Month: April 2012

health and capitalism – a marxist view

Health and Capitalism. 

“Resistance is futile” and if you heard those words uttered by the Borg, it often was. However, that did not deter the crew of the starship ‘Enterprise’ from carrying on resisting. And so it is with our current ‘predicament’ on his planet. The Borg for us is the globalised ‘surplus capital accumulation problem’.  The resistance to it is legion, but it is disorganised, fragmented, unfocused, without a clear plan and often unsure of who the real threat actually is. Some of the resistance movement of course would misguidedly seek to replace  one form of exploitation and crisis generation with another, but with a kinder social democratic or green face. 

I seek in this paper to cut through the mess of analysis as to why we are heading for continued economic disaster which underpins the ecological one, a disaster in which we are lied to as being ‘all in it together’, while the distribution of wealth remains in very few hands and is then turned to exploiting the planet’s natural and social capital with often deadly results.

This analysis has emotional elements to it, given what the science is telling us about the crossing of planetary boundaries, how could it not? It is not however based on an emotional analysis but an attempt to understand how social worlds change and upon what basis current societies are organised. It is a complex interdependence of economy and ideology shaping social relationships which in turn shape who we are. In the coming together as individuals to trade, work, exchange, distribute, sell, buy, advertise we bring our hopes, values and ideals to that process and in turn that process shapes our hopes, values and ideals. 

This is an agenda that brings together the inequalities in health, the social determinants of health and critiques of political economy. It is a realisation that education has failed us on a grand scale. It is a realisation that a few powerful men (and it is usually men) have commandeered the levers of power and wealth for their own benefit, arguing as they do that it is for our own good. It is a realisation that only when populations wake up to the fact of this (old fashioned) class war and demand a better way of social organization that we will we have a hope of bequeathing to our children a better world. It is a realisation that well meaning individual action that does not challenge the fundamental driver is at best useless and at worse a distraction from the real battle. 

It is a realisation that the war is already lost and the best we can hope for is managed decline in human welfare before restructuring of the social economy is forced upon us.  


Upon what is human health based? It is largely social in nature,  determined by the social relationships in a material world. No one lives alone and so it is in the coming together in communities and societies that we fashion the determinants of health. There is a biological basis for some individuals, however genetic determinants (e.g. in cystic fibrosis) operate at this individual level and are manifest in a relatively minor way. This is not to deny that for the individual the medical condition is anything but minor, but health on population levels are not determined thus. Even genetic manifestations are at times made worse or better by the social conditions in which the individual finds themselves. Poverty has a knack of making underlying biological problems much worse. 

Social Conditions

If health is socially determined by social relationships, what are the current forms of social relationships that give rise to certain patterns of health, illness and disease? We know from studying inequalities in health that socio-economic conditions and relative social status determine populations’ health status including measurable outcomes such as life expectancy and the under 5 mortality rate. Other social relationships such as gender and ethnicity also affect health status. However, these are subservient social conditions to the socio-economic in the last instance. That is not to deny that affluent women and affluent BME’s may also experience ill health disproportionately in certain medical catagories. However, the major driver for global health are the socio-economic relationships which are based on a certain forms of political economy.  What are the dominant socio economic conditions therefore that give rise to the patterns we note?

Political Economy.

A feature of modern capitalism, which in its neoliberal form especially has now gone global, is that it determines in the last instance forms of social relationships that are exploitative and unequal. The material conditions of life are shaped by these unequal and damaging social relationships. Thus, how much land you have to feed your family and where that land is, is determined by systems of private property, commodity prices and the rules of the state. The same goes for water and shelter. The fundamental building blocks of life, including eco systems services (e.g. fresh water, waste recycling) are subsumed within capitalist social relationships. Nature (the air, water, livestock etc) upon which we depend has been fashioned into a mere instrument for human survival and development. There is very little ‘nature’ left untouched by human hand. All of nature has been turned into natural capital and is being used up as if it is limitless. 

Capitalism has to continue to do what it does because of surplus capital accumulation problem (SCAP). Because only labour produces value, capitalism involves the expropriation of labour’s surplus value. As surplus value accrues to the ruling class (those who own and control the means of production) it has to be reinvested or it is lost. Thus capital continually seeks new markets and new profits. It cannot stand still and so it looks to exploit more and more natural capital in the process. When it comes up against a barrier to this process (e.g. strong labour organisations who demand living wages and pensions) it either designs a solution (e.g. strict labour laws that outlaw strikes and labour organisations) or finds other investment opportunities (takes manufacturing to countries where there is weak, cheap or surplus labour). An economy that is not returning 3% growth is seen as sluggish and, as we are experiencing in the UK, recessions (which result from lack of aggregate demand and lack of surplus capital investment) result in unemployment and social unrest. 

Capitalism has proved to be dynamic and inventive. It has taken on many forms – mercantile, industrial and recently financial and consumer based. Apologists for capital accumulation argue it is good for societies, pointing to the jobs and wealth created while ignoring the social misery that often follows in its wake. Whole populations have been ‘bribed‘ by the baubles that capitalism produces which, as the recent credit and consumer led boom and bust has proved, are merely will o’ the wisps. The phrase ‘wage slave’ resonates with many in so called ‘advanced’ societies who are trapped in alienating forms of work ameliorated only by the lures of consumer products and services. The promises of ‘you’ve never had it so good’ turning sour on sovereign and private debt while the ruling class run away with the spoils in ‘Richistan’.

Green thinking

One way to confront this machine is to get off the consumerist treadmill and hope that through collective consumer choices (i.e. not to buy stuff), that the ruling class will mend their accumulative ways, invest in health, education, the conditions of social life and design products that are ‘green‘ and ‘environmentally friendly’. This is already occurring. The plethora of products from hybrid cars to organic and locally sourced food products indicate that some companies are basing their business models with sustainability in mind. What this does not do however is change the underlying dynamic of the surplus capital accumulation problem which demands growth in the economy and the overuse of natural resources. 

This means there is a race on between developing goods and services that are carbon neutral and environmentally friendly and the supply of goods that are killing ecosystem services and wreck social relationships.  This race occurs within the context of the SCAP which will seek to overcome any barriers to the investment of that surplus value and will not wait until all goods and services become eco friendly. If investment in eco friendly products can be found, and is profitable, capitalism will do so, but it is not fussy in this regard. Canadian tar sands exploitation is an example in which demand for oil and the chance for investing surplus capital to turn a profit cannot be overlooked.

Thus, living the good life runs up against globalised capital surplus accumulation.  

Green thinking is also a minority sport as it is up against other forces as well. The idea of human progress and technological advances to solve our problems runs in tandem with those who have the capital to invest. This also includes some forms of religious ideology which affirms man’s right to dominate nature and an anthropocentric world view. 

Greens need a critique of political economy or risk being sidelined in the Shire as Mordor advances its deathly grip.

So what?

It is unlikely that human populations under globalised capitalism will stop the SCAP dynamic. They don’t understand it. What they do understand is that there are winners and losers in the current system. If you win, you win big. Many also feel impotent to prevent the investment decisions being made by suits in the financial districts of first world countries. Politicians have let their electorates down or more likely could not deliver as they are merely apologists for the ruling class. Democracy is under challenge (ironic given that many are currently dying for a democratic ideal). Many shrug and say ‘nothing can be done’. They may be right. The ruling class may have too powerful a grip and ‘enjoy’ too much of the spoils to change. Meanwhile the political economy of SCAP produces social relationships that determine our current unequal patterns of health. 

To date, not enough people are discussing the underlying dynamic of capitalism that produces periodic crises and which may eventually allow Gaia to take revenge. We are locked into a cluster of high carbon systems underpinned by this capitalist dynamic and we  don’t have a key. There is an urgent need to design one but our (elite?) Universities are currently so wrapped up in producing technologies for capitalist production and equipping people with skills fit for capitalist purpose that they are ill placed to produce radical thinking, challenges and alternative plans. Education is not the solution, it is the problem. Politics is not the solution it is the problem. Ecology is not the solution it is the problem. 

“Philosophers have hitherto interpreted the world in many ways, the point however is to change it”.  That means confronting Capital. Changing the light bulbs ain’t enough and may give a false sense of ‘doing something’.

  1. Join/start an anti capitalist social movement.
  2. Use social media to connect.
  3. Confront your elected representatives in writing. 
  4. Identify and contact the ‘suits’ 
  5. Find someone who knows what campaigning is all about and share skills.
  6. Focus on your core skills, attributes and role and fashion a response that suits them.
  7. Identify a sphere of influence and work within that.
  8. Read and understand the issues.

…or realise that no one gives a toss about any of this, go home and get pissed. 

An Easter message

Atheism v religion debate moving on from stalemate, says archbishop Rowan Williams:

Contrasting the “hysteria” of “aggressive polemic against religious faith” with an increasing recognition among “serious and liberal-minded commentators”, he said faith was no longer seen as “a brainless and oppressive enemy” but recognised as a potential ally against a greedy and individualistic way of life that feels “increasingly insane”.

Faith…seen as brainless? When faith revels in lack of evidence and reason…..accepting a proposition “just because I believe it”, er, that’s not brainless? He shoots himself in the foot later in the piece by claiming the ‘resurrection of Jesus Christ’ is fact, not metaphor mind you, but fact. He suggests that christianity is true (sorry muslims, hindus, sikhs etc etc…you are now wrong coz the archbish says so), and the resurrection was a fact, not “a beautiful imaginative creation that offers inspiration to all sorts of people”. If the resurrection is a fact, then what jesus said was fact too? “No one comes to the father except through me?” (John 14:6, since you ask) which if true sounds a tad egotistical and exclusionary to me. So we are asked to take as a matter of a faith (with no evidence, no reason to believe the story and a billion reasons not to believe it), that ‘God’ sent himself to be murdered so he could forgive his creation (knowing that the creation would sin in any case) and he chose a medieval obscure ethnic group to reveal this fact to. I would have chosen the Greeks actually, Socrates Plato or Aristotle could spin a better yarn..and the greeks would not now be in the shit they are with God on their side (ok i am taking the piss). Williams has been lauded in the media as an intellectual. With arguments like this, ‘cretin’ seems too soft. Easter is for chocolate eggs and bunnies…and for dressing up and telling funny stories it seems.

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