President Obama’s press conference Wednesday night was an hour-long effort to conceal from the American people the sweeping impact of the cuts in medical benefits that will be imposed in his administration’s planned restructuring of the US health care system.

With major health care bills proceeding through both the House and the Senate, and the White House engaged in detailed negotiations with congressional Democrats and Republicans, Obama focused his opening statement on the issue and nearly every question from the White House press corps followed suit.

The opening statement made only one mention of the 47 million people now without health insurance, and did not repeat Obama’s election campaign promises of universal coverage. Instead, he spoke almost exclusively about the need to slash spending on medical care, particularly on the federal Medicare and Medicaid programs which underwrite health care for the elderly, the disabled and the poor.

“The biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid,” he said. “So let me be clear: If we do not control these costs, we will not be able to control our deficit.”

“I have also pledged that health insurance reform will not add to our deficit over the next decade, and I mean it,” he added, pointing to a plan to “create an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency in Medicare on an annual basis.”

As always is the case in a US presidential press conference, Obama was addressing two basic audiences—the ruling elite and the general population. But rarely have the messages being delivered been so fundamentally at odds. Obama combined vague promises of improvements in health care for the American people with direct pledges to the financial aristocracy that his plan would cut health care spending.

Obama repeatedly stressed that his number one priority was to slash spending on medical care, both by corporate America and by the federal government. At one point he declared that unless costs are reduced, “Medicare and Medicaid will break the federal budget.” No such considerations have restrained his administration’s open-ended bailout of Wall Street—at a direct cost of $4.7 trillion, with another $19 trillion in guarantees—or the spending of trillions on continuing and escalating the wars in Iraq and Afghanistan.

To working people, Obama offered examples of the abuses inflicted by private insurance companies—cutting off benefits, arbitrary rate increases, refusal to pay for life-saving procedures—making a show of sympathy with the victims of medicine-for-profit, even as he pushes ahead with plans to make these conditions even worse.

In response to reporters’ questions about the sacrifices he was prepared to ask of ordinary people, Obama was careful to disguise the real implications of the measures now being prepared. One reporter asked if he would support a list of cost-cutting measures—fewer tests, fewer choices, less end-of-life care. Obama evaded the issue with a glib phrase, saying he would ask people only to “give up paying for things that don’t make you healthier.”

Another reporter asked the US president to detail “specifically what kind of pain and sacrifice” he was prepared to demand of current or future Medicare beneficiaries. Here Obama simply lied, saying that he “won’t reduce Medicare benefits” but would “make delivery more efficient.”

The final questioner along these lines asked Obama to guarantee that under the public insurance option proposed as part of his plan the government would not reduce benefits or coverage for anyone. Obama first made a diversion, defending the public option against Republican criticism and citing record insurance company profits. Then he gave an evasive answer, saying he “can’t guarantee there will be no changes in the health care delivery system.”

Given the opportunity to promise there would be no reductions in benefits or coverage under his health care plan, Obama refused to do so—a much clearer indication of the real direction of government policy than all his pretended empathy for working class families facing the loss of jobs, health insurance and their homes.

At one point, asked about his bottom-line requirements for a health care bill, Obama said that he would not sign a bill that increased the federal deficit or failed to cut health care costs. He made no such pledge to reject a bill that failed to cover the uninsured or imposed cuts in the availability of medical procedures, tests or drugs.

Obama said that he did not want the additional tax revenues required under his plan to be “completely shouldered” by middle-class families, an indication that a substantial portion of the costs will be imposed on working families.

No reporter, in line with the general media coverage of the health care issue, raised the simple fact that it is impossible to combine expanded benefits and drastically reduced spending, or improve health care for masses of people on the basis of a plan supported by the giant pharmaceutical and insurance companies. In fact, Obama’s drive to restructure health care represents a frontal assault on the social conditions of the working class.

His talk about eliminating “inefficiencies” and cutting the “quantity but not the quality” of health care can only mean, within the framework of a for-profit health care system based on the capitalist market, an attack on both the quantity and quality of health care for broad masses of people.

The dimensions of the coming assault are suggested by two figures cited by Obama. He pointed to the projected $7.1 trillion in federal deficits over the next decade, declaring that his health care plan was an essential part of cutting that deficit. And he noted that the annual average cost of health care in the United States was $6,500 more per person than in other industrialized countries—a gap that puts American corporations at a disadvantage against their international rivals.

The class character of Obama health care plan is demonstrated by the process through which the plan has been put together.

The last few days have seen extensive press reporting on the millions in campaign contributions from the health profiteers to leading congressional Democrats like Senate Finance Committee Chairman Max Baucus. At the same time, the Obama administration has refused to release the names of top health care company CEOs and lobbyists who have been visiting the White House to ensure the legislation is drafted to their satisfaction.

According to the Center for Responsive Politics, health care companies gave a staggering $170 million to congressional candidates in 2007 and 2008 combined, 54 percent of that total to Democrats. This spending spree is accelerating. According to the Washington Post, “The industry already set records from January to March, when health care firms and their lobbyists spent money at the rate of $1.4 million a day.”

The horror stories about insurance company abuses cited by Obama in his press conference could be multiplied endlessly. It is no exaggeration to say that thousands die needless deaths every year and millions are condemned to suffering because the health care system is driven not by human needs, but by the profit interests of drug and medical equipment manufacturers, hospital chains and insurance companies.

It is precisely these corporate interests that are working in close collaboration with the White House and Congress to write the Obama health care plan, whose aim is precisely to deny tests, medicines, procedures and treatments to working class people and restructure the health care system more directly and openly along class lines. The outcome will be cut-rate, third-class care for the vast majority, while the affluent few will have access to the best care available.