A Revolutionary Vision for Health
A Revolutionary Vision for Health
The novel coronavirus pandemic has opened a gateway for scientific world-shattering changes in the forces of production, especially in healthcare. It has also laid bare the malignant political and social construct of a white supremacist class society. The normalizing of over 900,000 deaths in the U.S. and millions more globally is a dystopian landscape of devalued humanity that provides fertile ground for fascism or social revolution.
Within the fascist offensive, different fronts of struggle intersect. Bitter school board challenges to masking, Roe v Wade in the courts, private-for-profit prisons and immigrant detention centers devoid of safety protocols, as well as climate crisis’ impacts on health, are center-points of a propaganda war using COVID to shape the direction of society as a whole. Nearly the entire court system is embroiled in a Republican Party offensive aimed at supplanting federal authority with a states’ rights doctrine of power from reproductive health to voting rights and public health mandates. Meanwhile, the Biden Administration and medical spokespersons shift the blame of capitalism’s inability to control pandemic spread to the unvaccinated, promoting vaccine status as another tool to divide the working class. Neither political party has taken governmental responsibility for the lack of access to community trusted health information, rural healthcare deserts and the deep separation of science from community needs and accountability.
Historically, the role of healthcare in a capitalist society has been to maintain and reproduce a productive workforce. Public health has played a dual role in that mission. On one hand in the early 20th century, it mitigated infectious diseases through sanitation, vaccinations and other measures to secure a productive workforce, mostly aimed at European immigrants. On the other hand, it carried out programs of eugenics, including forced sterilization and unconsented experimentations on populations whose labor no longer fit in an industrialized labor market. Rural Black, Indigenous and incarcerated populations still hold that racist trauma and these eugenic practices continue in Detention Centers, such as the now closed Irwin County ICE Detention Center in Georgia.
https://www.thenation.com/article/society/hysterectomies-sterilization-irwin-county/
Today, public health is a hollowed out shell with most of its functions privately subcontracted. From coronavirus testing to PPE and vaccines, private corporations dominate and drive policy. This stands in sharp contrast to other systems of modern health provision, such as the Cuban model of healthcare with its neighborhood based, scientifically rigorous and universal free healthcare. Cuban health indicators & life expectancy are higher than the U.S. despite a crippling embargo. https://cubaplatform.org/healthcare.
Driving Disruptions
With more labor replacing technologies restructuring the nature of work, the Medical Industrial Complex (MIC) with its entrenched archaic system of employment based private health insurance, continues to expand for its own profitable preservation. The ACA, while responding to a need to expand access to the current system, is a prime example of State protection of privately owned health resources. More jarring is the merger of the State and corporate healthcare as elements of social control. The latter is criminally apparent in Big Pharma’s propagation of the opioid epidemic and the cynical deadly use of vaccines as ‘global diplomacy’ and patent protection.
Today the healthcare system or (MIC) is 18% of the overall economy and the largest sector of the workforce. It includes the private insurance industry, Big Pharma, medical devices, biotechnology, hospitals, clinics, nursing homes and healthcare workers/providers. Newer forces include ubiquitous telehealth, data collection, AI development & management companies, private equity, and a myriad of wearable ‘smart’ electronic devices companies. Roughly 14% of the workforce is employed in ‘traditional’ health care jobs. The pandemic has accelerated the collapse of a medical-hospital centered model of healthcare. Between 2020-2021, twenty-seven more hospitals have closed, most in the rural south.
Displacing the ‘old’ industrial model is a huge new market that utilizes digital technologies and massive public data collection to sell ‘healthcare analytics’ to a multitude of varied corporate ‘care’ companies from pharmaceuticals to insurance companies and medical institutions. The data entered and the algorithms applied perpetuate existing class, gender and color biases inherent in capitalism’s mandate for maximum profitability. One of these health data analytic companies privately owns the largest integrated database of multi-sourced clinical diagnostic data with 19 billion health records for 325 million patients.
Capturing and comprehending anonymous data in and of itself need not be exploitive and could potentially yield great benefits for humanity but that outcome is perverted by private ownership for private wealth accumulation.
“To the extent that machine learning relies on large, ‘naturally occurring’ datasets that are rife with racial (and economic and gendered) biases, the raw data that robots are using to learn and make decisions about the world reflect deeply ingrained cultural prejudices and structural hierarchies …But his is not inevitable”, Race After Technology, by Ruha Benjamin pg. 53.
Social Response
The burden of illness, death and chronic health insecurity both before and during the pandemic has disproportionately fallen on essential & marginalized workers including the elderly and those with disabilities. Women are 70% of those frontline workers and Black and Latinex, immigrant and Asian & Pacific Islander make up more than 1 in 4 of all ‘essential’, hands on and potentially unprotected workers. Health disparities are at the deadly core. 53% of the government’s definitions of essential workers are demographically low-income people of color but all workers, employed and unemployed are under attack.
According to Cornell University there have been 30 strikes of healthcare workers this year as well as ‘strikes by resignations’. Mutual Aid Centers build health & healing care into their work and connect it to environmental racism, food deserts and the oppression of State violence and surveillance. There have been scores of community and workplace demonstrations for PPE and safety protocols.
Committed work to dismantle white supremacy in healthcare institutions is growing, especially among students of the healing arts. Harm reduction and the Precautionary Principle are being learned along side of healing justice and abolitionist strategies of transformation. And Medicare 4 All continues to be an important part of polarization within legislative arenas.
The vast complexities of our society and the global nature of the converging crisis of poverty, climate, environmental degradation, and multiple forms of state violence, forces us to examine another way to organize society where the sciences that humanity has created can be used to heal our relationships with each other and with the natural world. We abhor the present conditions because we have the capacity to vision and make another world. Principle to vision is the end of private ownership of the wealth of society and taking up the responsibility of what kind of healthcare system do we need? What does a truly healthy society look like? These are the conversations, actions and work that millions cross the globe, who are living the shared experience of a largely preventable pandemic toll and unabated expanding climate crisis are moving forward. Once we begin to share a vision then the work to realize it becomes palpable.
The long sweep of human history reveals that the class inequalities in the present illness-breeding social order are a relative ‘new comer’ in life’s timeline. The rise of commercial private property in the last 500 years is barely a blip on humanity’s timeline and the growth of corporate health care resides in the present. The leap forward to a communal communism underlies a society of caring, not as an ideology but as a practical solution.
The revolutionary process moves into a society convulsing with change but lacking class-consciousness in the context of the pandemic where frontline workers are considered both essential and expendable at the same time. The digital technologies embedded in the economic base are upending the social superstructure and driving fascist political solutions. But we reject that! We are not passive recipients of technological change and political upheaval. We have a choice. We have agency. We are capable of making our own history and our ancestors and future generations demand that we do so!
Some Other resources:
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mRNA.html
https://orthostreams.com/disruptive-trend-in-orthopedics-the-smart-implant-revolution/