Given the horrendous record of the Bush administration in foreign and domestic policy, it is not surprising that many hope a Democratic victory in 2008 will bring dramatic change for the better.  Those of us in APHA have witnessed with dismay the rising number of the uninsured, cuts in public health and health care spending, rising costs of medications and conflicts of interest in medical research and regulation. We could almost forget that our priority is a program for universal quality health care.

Although Democrats from Roosevelt to Clinton have talked about a national health care plan, all have abandoned the fight under pressure from the pharmaceutical and insurance industries. This year’s crop of Democrats, from Hilary Clinton to Barack Obama, don’t even mention the idea of universal coverage. Pretty much they all agree on the same few points, as we heard from Kerry at last year’s convention or as described in The American Dream Initiative, the recent position paper of the Democratic Leadership Council (http://www.dlc.org). They propose promoting electronic medical records, focusing research on particular diseases like AIDS and Alzheimer’s, lowering insurance costs for small businesses, negotiating lower drug prices for Medicare, and expanding coverage for children through CHIP and insurance subsidies. Although all of these steps would do some small good, they do not actually provide the funds to allow nine million children not eligible for CHIP or adults working for small business to be insured, and ignore the gaping needs in the public health and health care infrastructure and the waste in allowing health care to continue as a profit-making commodity.

In a larger sense, the Democrats have plans that will cause even more death and hardship than the Republicans are wreaking on us now. To quote from another position paper, How America Can Win Again (Blueprint Magazine, 7/23/05): “The U.S. faces competitors in China and India that, if we fail to act, have the potential to eclipse our economic might….Economic and military might go hand in hand, and victory can only be assured when all Americans…sacrifice…. Our leaders have failed to arm us economically and militarily for a war that could go on for decades.” They then propose adding 100,000 more troops, requiring colleges to allow recruiters on campus, and a “voluntary” national service program but required for college admission. The purpose of bolstering the middle class and providing people the services they need is seen as needed to win their loyalty and participation for the long struggle ahead. Thus, the Democrats do not have an outlook that puts the well-being of people first, but only see the need for expanding international struggle more clearly than the Republicans.

For us the lesson is that we must rely on organizing rank and file people to fight for what we need, without expecting politicians of any stripe to give it to us.