BROOKLYN, NY, June 1 — Workers and patients at Downstate’s three hospital campuses face the fight of our lives as Governor Cuomo’s consultants and our administration make plans to “Right Size” the institution. 

These racist plans will likely involve hundreds of layoffs and cuts in services in central Brooklyn. A year ago, as Downstate Medical Center  “saved” Long Island College Hospital from closing, we felt secure in what we thought was an economically sound, indeed growing, institution in a sea of troubled Brooklyn hospitals. But the appearance belied the essence of what was going on. How could this happen?

To understand this and how to fight back, we need to take a step back and grasp what is driving the changing capitalist health care system in 2012. Change is caused by the interplay of contradictory or competing forces. What are the forces at play in healthcare?

Some, like insurance companies, medical technology companies, pharmaceutical companies and providers (hospitals) must make profits from health care to survive in the capitalist game. Others, like employers paying for health insurance and governments, are out to limit their costs for health care.

The major capitalists take a broader view. They want to minimize the resources put into health care (as well as other services for the working class) so that resources can be focused on world domination (wars). Cuomo with his presidential aspirations represents the latter — and they are winning.

Where are the patients and healthcare workers in all this? The various bosses try to divide us and/or win us to their side. Cuomo, whose main financial backers are insurance, finance and real estate, tells New Yorkers that State workers are just too privileged and greedy. The beginning of the 2011 State of the State address put blame for budget woes on our pensions ($6 billion out of a $132 billion budget). Now we have a sixth pension tier.  Downstate Hospital President LaRosa echoed his words when he whined to the press that our pay and benefits are the source of his money problems. Cuomo pits upstate against the city, implying that the problem is mismanagement of inner-city hospitals. But these hospitals have been set up to fail by years of Medicaid cuts. 

Let us become a true force in the development of healthcare by uniting patients and workers to fight against the attacks. Our union leaders blunt our efforts. Civil Service Employees Association (CSEA) leaders tell us not to worry because there is no-layoff language in the contract. But that expires in January. The Public Employees Federation’s expires in April. Think you can get all your furlough days in by then?

They divert our anger into writing and calling legislators. They caution us that going to our patients could scare them away and make Downstate more vulnerable. We are the human face of the hospital to our patients. We should not leave them in the dark to be surprised when a service disappears. Rather, we should have confidence that we workers and patients have the same enemy and the same fight. If mass layoff notices come out, we should gather that very day in the lobby to take action!

PLP says that workers’ needs cannot be met under capitalism. We fight for a workers’ revolution for communism. What will be the conflicting forces in the development of health care under communism?

One force will be the organized power of the working class led by its communist party to overcome scarcity, inequality and other obstacles. The opposing force will be the old capitalist ideas of pacifism, individualism and defeatism. There will be no money or profit to get in the way of health care — from each according to commitment, to each according to need.