I am wrestling with despair
is the author of many books of poetry, most recently Made in Detroit. | more…
The Battle for the National Health Service
England, Wales, and the Socialist Vision
England and Wales represent two very different, indeed incompatible, approaches to health care. In the former, health care has come under increasing threat from the predatory forces of privatization. In Wales, however, an explicit effort has been made to defend socialist values and formulate them for the twenty-first century, defending and expanding a system that puts the health and well-being of its citizens over profit. | more…
Marx as a Food Theorist
Food has become a core contradiction of contemporary capitalism. Discussions of the economics and sociology of food and food regimes seem to be everywhere today, with some of the most important contributions made by Marxian theorists. Amid plentiful food production, hunger remains a chronic problem, and food security is now a pressing concern for many of the world’s people.… Despite the severity of these problems and their integral relation to the capitalist commodity system, it is generally believed that Karl Marx himself contributed little to our understanding of food…. [Yet] food for Marx was far more than a “passing interest”: in his work one finds analyses of the development of agriculture in different modes of production; climate and food cultivation; the chemistry of the soil; industrial agriculture; livestock conditions; new technologies in food production and preparation; toxic additives in food products; food security; and much more. Moreover, these issues are not peripheral, but organically connected to Marx’s larger critique of capitalism. | more…
A Working-Class Sherlock
Timothy Sheard, the Lenny Moss mystery series (New York: Hardball).
At its best, the art of fiction reveals the underlying truth of human relations: we are communal and collaborative by nature. Selfishness and greed are social aberrations because, ultimately, they violate the principle of self-preservation. No wonder we are drawn to crime stories: they mirror our common experience. Capitalism is high crime disguised as church doctrine. Conspiracy is evident, though the evidence is concealed. Hence, our fascination with the detective genre. We are in dire need of Timothy Sheard’s scrutiny—a detective who peers through a working-class eyeglass. | more…
Obamacare
The Neoliberal Model Comes Home to Roost in the United States—If We Let It
As the Affordable Care Act (ACA, otherwise known as Obamacare) continues along a very bumpy road, it is worth asking where it came from and what comes next. Officially, Obamacare represents the latest in more than a century of efforts in the United States to achieve universal access to health care. In reality, Obamacare has strengthened the for-profit insurance industry by transferring public, tax-generated revenues to the private sector. It has done and will do little to improve the problem of uninsurance in the United States; in fact, it has already begun to worsen the problem of underinsurance. Obamacare is also financially unsustainable because it has no effective way to control costs. Meanwhile, despite benefits for some of the richest corporations and executives, and adverse or mixed effects for the non-rich, a remarkable manipulation of political symbolism has conveyed the notion that Obamacare is a creation of the left, warranting strenuous opposition from the right. | more…
The 3,000 Who Stayed
Stories of Cuban medical accomplishments often note that half of the country’s 6,000 doctors had left by 1963. But just as professionals were forsaking their homeland en masse for the comforts of Miami, 3,000 doctors chose to stay. Why did they remain? More important, the number of patients per doctor now doubled, how did they face the daunting task of transforming medicine? In addition to treating patients, their goals included expanding medical care to rural regions; increasing medical education to replace doctors who had left; making care preventive, community-oriented, and focused on tropical diseases; and redesigning a fractured and non-cohesive health system.… The consciousness of the 3,000 who stayed became the “material force” in the production of Cuban health care, as much a material force as the manufacture of pharmaceuticals or the construction of hospitals. | more…
Cuba’s Medical Mission
John M. Kirk, Health Care without Borders: Understanding Cuban Medical Internationalism (Gainesville, FL: University Press of Florida, 2015), 376 pages, $79.95, hardback.
When the Ebola virus began to spread through western Africa in fall 2014, much of the world panicked. Soon, over 20,000 people were infected, more than 8,000 had died, and worries mounted that the death toll could reach into hundreds of thousands. The United States provided military support; other countries promised money. Cuba was the first nation to respond with what was most needed: it sent 103 nurses and 62 doctors as volunteers to Sierra Leone. With 4,000 medical staff (including 2,400 doctors) already in Africa, Cuba was prepared for the crisis before it began: there had already been nearly two dozen Cuban medical personnel in Sierra Leone.… Since many governments did not know how to respond to Ebola, Cuba trained volunteers from other nations at Havana’s Pedro Kourí Institute of Tropical Medicine. In total, Cuba taught 13,000 Africans, 66,000 Latin Americans, and 620 Caribbeans how to treat Ebola without being infected. It was the first time that many had heard of Cuba’s emergency response teams.… The Ebola experience is one of many covered in John Kirk’s new book Health Care without Borders: Understanding Cuban Medical Internationalism. | more…
Imperialism’s Health Component
Medicine and public health have played important roles in imperialism. With the emergence of the United States as an imperial power in the early twentieth century, interlinkages between imperialism, public health, and health institutions were forged through several key mediating institutions. Philanthropic organizations sought to use public health initiatives to address several challenges faced by expanding capitalist enterprises: labor productivity, safety for investors and managers, and the costs of care. From modest origins, international financial institutions and trade agreements eventually morphed into a massive structure of trade rules that have exerted profound effects on public health and health services worldwide. International health organizations have collaborated with corporate interests to protect commerce and trade. In this article we clarify the connections among these mediating institutions and imperialism. | more…
Resisting the Imperial Order and Building an Alternative Future in Medicine and Public Health
Although medicine and public health have played important roles in the growth and maintenance of the capitalist system, conditions during the twenty-first century have changed to such an extent that a vision of a world without an imperial order has become part of an imaginable future. Throughout the world, diverse struggles against the logic of capital and privatization illustrate the challenges of popular mobilization. In addition to these struggles, groups in several countries have moved to create alternative models of public health and health services. These efforts—especially in Latin America—have moved beyond the historical patterns fostered by capitalism and imperialism…. All the struggles that we describe remain in a process of dialectic change and have continued to transform toward more favorable or less favorable conditions. However, the accounts show a common resistance to the logic of capital and a common goal of public health systems grounded in solidarity, not profitability. | more…
The Scars of the Ghetto
The article that appears below is reprinted from the February 1965 issue of Monthly Review. Despite her small body of work and short life, Lorraine Hansberry (1930–1965) is considered one of the great African-American dramatists of the twentieth century. Her play A Raisin in the Sun (1959) is required reading, and performed regularly, in high schools and colleges nationwide, as well as on Broadway and London’s West End. Hansberry’s association with the left, and especially with Monthly Review, began in her teenage years. When she moved to New York, she became good friends with Leo Huberman and Paul M. Sweezy. In spring 1964, although terminally ill with pancreatic cancer, she left her hospital bed to speak at a benefit for Monthly Review Press; her speech appeared posthumously as the article below.…
December 2014 (Volume 66, Number 7)
Notes from the Editors
In 1832, when the global cholera pandemic was approaching Manchester—as a young Frederick Engels was later to recount in The Condition of the Working Class in England (1845)—“a universal terror seized the bourgeoisie of the city. People remembered the unwholesome dwellings of the poor, and trembled before the certainty that each of these slums would become a centre for the plague, whence it would spread desolation in all directions through the houses of the propertied class.” As a result, Engels noted, various official inquiries were commissioned into the condition of the poor. But little was done in the end to combat the social factors that facilitated the spread of the disease.… One can see an analogous situation today in the growing concern that has materialized in the United States and other wealthy nations over the Ebola epidemic in Africa. | more…
The Political Economy of Dyslexia
There are two diametrically opposed conceptions of reading and dyslexia, each with loyal advocates. This analysis will clarify some of the important categories that are needed in order to participate knowledgeably and critically in current discussions about dyslexia.… The first conception is dyslexia as biological disease—medicalized dyslexia. By the medicalization of dyslexia is meant that dyslexia is considered to arise from a pathologic condition of the human brain and mind.… A very different conception of why some people fail to learn to read can be found in the transactional sociopsycholinguistic model of reading, whose most widely cited figure is educator Kenneth S. Goodman. Rather than looking inside the poor reader for the source of the problem, this model looks to the surrounding social context. | more…