What do I think? Anybody?
I'm ready to support State control of health distribution as a lesser evil. It makes me feel dirty... I'd like to have some discussion about this before my statist, reformist and capitalist friends start asking me questions. Anybody know where to start?
There's nothing dirty about thinking universal healthcare provision is better than income-related healthcare provision, in the same way as there's nothing dirty about supporting pay-related strikes which clearly aren't about overthrowing the state. The point is that when the other option becomes available, you don't falter in demanding it.
And, as Lazy Riser would point out, you endeavour to make it the case that another option becomes available.
It comes out on the 29th.
I think an argument might be made that putting healthcare in the hands of the state wouldnt make that much of a difference. think about who would control this coordination, who would be given the power to doll out contracts and who would get these contracts? what would make state run universal health care anything more than a way for pharmaceuticals to offset even more of their costs? On the plus side, everyone would be able to get some (supposedly), but on the down side, access to this is sort of like a steam valve, things will get just better enough to prevent anything resembling a revolution for an even longer time. it will lock people even more into the arms of the state and discourage medical autonomy.
whaddayathink?
I would give my left nut for single payer universal health care instead of the system we have now. And I'm sure the 42 million people without healthcare insurance would love it too. Most of my working life I haven't had any insurance. Why would you feel dirty?
It comes out on the 29th.I think an argument might be made that putting healthcare in the hands of the state wouldnt make that much of a difference. think about who would control this coordination, who would be given the power to doll out contracts and who would get these contracts? what would make state run universal health care anything more than a way for pharmaceuticals to offset even more of their costs? On the plus side, everyone would be able to get some (supposedly), but on the down side, access to this is sort of like a steam valve, things will get just better enough to prevent anything resembling a revolution for an even longer time. it will lock people even more into the arms of the state and discourage medical autonomy.
whaddayathink?
a majority of private healthcare company profits are from medicair and medicaid. You're already paying for the healthcare. You just don't get it any of it.
Ultra-leftism, a condition which leaves people in absolutely impractical political positions rather than accepting that working people can have their lives improved by something other than a total communist revolution until we build that revolution.
dont be a dick. i was playing devil's advocate. as i said above i am ready to support state healthcare. i feel dirty b/c that means i'm sharing a podium with limp-wristed liberal democrats and grinning politicians. the argument i was presenting was done so to build some nuance to this issue, namely that reform, even with immediate benefits can have structural detriments. the argument it isn't my opinion, i am still developing one through this discussion. please send the article you mentioned, it sounds helpful.
I think Sicko is Moore's best bit of propaganda so far. I'm even willing to forgive him his patriotic pandering (Al Qaeda gets better health care than 9-11 rescue workers!) and cheap shots. The popular appeal for this film should be huge. One of the brilliant things about the movie is that it's not just about the folks in the U.S. without medical insurance; it's mostly about the poor quality of service people who pay for medical insurance get, and how they often become bankrupt, lose jobs, lose homes, etc... to pay for things that are universally socialized elsewhere.
I do think Moore could have drawn a bigger connection between the difference between universal health insurance versus insurance tied to your employer (which discourages folks from striking or seeking other jobs). He did draw a connection to having universal health care (and time off) to a feeling empowered enough to take action... it just would have been nice if he'd shown it a bit more clearly in terms of employment.
Do you think state healthcare is something that can realistically be fought for in the US - given that countries like the UK are actively dismantling institutions like the NHS - handing as much as possible over to private companies and asset stripping/cutting back the rest?
Obviously universal healthcare free at point of use is better than the US system, but I don't think that necessarily means it's something communists should actively campaign for. It's the material provision of health care that should be fought for rather than the form it comes in.
http://libcom.org/forums/organise/defending-nhs goes into this a bit, I think Joseph K's posts on that thread were good.
Thanks catch, this discussion you linked seems very useful. I'm gonna read it before posting anything else.
Do you think state healthcare is something that can realistically be fought for in the US - given that countries like the UK are actively dismantling institutions like the NHS - handing as much as possible over to private companies and asset stripping/cutting back the rest?
That's like arguing that where workers gains are being rolled back at one shop, that folks in another shop can't fight and win those gains?
Couldn't it possibly be that the lack of those gains by workers in the U.S. is what's making the ruling class in the U.K. think it's possible to get away with rolling back benefits workers in the U.K. have had since WWII?
There ain't anything inevitable about class struggle. That's why it's a struggle.
There ain't anything inevitable about class struggle. That's why it's a struggle.
Damnnnn... is this a T-shirt yet? 
Some form of socialized healthcare is going to be huge in the US, we will win it, but it will also result in an increase in for profit hospitals. They'll just collect more money from taxes and less money from insurance.
Some form of socialized healthcare is going to be huge in the US, we will win it, but it will also result in an increase in for profit hospitals. They'll just collect more money from taxes and less money from insurance.
one step forward and two steps back? or just a step forward?
Quote:
Some form of socialized healthcare is going to be huge in the US, we will win it, but it will also result in an increase in for profit hospitals. They'll just collect more money from taxes and less money from insurance.one step forward and two steps back? or just a step forward?
well, it'll result in coverage for more people, rich people will get richer and our taxes will go up. Well, I'm for more people with health coverage. I just don't think its gonna be much more than a way of further shifting costs of poor people onto the backs of not quite poor people and make rich people happy in the process.
I just don't think its gonna be much more than a way of further shifting costs of poor people onto the backs of not quite poor people and make rich people happy in the process.
Economically speaking. But in terms of health outcomes it'll be huge. That'll be a role for lefties, to help struggle for as much local control over health outcomes and assessments as possible.
one of the things that really shocked me, and continues to shock me, in the US is why the poor state of their health care system is not the number one organizing issue today. I was appalled to find the conditions both insured and uninsured Americans live under. And what was even more amazing, was the sustained propaganda conducted by the US government trying to distribute blatant lies about the Canadian health care system.
You'd have to be pretty sick to argue against socialized medicine, at least as a basic step forward -- a huge one at that.
Sicko is a good movie, and I think it will have a huge impact. I also think a huge public awareness campaign by @'s over the benefits of socialized medicine would do wonders.
Mike Harman wrote:
Do you think state healthcare is something that can realistically be fought for in the US - given that countries like the UK are actively dismantling institutions like the NHS - handing as much as possible over to private companies and asset stripping/cutting back the rest?That's like arguing that where workers gains are being rolled back at one shop, that folks in another shop can't fight and win those gains?
No not really, it's asking if you think it's realistic to do that in these specific circumstances. If you asked me if I thought it was realistic to ask for the same wages, benefits and conditions of service as (say) tube drivers in my workplace, I'd say no. Doesn't mean I don't think that people shouldn't be organising around those things, just not in those terms.*
I don't know how much grass roots support there is (and more importantly will and organisation) behind better social healthcare provision, or how much 'liberal' support there is amongst legislators etc. so it was a genuine question as well as a partly rhetorical one.
If it's something that might happen anyway, then it would be worth organising around to try to gain maximal benefits from it and expose any contradictions or shortfalls in implementation. As tiny organisations (or isolated individuals) the best you can hope for is to nudge something that's already moving towards a better direction - a few anarchists (or for that matter lefties in general) aren't a movement by themselves. At a micro level, you can start the process of organising from existing grievances, but you can't pick something and impose it on people.
If you don't think it's realistic, then it's close to a "transitional demand" - note I'm saying a state healthcare system in particular, not "socialised healthcare" in general - which obviously is an end goal alongside socialised everything. As thugarchist points out, it would be possible to move from insurance to a state healthcare system in such a way that it provided very little gains (or no gains at all) - certainly for those who can just about afford health insurance now who might be worse off. It could also mean serious attacks on health sector staff - shifting costs onto unpaid volunteers and third sector workers - I'm thinking mainly nurses and care assistants who'd be in between cleaners and doctors (both of which groups could both potentially gain or be unaffected by such changes).
Couldn't it possibly be that the lack of those gains by workers in the U.S. is what's making the ruling class in the U.K. think it's possible to get away with rolling back benefits workers in the U.K. have had since WWII?
I'd say the lack of militancy in the UK since the 1980s, and a whole series of defeats, is what's led to the far more comprehensive attacks under New Labour, allied with the close relationship of some big public sector unions to the Labour party (and leadership, especially with Unison) which has led to additional reasons for them to try to avoid strikes at all costs.
I'd say the lack of militancy in the UK since the 1980s, and a whole series of defeats, is what's led to the far more comprehensive attacks under New Labour, allied with the close relationship of some big public sector unions to the Labour party (and leadership, especially with Unison) which has led to additional reasons for them to try to avoid strikes at all costs.
I've never really understood the relationship of your unions to the labour party. In the states folks complain about unions supporting the democrats all the time etc etc, Its practically true, but the relationship isn't even remotely like the one y'alls union have to party politics. One of the interesting shifts here is the organizing unions attempting to break from party allegience. In real world terms this is already playing out on the local and state levels increasingly and is at least being paid lip service on the national level. In the southwest on the local level most union members are either republican, libertarian-right leaning or social-conservative dems. There ain't many liberals really like back east or in cali.
it's a historical thing with social democracy, the labour party came out of the labour movement so that may explain their closeness to a particular party
I've never really understood the relationship of your unions to the labour party.
Put it this way, I got a glossy magazine from mine imploring me to vote New Labour at the local elections and saying what wonderful things they'd done plus how lovely Gordon Brown is.
I just don't think its gonna be much more than a way of further shifting costs of poor people onto the backs of not quite poor people and make rich people happy in the process.
insurance is all about pooling risk. a single payer system maximizes the size of the pool. however, it also increases the efficiency of the system as it eliminates the duplicating bureaucracies of the insurance companies, plus their private profits. also, if people rely on emergency rooms too much, this increases the costs of providing health care in general, as that is one of the most costly forms of care. universal single-payer would tend to encourage people not to rely on that practice, and would encourage more preventative care, as people would be more willing to see doctors.
the labor movement does seem to be coming together around single-payer. this is a change from past practice in the post-World War II period, with the emphasis on negotiated "private wefare state" for the organized segments of workers. the plumbers union just endorsed single payer at its recent convention. the American plumbers are the highest paid blue collar workers in the world. this is one of the most conservative American unions. historically the building trades have opposed single payer in the interests of protecting their "private welfare states".
the leading Democrats are still in the pocket of the private insurance racket, tho. all of the main Dem canidates for president refuse to support single-payer (but who knows what effect Sicko might have on the public debate), as does the leader of the Dems in the California state legislature.
single-payer is not actually about government provision of health care. it's only about social insurance. the health care industry would still be made up of big private for profit outfits and fee for service medical practices.
Quote:
I just don't think its gonna be much more than a way of further shifting costs of poor people onto the backs of not quite poor people and make rich people happy in the process.insurance is all about pooling risk. a single payer system maximizes the size of the pool. however, it also increases the efficiency of the system as it eliminates the duplicating bureaucracies of the insurance companies, plus their private profits. also, if people rely on emergency rooms too much, this increases the costs of providing health care in general, as that is one of the most costly forms of care. universal single-payer would tend to encourage people not to rely on that practice, and would encourage more preventative care, as people would be more willing to see doctors.
the labor movement does seem to be coming together around single-payer. this is a change from past practice in the post-World War II period, with the emphasis on negotiated "private wefare state" for the organized segments of workers. the plumbers union just endorsed single payer at its recent convention. the American plumbers are the highest paid blue collar workers in the world. this is one of the most conservative American unions. historically the building trades have opposed single payer in the interests of protecting their "private welfare states".
the leading Democrats are still in the pocket of the private insurance racket, tho. all of the main Dem canidates for president refuse to support single-payer (but who knows what effect Sicko might have on the public debate), as does the leader of the Dems in the California state legislature.
single-payer is not actually about government provision of health care. it's only about social insurance. the health care industry would still be made up of big private for profit outfits and fee for service medical practices.
Thats what I said only I said it in one sentence. 
Hi. I just posted a news story about the health care workers’ strike in Poland (hopefully to be approved by the moderator soon) which includes something about privatized healthcare. A few thoughts from my side.
Obviously there’s no way to support private, for profit health care in light of the capitalist system. Yet the idea that somehow we should “let the state” deal with this is rather defeatist and actually could be quite dangerous.
Some example of state-run health care systems that run well were given as arguments that ultimately, the state-run system is better than the private one but this overlooks the fact that the quality of the state-run systems differ dramatically from country to country. This depends on a lot of factors, including the relative wealth of a given country, the ratio of employed to unemployed people, the level of corruption in a given country, the dominant social philosophy and even the level of activism of the people themselves. This is not at all to say that I am suggesting that in any case privatized health care may look like a better option – but that simply state controlled health care is not a panacea, as some here have rightfully suggested.
As Sam Dolgoff used to say, when anarchists are asked tto choose between two options, they can usually present a third. I don’t see any reason why any anarchist would not opt to instead present other ideas for the health care system – for example direct popular control of medical services. I’m sure that most people here would agree that our ultimate goal is socialized medicine, not state-run health care but it seems like some feel that we should be moving towards this in increments and that getting the state to take over is a healthy step in this direction. Possibly, if one is lucky, this may prove true – but still this is no reason not to present a real alternative vision to the provision of public services right now.
Ultimately, the anarchists are not going to swing anything against the introduction of universal state-provided health care if they decide not to support it uncritically. It’s not the anarchists who are going to force the issue but some conjucture of different forces, including capitalists who ultimately still stand to earn off the system, regardless of whether it’s state or private. We should be trying to promote our ideas, not the ideas of state protectionism, which ultimately work against our interests.
I saw Sicko and we liked it, and even we want to get a translation done so we can show it to striking health care workers. The average person here just doesn’t get the class realities of what privatized health care means and people tend to be convinced that in the US, the level of health care is “high” – because quite frankly, it is very high for those that can afford it. Some treatment which is standard in some richer countries is simply unthinkable here because there’s no equipment for it. So the message for people here is extremely important that, having something “available” is not the same as having something “available to you” – one of the great lessons of capitalist “abudance”.
As Sam Dolgoff used to say, when anarchists are asked tto choose between two options, they can usually present a third. I don’t see any reason why any anarchist would not opt to instead present other ideas for the health care system – for example direct popular control of medical services.
"Despite the force and unquestionably positive character of anarchist ideas, despite the clarity and completeness of anarchist positions with regard to the social revolution, and despite the heroism and countless sacrifices of anarchists in the struggle for Anarchist Communism, it is very telling that in spite of all this, the anarchist movement has always remained weak and has most often featured in the history of working-class struggles, not as a determining factor, but rather as a fringe phenomenon. "
If you are trying to make an argument for socialised medicine in a country where such a concept is at a very charitable best hugely impractical and unrealistic you are pigeonholing yourself into being a vocal irrelevance, or worse (if your ideas are taken seriously) actively dangerous. In most countries the concept that popular organisations could somehow take over the huge burden and responsibility for the provision of healthcare, with all that entails in terms of the necessary huge aggregations of capital and a logistical network that is required to maintain a healthcare system, is definitely problematic. For a start it would kill people as they'd be crap at it, and on a strategic footing it would absorb so much energy that I would be surprised if it didn't detract from the more serious proposition of actually taking over the existing means of production, which includes that of healthcare. It would also be forced by definition to work within the constraints of capitalism, turning people's movements into an effectively 'franchised' arm of the state in relation to this.
Anarchists should fight for state provision of healthcare in most circumstances. They should fight for ever increasing investment in healthcare of course, and they should fight for more and more democracy to be built into the provision of that healthcare, but outside of a revolution or a collapse in society attempting to provide healthcare I think would be seriously misjudged, and also will make you look completely loony.
The UK's NHS is the second largest employer in the world. It has been an absolutely massive step forward for the working class in this country. If the 1930s and 40s labour movement had attempted to provide healthcare it would have been completely crap and definitely would no longer exist. Life expectancy for the poorest people in this country, and the quality of life of society as a whole would have been vastly different to today. Furthermore as our American comrades have pointed out unions (while by no means perfect, but definitely mass organisations of the class) in the 'States do effectively provide healthcare for their members, as you are advocating - as our comrades point out, it's crap. Healthcare, like high tech or military engineering systems research, is, because of the necessity to run it centrally with massive concentrations of capital - which the private sector can never provide - something the state is, by definition, really fucking good at.
Economically speaking. But in terms of health outcomes it'll be huge. That'll be a role for lefties, to help struggle for as much local control over health outcomes and assessments as possible.
Exactly, as a health care worker and anarchist i've thinking/working on this in my brain. I think the realistic demand to fight for is collective local control over healthcare adminstation. That is, the state will already be extracting the wealth for healthcare, but we can push to take administration, allocation, and organization out of its hands.
Thugarchist the relationship between the Trade Union leadership and the Labour Party goes way way beyond that of the former supporting the later. I think it has changed a bit under Blair but traditionally union leaders had a big vote at the Labour Party annual conference, one third of the seats on the Labour Party National Executive Committee, and directly sponsered one third of Labour Party constituency organisations. That is, they were a power within the party.
Both the British and Irish Labour Parties were established by the trade unions. Some Labour Party politicans got to their position via the trade union hierarchy. Bevin in the 40s for instance was TUC general secretary and one of the three person ministerial cabinet that was to organise the last ditch defence of Britain in the event of German invasion. The Social Democrats and Communists on the continent were someways similar. I think you also have trade union leaders being the directors of state owned companies.
Unions have a 50% block vote at conference, though this rarely makes much difference to actual policymaking.
I would give my left nut for single payer universal health care instead of the system we have now. And I'm sure the 42 million people without healthcare insurance would love it too.
As one of the 42 million, I'm with you there!
As far as the pushing for local, collective control of healthcare goes...its a good idea but completely impractical for the American situation...I've gone through the exact same thought process and come to the conclusion, on similar terms to what others have already said, it simply isn't possible. Really...how would it happen?
Even if healthcare workers unions were anything but on the defensive (where they exist), they still wouldn't be strong enough to take control of hospitals, etc. Even if they were, what solidarity could they expect from other workers organizations? US unions are weak and getting weaker...taking control of healthcare would require not just strong healthcare unions but also strong unions in every other sector in order to provide them with the logistic, material, and ultimately military support to keep up their occupations.
In the meantime, me and 42 million other folks don't have insurance...and we aren't willing to wait decades to build the labor movement to the point where we could do something about it without the state.
The only realistic alternative, absent necessary government action, would be the churches organizing mutual support networks among their membership...we've got WAY more people organized in churches than in unions.
SEIU ain't on the defensive. Just reached over a million healthcare members and launched SEIU Healthcare in Baltimore this past weekend.
http://p-crac.blogspot.com/2007/06/seiu-healthcare-launch.html
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That film looks like it might be interesting, anyone seen it?