by Daphna Whitmore
Dunedin hospital’s substandard food has come in for some well deserved criticism. At a protest outside the hospital Andrew Tait of the International Socialist Organisation argued that the public hospital was socialism in action, and he went on to call Britain’s National Health Service socialist:
There’s a lot that is good about the public health system in New Zealand, (excluding the hospital meals) but socialist it is not. Nor could it be. While we have a relatively well-funded public health system it follows a capitalist model adopted by most western countries.
First World countries maintain a centralised government-regulated and funded health-care system at the insistence of the public. It is also out of pragmatism. A public health system is more cost effective than America’s relatively decentralised private-sector system where hundreds of millions of dollars go on health lobbying rather than providing services. New Zealand, like many other western countries, has a large private health sector too, and it is in the business of making money. But that doesn’t make the public sector socialist; even the best health system in a capitalist country will not be socialist.
For a start the public system does not meet the needs of the population. Funding is substantial but limited, and the health care system is constrained by these limits. That’s typical of public services in a capitalist society. It comes down to how the rationed resources will be allocated.
Andrew Tait implies that because hospitals are funded from taxation that makes it socialist. (“This is my hospital, I pay for it”). Just because something is funded from taxes doesn’t make it socialist, otherwise the prisons could be held up as bastions of socialism.
Public services in capitalist society are funded out of the exploitation of the working class. Much of that exploitation takes place in the Global South – that’s where over 80 percent of the world’s industrial workers live. NZ has only 10 percent of GDP from manufacturing, and enjoys relatively cheap goods being made in cheap-labour countries. From t-shirts, to whiteware, NZ manufacturing has, since the 1980s, moved offshore to where there is cheap labour and superprofits. Workers in the west have a relatively high standard of living thanks to the sweated labour of those workers. To get a detailed picture of this reality check out John Smith’s book Imperialism in the Twenty-First Century.
Marxists favour public health over private, but don’t confuse that with socialism. What a socialist society will look like isn’t something that can be forecast. The first wave of socialism has been and gone. The next wave will be in a different era. Maybe it will resemble aspects of Cuba’s health system, where the health of the whole society is the focus, where preventive measures are given priority, where doctors are part of the community they live in and put medicine before personal wealth. Institutions reflect the societies they are created in, the public hospitals are no exception.
Further reading: Capitalism, the state and the NZ left