Aotearoa: Capitalist Health is failing: Socialize!

Health workers on strike against government cuts

Health Services are clearly under-funded to meet the demands workers put on it. Why? Under capitalism workers are paid to consume only those commodities, including health services, which are necessary to reproduced their labour power. If capitalism no longer needs their labour power, or has a pool of cheap labour to replace it, then it has no need to reproduce them, healthy or not. In fact for capitalism to live more and more workers must die. We will not let this happen. Socialize health! For workers to live capitalism must die!

In Parliament, year after year the capitalist parties debate the details of health budgets. Spending was 9.1% of NZ GDP in 2007 ($16.2 billion)– of which public funding was 70% ($13.6 billion). Now government spending has is estimated to reach ($16.1 billion 2016-2017). While over ten years the numbers have increased, funding has failed to keep pace with costs and needs. State health services have been continuously told to ‘tighten their belts”. That has a negative impact on services quality or quantity and is an attack on the whole population (working class).

The health workforce has carried much of the costs because of increasing workloads; health workers increase “productivity” however mostly this is not through technological advances, just increasing workloads and increasing stress.

The NZ state had always allowed “non-government” health services, the little capitalist’s accumulation created the conditions to undermine state health services. Even the first Labour government of 1935 allowed the doctors in “private practice” to charge a fee on-top of government funding. The capitalist profit system was in play – and the “for profit” health sector has continued to expand. Private surgical hospitals performed 164 “elective” surgical procedures back in 2008-09, most contracted to the state (DHB – District Health Boards). The bulk of private hospital’s work is from medical insurance. The proportion of population with some health insurance has risen to approximately 1/3.

The private system undermines the state system and subverts equality of access by fast tracking the insured (capitalists and rich workers). Private hospitals and specialists take money for simple procedures, and queue jumping, yet when patients continue to have problems it is the public system that remains to do the hard work.

Drug companies put their own profits before peoples’ lives. Pharmaceutical companies have become big players on the national political scenes around the world. In the USA they lobby for patent protection and inflate the price of HIV / AIDS medications to $15,000 per year, whereas the costs of production were around $350 per year. Their extortionate profits were broken by an Indian drug producer who promised to supply Africa (anti-retro viral medications) for $350 per year (per person). E.g., the documentary called “fire in the blood”.

Often the USA acts to protect the drug companies profits (patent law) however when an anthrax scare killed less than 20 US people, they were prepared to suspend patent laws to produce medications for their own population. So the hypocrisy of U.S. national drug profits was exposed. The U.S. pharmaceuticals have set up the TPPA (Trans-Pacific Partnership Agreement) as a weapon to extort other nations and profit from drug monopolies. It is expected to increase the costs of medications in NZ – even the right wing Prime Minister John Key had to admit it. Currently the NZ state is currently able to control pharmaceutical/medicines costs by running a single buyer for the whole country (“Pharmac”).

Whereas the US capitalist model is that the insurance companies (finance capitalism) negotiates with the pharmaceutical companies (behind closed doors). The pharmaceutical companies have their own direct (advertising) and indirect (lobbying, etc) campaigns to manipulate the U.S. population to pay profitable prices for life saving drugs. They expose that the capitalist model is clearly die or pay for profits of capitalists. This was shown recently when Martin Shkreli took over a drug company and raised the anti-retro viral drug price by 50x, and put up the price of a incurable kidney disease drug.

The capitalist consensus is for a financial assessment of life vs death rather than universal provision of quality state health service. It is finance capitalism (the insurance industry) where this is most laid bare, with the insurance premiums vs disease risk assessment formula used in a pre-paid health insurance process. The state health services are slightly moderated by political considerations, to try to appear more universal and caring. Yet the National/Act government only measures the performance of district health boards on 6 health process indicators, and of course on finances.

Those health indicators are: waiting times in emergency departments; wait between referral and treatment for cancer patients; waiting times for surgical procedures; increasing immunisation of children; support for stopping smoking; heart and diabetes checks. These areas mean that the whole health system becomes geared around meeting these so that all other areas become neglected. The recent example of district health boards (DHB) referring more and more patients back to GPs claiming they are not bad enough for surgery, is a scam to clear the waitlist.

Yet, state provided health within capitalism is only re-producing capitalist class relations in the entirety. The capitalists are looked after, to exploit another day and breed more capitalists, while the rest looked after only enough to provide (and breed) a working population - the exploited class. The state health system is only useful to the capitalist class in as much as it can deliver workers ready for work – cheaper than a for-profit capitalist health system could.

Within the capitalist system health workers unions should join forces with the wider union movement to increase access for the working class by demanding a free universal health care! This must be at the expense of the capitalist class who have better access to health services through the two tiered system and private insurance so they can jump the queue in the public system.

How could health workers unite with the organised labour movement to fight for a socialised health system? [see note below] A first step would be to raise immediate demands to meet the huge unmet need for healthcare:

· We say equal access to assessment, accurate diagnosis and treatment for all! The statistics on working class (& Maori) recovery rates for all major illnesses are worse, in good part due to uneven access to medical services.

· No discharges from emergency services without full diagnosis, suitable treatment and a complete rehabilitation plan!

· No waitlists. No delays for so-called ‘elective’ surgery. This will expose the existence of a two tier public and private system!

· For free, universal health care! Capitalism cannot meet this demand which will prove the urgent need to socialise health!

· Socialism is necessary to smash the limits of the capitalist system: expropriate the private system without compensation!

· Build (socialist) health services that can maximise our lives potential for the benefit of all. From each according to their ability to each according to their needs!

· Health workers will need working class solidarity to be able to build a health system that can meet the needs of all, and a socialist party to lead this all!

· For a Workers’ and Working Farmers Government to plan a socialist economy!

[Note] Socialised health care is not the bogey man painted by the neo-liberal right wing to justify cuts. It is not the rich subsidising the health of the undeserving poor. The poor are mainly workers who produce the wealth anyway for slave wages. The existing state health system subsidises the private, capitalist, health system at the expense of the health of workers particularly those demonised as an ‘underclass’. A genuine socialist health system would be controlled by the working class and financed by the expropriation of capitalist assets to meet the health needs of all!