In 2018, Alec Raeshawn Smith of Richfield, Minnesota died an excruciating death from diabetic ketoacidosis. His body didn’t have enough insulin. His blood sugar skyrocketed, his cells deteriorated, and his body shut down. Raeshawn was only 26 years old, just starting his adult life.
The problem wasn’t that a cure didn’t exist for his diabetes or that life-saving medicines weren’t readily available. Insulin is a common drug, widely available since 1923.
The problem is that in America, healthcare and medicines aren’t basic rights, they’re commodities for sale. Their price, production and distribution are dictated by the needs and workings of the capitalist-imperialist system—not the needs of people here and around the world.
Raeshawn just couldn’t afford the price the giant pharmaceutical monopolies were charging, so he paid with his life. "That cause of death of diabetic ketoacidosis should have never happened," his mother said.1
Yes! Raeshawn’s death and the deaths of tens of thousands of others due to lack of medicines or healthcare should never have happened! But they do keep happening because of the murderous workings of this system—which is not fundamentally driven by individual greed, but by the cutthroat, expand-or-die competition between rival capitalists—which is enshrined in and protected by the U.S. Constitution.
Apologists for this system hail the U.S. Constitution as one of the greatest documents ever written. But the revolutionary leader Bob Avakian has exposed it as an exploiters’ charter, designed to legitimize and protect private property, exploitation, capitalism (now capitalism-imperialism)—and legalize the needless suffering and death that result. (See sidebar below.)
This is why even though medical technology has advanced by leaps and bounds, and a raft of new life-extending and life-saving drugs have been developed in recent decades, getting adequate, affordable healthcare is a nightmare for millions in America:
- Why some 30 million people in this country don’t have health insurance2, and why at least 25,000 people needlessly died in 2020 because they don’t3.
- Why millions—as much as 25 percent of the U.S. population—“are delaying getting medical help because of skyrocketing costs.” 4
- Why prescription drug prices, especially for new cutting-edge drugs, have steadily risen, even skyrocketed.
- Why thousands die each year because they can’t afford life-saving medicines and literally millions are forced to skip doses or go without—risking their health and lives.5
- Why the pharmaceutical industry has reaped trillions of dollars—yes, trillions—in profits over just the past two decades, profits they are driven to accumulate or risk going under due to the workings of this system.6
Somewhat Lower Drug Prices? Capitalist-Imperialist Pharmaceuticals Say NO!
A legal battle is now taking place over prescription drug pricing and availability, which is a damning exposure of the bankruptcy of this system.
The Biden administration is trying to band-aid this open sore through the Inflation Reduction Act, passed by Congress in 2022. It gives Medicare officials the right to negotiate lower prescription drug prices with the drug companies. If the companies refuse, they’re forced to pay a fine. The process is set to begin on September 1.
This reform doesn’t change the predatory, capitalist-imperialist character of U.S. healthcare, or fundamentally remedy the nightmare of prescription drug pricing and availability, though it could benefit sections of the population and no doubt save lives.
Yet even this limited reform drew a fierce backlash from the biggest drug companies. One pharmaceutical executive declared, “You can’t take hundreds of billions of dollars out of the pharmaceutical industry and not expect that it’s going to have a real impact on the industry’s ability to develop new treatments and cures for patients.” When this executive talks about “ability to develop new treatments and cures,” they’re actually talking about the ability of capitalists to accumulate profit, in the face of competition from other capitalists. So the complaint from this executive is an expression of the competitive compulsions driving capitalism-imperialism: even giant corporations making billions of dollars in profit still need to continually expand and accumulate more capital—or they will be driven under by competing capitalists doing the same thing.
Four pharmaceutical giants—Janssen [Johnson & Johnson], Merck, Bristol Myers Squibb and Astellas Pharma, as well as the U.S. Chamber of Commerce (the industry’s main trade group)—have filed lawsuits in federal court to halt any price negotiations. One public health legal expert told the New York Times the drug industry was “throwing the kitchen sink at the government.”7
Where Do the Drug Companies Turn? The U.S. Constitution!
All these lawsuits argued (in various ways) that the Medicare drug price negotiations were unconstitutional. They cited the Fifth Amendment’s “Taken” clause: “nor shall private property be taken for public use, without just compensation,” arguing making them negotiate or pay a fine constitutes taking their property without “just compensation.” 8
They claim their First Amendment rights are being violated by their having to state publicly that they’re negotiating a “fair price” with the government. They also cite the Eighth Amendment’s prohibition of “excessive fines.”9 (See, for example, the recent filing by Johnson & Johnson,10 Merck,11 and Bristol Myers Squibb.12)
The outcome of the proceedings is far from certain. But it’s not like the pharmaceutical giants are simply lying or grasping at straws—their legal arguments are rooted in the U.S. Constitution and its amendments, which are grounded in and shot through with defenses of private property, capitalism and exploitation.
In stark contrast to this capitalist-imperialist system and its constitution, the Constitution for the New Socialist Republic in North America mandates health care to serve the people as one component of a liberating society on the path to the emancipation of all humanity.
Bob Avakian on Why He Wrote the Constitution for the New Socialist Republic in North America
We Need and We Demand: A Whole New Way to Live, a Fundamentally Different System
This whole situation—of millions and millions without adequate healthcare and this system and its laws and founding Constitution unable to remedy this needless suffering—is outrageous, intolerable, and unnecessary!
At this time when revolution and a radically different society have become more possible, it’s urgent that thousands growing into millions of people take up and spread the demand from WE NEED AND WE DEMAND: A WHOLE NEW WAY TO LIVE, A FUNDAMENTALLY DIFFERENT SYSTEM:
Health Care to Serve the People
Health care will not be oriented (and distorted) to make profit for big medical and pharmaceutical corporations, with the result that great numbers of people cannot afford decent health care under the present system. Such corporations will no longer exist—they will be replaced by government-funded health care. The purpose of health care will be to serve the people and continually develop and apply the science of medicine to meet the medical and health needs of people in society as a whole, in a way that is affordable for the masses of people, with the goal of finally making free, high-quality health care available for all. 13
As Bob Avakian writes in “U.S. Constitution: An Exploiters’ Vision of Freedom—Added Notes (and Brief Introduction)”:
Madison got to the heart of the matter, the essence of what the U.S. Constitution is all about, when in the course of upholding the decision to treat slaves as three-fifths human beings he agrees with the following principle: "Government is instituted no less for protection of the property than of the persons of individuals." 14 Property rights—that is the basis on which outright slavery as well as other forms of exploitation, discrimination, and oppression have been consistently upheld. And over the 200 years that this Constitution has been in force, down to today, despite the formal rights of persons it proclaims, and even though the Constitution has been amended to outlaw slavery where one person actually owns another as property, the U.S. Constitution has always remained a document that upholds and gives legal authority to a system in which the masses of people, or their ability to work, have been used as wealth-creating property for the profit of the few.15