Capitalism puts a price on everything including human life.Today the promotion and maintenance of good health and the treatment and cure of ill people is divided among three sectors: private, public and voluntary. The motivating concept in the private sector is pursuit of profit for the providers. The public sector aims primarily to provide goods and services for the consuming public, usually with state or other subsidy. The voluntary sector is the least money-oriented of the three; it is concerned with helping people to help others and themselves.
To some extent the three sectors compete and even conflict with each other. People in urgent need of a serious operation ponder whether they can afford to “go private” quickly or have to join a lengthy NHS waiting list. Can those with extensive work and domestic responsibilities find the time to volunteer in the same way? (In fact one in six people in Britain do volunteer work of one kind or another.)
The three sectors also work together to form the health part of the capitalist system. Public-private partnerships have grown within the welfare state. Paid organisers and administrative staff help to run part of the ”voluntary” sector, in effect employing unpaid labour.
All three sectors are concerned in different ways with the meeting of human need. The private sector uses capital and labour to meet needs that are expressed in economic terms and with the expectation of profit for the providers: “We’ll try to keep you well and treat you if you’re not, but only if you pay the market price for this.” The public sector is more concerned with meeting the needs of the system than of people: “If you can’t pay you can wait for free or cheap treatment because the economy needs fit workers, not unproductive ones.” The voluntary sector focuses on meeting human needs, but it does so to help keep the system going: “You are a good citizen if you volunteer—give free labour—to meet the health needs of others.”
Capitalism puts a price on everything, including human life. The nice (National Institute for Clinical Excellence) people in the NHS reckon that £30,000 is the maximum price to pay for a year’s drug treatment if you’ve got terminal cancer. There is a profitable (to shareholders) insurance industry that has a tariff of payouts for various injuries and health losses.
Capitalism is bad for your health, especially if you are a worker. In employment you are likely to be worried about the consequences of losing it or struggling to find the money to pay all the bills. The use of antidepressants is widespread, particularly among the unemployed. Four in ten people on invalidity benefit are now off work because of mental illness—twice as many as in the 1980s. “Presenteeism”—turning up for work ill—is also on the increase.
Cheap fatty food leads to problems of obesity, while ill old people who lack care are undernourished. Addiction to medicines and alcohol is encouraged by the profit-seeking providers, marketing firms re-brand foods rich in antioxidants as “superfoods”, but these may do more harm than good. Wars in which no working-class interest is at stake benefit the élite in the war industry, but kill, maim and cause mental illness to the armed forces and civilians.
What can we say about the likely effects on health and illness of future socialist society? It is easier to foresee what won’t happen than what will. The promotion of good health and the care of the injured and sick won’t be restricted by money considerations. There will be no profit to be made out of employing people in dangerous occupations, supplying them with unhealthy substances or encouraging their harmful addictions. No sales-people will advertise items and services that at best have no good effect on health and at worst damage it. Health and injury insurance and the compensation industry won’t be necessary.
The types and incidence of health problems are likely to differ in the early stage of socialism from later stages when the legacy from the money system will have receded. Also, some parts of the world today have different degrees of economic development, commonly referred to as under-developed, developing and developed. We don’t know the extent to which present trends, such as urbanisation and environmental degradation, will continue, accelerate or be reversed.
One thing we can say for certain is that socialism will release us from useless and harmful capitalist employment. We shall be free to take up work that will meet the needs of ourselves, others and the community, society and world in which we live. This is not to say that there won’t be problems to overcome. Natural disasters and pandemics won’t end with capitalism, although more effort will doubtless be devoted to avoiding and coping with them.
The recruitment, training and deployment of committed volunteers will take much organising and administration. The emphasis will be on activities and tasks rather than on occupational labels: nursing, brain surgery, portering, scientific research, and so on, rather than nurses, brain surgeons, porters, scientific researchers. Everywhere we shall treat each other as friendly co-operators, not competing commodities.