Socialism

Socialism is an economic and political system where public goods are publicly owned and workers own the means of production. Socialism has many currents, including communism, anarchism, syndicalism, and social democracy.

What is socialism's role in public health?

Ernesto 'Che' Guevera argued that the aim of socialism is to reduce or eliminate health disparities through free provision of medicine and health care to the poor.1 We know that inequality makes us sick, so removing the economic system that fosters inequality (namely capitalism) would improve health outcomes for all people.2 Socialism explicitly seeks to guarantee all human beings a right to life, health care, housing, food, and employment.13

Socialism as the alternative to capitalism.

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Capitalism is the economic system by which society distributes scarce resources in a market system. The reality is way more complicated than that, as "free markets" don't really exist, and capitalism requires a massive underclass of the destitute and unemployed to function.3 Capitalism as applied to health care creates a for-profit industry that cannot guarantee basic levels of care to all people. This fact alone has killed millions of people in India every year, as Chomsky argues — far more than have perished under dictatorial communist regimes in the entire 20th century.4 80% of humanity lives under $10 a day.5 Systems of racism and oppression are a function of capitalism, explained here by Charlie Post:

Workers under capitalism have a dual existence: both as collective producers struggling against capital for control of the workplace, for hours and wages, but also workers compete as each other. They're sellers of labor-power, which gives rise to what the early 20th century Marxists used to call "sectional interests"; divisions along the lines of race, citizenship, nationality, gender, sexuality, etc.

Howard Zinn points out the level to which capitalism in the United States led to mass violence against Blacks, women, and union organizers in the 19th and 20th centuries.6 For all its faults, capitalism is still better than the feudalism that preceded it.7 We can probably do better, though.

Actually-existing socialism vs. actually-existing capitalism

To distinguish between the idealism of revolutionary socialism and socialist regimes in Eastern Europe and Asia, the term "actually-existing socialism" was invented. Ignoring the fact that the Soviet Union was state-capitalist (by the admission of V.I. Lenin, of all people8), and acknowledging the fact that existing "socialist" regimes were by-and-large terrible, they still managed to improve the standard of living for millions of people, including life expectancy and infant mortality.

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In 1926, life expetancy for a Russian newborn was 44.4 years, up from 32.3 years in Tsarist Russia. In 1960, life expectancy in the Soviet Union approached 69 years, about the standard for all Western countries (including the US).10 Life expectancy declined in with the liberalization and privatization of the 1980s, and dropped immensely after the USSR's collapse in 1991 (to 59 for males, about the same as Ghana.)9 The Soviets made tremendous advances in infant mortality and had the first universal health care system in the world 14, although Bismark's social insurance system that covered about 40% of the population of Prussia is sometimes listed as the first health insurance system 15. See also, Cuban health care system.
Actually-existing socialism also supported the liberation of subjugated and oppressed people in Latin America, Asia, and Africa. See: postcoloniality.

Failed experiments

Through its first inception in the Paris Commune, socialism has been consistently under attack by capitalist interests which formulated a culture of defense and paranoia in socialist political experiments. This partially led to the massive atrocities committed by the Soviet Union, Maoist China, Khmer Rouge, etc. that are not excusable but explainable and predictable. The US' response to socialist resistance in Vietnam was, after all, a genocidal war.

Chile's democratically-elected socialist leader Salvador Allenda was overthrown because he implemented socialist reforms in a capitalist country, including a national health service11. The US send paramilitary thugs (the "contras") to slaughter the Sandanistas in Nicaragua because they educated women, offered free healthcare, and redistributed land to poor peasants. [ref. needed] The US has tried to kill Fidel Castro 638 times, and Fidel was not even a Marxist (unlike Che or his brother Raul)12. "Actually-existing socialism" looks pretty bad as a result, and it should surprise no one.

"Actually-existing capitalism" looks like this Bangladesh factory collapse, for example, but don't tell that to the free-marketers who think "capitalism" is someone trading a fur for a jug of wine in a forest somewhere.

We can move beyond capitalism.

Cooperative workplaces, mutual aid, community organizing, and revolutionary autonomous movements are forms of anti-capitalist resistance that don't involve nation-building. For a model that works despite massive US and corporate resistance, see Zapatista Army for National Liberation (EZLN).


1 http://www.marxists.org/archive/guevara/1960/08/19.htm
2 http://www.unnaturalcauses.org/
3 http://robertreich.org/post/61406074983
4 http://www.spectrezine.org/global/chomsky.htm
5 http://www.globalissues.org/article/26/poverty-facts-and-stats
6 A People's History of the United States
7 http://libcom.org/files/feudalism%20to%20capitalism.pdf
8 http://www.worldsocialism.org/spgb/socialist-standard/1970s/1970/no-788-april-1970/state-capitalism-russia
9 http://deepblue.lib.umich.edu/bitstream/handle/2027.42/40126/wp740.pdf?sequence=3
10 The Seeming Paradox of Increasing Mortality in a Highly Industrialized Nation: the Example of the Soviet Union : 1985. author Dinkel, R. H.
11 Waitzkin H, Modell H: Medicine, Socialism, and Totalitarianism: Lessons from Chile. New Engl J Med 1974;291:171-7.
12 http://www.theguardian.com/world/2006/aug/03/cuba.duncancampbell2
13 http://www.politicsresources.net/area/uk/man/lab45.htm (Britain's Labor Party was social democratic in 1945 — guaranteed employment for all. Compare that to today.)
14 Newsholme A, Kingsbury JA. Red Medicine: Socialized Health in Soviet Russia. Garden City, NY: Doubleday, Doran & Company, Inc; 1933. Full text available at: http://www.marxists.org/archive/newsholme/1933/red-medicine/ (accessed February 14, 2014.)
15 Newsholme, A. International Studies on the Relation between the Private and Official Practice of Medicine with Special Reference to the Prevention of Disease. Volume One: The Netherlands, Scandinavia, Germany, Austria, Switzerland. Williams & Wilkins Co., Baltimore, 1931, p. 159.

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