News Can Health care Reform Work Without Changing the Capitalist System?  
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The passage of the health care reform bill in Congress is a significant step, but it is unlikely to make a large impact on health care. The American health care system has become the most inefficient in the industrialized world. America spends the highest percentage of the GDP without delivering the results. America has the unhealthiest population in the whole industrialized world. The main reason for this state of affairs is the inefficiency of the American capitalist system itself. The capitalist system has become outdated and needs fundamental reform. Without the fundamental changes, the system is likely to collapse before the middle of the century.
How is the American capitalist system different than the European capitalist system? The European system made changes to make the system responsive to the needs of the majority of the population. However, the American capitalist system has only worked for the top 1%. For the last thirty years, the top 1% has been increasing their assets while the bottom majority kept losing their income and purchasing power. The last thirty years, after Regan came to power, saw the gap between the rich and the poor widening. This is the main cause of so many people being unable to buy any insurance coverage. The number of uninsured Americans continued to climb in the last thirty years. About 46 million Americans have no insurance and even a larger number have inadequate coverage.

Europe has not allowed the gap between the rich and the poor to grow so much. The European working class has not seen their real income decline like their American counterparts. The European state has intervened to make sure that the fundamental needs of its people are met. The state has assured education and health care for all of the population.

Another big difference between the American and European capitalists is their attitude towards race. Even though all capitalists have never hesitated to use the racial factor to their advantage, but there is a big difference between the degree to which the factor has been used. The American capitalist system was founded on the super exploitation of the minorities. Slavery was practiced in Europe, but that was thousands or hundreds of years ago, but America has the rare distinction of practicing slavery in the nineteenth century. The systematic robbing of the lands of the Native Americans and Mexicans continued until the twentieth century, as did the lynching of black people.

The American capitalists have been able to align the white working class against the minorities. Even though the white working class has been the victim of exploitation, yet it has mostly sided with the exploiters rather than the exploited. This phenomenon has helped the capitalist class to keep the working class divided and deny them the benefits which the European working people were able to get.

The American health care suffers from both the relatively inefficient American capitalist system as well as from racism. All studies conducted have shown that the health of minorities is worse than the health of whites. Unfortunately, there are not studies available to show that the minority health care providers are not treated at par with white health care providers.

I have personal experience and know many other minority physicians who tried to practice in areas with large white majority populations. Many of these physicians, including myself, had to suffer tremendously for their experiments.

I have very serious doubts that unless the two major factors affecting our health care system, American capitalism and racism, are changed, we are not going to see a major impact in the delivery of health care. President Obama has tried to start the process of addressing the growing gap between the rich and the poor. Even though it is a step in the right direction, yet it does not go very far. That is why it is unlikely to make a big difference.

Dr. Sawraj Singh is Chairman of Washington State Network For Human Rights, and Chairman of Central Washington Coalition For Social Justice.

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