Medical economics (1947)

From the December 1947 issue of the Socialist Standard

The religious racket has, been exploded by Socialists since the days of Marx; but the more scientific racket, the medical “business” has received little attention, in spite of the fact that it is now generally recognised as the strongest and most militant trade (or professional) union in the country.

Millions of pounds are daily spent on therapeutics (curing disease) but scarcely anything is spent in comparison on prophylactics (preventing disease), for the simple economic reason that it is far more profitable to pursue, therapeutics. If too much attention was devoted to prophylactics it might render therapeutics redundant by “killing the goose that laid the golden eggs.” Doctors and hospitals must have sick people, and millions of them, or go out of business.

The workings of the medical profession provide a wonderful example of the economic factor in determining events and culture. Perhaps in this respect it is even more clearly demonstrable than in the case of the spiritual counterpart in religion. In this country there are more doctors and hospitals per head of population than in most countries, and strange to say, there is also a vast and increasing number of sick or ailing people. The same is the case with dentists; in spite of the fact that they are to be seen everywhere, and in spite of the widespread use of the tooth brush and dentifrice, the state of the teeth of the average English person is appalling, when compared to those of many primitive tribes who have no dentists, no tooth brushes and no dentifrice. In fact it would appear superficially that the more dentists, and care of the teeth, the worse is the final result.

Strange to relate with all the efforts of the medical profession and all their scientific research, Cancer, Diabetes, Heart Disease, Nephritis, Rheumatism. Nervous Diseases, Occupational Neurosis, and a host of other complaints, continue to increase yearly, which clearly indicates that something is radically wrong somewhere.

Capitalism regulates, the channel in which medical money goes, and stipulates broadly how it shall be spent; “for the hand that pays the piper, calls the tune.” Surgeons who can get, (or extract from the patient), 100 guineas for a certain operation, are always lurking for possible clients ; and why not, for their success depends very largely upon how many they find. Would anybody pay a surgeon for saving them from an operation? They certainly would not be prepared to pay the same fees.

Drug manufacturers, and patent medicine vendors, make enormous profits on certain chemical preparations, and do not fail to take full advantage of the power of advertising through the medium of those who handle and prescribe the drugs. Only too often quite worthless and harmful drugs are applauded as having health-giving properties, and statements made about them which could never be justified.

The late Lord Trent (formerly Sir Jesse Boot), owner and controller of about 1,000 chemists shops which hears his name, was bed ridden with Rheumatism, and had to be wheeled about in a bath-chair for many years of his life before he died, whilst his shops sold dozens of different chemical preparations for alleviating rheumatism.

A lady who is quite a public figure, owns or used to own, a once much advertised slimming product, and yet she herself regularly tipped the scales at 18 stone. Just imagine this 18 stone of beautiful womanhood ; what about a shovelful of her own slimming mixture for breakfast? But business is business, especially in anything connected with medicine and health, so why worry?

Today certain drugs are making fortunes for the companies behind the medical profession. Just think of the amount of advertising the B.B.C. gives to Penicillin, Streptomycin and Pheno-barbitone. Almost every day the B.B.C. has to announce that some doctor has carelessly mislaid quantities of the latter, thus giving further free advertising to these drugs, incidentally, who says the B.B.C. don’t advertise?

Blood squirting (hypodermic injections of serum), is popular today because apart from their simplicity, and certain medical reasons, these, practises, are enormously profitable, both to doctors and the companies responsible for the serum preparation. An old horse, of little use for its traction power, might fetch about £10 in the cats’ meat market (although horse flesh has many other uses than for cats’ meat). If the horse is deliberately given a dose of a disease resembling smallpox or diphtheria, it can be made capable of producing many times its cats’ meat value by producing suitable serum, at wholesale prices.

The enormous amount of injections done during the war on soldiers—where the men lined up before the doctor who did one after the other just like shelling peas, till the needle got blunt and was thrown away— was not done for nothing, nor even without profit. Manufacturing chemists were reaping thousands out of it.

Medical research under capitalism has got itself into an absurd scientific entanglement. Shaw’s “Doctor’s Dilemma,” and Cronin’s “Citadel,” only touch on aspects of this contradictory muddle. After millions of pounds had been spent on Cancer research (and the figures for cancer mortality steadily rising), the medical profession were instrumental in causing the government to pass the Cancer Laws of 1939, to prevent anybody except a qualified medical man from treating cancer. It would appear that the large amount of criticism they were receiving at this, time had to be silenced, and freedom of action as well as freedom of criticism was debarred to the public.

It is not always those who have the biggest purses who receive the best treatment. Sometimes the more money you have the more operations and specialists’ fees, and subsequently a quicker route to the grave. This was the trouble with the one-time world famous film idol, Rudolph Valentino, who wasted his money on medical attention to no purpose. Doctors are specialists in the art of knowing how to bleed (financially) those who have too much (pecuniary) blood. Kings and presidents, Lords and business magnates have to watch their step where doctors are concerned, as do also the working class. Even Karl Marx was helped to an untimely grave before his life work was completed through advertised chemical dope. Engels observed when Marx was obviously dying, that his body was literally full of patent medicines.

It is regrettable that so many workers have little real interest in health matters, and consequently become such easy victims to medical frauds, and tyranny. Doctors thrive through the advertisements for medicines, cigarettes, alcoholic drinks, doped foods and the health-destroying habits that follow their use. Why should the medical profession endeavour to educate the workers on these topics, and lose them as potential clients as a result? Is there any wonder why the doctors and specialists confine their nomenclature to technical terms derived mostly from the. Latin: or Greek, and pharmaceutical abbreviations that few can understand. It is not easy either to climb into the profession nor to understand its workings; those in it see to that.

“It’s your blood they’re after.” The recent blood transfusion campaign, coming at a time when it is extremely difficult to obtain blood-making foods of the right nature, quality and quantity, is enough to make us sit back and do some thinking. Every day appeals are made on the radio that blood donors are urgently needed, and thousands have responded, to what they consider a humane cause.

At one time in capitalism’s youth, we were told that disease was due to too much blood. When the public were convinced of this doctrine a new line of business was established in removing this surplus. The barber-surgeons were brought into existence for the purpose of taking a pint of blood from all comers who were sick (plus of course a fee for services rendered). The fact that many people treated by these methods were suffering from anaemia and afterwards died, and many others through lack of antiseptic precautions became infected and succumbed, did not worry the barber-surgeons much. Today we can get our blood taken for nothing, and by the latest scientific methods. Tomorrow we might be paid for giving it, but that all depends on how many “blood blacklegs” there are, and also the degree of health consciousness of the masses. No longer is the theory held, “let us take some of your surplus blood and you will get health,” but rather, “let us give you some more blood and you will gain health, or have your life saved.” A curious biological reverse !

Of course there are thousands of street and industrial accidents today that need immediate supplies of blood. But this is not the whole story, there are also many hospital accidents, for modern surgeons, with the aid of anti-septic surgery and anaesthetics, regularly take risks that but a few decades ago they could, or would, never have taken. There is more surgery today than ever before, and there is going to be more tomorrow, especially if a third world war occurs. Consequently a blood donor campaign becomes necessary to capitalist society. Surgery is a very profitable department of science and those that are in it intend that it shall remain so. These strange changes in doctrine become practical politics to the high priests of the medical profession.

Capitalism has long ago converted the cow into a milk producing machine, and the hen into an egg producing apparatus; it now seeks to convert the worker into a blood producing factory, and this has got to be done on a restricted diet.

Horace Jarvis

SPGB Meetings (1947)

Party News from the December 1947 issue of the Socialist Standard

Socialist Sonnet No. 214: Your Party – Not Mine (2025)

   From the Socialism or Your Money Back blog

Your Party – Not Mine

 Is it time a new party was founded?

Sure, the old one’s comprehensively failed,

The locomotive of Labour derailed.

It seems hope is once again unbounded,

As so often before, another red flag

To be run up the polls and kept flying.

Then come the splits, the schisms, the dying,

Such a weight of expectation to drag

Down the vision that was always myopic.

The old nostrums and canards trotted out,

Members who cannot debate, only shout:

Who is going to vote for the shambolic?

This challenge to capitalism’s resolved,

With, at no point, socialism involved.

 

D. A.

Running Commentary: Famine Relief (1986)

The Running Commentary column from the November 1986 issue of the Socialist Standard

Famine Relief

In a hangar at Khartoum airport in the Sudan, an aeroplane sits loaded with milk powder, butter oil, high protein biscuits and medical supplies. Elsewhere in the same city warehouses contain enough food to meet the basic needs of several thousand people for a number of months. Lorries able to transport the food to where it is needed also stand idle.

Meanwhile on the outskirts of Juba, several hundred miles south of Khartoum, at least 50,000 refugees are camped with a further 40,000 expected to arrive from the countryside in the ensuing days and weeks. There is food in Juba's shops but the refugees have no money with which to buy it. They are dependent on emergency food supplies handed out by the aid agencies which are now almost exhausted.

The plane in the airport at Khartoum cannot take off and air-lift the food supplies into places like Juba in the south because no company can be found that is willing to insure it. No company will insure it because the Sudan People's Liberation Army (SPLA) has said that it will shoot down any plane that tries to land in the towns of Wau, Malakal or Juba. This is no idle threat: the SPLA claims to have shot down 24 planes over southern Sudan in the past three years. The trucks cannot move the food because it is feared that they will be attacked or diverted by fighting between Ugandan government troops and Sudanese rebels.

So while politicians and the military play their war games, while insurance companies haggle over premiums, innocent refugees must die of starvation — unwitting victims of power struggles in which they play no part.

Political circus

As another summer season drew to a close and the holiday entertainers packed their bags and headed for home, some seaside towns prepared for the arrival of the circus. Not the usual big top and sawdust affair but a collection of clowns, jugglers and illusionists who make up the political circus, each group demonstrating that no one party has the monopoly of political ignorance.

Possibly, with the media providing saturation coverage, many workers were deluded into believing that these events should be taken seriously. But whatever importance a minority of the working class attached to these proceedings for the vast majority the speeches, interviews and standing ovations were of little significance. After all, once you have seen one circus you have seen them all.

How many times have we watched the juggler with the unemployment figures. Up they go higher and higher, out of control then suddenly they drop when a new set are plucked out of the magician's hat.

Year in, year out it is the same old material. Even when it is borrowed or stolen from one of the other parties, it is always presented as something new. Dress an elephant in a tutu, parade it around the ring and it will still be an elephant. Do the same with some forgotten economic theory and in the crazy world of the political circus it becomes a wondrous new idea capable of solving all manner of problems.

To some people a man with a red nose and baggy trousers who talks nonsense, squabbles with his partners and makes rude noises is a clown, but to others he is an elected representative entrusted with the responsibilities of running the country. A figure of fun he may appear to be but his contribution to the greatest illusion of all is no laughing matter.

For the famous "Make Capitalism Operate in the Workers' Interest" trick is one that has kept the clown and other buffoons employed for a long time Like all good illusions this one relies heavily on deception and the willing participation of the audience. It is not in performing the trick that the deception lies but in convincing the audience that it can be done. For their part the audience has possibly assisted in the deception. Duped into supporting the very system that causes the problems around them the answer must lie with themselves. Because of their acquiescence capitalism continues. In a world of potential abundance this sickening farce should have no place.

It is up to the working class to bring down the curtain on the present economic system and introduce socialism. Only then will the world be able to live in peaceful co-existence freed from the constraints of the profit- motive and the absurd posturings of a small band of professional idiots will be as out of place as a one-legged cyclist in a present day circus.

Independent It’s Not

The new "quality" newspaper the Independent is, we are told, politically, financially and editorially independent. So is this the breakthrough we socialists have been waiting for? A chance to put across our ideas to workers through the columns of a newspaper that claims to be politically non-partisan?

Well, this socialist hasn't actually tried submitting an article to the Independent putting the socialist viewpoint, but then I haven't much confidence in the "independence" of a newspaper whose editor. Andreas Whittam Smith, previously worked on the Financial Times, the Daily Telegraph and the Investors Chronicle and who is described by those who claim to know as a "wet Tory or Social Democrat". An editor who had relatively little trouble in raising the £18 million necessary to start the new paper because he enjoyed the confidence of City investors with whom he had developed extensive contacts when working for the FT etc.

It is hard to believe that a newspaper that has such close ties with the capitalist class can really be taken seriously as independent. If the Independent gives good factual news coverage on a wide range of issues so that people can make up their own minds about those issues, then that would be a small step forwards. But the question will still remain which facts are we being given; on what basis are they being selected; and by whom? The Independent may be politically unaffiliated and editorially independent, despite the editor's personal political views; it might even be financially independent in that a number of investors have bought shares in it rather than just one member of the capitalist class owning it outright; what is extremely unlikely is that it will offer us anything like an alternative perspective on the world around us.

Socialism and democracy (1986)

Book Review from the November 1986 issue of the Socialist Standard

The Battle of Democracy by Keith Graham, Wheatsheaf Books, £8.95

What is democracy? Why should it be considered a good thing? Why should an individual accept a democratically-arrived-at decision with which they disagree? These are the questions Keith Graham sets out to answer in the first, more philosophical, part of his book (The Battle of Democracy, Wheatsheaf Books, £8.95)

The simplest definition of democracy is that it is decision-making by the whole people (“rule by the people”, as the Greek words from which it is formed mean) involving procedures such as free and open debate, free access to information, one person one vote, and the accountability of public officials and elected representatives. Graham argues that such a decision-making system can be regarded as desirable because one key aspect of the nature of human beings is their ability to reflect and weigh up options before deciding what to do. In other words, a system in which the people as a whole freely decide what to do is the only decision-making system worthy of humans as self-determining (“free”) agents.

The idea of democracy is also bound up with that of equality, if only in the sense that it is a decision-making procedure in which every human deemed capable of making a reasoned decision has a vote of equal weight. Pursuing this further, Graham shows that ensuring each person an equal as possible say in the decision-making process requires a high degree of social equality and not mere equal political rights. This introduces the idea that it is not only political democracy that is desirable for humans as self-determining agents but a democratic society. As Graham makes clear in the second, more political, part of his book where he discusses the views of Marx, Lenin and others on democracy, this democratic society would have to be “a world where private ownership of the means of production, buying and selling, the wages system have all been abolished, in favour of the communal ownership of the earth’s resources”. In other words, the philosophical justification for democracy is also, even more so in fact, a philosophical justification for socialism—though, of course, as Graham is quick to point out, Marx himself did not justify establishing socialism on such “an appeal to abstract, timeless principles to do with the nature of human beings”.

Graham’s discussion of the views of Marx and Lenin on democracy—in which he convincingly makes the point that “the terrible fate which befell Marx was that he was Leninised—corresponds exactly to our own position on this subject: Marx stood for the establishment of a democratic, classless society as a democratic act on the part of the wage and salary working class as a whole. In contrast, Lenin saw the agent of social revolution as a minority “vanguard” of professional revolutionaries who, on winning power, would establish their own undemocratic, even if supposedly temporary, rule over the rest of society. Graham’s discussion of the differing views of Marx and Lenin also allows him to clarify the reform versus revolution dilemma, often seen as a choice between gradual, constitutional change and violent insurrection. He can also set out, for the first time in a book of this sort, the case for a revolutionary but essentially peaceful use of existing political institutions as the means of establishing socialism.

Marx’s presuppositions enable a distinctive challenge to be made to the two alternative positions on the question of constitutionalism as we have been considering them. In one way, the most important political development for Marx takes place prior to any revolution and outside parliamentary institutions, namely in the growth of working class consciousness. This is distinct from Kautsky’s parliamentary constitutionalism, where the entry of a party into parliament, which may form alliances with non-revolutionary groups and the like, is seen as the chief means to revolution . . . On the other hand, Marx’s position is distinct from Lenin’s. The state is not to be smashed but taken control of, so that it cannot be used against a revolutionary working class: and some of the institutions of a parliamentary system, notably universal suffrage, will be something to foster for a majoritarian like Marx, though not for a vanguardist like Lenin. In the light of Marx’s presuppositions, there do seem to be oversimplifications in the terms used to express the original dilemma of the route to the new society. There need be no straight-forward, exclusive and exhaustive choice between constitutionalism and violent seizure of power. Certain elements within existing institutions may be valued, and action taken in conformity with them, while others may not. Connectedly, the aspiration to a peaceful transition need not be identified with an attempt to effect it by piecemeal means, an identification which both Kautsky and Lenin are prone to make. It is consistent with Marx’s presuppositions to recognise parliament as an institution geared to the needs of capitalism, and therefore inappropriate as the vehicle for a fundamental transformation, but yet to regard its connected electoral practices as coinciding, to some extent, with the principles governing that transformation, and to that extent adding the possibility of a peaceful transition. This is not tantamount to the view parodied by Lenin as the expectation that the ruling class will meekly submit to the working class, as minority to majority. It does, however, limit violence to the role of counter-violence in the event of resistance when a clear majority for revolutionary change is apparent, rather than seeing the use of violence as itself a primary means of change, even in the absence of majority support.

Leninists sometimes try to argue that this is only a question of tactics, that they too share the ultimate goal of a truly democratic society (socialism) but that because a majority of workers can never be expected to acquire a socialist understanding within capitalism (“the ruling ideas of an epoch are those of the ruling class”, as Marx put it), a minority must act on their behalf. Graham answers this by pointing out that, in the case of socialism as the democratic society, there is a very real sense in which the end determines the means to achieve it.

What is the nature of the transformation which, according to Marx, it is the role of the proletariat to bring about? In place of the compulsion to work which is characteristic of their position in capitalism, there will be a free association of people. In place of the exploitation of one section by another there will be common ownership of the means of production. In place of the political domination of a bureaucratic elite there will be widespread participation and revocable delegation. Leaving aside all question of the realism of Marx’s proposals, these are the arrangements which he regards as meeting the real interests of the proletariat. But these are arrangements which in their very description are incapable of attainment without the voluntary co-operation of the proletariat itself. Whereas you can make people do what they do not wish to do, you cannot make them adopt a set of social relations which require their voluntary co-operation if they do not voluntarily co-operate (Graham’s emphasis).

In other words, democratic organisation and methods are not just one among many possible means to establish a democratic society; they are the only such means. Leninist minority action can only lead, as historical experience has confirmed, to some form of minority rule—in fact to a more undemocratic society than the sort of capitalism we know in countries like Britain.

The Battle of Democracy, is a very useful book about the nature of democracy written by a socialist. It is hoped that it will spark off a wide-ranging discussion about the desirability and feasibility of “a world-wide society of common ownership” and of the means of bringing it into being.

Adam Buick