PHM-Exch> Moving Beyond Capitalism for Our Health

[Claudio Schuftan]

*Sent as a letter to The Lancet, but got no response.     Claudio*

*Moving Beyond Capitalism for Our Health*



            Richard Horton’s ‘offline’ articles capture the essence of why
capitalism continues to hinder equitable health access and outcomes
worldwide. His piece ‘Medicine and Marx’ centers on Marx’s visionary
explanation of the key problems of capitalism that continue to afflict
today’s public health.[1] <#m_535924193500748062__edn1> Fittingly, among
other sources, Horton quotes from Howard Waitzkin’s 1978 article in the *Annals
of Internal Medicine, ‘*A Marxist View of Medical Care’: “The Marxist
viewpoint questions whether major improvements in the health system can
occur without fundamental changes in the broad social order.”[2]
<#m_535924193500748062__edn2> Horton concludes, “…we might agree that
medicine has a great deal to learn from Marx.”1

            Horton also reminds his readers of another great theorist and
revolutionary in the Marxist tradition, Rosa Luxemburg.[3]
<#m_535924193500748062__edn3> Murdered a century ago, Luxemburg focused on
the accumulation of capital and on capitalist imperialism as fundamental
problems that called for revolutionary transformation. Considering
Luxemburg’s theses relevance to medicine, Horton describes key work by my
colleagues in the People’s Health Movement (PHM), i.e., work by Amit
Sengupta, Chiara Bodini, and Sebastian Franco (‘*The Struggle for Health’*),
that emphasizes the deepening threats to health brought about by
contemporary global capitalism.[4] <#m_535924193500748062__edn4> Sengupta
died on Nov 28, 2018, in a tragic drowning accident.[5]
<#m_535924193500748062__edn5> To honor Amit’s memory, I focus this brief
article on ‘moving beyond capitalism for our health’.

            The transformation that this move requires is powerfully
portrayed in Howard Waitzkin and the Working Group on Health Beyond
Capitalism’s new book that points to capitalism as the central threat to
the health of people worldwide. Consequently, it identifies moving beyond
capitalism as the only long-term solution.[6] <#m_535924193500748062__edn6>
The book rightfully argues that we can no longer defer the urgently needed
transformation of global capitalism until future generations; humanity and
other life forms depend on our embracing the needed revolutionary changes
--here and now.

            The book’s subtitle, ‘Moving Beyond Capitalism for Our
Health’, points
to the authors’ intention to clarify the true determinants of preventable
ill-health and early deaths ultimately due to the prevailing global
political-economic system. Moving beyond capitalism also points toward a
roadmap to transform this system --and in this aim the book fully delivers.
The struggle that the book calls for was embraced by Sengupta and has, for
years, been at the core of PHM’s and other social movements’ struggle. This
moment of our planet’s history deserves no less.

            Smoothly written and provocative, the book contains no
caricatures, no stereotypes. Even though the book exposes the troubling
guts of neoliberalism and how it affects health globally, the writing is
not depressing. It walks the reader through the complex geopolitical and
economic challenges we face and does so with informative and engaging
prose. I do not know any analysis that better explains the ravages of
capitalism on health and health services; it complements the views
expressed in Horton’s pieces.

            The book’s optimistic closing is welcome. Let me give you a
flavor here.

“We recognize”, it says “… that we hold no corner on a strategic truth.…
Still, we see four main priorities for action”, namely:

·      Fostering a sustained, broad-based movement for single-payer
national health programs that reduces the role of corporations and private
profit.

·      Working towards an activated labor movement that includes health
professionals such as physicians whose deteriorated social-class position
and a proletarianized condition of their medical practice have made them
ripe for activism and change.

·      Calling for greater emphasis on communal organizations that
participate in the revolutionary process of moving ‘beyond capital’.

·      Promoting the understanding that the importance of party building
goes far beyond electoral campaigns to more fundamental social
transformation.
All these priorities emphasize the urgency of creating bridges that link
health activism with social movements that focus on social-class oppression
including poverty and inequality, racism, sexism, environmental
degradation, militarism and imperialism, as well as the dominant ideologies
that lead women and men to accept pathological social conditions as being
‘normal’.

Before us is a path to revolutionary transformation of the social
conditions that distort our best efforts in medicine and public health.
This vision reinforces Sengupta’s and many others’ understanding that PHM
and similar social movements worldwide must now move beyond capitalism to
achieve health.

*Claudio Schuftan*

*cschuftan at phmovement.org <cschuftan at phmovement.org>*

------------------------------

[1] <#m_535924193500748062__ednref1>    Horton R. Medicine and Marx. *Lancet
*2017; *390:* 2026.

[2] <#m_535924193500748062__ednref2>    Waitzkin H. A Marxist view of
medical care. *Ann Intern Med* 1978;* 89: *264-78.

[3] <#m_535924193500748062__ednref3>    Horton R. Rosa Luxemburg and the
struggle for health. *Lancet* 2019; *393: *114.

[4] <#m_535924193500748062__ednref4>    Sengupta A, Bodini C, Franco S. The
struggle for health: an emancipatory approach in the era of neoliberal
globalization. Brussels: Roxa-Luxemburg-Stiftung, 2018.

[5] <#m_535924193500748062__ednref5>    Green A. Amit Sengupta. *Lancet*
2019; *393: *24.

[6] <#m_535924193500748062__ednref6>    Waitzkin H and the Working Group on
Health Beyond Capitalism. *Health Care Under the Knife: Moving Beyond
Capitalism for Our Health. *New York: Monthly Review Press, 2018.
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