Capitalism is above all a contradictory social system, and this is very evident in the area of human health and well-being. At the same time that capitalism has greatly increased the potential to curb disease and improve health, it squanders this potential and creates many new causes of ill health.
Capitalism is based on perpetual expansion. Through the course of the 19th century, industrial capitalism grew from its initial base in North Western Europe and came to dominate the planet. In this period a massive increase in society's productive forces was reflected in the health field by greatly improved sanitation, the development of public hospitals and public health campaigns and the growth of clinical research.
However this expansion is driven by market competition, and accompanied by the commodification of ever-more aspects of society and the natural world. Everything, down to the genetic structures of life itself, eventually becomes marketable, and the social provision of goods and services, such a public health systems, are more and more subordinate to the interests of the big corporations that have come to dominate the system.
Capitalist interests and ideology distort every aspect of medicine and health care, often with horrendous cost. A study published in the June 6 Medical Journal of Australia found that drug trials are routinely fudged, delayed or buried if results do not suit the pharmaceutical corporations that fund most clinical research. A class of anti-arthritis drugs (COX-2 inhibitors) was widely marketed before adequate testing was carried out — and found the drugs to cause serious cardiovascular problems. Some estimates put the damage at up to 50,000 premature deaths.
The targeting of specific diseases with the "magic bullets" of synthetic drugs is prioritised, as this approach is the most profitable, while natural, preventative and educative approaches often have to struggle in the market place, rather than be considered on their merits as part of a holistic health system.
An example is the increasing use of anti-depressant drugs such as lithium, Zoloft and Prozac in Australia, now reaching more than 8 million prescriptions per year. The quick recourse to medication is largely because such drugs, while undoubtably necessary in some cases, is cheaper than other therapies such as counselling. Side effects from the drugs can include panic attacks and aggression.
In a market system access is based on wealth rather than need. To see the future of Australia's increasingly privatised health care we can look at the US, where increasing numbers of people have no health insurance, meaning they must pay upfront the full cost of all medical treatment or go without. In 2003, 45 million people, 16% of the population, were uninsured and the US Institute of Medicine estimates that this led to 18,000 premature deaths that year.
The imperialist nature of capitalism creates gross inequalities in wealth and hence access to health care between countries as well as within them. One consequence is a drain of skilled labour from the Third World, a stark illustration of which is the fact that there are more Ethiopian doctors practicising in the Washington DC area than in Ethiopia.
The profit motive also drives capitalists to minimise controls on pollution, and health and safety measures in workplaces. The results have ranged from the testicular cancers endemic among 19th century chimney sweeps, to the havoc among mining communities and builders wrought by asbestosis, not to mention the results of war, malnutrition and environmental disasters.
A socially owned and democratically run economy is required to provide health care on the basis of truly rational science and need rather than profit. Cuba is able to maintain indicators of health and well-being on a par with much richer countries. It undertakes innovative medical research and development that combines traditional knowledge with the latest technology, and sends more doctors to work around the globe than the World Heath Organisation. It can do this because it has overthrown capitalism. The 15,000 Cuban volunteer doctors currently serving in Venezuela, treating many poor people who have until now never seen a health worker, shows how solidarity and cooperation can heal the ill effects of competition and greed.
Capitalism makes us sick. It's time to put it out of our misery.
Nick Fredman
From Â鶹´«Ã½ Weekly, August 10, 2005.
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