By Larry Stavinoha for Paste Magazine. Photo by Getty.
So why aren’t Democrats fighting?
Bipartisanship. This was and is the buzzword among US politicians in the lead up to, and in the wake of, the failure of the Republicans in the Senate to pass an Obamacare repeal. While the people have taken to the streets not just to prevent the Republican rollback on healthcare rights but to organize for Medicare for All—doing everything from canvassing their cities to protesting in the offices of their elected so-called “representatives,” risking arrest and police brutality for the very right to live—the political class and their defenders have continued to argue that the answer is to save the ACA and not go one step further. That even after the ACA has ostensibly been saved (at least for now) from complete repeal by the Republicans, the only thing left to do is “market stabilization,” and to lower premiums here and there.
The Center for American Progress put forth a bill for an “improved” ACA touting its bipartisan appeal. Bipartisanship was the theme of McCain’s widely-praised (yet hypocritical) speech about the disorder and secrecy that’s marked Mitch McConnell’s Senate. Indeed, the speech earned praise from American punditry for its appeal to an imagined senatorial dignity that comes from bipartisanship. Bipartisanship was at the heart of Nancy Pelosi’s recent letter to McConnell that Democrats are willing to work with Republicans on a new healthcare plan, barring certain exemptions. And bipartisanship has been the repeated rallying cry of the man who was almost Vice President, Tim Kaine:
RT if you want Senate Republicans to start over and work with Democrats on a bipartisan plan to improve the health care system
— Senator Tim Kaine (@timkaine) July 11, 2017
The end result for Americans under #TrumpCare: higher costs, less care. We should be working on bipartisan fixes to bring down costs
— Senator Tim Kaine (@timkaine) July 16, 2017
Senate Democrats and Republicans have already rejected three versions of ACA repeal because it would harm millions of people
— Senator Tim Kaine (@timkaine) July 31, 2017
Invocations of this word conjure up images of Senators “putting aside” politics and rolling up their sleeves to work on “common sense” solutions to the problems that face the country. A word that is meant to convey a view of serious adults rising above differences to find the “pragmatic” middle ground is instead nothing more than expression of bourgeoisie class solidarity. Republicans like McCain and Democrats like Tim Kaine can come together to talk about healthcare solutions they would agree on because they share a class interest: the preservation of the private insurance industry and profit motive. Bipartisanship in this context is not a solution to the problem of American healthcare, but a direct attack on the interests of the vast majority of Americans.
While there may not (yet) be bipartisanship in action on the healthcare debate, there is a kind of bipartisanship of theory. Whether it’s an email from Ted Cruz to supporters promising that despite the failure of the latest Senate effort, he is still committed to “fixing the massive failings of Obamacare,” or Senate Minority Leader Chuck Schumer’s call to fix Obamacare in a “bipartisan way,” representatives of both parties can’t stop saying the word “fix.” This in-and-of-itself is not necessarily damning—after all, one could argue that the creation of a Medicare for All system, or ideally a complete nationalization of the healthcare industry, would “fix” problems in healthcare. But the Democratic Party, at the level of leadership and organizational messaging, is not seriously proposing either solution (the absence of any concession towards the growing Medicare-for-All movement from the “Better Deal” was noticeable).
What makes the cross-party talk of fixing Obamacare damning (and an expression of bourgeois class solidarity) is that these fixes concede 1) that the best basis for American healthcare coverage lies with the insurance industry, and 2) that if the markets perform “correctly,” the existing problems with American healthcare will resolve themselves. Politicians often talk about the access to affordable healthcare. This is a distinct position from saying that people have the right to healthcare—full stop—to begin with. The unspoken assumption about calls to “fix” Obamacare is the preservation of profit for private insurers. In this formulation, the capitalist right to profit supersedes the right to healthcare!
This is ultimately the basis on which any imagined bipartisan healthcare plan would be founded upon. This too is the basis on which Obamacare was founded—at a time when the Democratic party had the chance, they passed what was not a universal healthcare program but a program specifically designed to protect and maintain a private insurance industry. The bipartisan healthcare plan that consumes the imagination of CAP, Schumer et. al. already exists—it was Obamacare. For the good this plan entailed, such as coverage for pre-existing conditions, it still left 27 million uninsured and, by not taking on the insurance companies, continues to leave the healthcare of millions of Americans up to the profit motive. Simply having insurance through Obamacare was not the same as actually being able to use those plans.
And now the failed Republican healthcare plan, rightly characterized as eugenic in nature, has stripped away this “human face” on the system and exposed it for what it is. It cannot be coherently argued that those without healthcare under Obamacare are deserving of their fate while those millions more who would be without under McConnell’s are not. It was important to beat the Republican repeal effort, and it’s good that it is (at least for now) defeated. Going forward, it must be acknowledged that in the wake of the Republican plan, the rhetorical middle-ground has been obliterated. Either everyone deserves healthcare or insurance companies deserve their profit. It is life or social murder. Bipartisan reforms to Obamacare alone concede that the latter will continue.
Bipartisanship and Rightward Drift
Not only are the pleas for a bipartisan solution an attempt to turn the clock back to a time when this lie was acceptable in mainstream discourse; they are a concession that the existing system will have to move further rightwards to survive. Mitch McConnell and Paul Ryan—the latter of whom spent his college years dreaming of gutting the social safety net—are not imagining dramatic expansion of Medicare when those in D.C. talk about “bipartisan” solutions.
With healthcare, as with other aspects of American political life, bipartisanship would be the watchword of yet another rightward drift. The great projects of bipartisanship in the last century have included a disastrous war on terror and an Iraqi death toll that reaches over one million, by some estimates. Hailed as the only adult solution to the problems of governance, bipartisanship has left only misery and death in its wake. The terms of bipartisanship in the US are not currently set by the left, they are not even set by the center-left, but by the right. Time and again it has been bipartisanship that’s protected the profits of everyone from military contractors to insurance companies. But perhaps this is not surprising. In a congress of millionaires, class solidarity is the only rational position for them to take.
When the letter from Pelosi to McConnel was made public, there was a justifiable outrage in some activist circles. At the moment when Republicans were weakest on the issue, the leadership of the Democratic party was only going to make modest and conciliatory demands about “the stability of the marketplaces.” The backlash from the self-described wonks and party hacks was quick—those critical of the move for a bipartisan solution didn’t understand healthcare, stabilizing the markets is a reasonable and necessary goal for the system. But this misunderstands what activists, and indeed the majority of the people, are demanding. The demand is not for a stable market for private insurers to sell “affordable” plans—it’s for universal healthcare!