The Trump administration and the Republicans in Congress suffered defeat as their proposal to “repeal and replace Obamacare” disintegrated. Historically speaking, a new President has the most momentum in his first 100 days. Trump has been president less than 65 days—with no victories and now a major defeat.
The Republicans withdrew the bill before a vote as they knew it had no chance of passing the House of Representatives. This is a body they control with a 237-193 majority, along with five vacant seats, and all they needed was 216 votes to win! This is an astounding defeat for Trump and it shows that the capitalist crisis has not only split the ruling class as a whole—it has split the Republican Party and their government. Workers and youth must study these events and take advantage of the situation to build the forces of Marxism.
Capitalist austerity and the healthcare industry
The Republicans have claimed for seven years that they wanted to repeal and replace Obamacare, but the problem they faced was that Obamacare was in fact the Republican healthcare plan. Years ago, the Heritage Foundation, a right-wing “think-tank,” drafted a plan with individual health care mandates as an alternative to single-payer health care, which was growing in popularity. Republican Governor Mitt Romney of Massachusetts passed such a bill in 2006. President Obama modeled his national plan on this state plan. Ironically, Romney was his future opponent in the 2012 presidential elections.
Karl Marx explained that capitalism often takes services that were formerly provided free of charge and turns them into commodities. At one time, hospitals were charitable institutions that provided care for the sick as part of a religious duty, not to make money. But there are massive profits to be made in medicine, medical machinery, insurance, and healthcare facilities, including hospitals, treatment centers, and “urgent care” facilities. The problem is that although the population has an expectation to receive care, most people cannot afford the out-of-pocket expenses or to purchase adequate health insurance.
In most of the industrialized capitalist countries, the working class has built mass socialist, communist, and labor parties. During the post-World War II capitalist boom, the working class of these countries forced their ruling classes to provide some form of universal healthcare and to somewhat curb the rapacious healthcare industry.
By contrast, in the US, there is no mass workers’ party, and therefore, no universal healthcare, although many unionized workers received health insurance through their employers. Some non-union employers followed suit as they wanted to keep the unions out of their work places. The Civil Rights and youth movements of the 1960s forced Lyndon Johnson and the Democrats to pass Medicare and Medicaid (known as Medi-Cal in California). Medicare is a single-payer healthcare plan for people 65 years and older. Medicaid is a second-class version of a single-payer health plan for the poor who are not covered by their employer. But reimbursement fees are low and some doctors avoid taking patients with Medicaid and those that do are not usually the “cream of the crop” of the medical profession.
The end of the postwar boom forced big business to aggressively drive down wages and benefits and break the unions. Over time, fewer Americans had healthcare coverage through their employer and were forced to pay a part of this coverage through rising employee premiums, deductibles, and co-pays. Obamacare was above all a colossal handout to the big insurance companies. It did not implement universal, government-sponsored healthcare or eliminate the second-class nature of Medicaid. But it did expand Medicaid coverage and it did provide some subsidies to a part of the population forced to purchase individual policies. More than 70 million people now depend on Medicaid.
Guns versus butter
Capitalism is a system in decline. The ruling class must implement austerity to maintain its decrepit system. The federal government now has a debt of $18 billion—the size of the entire GDP in 2015 and the growth rate of the economy has been low since then. They must pay this debt back with interest, to all the banks and investors who hold bonds.
At the same time, the Trump government wants to spend more on the military, as US imperialism’s power continues to decline, along with a “wall” on the Mexican border. This requires cuts in the federal budget and the repeal and replace plan was seen a way of cutting health insurance subsidies and Medicaid. It was estimated that by 2024, an additional 24 million people would no longer be covered if Trumpcare had passed. In addition, many on Medicaid would have seen their healthcare coverage worsen as the reimbursement to doctors continues to drop. Many Medicaid recipients have longer waits to see a doctor, and when they do see them, the doctor has limited time. Millions would have been deemed “not qualified” for Medicaid coverage. In 2015, the government spent more than $545 billion on Medicaid.
This created a problem for Trump and House Speaker Paul Ryan. On the campaign trail, Trump said he would “easily” repeal Obamacare and replace it with something better and cheaper that would provide healthcare coverage for all, but he refused to provide details. Sections of the working class voted for him on the assumption that Trump’s word was good. But as the facts on this replacement bill started to get out to the public, many Trump voters in West Virginia, Pennsylvania, Kentucky, Wisconsin, and Michigan turned against this. Masses of people went to congressional town meetings in February to show their disapproval—with many congresspeople declining to hold such events, fearing the wrath of the population. The NY Times reported that a recent Quinnipiac poll showed only 17% of Americans approved of Trumpcare, while 56% opposed it. Among self-identified Republicans, only 41% approved of the bill.
Splits among the Republicans
The International Marxist Tendency (IMT) has explained that the crisis of capitalism leads to splits in the ruling class and its parties. The Tories in Britain are split. The traditional French right-wing is also split. The Democratic Party in Italy are coming apart. The US is no exception to this process.
The Republican Party began to split with the rise of the so-called Tea Party, now known in the House of Representatives as the “Freedom Caucus.” The only “freedom” that this caucus supports is the right of capital to exploit workers and destroy the environment. It was the Tea Party ideologues who led to the resignation of former Republican House Speaker John Boehner. Maybe they would like Paul Ryan to now play the role of Julius Caesar, although the ides of March has just passed?
These right-wing fanatics receive large sums of money from the Koch brothers—ironically a family that made money with investments in Stalin’s USSR. These hard liners of the Republican Party want a more draconian bill than Ryan and Trump proposed. They want deeper cuts to subsidies and Medicaid, if not outright elimination of these programs. When Trump began to negotiate with these people, the bill shifted even further to the right and the more “moderate” Republicans began to turn against it. The so-called moderate Republicans are simply the traditional Reaganites who are fearful of losing their seats in the next election. Theoretically, they would love to cut all government spending on social welfare, but then they would not be in Congress any longer—they could see the anger among some of the Republican voters.
Trump and Ryan’s bill also faced pressure from Republican governors who would have had to directly implement the Medicaid cuts, as working class and poor voters in these states were outraged that they would lose coverage. Yet another factor in the defeat is the healthcare industry itself, which reaps huge benefits from government handouts. Many insurance companies did not want cuts in subsidies to those who purchase health care—subsidies that end up going straight into the pockets of the insurance companies as profits.
Even with the help of Vice President Mike Pence, an extreme right-winger, and Trump’s heavily touted negotiating skills—remember his book, The Art of the Deal? — they could not secure enough votes to pass this bill. Given that the Democrats were not about to dismantle the policy they themselves implemented, the split in the Republicans led to this defeat. In the face of such a humiliation, it is unclear whether Paul Ryan will be able to maintain his Speakership, and the eventual fight to replace him will mean even sharper clashes within the Republican camp.
The role of the Democrats
The Democrats celebrated the defeat of the Republicans, but do they deserve credit for this? Within hours of Trump’s election, millions hit the streets in protest. In an unprecedented event, more than 1% of the US population in more than 200 cities protested against Trump the day after he was inaugurated. Then there was a series of protests at the Congressional Town Halls in February. These events show the massive anger from the population against the attacks of Donald Trump and the Republicans. Because of the unwillingness of Bernie Sanders and the labor leaders to break with the Democrats, the Democrats stand to gain from this vacuum.
However, like the Republicans, the Democrats are also a party of the ruling capitalist class. They are also split between the Hillary Clinton and Bernie Sanders wings. The Clinton camp just secured a victory in electing Tom Perez to the DNC Chair position against Congressman Keith Ellison, a Sanders surrogate. When the Democrats are in opposition, they can put forward a more radical face. This mask is put away when they get back into power—and the taste of power is something they can’t resist. After this defeat, Trump held out the proposal that if the Democrats would deal with him, they could “fix Obamacare.” The Democrats may well oblige him—to get some patronage goodies in return.
Historically, the worse austerity is implemented via bipartisanship. The two parties know that if just one party implements austerity, that party takes the blame. This is why they pass austerity under the cover of “compromise”—as if there were no other alternatives but cuts and more cuts. As an example, the last major regressive measures for Social Security were applied during Reagan administration with the help of Democratic House Speaker Tip O’Neil. This is when it was determined that the retirement age would be raised over time. Workers and youth must not fall into this trap. No matter their present posture, the Democrats are not the friends of working people. The working class needs its own party!
Checks and balances or paralysis?
The Constitution of 1789 is a peculiar form of bourgeois government. Most bourgeois democracies have some form of parliamentary government system. In the US, the president is the head of state and the government, i.e., an elected Chief Executive, independent of the legislature. They rely on a majority in the House of Representatives and the Senate to pass legislation. Frequently, the two houses of Congress are divided against each other and the President, who runs the executive branch.
In the past, American capitalism and imperialism was a growing system with massive super profits. This provided the fat to grease the wheels of the system and to make deals between the President and both houses of Congress. But American capitalism is on the decline. The system of checks and balances set up to keep the masses in check has now turned into trench warfare between elements of the ruling class—a state of paralysis—as they don’t have the same material basis to oil the governmental machinery.
Donald Trump, like Obama before him, will see that there are limits to the powers of the Presidency. Trump will likely have similar problems with his “tax reform” proposals. These will likely include some form of import tax, which is heavily opposed by WalMart and the Koch brothers. More and deeper splits among the Republicans are likely.
The crisis of Trump and the Republicans, like the impasse of the Obama years, is really a reflection of the crisis of the capitalist regime. Only the working class and socialism can show a way forward through this nightmare.
Build the revolutionary organization!
Trump has suffered a defeat, but he is still president and the Republicans and Democrats still control Congress. When the class enemy suffers a defeat, the working class should organize its next step forward. We must not lose this opportunity!
The labor leaders have a responsibility to organize meetings in every central labor council around the country to build and mobilize for a massive demonstration on 1st May. A big turnout on May Day would allow the working class to assert its own interests and demands as a class. If this is coordinated with job actions and strikes, it would be that much more effective. Imagine the longshore unions going on strike for May Day. Construction sites and factories closing down for that day. Teachers going on strike and rallying their high school and college students to join the protests. Mass transit workers could agree not to strike as to facilitate the movement of protesters. An appeal should also be made to non-union workers to join this day of action. Such a day would begin to pose the question: who really makes society run? Who should really control society?
The movement for quality, universal healthcare—free at the point of service for all—must be linked with the fight to defend immigrant workers and their families, the fight against austerity, for a higher minimum wage, and the campaign to unionize presently unorganized workers. If the labor leaders take up this fight, Trump, the Republicans, and the Democrats could be defeated quite easily. However, the unwillingness of the labor leaders to adopt class struggle methods means our struggle will be protracted.
Ultimately, these demands can only be secured in a socialist society, with a workers’ government. In order to achieve this, we need to build a revolutionary tendency in the labor movement and among students and youth. This force will battle for a mass socialist party of the working class. The IMT is working on building this force now. One hundred years ago this coming November, the Russian workers took power, sweeping out the capitalists and the landlords. The American working class is a far bigger force than the Russian working class and the US is an industrialized and technologically advanced country. All the material conditions exist to provide housing, education, healthcare, and much more for everyone. Join the IMT and help us make this a reality!