well, not to make a buck. Consistent with the proletarian internationalist course of the revolution, these conquests are not jealously guarded as a scarce resource available only to the Cuban people. Instead, Cuba has sent doctors and nurses around the world, and has opened its schools and facilities to treat people and train doctors from Latin America, Africa, Asia, and elsewhere.

This contrast with the coarseness and brutality facing working people under capitalism has to do with the different priorities and values of different classes. The capitalists who rule this country demonstrate daily that they are beneath nothing in their quest to ensure that they appropriate every bit of wealth for themselves that they can, regardless of the cost to the lives of human beings. On the other hand, the only class interests that workers and farmers have is to make the fruits produced by their social labor, the only source of wealth, available to all.
 
 
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