The health care system and the war against the working class

 

By Steve Halpern

The other day I had a doctor's appointment. This was at the recently constructed Honickman Center of Jefferson University Hospital located at 1101 Chestnut Street in downtown Philadelphia. The parking lot was under the 19 story Honickman building. 

The elevator in the parking lot brought me to the first floor of the building. There, I was met with a security guard and a metal detector. The security guard told me to register at one of a line of screens that took my information. Then, I was transported to the eleventh floor on what appeared to be a state of the art elevator. 

In the room where the doctor examined me, there was a widescreen television with my name welcoming me to the to the facility. This screen enabled me to choose music and art while I waited to see the doctor. 

After my examination, I spoke to someone who scheduled me for my next appointment. This was via the widescreen television. The person who scheduled me for the appointment was at her home in New Jersey. I needed to wait an extra month before she could find a time when the doctor would be available. Other that the delay in scheduling for my appointment, I found the doctor to be helpful and competent in treating my condition.   

The construction cost of the Honickman Center exceeded one billion dollars. From what I could see, there are few, if any hospital beds in this building. I also did not see offices for primary care, mental health, maternity, or pediatric care. These specializations might be among the least profitable.    

On the other side of the Schuykill River in West Philadelphia, the Hospital of the University of Pennsylvania erected their Pavilion building. The construction cost of this medical facility was about $1.7 billion. The Pavilion is only one of several relatively new buildings constructed for the University of Pennsylvania Hospital. 

Hospital Closures  

A few years ago, I attended a demonstration protesting the closure of Hahnemann Hospital in Philadelphia. A few years before that I attended another demonstration protesting the closure of Women's Hospital of Philadelphia. At that demonstration, the President of the Hospital Workers Union 1199, Henry Nicholas, reported that this was one of about 700 hospital closures throughout the country.

Before Women's Hospital closed, the owner, Tenet Healthcare, effectively forced the nurses to go on strike. The strike lasted about one month. A day after the strike was settled Tenet announced the closing of the hospital. During the monthlong strike, Tenet recruited scab nurses from across the country and bussed them to the hospital every day. This was the thank-you that Tenet gave to their employees.

We might also ask a question: If so much money is being spent on health care, why was there an acute shortage of hospital beds and face masks during the COVID-19 pandemic? 

What is going on?

So, these facts beg another basic question. Why are hospitals investing astronomical amounts of money in health care, while at the same time they are closing hundreds of hospitals? 

Dan Cooney was a friend of mine who passed away a few years ago. He was a nurse in the mental health department at Jefferson University Hospital. Jefferson eliminated this department and laid off Dan to make way for a more lucrative orthopedic practice. 

Dan and others spoke to me about how he managed to talk patients through the reasons for their drug addiction and saved their lives. The Center for Disease Control estimated that there were 107,543 overdose deaths in the United States in 2023.

Saying all of that, we need to understand the economics of hospitals. There are many corporations that profit from hospitals. There are the hospital equipment manufacturers. There are the drug companies. Banks receive interest on loans from all those corporations. Insurance companies profit from minimizing payments for health care. Yet the people who work for banks and insurance companies never actually treat patients.

Karl Marx and Frederick Engels wrote their Communist Manifesto in 1848. In that document they argued that the capitalist system has a disease that was never experienced before in human history. This is the disease of overproduction.

In other words, banks need to continually find investments where they can grow the assets they have. However, since banks never actually produce useful commodities there is only one way they can get the capital needed to grow their assets. This is to be obsessed with cutting costs. 

We saw how this system blew up in 2008. Banks floated all kinds of real estate loans, but large numbers of borrowers weren't able to pay back their loans. As a result, the investment companies of Lehman Brothers and Bear Sterns closed. The news media is determined to never report on the real causes for this banking collapse. When the economy continually grows, while there is an obsession to cut costs, a financial collapse is inevitable.

The effects of capitalist economic growth

Today, about six percent of the population has medical debt of about $220 billion. Student loan debt is about $1.7 trillion.

All the astronomically expensive medical facilities I mentioned in this blog are located in Philadelphia. Philadelphia is also the home of the Comcast Towers that had construction costs of $2.6 billion. So, with all these expensive buildings in the city, we might think that the public educational system would be adequately funded. 

Today per student funding for education in Philadelphia is about $10,000. When we walk across the street on City Line Avenue, we enter the Lower Merion School District. There per student funding is about $26,000. Lower Merion is a suburban community and lacks the billion dollar buildings housed in Philadelphia. 

If you think this disparity in funding for education isn't fair, you aren't alone. Commonwealth Court Judge Renée Cohn Jubelirer wrote a 780 page decision arguing that the gross disparity in funding for education in Pennsylvania is illegal. However, since the Pennsylvania state government says that this decision is non-binding, it hasn't been enforced.

However, in New Jersey the courts of that state ruled in their Abbott v. Burke decision that the inequality in educational funding in the state was also illegal. However, that decision was binding.

Instead of taking the money from the most affluent New Jersey residents to correct this problem, the state had other ideas. They increased property taxes making New Jersey the state with some of the highest property taxes in the nation.

Conclusion  

In order to put all this information in perspective, I believe we need to look at the nation of Cuba. Today Cuba is having a difficult time largely because of the economic embargo enforced by the United States government.

However, Cuban citizens have no debts for education or health care. In fact, both education and health care are lifetime rights to citizens on the island. In fact, Cuba has twice the number of doctors as the United States per capita. Cuba has trained doctors from around the world free of charge. Cuban doctors have also gone all over the world to treat patients in need.

All of this is possible when there is a government that makes human needs the priority over profits. As the capitalist system continues to demand that workers give up more and more just to sustain ourselves, we need to understand that there is another way.