The system is sick

Cigar-chomping millionaire Joe Hockey says, “People need to take responsibility for their own health.”

It can seem like a fair enough proposition, right? It’s my responsibility to do a bit of exercise, eat well, clean my teeth. I don’t expect Joe Hockey to clean my teeth; actually I wouldn’t let the filthy animal anywhere near my mouth.

But such triviality ignores the bigger picture – a picture of sick and injured people condemned to suffer and die in their millions every year because the profits of a few parasites at the top get in the way of society curing what ails them. Capitalism is a world cleft in two: exploiters and exploited, us and them.

How can we be “responsible” for our own health when we have little control over our own bodies? If we don’t have a job, we starve, but to get a job we have to sell our bodies to someone else – give them the right to wrench as much profit from us as they can.

In every workplace our bosses maim and mangle us. Some force us to move too much, breaking our bones and tearing our muscles from over-exertion. Others prevent us from moving at all, disfiguring us by keeping us frozen still in battery-hen cubicles. They send us blind, they give us RSI, they give us cancers, tumours, asbestosis and probably ills that don’t yet have a name. Spending most of your waking life with the ever-present threat of being sacked or bullied is recognised as a key source of stress. It is linked to heart disease, stroke, obesity, smoking and alcoholism. This applies to everyone, not just those workers who seem hardest done by.

A 2004 study reported in the British medical journal Lancet found that when a company downsizes, those workers who keep their jobs are twice as likely to die from stress-induced cardiovascular disease.

Workplace accidents are a leading cause of death in Australia; there are about two deaths every three days. The official statistics include only deaths caused by particular workplace incidents. More useful reports consider deaths related to the workplace, e.g. from chronic exposure to toxins. They put the figure in Australia as high as 7,000 deaths per year – almost five times higher than the road toll.

The individual or society?

There’s an even bigger picture here. No individual on this planet, including Joe Hockey, can take responsibility for their own health. Individuals can’t build their own home, connect it to the sewer system, the water mains and the power grid, grow their own healthy food, make their own clothes, their own fridge, their own bedding, their own cutlery, their own soap or any of the things necessary for decent health. They can’t build their own medical clinic and treat themselves when they feel unwell.

Society has to provide these things collectively; there’s no way around it. Hockey knows that, of course. So what he really means when he talks about individuals taking responsibility is that health care should be a commodity bought and sold on the market.

He’s not alone. The executives of private health care and pharmaceutical companies see only money in human suffering. The CEO of Bayer Pharmaceuticals, Marijn Dekkers, for example, rebelled against moves in India to create a cheap generic version of Bayer’s cancer medication Nexavar. He protested: “We did not develop this medicine for Indians. We developed it for Western patients who can afford it.”

Health care is a massive and profitable industry, right across the globe. The people who own and control it, like Dekkers, are no different to the likes of Rupert Murdoch or Gina Rinehart. They are part of a capitalist class, and this is their system – a system based on exploitation.

The problem is not just cruel government policies or lack of regulation, but capitalism itself. Capitalism has at its core an irreconcilable conflict. The system is based on individual appropriation and accumulation on the one hand, with social and collective production and distribution on the other. Or Marijn Dekkers on one hand and millions of health care workers on the other.

The mass of humanity works together to produce things, but these things are owned by the tiny minority at the top. Moreover, those at the top are always trying to increase their exploitation of us.

Governments have power over only part of society. No government can simply sack the CEO of Bayer. He sits as an unelected and unaccountable dictator, alongside every member of his class – even the lesser lights such as the board members and administrators who control local hospitals. No government can legislate away the “right” to make a profit and hence to exploit people. Indeed, the essential function of government is to manage the rules and conditions under which that exploitation takes place. Of all the laws of capitalist governments, the prime law is simple: any individual with enough capital has the right to run a business, employ workers and make a profit. That is the bedrock of capitalism.

Defending our health

When workers organise to defend our interests, even in the smallest everyday ways, we challenge the rule of the capitalists. At times we’ve used that power to win dramatic improvements in our lives, including the provision of affordable health care. In 1976, when the Fraser government tried to smash Medicare (then called Medibank), it was only a national strike that held it at bay. At times when the stakes are particularly high, workers’ resistance tends to throw up new organisational forms that prefigure a whole new way of running society.

In February 2011, the 600 staff of Athens’ Kilkis Hospital took a momentous decision. In the face of extreme austerity being forced on the Greek population by the European capitalist class, the hospital’s employees (nurses, doctors, technicians, janitors, everyone) joined together in an emergency mass general assembly to decide what to do. Lena Zotaki – one of the doctors and local district president of the doctors’ union – explained the context of economic crisis and austerity in which the mass meeting took place:

“The workers at the hospital of Kilkis and most hospitals and health centres around Greece are not paid on time, while many of them see their wages being slashed, to practically zero … One colleague of mine was rushed to the heart clinic in a state of shock when he realised that instead of receiving his usual monthly cheque of 800 euros … he received a notice saying that not only was he not going to be paid for that month, but that he had to return 170 euros instead. Other workers were paid only 9 (nine) euros for that month.”

The workers in the hospital, not being millionaires, politicians or army generals, responded by wielding the only power they have. They took over the hospital. They announced it to the world like this:

“The workers at the General Hospital of Kilkis answer to this totalitarianism with democracy. We occupy the public hospital and put it under our direct and absolute control. The General Hospital of Kilkis will henceforth be self-governed and the only legitimate means of administrative decision making will be the general assembly of its workers …

“Keeping in mind our social mission and the moral character of our profession, we will protect the citizens’ health, providing free care to people who need it …

“We call upon our fellow citizens to show solidarity in supporting our effort, we call upon every mistreated citizen of this country to actively stand up against their oppressors, we urge … our colleagues in other hospitals to make similar decisions and we also call employees in all fields of public and private sectors, members of labour unions and other progressive organisations to do the same, until our mobilisation becomes a mass popular and labour movement of resistance and uprising, until the final victory against the economic and political elites that today rob our country and destroy the whole world.”

It was a bold move, illegal under any number of laws of the capitalist state, and the workers’ control of the hospital lasted just a few weeks before the government managed to reassert its control. But in that brief period, the workers of Kilkis Hospital demonstrated the way to fight back.

If the occupation were to survive, it had to spread. For example, the workers who deliver supplies and electricity to the hospital would also have had to start providing that service for free, or at cost, and would immediately face the same battle with their own bosses. The hospital staff understood this instinctively, as any workers who move into serious struggle do, and hence their statement called for urgent solidarity.

How did workers’ control in the hospital actually function? They had daily meetings and regular general assemblies. They had to decide things collectively and democratically because their power as workers rested on cooperation. One person can’t operate the hospital in defiance of the rest. Nor could they just divide the hospital into 600 parts that each could take home. In order to fight to defend their living standards through taking over their workplace, they were compelled to forge unity and solidarity and to act with common purpose.

This is a million kilometres from what “ownership” means for capitalists. For them, ownership involves, not solidarity, but cut-throat competition. Compare the slogans of the workers’ movement to those of the capitalists. Where the workers say “An injury to one is an injury to all”, the capitalists say “It’s dog eat dog.” Where workers see the workplace down the road as a site for potential and necessary solidarity, the capitalist sees the workplace down the road as a bitter rival that must be crushed mercilessly. Where workers see each other as human beings and are disgusted by the inequality around us, the capitalists say, “We didn’t make these medicines for Indians.”

If the struggle at Kilkis Hospital had indeed spread along the entire chain of production and distribution, then the mass general assemblies would soon have had to be accompanied by some type of organising between different workplaces. Workers in past struggles have shown us how this is done, and at its peak it means taking on the state and defeating it. It is a revolutionary movement, one that must sweep away the rule and the power of the capitalist class and take all the productive apparatus of society under our own mass ownership and democratic control – the hospitals, the factories, the internet service providers, the call centres, the trucking companies, the schools, everything.

This is what socialism means. It’s why socialists emphasise that the working class is the only force that can create it. We know that a better world is possible – a world in which health care is not a commodity available only to the wealthy but a basic feature of a free and democratic society, available to all. We’ve even seen glimpses of this in places like Kilkis Hospital.

There’s no detailed blueprint for a better world. There is only a call to join the fight in order that we can finally sweep away those forces in society that keep us sick, that mangle our bodies and that deny us the medicines and health services our own labour has produced.