WORKERS OF ALL COUNTRIES, UNITE!

The Workers' Advocate Supplement

Vol. 9 #3

VOICE OF THE MARXIST-LENINIST PARTY, USA 50¢

May 20, 1993

[Front page: Which way for health care: Protecting profits or protecting health?]

Inside

Which way for health care: Protecting profits or protecting health?

The civil war in El Salvador:

Truth Commission confirms what the left said

A scandalous nursing home homicide

'Bureaucratic genocide'

Employees need to organize for united action:

Layoffs and cutbacks at Alta Bates Medical Center

The case of Manuel Salazar in Illinois

Justice and injustice-Just words to the racist court system

The restructuring of the world economy, and the future of working-class communism

Correspondence:

Notes from Germany

More correspondence on the population bomb

Socialism and the future of health care

Some health care terms

At a Catholic college:

Right-to-lifer Scheidler mourns the decline of that old-time religion

Bellamy's utopia and what the society of tomorrow will look like

Around the world

• Youth riot in France over racist police shootings
• Japanese nurses strike
• Ford workers strike in Mexico

Which way for health care: Protecting profits or protecting health?

This year, the Detroit branch of the MLP commemorated May day with a meeting on health care on May 2. Below is the first of the two speeches given there; the second speech, on socialism and the future of health care, starts on page 19.

May Day is a time when the workers and poor speak out against the capitalist system and its crimes. Today, the rottenness of our capitalist system is showing itself everywhere. Joblessness is rampant and the economy languishes in recession with no signs of reviving anytime soon. The murder of Dr. Gunn outside a Florida clinic is symbolic of the assault on abortion rights and the second-class status of women. Racist discrimination and police brutality is rampant. To even get partial justice against racist cops in the courts requires not only having the luck to have the incident videotaped, but a full-scale riot. And this is considered an example of the system working according to Clinton and other apologists for the system.

Meanwhile, U.S. imperialism continues the search for new enemies around the world so it can continue to play cop for the world and keep the military budget swollen.

Medicine for profit is in crisis

Today we want to look at another big disaster brought about by our capitalist system, the health care crisis. Our "free-market" medical system is the most costly in the world, approaching a trillion dollars annually. Yet there are 60 million people with little or no insurance coverage. We have the tragedy of health insurers refusing to provide coverage to people with certain illnesses. We see the spectacle of workers who have slaved away their lives for a company having the health benefits they were promised for retirement snatched away by greedy corporations.

For many of those with insurance, it is no picnic. Businesses that provide health benefits are shifting more costs onto their employees. The price of premiums is skyrocketing as are out-of-pocket expenses. But if you need medical care beyond a check-up, good luck. The insurers have perfected a system of restrictions and red tape to make getting further treatment a nightmare. What the present system amounts to is this: for the most expensive medical system anywhere, we have the most severe medical rationing of any developed country -- and some poor countries, for that matter.

Why is the medical system such a disgrace? Because what drives the system is not the needs of the masses, but the frenzy for profits. Let's look at the main components of this "free market" system.

Insurance

The system of hundreds of competing health insurers has created a huge bureaucracy that afflicts the whole health care system. This means that while health care is rationed, about one of every five dollars spent on health is sucked up by administrative expenses. These administrative costs include the insurance industry's "utilization review" of medical treatments, which they pretend just weeds out wasteful spending and therefore provides more economical coverage. But the insurers don't tread on the lavish incomes of the doctors and health industry executives, but on the ability of patients to get needed treatment. These so-called "cost control" measures are a big money-eater themselves, even giving rise to a multi-billion industry that hires itself out to "control costs."

Hospitals and doctors

Then there is the question of the actual providers of medical care, the hospitals and the doctors. Each hospital lives or dies not based on the health needs of the local population, but on its ability to rake in funds in the medical marketplace. This means hospitals who serve more poor patients often face big budget woes and either go out of business, close down emergency services for those who can't pay, squeeze hospital workers, etc.

At the same time there is a dogfight for better-off clientele. How do you win this battle? You throw money into luxury accommodations. You buy every piece Of expensive technology not because it fills a big medical void but to keep up with the Joneses. Hospitals also throw a lot of money and perks at doctors. In fact, U.S. doctors are, next to the Japanese, the highest paid in the world, with incomes averaging about $170,000 a year. By way of comparison, doctors in Sweden, which has a national health service providing better care than the U.S. system, make only about a fourth of what U.S. doctors do. "Cost cutting" measures only apply to the underpaid lower employees and sections of the nurses.

Oh, yes. Your hospital dollars are also hard at work supporting the high-living of the top execs and investors. In fact the highest paid CEO of 1992 was the head of Hospital Corporation of America, Thomas F. Frist Jr., who was compensated last year to the tune of $127 million. Compared to him, Lee Iaccoca looks like a welfare case! In fact four of the top twenty of the highest paid executives are in the health industry, raking in a collective $225 million, enough to provide decent insurance to 56,000 people at going rates.

Drug companies

Last, but not least, are the drug companies. Their rate of profit puts other capitalists to shame. Meanwhile, people are going bankrupt or without treatment because of high prices. The low rate of vaccinations for kids, in part due to the huge jump in costs, is a national^embarrassment. And no effort is made on developing drugs for some diseases because the rate of profit might be a little lower.

We now leave our quick tour of the disaster brought about by for-profit medicine.

Clinton's "managed competition" protects the profiteers

The crisis is so severe, that everyone is now talking about changing the system. Even the medical establishment and big business are clamoring for reform. But when those who caused the mess talk about cleaning It up, it's time to watch out and carefully examine just what reform is being proposed.

Today, the establishment debate on health care is centering around Clinton's plan. This plan is usually called "managed competition." The Bill and Hillary plan is not due out until the end of May. But already the main directions of the plan are clear.

If it were just a matter of general declarations, you might think Clinton was really for big change. He talks about health care being a right, about health coverage for all and other good things, while reining in costs. Can his managed competition really make good health care a right, though?

Well, it seems Clinton himself is hedging on this. First, he assured us there would be universal coverage. Then universal coverage IF money was available to finance it. Now universal coverage in 2 to 8 years. And so the faster Clinton rides toward health reform, the faster any improvements fade into the distance. But if we look at Clinton's health reform, we'll soon see why he's welshing on his promises.

Under managed competition, the same patchwork system of private insurers and health providers will still be around. But insurance will no longer be purchased directly but through regional super-agencies So what is this supposed to do? Well, the theory is that the super-agencies will have more purchasing power than individuals or companies that now do business directly with insurers. The economic clout of the super purchasers is supposed to get good bargains from the insurers. And, at least in managed competition theory, this is supposed to result in savings so that health coverage becomes accessible to more and more people.

The idea that you could get any more than marginal, temporary savings from such a plan is dubious. It might mean the little guy could get the discounted premium rates that a big corporation gets, but this would do little to arrest the general rise in health care prices. On top of this, you would be adding the expense of a whole new bureaucracy between the insurers and purchasers of health care.

The theory that super-agency purchasers, in and of themselves, will lead to universal coverage is just a pious wish. There will still be a need to find funds to pay for universal coverage. If Clinton wanted to get a really significant source of savings he should eliminate the private insurance companies. After all, if you are going to create new agencies just to pool money to purchase health care, what purpose do the insurance companies serve? All they would do is continue to suck $100 billion or so from the health care system for doing nothing.

Various theorists of managed competition admit that eliminating private insurance and having a Canadian-style universal government health insurance would save more money than their own plan and give everyone health coverage. But, they argue, this is just not politically practical under U.S. conditions. Why? Because of the clout of the medical establishment in Washington. In other words, their main argument for managed competition is that the health capitalists oppose serious reforms. What a powerful argument -- against managed competition! Not surprisingly, several years ago some insurance monopolies, realizing that some change was coming, set up their own managed competition "think tank" which has greatly influenced the Clinton plan.

But if Clinton is not willing to take a serious measure like cutting out parasites like the insurance companies, where will his funds for extending coverage come from?

Recently, Clinton floated the idea of price controls on health care costs. However, they are only supposed to last two years. As long as Clinton has no intention of substantially changing the present system, price controls will be no more than a brief interlude between sparing costs. It will be like putting a flea in front of a rampaging elephant.

However, even talk of a tiny restriction on doctors fees is not to the liking of the American Medical Association, the main doctors' organization, last seen crying about how they are being left out of Hillary Clinton's traveling health forum show. What they don't mention is they are wheeling and dealing in the back rooms with high administration officials. Even if the AMA winds up chaffing under Clinton's plan, managed competition is designed to preserve the basic status quo and fat incomes for doctors. The main thing in Clinton's "cost control" measures is not reining in the medical establishment's money-making, but limiting health care. For example, Clinton advisors are suggesting taxing company-paid health benefits that exceed some minimum benefits package. This is intended to drive workers with something approaching adequate health coverage into bargain-basement HMO's that have all sorts of restrictions on getting medical care. This tax proposal is meant to punish people for having plans enabling them to get necessary medical treatment.

At the same time, this proposal does nothing about the real problem of doctors who perform needless operations and other treatment just to make a financial killing.

The tax proposals -- who will pay?

All sorts of other taxes are being floated as well. At one time or another, a Value Added Tax, which is essentially a sales tax on everything, or a sin tax on alcohol and tobacco or a gasoline tax have been suggested. Different capitalist interests are squabbling over which one they prefer, but all of these fax schemes share one thing. The poorer you are, the harder they will hit you.

Such measures show how Clinton is tailoring his plan for big business. The larger companies are the ones that tend to have company-paid health insurance for their employees. They want to get out from under these costs and they see national health care as a way to do this. Clinton is doing his best to accommodate their wishes. What employer wouldn't like to see a tax proposal that pressured workers to switch their health plan to the cheapest one around? And companies with big health care expenditures see a plan to finance health care through regressive taxes as a way to dump more of the burden for their employees health insurance onto the working masses as a whole.

So when we look at Clinton's plan we see it is crafted so as to maintain the profits of the health industry and cut costs for the capitalists. Some new funds will be thrown into the current marketplace madness, some regulations will be tacked on, and voila, this is supposed to be health care reform. Clinton's other priority is to cut costs for the capitalists. Any system of universal care is destined to take a back seat to these interests.

The workers must make their imprint on health reform

The workers and poor cannot stand idly by in this situation. For us, the issue is not how to keep the health aristocrats happy or save the company money. It is insuring the health care needs of the masses are met and met now.

Any big improvement in health care for the masses requires a radical change in the whole medical system. But as we fight to bring about a better health care system, there are some smaller skirmishes that also must be fought. Workers must resist the attempts of employers to shift health care costs onto them or cut benefits for themselves and retirees, and demand coverage for all employees. As well, we need struggles to maintain and extend present government health programs and need to press for more research and treatment for AIDS and other illnesses.

When we talk about the workers fighting back, we emphasize that the success of the struggle depends on the extent to which the rank-and-file get themselves organized.

There is no point in hoping the trade union officials will do the job. The labor bureaucrats refuse to wage a serious struggle against employer takebacks. And now they are watering down their own former demands for a Canadian-type system of national health insurance so they can line up behind the managed competition scheme of their hero, Clinton. UAW president Owen Bieber has even said he would go along with regressive VAT taxes to pay for health care.

The day-to-day struggles with the employers and the government are important in their own right. But they also can play a role in helping the workers leave their class imprint on the question of what type of national health care we have. They can help develop the workers' ability to organize and fight. And these struggles create a good climate to discuss what form of national health care system would best serve the masses.

Ultimately, we would like to see the overthrow of capitalism and the establishment of a socialist health care system. (This will be the subject of the next speech.) But even now, under capitalism, the world has already shown many examples where some form of nationalized health care has done a lot better than what our "free market" model or Clinton's slight tinkering can accomplish. These nationalized systems have their problems, which have grown more serious as the capitalist governments slash social programs to deal with their budget crises. Still, on the whole, the nationalized systems show that there can be health reforms that provide fairly comprehensive health care for all, and more economically to boot. What is the secret that makes such a health system possible in these other countries?

These governments have been forced to accept that their health care systems should not exist only for the purpose of making money. Health care should also be a right all the people are entitled to. This means that while their health care systems haven't done away with the profit motive, while the systems are still run for the benefit of the capitalists as a whole, some institutions of medical profiteering have been eliminated. And this makes a real difference.

Canada did away with its private insurance system and replaced it with a government run national health insurance. This gave all Canadians the right to get medical treatment at a doctor of their choosing without worrying about being able to afford it.

The elimination of private insurance for treatment covered by government insurance has resulted in a fairly simple system with much less bureaucracy. This saves a bunch of money. Canada has half the bureaucratic costs of the U.S. Canadian doctors face less paperwork and this has been one thing that has helped reconcile themselves to the system which had to be established in the face of doctors' strikes.

The system is not ideal. It has experienced under financing and soaring health costs, but per person health cost still remain 45% higher in the U.S. Canadians may have to get on waiting lists for some non-emergency treatment, but in the U.S. 60 million people can't even get on the list while others go broke paying for treatment.

In other countries, like Great Britain and Sweden, not only does the government pay for everyone's health care, the hospitals were taken over by the government and most or all of the doctors became salaried employees of a national health service. The result? A more rational distribution of medical services and more reasonable doctors' incomes.

Unfortunately, budget crises and market reforms are being implemented in both countries and this has brought about, in Britain at least, a marked deterioration of health services. Even with this, universal coverage remains with virtually no out of pocket expenses. And the whole system costs only a fraction of our "free market" system.

The improvements in medical care under the nationalized systems in other countries are further proof the profit-mad system in the U.S. has got to go. It is time for medicine for profit to yield to medicine as a right. No longer must success of the system be determined by how wealthy the health industry has become but by how far it has solved the health problems of the masses.

The elimination of the private insurance companies is the very least that will be necessary. Other sectors of for-profit medicine should be cut out as needed to provide quality care to all. And the system must be financed by taxes on the rich and the corporations. The rich caused this crisis -- let them pay for it!

Prospects

The radical changes that are needed are not going to come about from appeals to reason to the powers-that-be. It will require a powerful struggle. Unfortunately, the fairly low level of struggle at present means it's quite possible that Clinton's plan will be set up in some form before the masses are able to greatly impact the shape of national health care. However, the more struggle that can be mounted today, the more Clinton will feel pressure to at least speed up the process of extending health insurance.

In any case, the fight for health care will go on. And having the fight take place on the issue of national health care at least means the struggle tends to be more unified compared to fighting workplace by workplace, contract by contract.

So let us help push forward the day-to-day struggle for better health care. Let us campaign in the workplaces and poor communities for a workers agenda on national health care.

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The civil war in El Salvador:

Truth Commission confirms what the left said

On March 13 the UN's Truth Commission on El Salvador released its report on human rights abuses that occurred during the 12-year-long civil war (1979-91). The Commission's report confirms what the left in El Salvador and its supporters were saying all throughout the civil war -- that the human rights abuses were almost wholly the work of the government itself, of death squads based on official military structures.

It confirms what we said, that the Salvadoran government supported by Reagan and Bush was nothing but a death-squad dictatorship of the rich against the poor.

Of course the report itself doesn't go so far as to draw this out fully. It confines itself to a narrow bureaucratic view of human rights abuses. But the conclusions to be drawn are pretty obvious, given the facts detailed.

Damning findings

The Truth Commission was set up by the UN as part of the truce that ended the fighting in El Salvador in 1992. Its purpose was to determine who was actually to blame for the tens of thousands of political murders. Members of the commission were Belisario Betancur, former President of Colombia; Reynaldo Figueredo, former Foreign Minister of Venezuela; and Thomas Buergenthal, an American lawyer who specializes in human rights cases. In other words, a very "respectable" group of establishment-minded legalists. Yet the facts they unearthed were quite damning to the establishment in El Salvador. Some of their main findings:

* The assassination of Catholic Archbishop Oscar Romero in March 1980 was planned and paid for by Roberto D'Aubuisson. D'Aubuisson was the founder of the right-wing ARENA party, the party still in power today.

* The murder of four American church workers (three nuns and another woman) in December 1980 was carried out by soldiers, operating "under higher orders." This was covered up by the then head of the Salvadoran National Guard, Carlos Vides Casanova. Casanova later became Minister of Defense.

* In December 1981 the notorious Atlacall Battalion wiped out the village of El Mozote, systematically killing everyone in the village -- men, women, and children. The number killed was in the hundreds, perhaps thousands. Similar massacres were carried out in at least two other locations.

* In November 1989 six Jesuit priests, their housekeeper and her daughter were murdered by soldiers operating under orders from Gen. Rene Emilio Ponce. Ponce ordered Col. Alfredo Benavidez to kill the priests "without leaving witnesses." Ponce today is the country's Defense Minister.

* In 1982 the armed forces "deliberately" ambushed and killed four Dutch journalists covering the civil war.

The commission investigated more than 22,000 cases of atrocities. Of these, 95% were determined to have been carried out by the armed forces, police units or death squads linked to the government.

The 5% attributed to the guerrillas included the killing of some local mayors by guerrillas. We don't know the details of these assassinations.. However, in an armed struggle for change, sometimes odious civilian figures are understandably targeted. Still, even if you accept the 5% figure at face value, the Truth Commission's overall conclusions show up the lie promoted by the Democrats that El Salvador was caught between the terrorism of two sides.

The commission backs off from criticizing the government

Taken as a whole, the list of atrocities is a severe indictment of the ruling party and state structures in El Salvador. But the authors refused to draw this conclusion themselves. Instead they focused on individual guilty parties and tried to deflect criticism of government institutions: "Institutions don't commit crimes," their report states, "...the commission believes that responsibility cannot and should not be laid on the institution, but upon those who ordered procedures to take place in the way in which they did... this way the institutions are preserved; the transgressors are punished."

To speak of "punishing the transgressors"--that's a fine thing. But without a change in the state structures, in the institutions, there will be no punishment of the individuals involved, and there will be more transgressions to punish in the future.

Another UN truce commission, the so-called Ad Hoc Commission, issued its report last December calling on the Salvadoran government to purge the government and military of leaders involved in human rights abuses, but the government has refused to do so. Not only that, it has prohibited anyone from publishing the commission's report in El Salvador. When a group of human rights activists published some facts from the report and called for the dismissal of Gen. Ponce and others, they were hauled into court on charges of slander.

The government continued this attitude after the release of the Truth Commission's report. Gen. Ponce insisted he will stay in office as Minister of Defense. And President Alfredo Cristiani called for an amnesty, to make sure none of the transgressors will ever be punished. The parliament, with a majority of ARENA supporters, immediately passed the amnesty into law.

Role of the U.S. ignored

Another glaring omission in the Truth Commission's report is any mention of the U.S. government. This is consistent with the commission's attempt to deflect blame from any bourgeois institution.

But if we're going to "name names" of individuals, as the commission says, then why not name Ronald Reagan, George Bush, Alexander Haig, Jeanne Kirkpatrick, Jesse Helms, Oliver North, and other architects of U.S. policy in El Salvador? These individuals bear much of the blame for the 75,000 death-squad murders of Salvadoran workers, peasants, trade unionists, political activists, and ordinary civilians who "got in the way." And it should not be forgotten that the crimes date back to the Democratic Carter administration, which initiated the U.S. war in El Salvador.

For the fact is, much of the Salvadoran government's repression was organized and paid for by the U.S. government. The Atlacatl Battalion, for instance, was trained in the U.S. Other police, military and intelligence officers were either trained in the U.S. or trained in El Salvador by U.S. military advisors or CIA agents. The U.S. supplied special propaganda tools, special "psychological warfare" training on how to lie, extract confessions, etc., as well as weapons, ammunition, tear gas and cattle prods.

During the civil war the U.S., publicly, supplied El Salvador with about $6 billion worth of aid. (This is aside from covert expenses.) This is about half a billion dollars a year, about the same as the Salvadoran government's entire national budget.

So the U.S. contribution to the Salvadoran government's death-squad war on its own people was no small amount. And today, though Clinton has cut off a few dollars in aid recently, the U.S. remains supportive of the rightist regime in El Salvador.

Clinton's Secretary of State Warren Christopher says he will investigate charges that State Department officials lied to Congress about atrocities in El Salvador. But don't hold your breath. Clinton officials have said that this would not be "a witch hunt," since they are "not a housecleaning administration."

The struggle will continue -- but in a different form

The Truth Commission's report is useful. It shows that, even according to bourgeois legalists, the Salvadoran regime was guilty of a fearful. terrorist campaign against the masses. This campaign was backed up, financed and organized by U.S. imperialism. Today liberals in the U.S. are whining that the U.S. government "should have been more conscious, should have exercised better control." But Reagan and his fellow fascists knew exactly what their money was being spent for. They knew, and approved. And the Democratic liberals went along, because both parties opposed the struggle of the Salvadoran people.

The UN or the liberal forces won't get rid of repressive institutions of the rich and their governments. Those who desire freedom must organize their own forces, spread among the working people, and oppose the forces Of the rich. The insurgent left and the oppressed masses in El Salvador, exhausted by the civil war, entered into a truce with the government, a truce that essentially maintained the old institutions. Unfortunately, the leaders of the Salvadoran left embellished this truce with the thought that these institutions had changed their nature. This remains an illusion, and disorients the organization of the working people.

The civil war seems to be over, but in the future the masses will have to develop a class struggle against the rich in other forms. And if we American workers and activists are to render support to our Salvadoran class sisters and brothers, than we need to organize on an independent class basis here in the U.S. too.

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A scandalous nursing home homicide

Contributed by comrade Frank of Seattle:

I

On December 19, 1992 Ms. Mary Jo Estep died in Yakima, Washington. She was eighty-two years of age. The story of Mary Jo's life and the circumstances of her death continue to stir souls and bring forth both anger and protest from people in Yakima as well as on the nearby Yakima Indian Reservation. And well they should.

Mary Jo Estep was born into a wandering band of Shoshoni Indians, probably in Idaho, probably in 1909. This group of relatives and friends, known as Shoshone Mike's band, had refused to be imprisoned on a reservation. The people, a dozen or so, gallantly but vainly attempted to wander the land and live in the free ways of old. This is said to have been the last free group of Native people in the west.

During Mary Jo's first year of life one of Shoshone Mike's sons was murdered by a white man said to have been a horse thief. Some members of the band avenged the murder by killing the murderer and the band then moved into Nevada. There they tried to survive the winter by killing cattle to eat. An ensuing altercation with ranchers led to the deaths of four other white men. All this was too much for the authorities. Didn't matter that the Indians were just trying to live as they had always lived, with a culture that saw the land and its products as belonging to everyone, and thus to no one. The authorities organized an army of posse men, hunted the Indian men, women, and children for 300 miles through Nevada, and massacred them on February 11, 1911.

Thus Mary Jo Estep was orphaned, her entire family slaughtered when she was just 18 months old. She was taken from the cradleboard on her dead mother's back and given to white people to raise. One of two (depending on the account) other infants also escaped the posse men's bullets only to contract and die of that scourge of the Native American people, tuberculosis, within a year. So the woman who died in Yakima on December 19, 1992 was in fact the sole survivor of a shameful footnote to American history--the kind of footnote one won't find in the sanitized versions of history taught in the schools.

As an adult Ms. Estep remained single all her life. She became a well-liked elementary school teacher and developed many friendships in the Yakima area. In old age she continued to have good friends and was planning to go out to a party with some of them the day of her sudden death. Mary Jo's friends have had to stand by her in death too for the profit-driven American health care system accomplished something which John Law bullets failed to accomplish 80 years ago. It killed a defenseless person and then tried to cover up the foul deed.

Mary Jo became a patient at the "Good Samaritan" Health-Care Center. On the morning of December 19 she was accidentally given strong drugs meant for another patient. According to a state Department of Social and Health Services (DSHS) report, as late as 4 p.m. she was still "alert, eyes bright and visiting with friends." But before the day was out she was dead. Two days later the attending physician issued a death certificate stating "age related" for the contributing factors to the cause of death. The fact that Ms. Estep had actually been poisoned was covered up. Two days after this, under pressure from Mary Jo's friends and other concerned people, the County Coroner ordered an autopsy and issued another death certificate. This time "accidental ingestion of prescription drugs" was given as the contributing factor and it was stated; "nurse' gave patient wrong medication".

But the crimes at the "Good Samaritan" Health Care Center go beyond poisoning an old woman with drugs and the attending doctor covering it up. Other damning facts have come out in the investigation of this homicide. It seems the "Good Samaritan" has been giving incoming patients a vague form to sign indicating whether or not they want extraordinary measures taken to keep, them alive. Ms. Estep signed one of these forms. It said "cardiopulmonary resuscitation should not be initiated". It said nothing about not treating a reversible condition, like the poisoning. Yet according to the DSHS investigative report the health care center staff is saying the doctor ordered that no treatment be given because Mary Jo was a "no code" patient, i.e., she had signed the above form. The report also says the victim was informed that she had been given the wrong medication but neither told of the seriousness of the error nor given any treatment options. And a nurse who had power of attorney over Ms. Estep's health matters is said to have refused an offer by someone from the Health Care Center to rush Mary Jo to a hospital for emergency treatment.,

Thus the monsters at the "Good Samaritan" Health Care Center (and we're not writing of the erring nurse here, but of the doctor, the nurse with power of attorney, and the responsible staff people) coldly stood by and watched a person they should have cherished very much die. Even the tears and questioning of their decision by the nurse who gave the wrong medication did nothing to deter them. And, when caught, they glibly admit what they did! A signature on some old forms is somehow supposed to absolve them. But it really only convicts them of unjustifiable homicide.

What's a life worth? Well, according to the State of Washington the life of an elderly Native American woman must be worth $2,500. That is the amount of the fine which it levied on the "Good Samaritan" for this homicide.

II

American convalescent care is a billion dollar industry. The owners of the private nursing homes (often big chains) get rich and the "non-profit" homes are a lucrative gravy train for administrators. Naturally, the drug companies get a big piece of the action too. Such a money-driven system has every motive for covering tip "accidents" (like poisoning). A nursing home has to keep patients coming in. Fines from state agencies (which are all too rare) can hurt a home's reputation. Worse, a nursing home can be decertified for patients on Medicare or shut down altogether (far too few are).

For the patients, especially patients in nursing homes catering to people with little money, this system is a nightmare. While the owners and administrators count their loot defenseless people are often forced to lay in their own bodily wastes for hours. They're half-starved, rudely treated, and drugged if they demand anything better. And this is generally not the working staffs fault. The owners and administrators can have more money for themselves if they keep staffing at a minimum, pay low wages (many staff people are forced to work two or more jobs because of low wages and short hours), force untrained people to do tasks which should only be done by skilled professionals, etc. It becomes physically impossible for the working staff to provide humane care. Such a set-up can't help but give rise to "accidents" like the one that killed Mary Jo Estep.

III

Bill Clinton has been selling his version of health care reform in every corner of the country for months now. Will his eventual bill result in any positive change for people in nursing homes? Don't count on it. He's already talked of cutting Medicare and Medicaid. More, his constant talk about "cost-cutting" can be used as another justification for not hiring more working staff people, upgrading their skills, and paying them a living wage. If the outrageous situation in so many of America's nursing homes is to be reversed, if justice is going to be won for the victims, one thing cannot he denied however, ordinary people are going to have to band together and make it so.

It appears that the friends of Mary Jo Estep and other concerned people in Yakima, Wa. have already taken a lot of steps in this direction. Thus while we mourn the death of Mary Jo we can at the same time hail their righteous efforts to get justice. The spirits of Mary Jo Estep and of her murdered family of long ago are living in their struggle.

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'Bureaucratic genocide'

Contributed by comrade Frank of Seattle:

For many millions of people the "American dream" has always been an American nightmare. This has been particularly true for African Americans and the Native people. Some recent news from the Shoalwater Bay Indian Reservation in Washington State once again bears this out.

One hundred fifty Shoalwater people reside on a small coastal reservation with 90% of them living below the government's official poverty line. If this wasn't bad enough, they are now having to deal with a major health crisis.

Even in ordinary times the Shoalwater people suffer from inadequate medical care. This is graphically illustrated by the fact that there is only one person on the reservation over 70 years of age (Ms. Hazel McKinney) and the tribal chairman, at 38, is the third oldest man on the reservation. He isn't in robust health either. He suffers from asthma, emphysema, liver problems and chronic fatigue, and he, like the rest of the tribal members, is forced to travel 82 miles to a clinic on the Quinault Reservation in order to get medical attention. But its the astonishing rate of infant mortality, stillbirths and miscarriages in recent years which have gotten the Shoalwater people up in arms. Of 27 confirmed pregnancies during the past,five years there have been 17 miscarriages, stillbirths or deaths in early infancy. This has led to the tribal council declaring a medical emergency and making demands upon the government.

A Shoalwater tribal representative informed the Indian Health Service (IHS) of what was happening in 1990 but there was no serious response. The tribal chairman, Mr. Herbert Whitish, has made two trips to Washington D.C. to demand action be taken by the responsible agencies. The result? According to Mr. Whitish; "Since we declared the emergency nine months ago, the IHS has done nothing.... A lot of promises, a lot of meetings and no action...It's bureaucratic genocide." (Seattle Post-Intelligencer, March 24, 1993.)

The Shoalwater tribal demands have been extremely modest ($350,000 in emergency federal aid to investigate the cause of the infant mortality and $490,000 annually to start up,their own medical clinic). But while the bureaucrats ponder a generation of children is being lost.

The cause of this tragedy remains unknown. Poor nutrition and lack of prenatal care are undoubtedly contributing factors. But these are nothing new for the Shoalwater people and don't explain the sudden increase in miscarriages and infant, mortality which started five years ago. One theory being investigated to some extent by county and state health authorities is that there may be environmental poisoning.

The Shoalwater Reservation is surrounded by pesticide-saturated cranberry bogs and oyster beds. An old dump also drains toward the reservation and a World War I gun battery may also be leaking toxins. Thus there are ample reasons for saying that investigation along this avenue should be stepped up. If the cause is indeed environmental poisoning then what has been occurring is more than a tragedy, it's a crime, a crime for which someone should pay.

But even if the cause were simply poor nutrition and little access to prenatal care, a crime has still been committed. The government and the capitalist system which it represents used every foul and mean method to destroy the ancient cultures of the Native people. It utterly devastated them, left them with nothing, and then turned around and mocked them for not being "white" enough for it. It the government really stood for democracy and equality for all living under its domination in anything but cheap words, then its responsibility would be to work closely with the Native people to ensure that they receive the same level of nutrition and health care as the rest of society.

But a thousand and one facts prove the government has ensured the very opposite. And precisely because this is so it's incumbent upon the American working people as a whole to stand with the Shoalwaters and other Native people. For as long as the present system exists, it will continually work to push all those it exploits and oppresses toward the level of existence of those at the very bottom. Thus the struggles of those at the bottom to improve their conditions and, in the Shoalwaters' case, even to have children, is very much our common struggle.

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Employees need to organize for united action:

Layoffs and cutbacks at Alta Bates Medical Center

From the May 2 issue of Bay Area Workers Voice, paper of the San Francisco Bay Area Branch of the MLP:

To maintain its profits and enhance its market position, the Alta Bates Medical Center has launched a major attack on its nurses and service workers. It has laid people off, changed schedules and eliminated benefits. And it is threatening more cutbacks in the near future. Nurses, licensed psychiatric techs, ward clerks and housekeepers have been hit.

In the mental health wards, one third of the nurses and more than two-thirds of the techs have been laid off and are being replaced with non-union, non-licensed people. On many units, nurses with twelve-hour schedules were told their positions were eliminated. On one day, 180 nurses were forced to bid for jobs. The administrators fabricated outrageous "qualifications" and gave each nurse five minutes to make her bid. About 25 nurses found no job on any shift and are out of work. Meanwhile, the administration took away benefits including health insurance from twenty housekeepers. Those attacks are also designed to intimidate the workers for the imminent contract negotiations.

The workers are not taking this lying down. They held well-attended, spirited informational picket lines at both the Ashby and Herrick sites. They distributed leaflets to passers-by, patients, visitors and fellow employees about the cutbacks and the effects on employees and patient care. Many workers are wearing buttons on their uniforms proclaiming, "By any means necessary" to show their determined stand during the current contract negotiations. And the nurses have held meetings and are getting prepared for their upcoming contract struggle,

Unfortunately, the union leaders' response to the hospital attacks, other than the informational picket line, was little more than filing NLRB [National Labor Relations Board] and other grievances. Workers with experience in the class struggle know such a route is usually ineffective. Direct action, such as slowdowns and work-to-rules, and mass strikes of all sections of workers are effective means of struggle against the employers.

The union contract for Local 250--the dietary, housekeepers, techs, patient care assistants and others--is coming up. The nurses' contract is up two months later. During the last nurses' contract, two years ago, the California Nurses Association [CNA] gave in to the hospital demand to give up the right to sympathy strike. So this time when 250's contract is up, if they go out, the nurses are in the difficult position of not having a sympathy strike clause in their contract. They can expect no help from the CNA leaders in organizing solidarity action. The nurses will have to organize among themselves to honor the picket line en masse. Solidarity among all hospital workers is essential or the hospital administration will pick off one sector at a time, driving everyone's wages and working conditions down.

Why should the nurses and service workers give up pay, benefits, staffing levels, and jobs to keep administrators, doctors, and the executives of the insurance, drug, and equipment 'companies living in luxury? Make the rich pay for the crisis in health care! Hospital workers and nurses, get organized for united action!

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The case of Manuel Salazar in Illinois

From the April 13 issue of Chicago Workers' Voice, paper of the MLP-Chicago:

In early March, around 400 people attended a conference organized by For the Defense in support of Manuel Salazar, a young Mexican American man from Joliet, Illinois, who is now on death row in the prison in Pontiac, Illinois. In 1985 Manuel was riding in a car with some friends, both Mexican and African American. According to o the police report, two officers decided to stop the car because it was 'suspicious that Blacks and Latinos were in a car together'. Manuel was frightened because he and his friends had been target practicing at his uncle's home and he had an unregistered pistol in his gym bag. When the police stopped the car, Manuel ran and threw the gym bag away. A police officer chased him and catching him, began to beat him viciously. Manuel tried to defend himself and the policeman pulled his revolver and told Manuel he was going to kill him. Manuel struggled to get away and the gun went off, killing the policeman. Manuel fled to a friend's house. When friends heard that there was a 'shoot to kill order' out for him, they and his family helped him to get to relatives in Mexico. He stayed with family in Mexico until 1986, when, one night as he was sleeping, armed men broke into his bedroom and kidnapped him. These were Mexican police hired by the police in Joliet. With a few days, he was in jail in Joliet, although no extradition petition was ever filed with the Mexican government.

The trial was held in a mainly white town outside of Joliet in an atmosphere of racist hysteria. Manuel's attorney was blatantly incompetent and later was disbarred for various offenses not related to Manuel's case. The prosecution accused Manuel of being a gang member, although there was no evidence.

The fact that the policeman had beat Manuel until he was unrecognizable and the fact that the autopsy showed that he had been drinking were ignored. Manuel was sentenced to death, even though it was admitted in court that the policeman still had the gun when it went off. In 1991, the organization, For the Defense, took up Manuel's case and is fighting to get a new trial. They have lost one postconviction hearing, but are collecting evidence for more appeals. Manuel's case has attracted attention from many groups and individuals who have written petitions and letters in his support. More than 100 organizations, human rights organizations, lawyers and others attempted to file a friend of the court brief in Manuel's favor, but the court refused to accept it. The Mexican government has protested Manuel's kidnapping and sentence also. For the Defense is planning a day of action for Manuel on April 29, 1993. Call them at [Phone number.] for more information.

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Justice and injustice-Just words to the racist court system

Editorial of the April 13 issue of Chicago Worker's Voice:

Protests, meetings and petitions from inside the U.S., from Mexico and other countries are protesting a number of cases of Latino prisoners on death row in the United States. In late march, despite many protests, a Dominican citizen and a Mexican citizen (Ramon Montoya Facundo) were executed in Texas. In the Montoya case formal protests against the execution were made by the National Commission for Human Rights of Mexico. Groups protesting the racist U.S. "justice" system and the death penalty itself are stepping up efforts in other cases. They note that these cases show racial bias of the courts and police, illegal or brutal actions by the police, and suppression of evidence showing innocence or extenuating circumstances. [The same issue of the Chicago Workers' Voice contained separate articles on a number of cases.--WAS]

Even among the biggest capitalist countries, the United States stand out for its unjust "justice". The United States has a higher percentage of its population in prisons than any of the other western capitalist countries. While the death penalty has been abolished in the majority of "civilized countries", including much of Latin America, the United States has 2,400 people on death row at this time. A disproportionate percentage of the prisoners in prison and on death row are African American, Latinos or other minorities. And, of course, almost all are poor and working class people. Meanwhile, really big criminals who steal millions or even billions from us, like the Savings and Loan capitalists, barely get a slap on the wrist from the courts. And the true mass murderers (for example Reagan, Bush and company), responsible for the deaths of many thousands in the Persian Gulf, Panama, Nicaragua, and El Salvador just to name a few place, are even praised as heroes.

This is a system which doesn't give a damn for the suffering of the people from unemployment, poverty, hopelessness, drugs, or crime. It is a "justice system" to protect profit and property for the rich, not a system to serve or protect the poor and working people. The so-called war on drugs, crime and gangs is a pretext for a war on the poor and minorities. The Chicago Workers' Voice condemns the racist and unjust "justice" system which sends so many to prison and even to death. The fight against police brutality and the racist court system is an important fight for the working class to make its own.

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The restructuring of the world economy, and the future of working-class communism

Following are notes for the speech at the May Day meeting of the Boston Branch of the MLP on April 30:

Comrades and friends,

Welcome to our May Day meeting. May Day originated here in the U.S. 107 years ago with a national strike called by the fledgling AFL unions to fight for the 8-hour day. It was declared an international day of struggle for the working class by the Second international 104 years ago. After the initial 1886 strike the right wing of the American union leaders opposed the celebration of May Day in the US, and by 1893 Samuel Gompers was making a deal with Congress to celebrate Labor Day in September to disassociate American workers from the international struggle of our class.

But the desire of the workers for international solidarity for struggle against the capitalists and the existing order made May Day, in a matter of a few years, into a worldwide day of struggle for the workers. In many countries the strikes were so widespread the capitalists had to make the day a legal holiday. Even in America for decades tens of thousands of workers continued to hold marches and rallies on May Day. Hundreds of thousands of workers marched and fought the police on May Day 1919 in the US in support of the Soviet revolution and against US intervention. Again hundreds of thousands marched for unemployment insurance during the 1930's. But under the pressure of McCarthyite repression and the CPUSA's abandonment of a revolutionary independent class stand, May Day in the US died out as a mass phenomenon. The left wing that came out of the 60's, including our Party, made an effort to revive the tradition of May Day among the American workers. But today the energy of the 60's wave has died out and the working class has not yet produced a new wave of struggle. As a result at this time, there are no mass demonstrations on May Day in the US.

But May Day is not only a day of united international workers struggle. It is also a day when class conscious workers and activists sum up the stage of the class struggle and discuss their tasks. The unhappy situation with regard to mass May Day events in the US is but symptomatic of the extremely depressed state of the working class struggle, not only in the US but in most of the world. Today we would like to examine some of the causes of the present situation, some of the factors that tend to radicalize our class, and our tasks today. In regard to much of this, we can only present the most general features, only pose the questions.

One of the more obvious and perhaps more temporary factors in the difficulty of the present situation is the collapse of the Soviet Union. Of course socialism died in the Soviet Union a long time ago, a long time before this collapse. But a large section of the workers only know what they can figure out from the bourgeois propaganda. And to them the collapse of the Soviet Union means the collapse of socialism. Thus the Soviet collapse and the bourgeois propaganda have a certain temporary demoralizing effect on the workers movement. They create a certain feeling that a better world is not possible.

The collapse of the Soviet bloc has a number of other effects on the class struggle. On one hand it means that various struggles that break out in the world no longer get ensnared in the framework of East/West rivalry. The real class issues can now develop more openly. The bourgeoisie will no longer be able to paint every class struggle, every revolutionary movement as a plot of the KGB, Thus we have a certain easing of the anti-communist hysteria. On the other hand the demise of the Soviet bloc means for a while less space for popular democratic and national movements to seize power in the Third world. The former Soviet Union, while imperialist, in its effort to extend its influence had to provide a certain opening and economic support for movements it did not control. The crack of US/Soviet rivalry no longer exists. New rivalries are emerging, but none that have reached that intensity yet.

Meanwhile the national liberation movement against colonial and neo-colonial regimes has more or less ended. The colonies have been liberated; the more or less puppet regimes are gone. You are not going to see more revolutions where a section of the bourgeoisie joins the people in a struggle for national independence or against a regime that stands only because of the support of Western imperialism. Today in most of the world the regimes are the regimes of the national bourgeoisie. Thus the class struggle of the rich against the poor comes more to the fore. This does not mean that the masses of the third world are no longer exploited by the rich imperialist countries. But this exploitation recognizes the local bourgeoisie as rulers of the country and includes them in it. So on one hand a certain crack of the national democratic revolution, which allowed the toilers a considerable opening for their independent struggle, is closed. On the other hand the class reality in the third world countries is becoming clearer, more open, laying the basis for more directly socialist, struggle in the future. But the future is not yet here.

This also does not mean that national struggles are over. But the struggles which are mainly occurring today are ones of reactionary squabbling among the different bourgeoisies as in Yugoslavia, the former Soviet Union, and India. So far the proletariat has been unable in any of these countries to come on its own to oppose this fratricide and use the crisis for revolutionary struggle against the bourgeoisie that is causing it.

One of the factors that undermined the class consciousness of the workers in the Western capitalist countries was the three-decades-long relatively stable; peaceful expansion of world capitalism in the wake of World War II under US hegemony. Many of the colonial and trade contradictions among the imperialist powers that had led to two world wars and inhibited the growth of capitalism were resolved as imperialism developed new, more joint, methods of exploitation of the third world. The rebuilding and automobilization of Europe and Japan created a vast market as did the militarization of the U.S. economy to maintain this New World Order.

At the beginning of this period the American capitalists came down hard on the workers. They suppressed the left in the trade unions,(which was assisted by the reformist policy of the now degenerated CPUSA), and they made it more difficult for unions to be organized. They helped the right wing consolidate a fairly autocratic control of the unions. They launched an intense productivity drive against the workers in all the major industries. Nevertheless the expansion of capitalism was such that the majority of workers, not just the labor aristocracy, were able to enjoy a fairly stable, increasing standard of living. As a result, although the workers were not happy with the situation, they acquiesced to capitalism, and to the hegemony of the pro-capitalist trade union bureaucracy over their struggle and unions.

But even during the golden era of U.S. imperialism there were periods of fairly intense struggle. Millions of black sharecroppers moved to the cities and became workers. The movement for civil rights, for equality, for liberation and against the grinding poverty erupted and shook America to its foundations. The U.S. got mired in Viet Nam and a huge movement broke out against this war of aggression. These great movements and conditions also brought a certain radicalization and renewed militancy to the workers' economic movement in the late 60's and early 70's. There was a whole new wave of wildcat strikes. There were sporadic attempts of the workers to build rank-and-file opposition to the labor bureaucrats.

Despite all the struggle the workers were unable to truly break free of the trade union hacks or the Democratic Party and build a truly independent class movement. There were two main reasons for this. First illusions of a whole class are not overcome in such a short period of time without a much more severe crisis than existed at the time. Secondly, the previous wave of revolutionary struggle, the 1930's, had not left a revolutionary class party that survived to the 60's. The CPUSA had become part of the problem, rather than part of the solution to building an independent class movement. As a result, the revolutionary activists who came out of the movements of the 60's had to learn everything from scratch. And by the time we had built up serious party organization and got our bearing, the spontaneous movement had passed.

By the mid 70's the post-World War II worldwide expansion of capitalism had run out of steam and capitalism entered a period of stagnation. By the early 80's the capitalists were on a major offensive against the workers. They closed factories, busted unions, and forced concession after concession on the workers. The labor hacks refused to organize a fight. And the workers were unable to break from them and build an independent movement. They lacked the confidence and the conception that anything real could be done outside the pro-capitalist trade union channels. As result the workers in basic industry and transportation were decimated.

Meanwhile great structural changes had been going on in the working class. In the post-war period the weight of the industrial workforce in large-scale establishments declined dramatically. And the professional and managerial strata grew from 15 per cent of the workforce to over 30 per cent. Meanwhile college education was opened up to a much wider section of the masses and a large percentage of the brightest, most active working class youth were stripped away from the class. A great number of workers began to think of themselves not as members of the working class? but of the lower section of the "middle class". They thought that they might be workers today, but they or their children would go to college and become professionals. The sense of being a hereditary class was undermined. Class lines and consciousness were blurred.

The weight of the workers in largescale mass industry, mining and transport who had been the basis of the workers movements from the turn of the century began to decline after 1950. Capitalism continued to develop but into new areas. The number of workers grew rapidly in the medical industry, retail trade, service industries of all types from McDonalds to travel agencies. The transition to a service economy has had an effect of fragmenting or atomizing the working class. While manufacturing workers tend to be concentrated in big factories (there was also a trend to smaller factories after World War II, a trend which continues today), the service workers by the nature of the service and retail trade industries tend to be dispersed in small workplaces. In 1989 the median manufacturing workplace employed 60 workers while the median service industry workplace employed only 11. In the one section of service work that tends to have large workplaces, hospitals, workers are very much surrounded by all kinds of professionals. These economic changes tend to undermine the workers' sense that, as a class, they are a power.

What is behind this transition to a service economy and the decline of the weight of the industrial proletariat?

To a certain degree it is due to the parasitism of imperialist capitalism. A large and growing part of manufacturing has simply been exported to low-wage countries. There is a tendency to turn America and other imperialist countries into the corporate headquarters and research and marketing centers of the world while the workers of the third world produce the goods. But this is by no means the main factor.

In our research we found the same trend of development in all countries that have reached a certain level of capitalist development. It seems that once capitalist agriculture has developed to a point that peasants are no longer a significant section of the population, further development of capitalism takes place not with the expansion of the scale of manufacturing but with the development of service industries. We noted the same trend in Singapore, Taiwan and Malaysia as in the US. Even though the size of the industrial proletariat is still growing in these countries, its relative weight in the working population is declining as the service industries and professional strata grow.

The productivity of manufacturing tends to grow much faster than the ability of the masses to consume under capitalism. At the same time growing complexity of technology and of the organization of industry creates a much greater need for education, schools and teachers; and the growing participation of women in the workforce creates new needs for extended hours in retail trade, for fast food, for daycare, for nursing care of the elderly, etc.

But whatever the reason, the immediate effect of the above-mentioned structural changes in the economy has been a setback in the development of the class cohesion and consciousness of the workers. That is the negative side.

On the positive side the capitalist development and organization of the service sector lays a much stronger technical basis for the transition to socialism once a revolution breaks out. It is much easier to socialize a retail trade industry that has already been concentrated in the hands of supermarket chains, shopping malls, and Radio Shacks than a million small owners. Or, for example, it is much easier to speak of the socialist emancipation of women if capitalism has already created a system of quick service restaurants, daycare centers, nursing homes, etc.

While the last 40 years have seen an enormous growth in the white collar workforce, about 40 per cent of that growth has been in the clerical workforce. And the growth of the clerical workforce has been accompanied by a rather largescale reduction in its privileged position. At the turn of the century clerical workers made twice what factory workers made. Today they are mostly women and make the same or slightly less than factory workers. Although on the average the clerical workers have closer contact with the bourgeoisie, the managers, and professionals and absorb some of the prejudices of those strata, there are significant sections whose conditions have been positively proletarianized, for example the postal workers. There is also a section of lower-level professionals and technicians whose conditions and wages are being pushed down to the level of proletarians.

While the shipping of manufacturing overseas may increase the chauvinist, pro-imperialist tendencies of the professional, managerial, and technical workers involved in the corporate headquarters and research centers, for the mass of manufacturing workers the competition of their lower wage brothers in the Third world means much greater poverty, job insecurity and unemployment. And indirectly, by the displacement of manufacturing workers, this competition affects broad sections of service, transport and other workers. No matter how much the trade union hacks may try to whip up anti-foreign worker chauvinism, sooner or later the devastating effects of this competition have to raise in the workers' minds the need for international class solidarity. Painful as it is, that is one of the revolutionizing effects of the much vaunted world market. It makes the need for international class solidarity much more immediate and palpable.

Another effect of growing international competition and the drive of the capitalists to lower their labor costs has been a major and rapidly growing structural change in the workforce. That is the growth of the part-time, temporary, contingent, or contract worker. 90 per cent of the new jobs created in the current so-called recovery are of this type. Today 25 percent of the work force is part-time, temporary, or contingent. By the year 2000 it will be 50 per cent. The staid IBM has converted 10 per cent of its workforce to such temporary, disposable employees. Today Manpower is the biggest employer in America. The majority of the retail trade and fast food industries run with part-time workers. Part-time workers predominate on our local transit system, and now the state is talking of contracting this work out.

The capitalists have resorted to this contingent-type employment to avoid paying higher wages and especially to avoid pension and health benefit costs. Thus the alienation and insecurity of a growing and soon majority section of the working class is increasing enormously. Should this change become a permanent condition of the workers, it will greatly radicalize them, and force them to wage more class-wide struggles. The struggle for medical coverage and old age pensions can no longer be considered a matter of a fight with an individual employer. It is a matter of the fight of the working class vs. the capitalist class. The pressure for national health care reform in part comes from this change in the composition of the workforce. Intelligent capitalists know that such insecurity as is presently growing may give rise to much more militant movements among the part-time and temporary workers, and they wish to head it off by a stopgap, universal health insurance reform. But private capitalists are so focused on their short-term profit interests that any serious reform will most likely be delayed until a workers' movement forces it.

At present the world is at a stage when the conditions that gave rise to previous waves of working class struggle are disappearing and the features of the conditions that will give rise to the next wave are not fully developed. What section of the class will be the base of the next wave is impossible to tell at this time. But that there will be another wave is certain.

World capitalism has known cyclical economic crises since 1825. But it has also known periods of growing and deepening economic and political crisis that develop over decades and climax in wars and revolutions. The first such period climaxed with the revolutions of 1848. The next wave first showed signs in Britain in the 1880's and became pronounced on a world scale in the first decade of the 20th century. This wave of crisis produced World War I, the October revolution, the Great Depression, and World War II. If world capitalism cannot stabilize Eastern Europe and find a way to relieve the Third World debt burden, then it is likely we are headed into another such round of escalating economic and political crises.

When and how the working class movement will revive we cannot tell. But as communist revolutionaries it is our task to remain close to the masses, to strive to enlighten them to their independent class interests, to maintain an organization which can help the masses learn the lessons of the class struggle more quickly once the movement does revive. The enormous changes in the world, the experience of the Soviet Union, and changes in the composition of our class raise huge theoretical questions that we must tackle if we are going to be able to help guide and inspire future movements with confidence. This theoretical work is not a matter of picking up any fashionable theory that comes along but of examining events in light of our Marxist theory, correcting that theory where necessary but always making sure that we have a serious integral theoretical outlook on the world that is based on fact. Our party has set itself these tasks. We invite you to join us.

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Correspondence:

Notes from Germany

Comrades,

Thought you might like some news and observations from Germany. I hope the German postal system can withstand the added burden. Have included some clippings from the local press here. They cover the refugee situation and the fight against the right wing and some economic issues. They don't give an overview, but are merely bits of news that caught my attention which I thought might interest you. I'll translate the key points or bits of info as best I can [clippings from German newspapers, with translations, were included the translations appear below -- WAS].

Overall the economic articles reflect the class struggle in the deteriorating German economy. [German Chancellor, i.e. government leader] Kohl [of the conservative Christian Democratic Union-Christian Social Union], with the urging of some of Germany's big capitalists, has proposed a return to the 40-hour week (currently 38.5) as a "means of boosting the German economy". Of course more rationalization, more unemployment will result. With unemployment as high as 50% in the worst off regions of the east, Kohl's proposal is staggering, to say the least. It has produced a big hue and cry among social-democrats and liberal circles. Mainly they point out the obvious--that more unemployment will result (more than 1.1 million jobs lost) and a greater burden on social services.

Related to this the steel capitalists are trying to renegotiate the steel workers contracts. The facts I'll include in the translations, but this issue and the length of the working week and who will pay are at the center here as well. Watching the news on TV I noticed that in the two demonstrations referred to, some workers carried banners with the number 35. I have to assume this is a call for a 35-hour week. They negotiated a 36-hour week already which is to take effect on April 1. Also included here, and on TV news, they plan to shut down completely a plant (in the East) which they modernized (getting concessions) and is said to be the most modern steel plant in Europe. Go figure.

Around town observations...Signs of the issue of the struggle against racism and far right are everywhere to be seen. Posters for meetings of anti-fascist and anti-racist groups. Calls for the release of a militant arrested after a confrontation with nazi-skins. Spray-painted slogans, graffiti, etc. Some people wear buttons showing their support for foreigners and their opposition to the far right. Very little to be seen from the extreme right here, I did, walking home, see a poster, last night from the "Reps", the Republikaner Party. It was an election poster and the slogan was "Always more/Always less/Always more"--the sort of slogan you'd expect to be delivered with a smirk and which is only truly understood by "real" Germans.

Also related--the interior minister [something like the attorney general in the U.S.] who praised the police in Rostock last summer [when they twiddled their thumbs and looked the other way as the neo-nazis and racist skinheads attack a hostel for immigrants night after night for a week] was fired recently. But the Rostock incident and his subsequent remarks were not given as a reason for his dismissal. Rather, some interior ministry documents were found in a garbage dump somewhere and this breach of protocol and security was what prompted it. The Kohl government doesn't want to give an# unfavorable signals to the right.

That's all for now.

Yours in struggle--C.

P.S. Should have translated articles before writing note--learned a lot. Apparently the German capitalists are trying to break up the solidarity of the steel workers. They want to get rid of the basic wage agreement in steel, which is binding on all associated steel producers (this includes nearly all, if not all of them) and deal with the steel workers plant by plant. Sound familiar? The trade union representatives, while calling some actions and making some threats of actions or strikes, characterize the workers as demoralized and say the thing to do now is form commissions to study the problem, give more subsidies to steel and appeal to the EC [European Community, the economic and political coordination of West European governments].

Summaries and translations of clippings:

West German steel producers accuse the trade unions of trying to shut out competition from the,east. The chairman of the German trade union congress demands "concerted action." He calls for appealing to the EC commission in Brussels as a way to avoid one steel mill being played off against the other.

One picture showed a steel workers' picket, with the following placards:

1. Stop destruction of jobs in steel;

2. We demand maintaining jobs for the entire region;

3. Hagen Krupp steel workers fight in solidarity.

Two articles from Frankfurter Reindschau, Feb. 12:

1. Metal workers intimidated?

The trade union at IG Metall Erfurt, has accused a series of metal works in Thuring of restricting workers' right to free speech. Trade union representative Gerd Bricker said workers in some shops were forbidden, under threat of firing, to participate in protests against the revision (renegotiation) of the basic wage agreement. The trade union won't accept that in this unconstitutional manner "democracy will be limited after work" says Gerd Bricker. Mediation/arbitration continues. No results expected until next week.

2. More than 1,500 metalworkers demo in Hagen to save their jobs. The Chairman of the shop Stewards, Paul Ring, calls for a nationwide conference to deal with the crisis in steel. According to him, the mood among the workers ranges from nervous to depressed. According to statements from Krupp/Hoesch, both Hoesch Steel and Krupp Steel in Hagen could be shut down, threatening 1200 jobs. In the past two years DM [Deutsche Marks, the German currency] 60 million has been spent in the Wehrmghausen section of Hagen to build the most modern stainless steel rolling mill in Europe. Paul Ring criticizes minister Gunter Rexrodt for relying on the strength of the economy. The trade union representatives demand a national concept for the crisis-ridden steel industry such as a "solidarity pact for steel" (after the solidarity pact with the east--this implies tax revenues should be directed to support steel companies). 5,000 expected to demonstrate Friday to remind politicians of their promises to keep open the steel mill in Eko. The trade union calls for deeds, not words from the government.

Four articles from Frankfurter Rundschau, Feb. 11:

1. With no conclusion, the second round of talks to revise the agreement to shorten the workweek was ended. The trade union (at IG Metall) and employers accused each of inflexibility. Therefore the introduction of the 36-hour week with a 3% wage increase in the region of Nordwiirtenburg/ Nordbaden is certain.

Industry representatives wanted to delay the shortening of the work week to a later point in time. Union representatives rejected an offer by IG Metall to go ahead with the 35-hour week with 1.4% reduction in wages as "outrageous". Besides, there was already a concession made in the current agreement which holds the wage increase to only 3%. "We're frustrated, by the ideological barriers of the other side," he said.

2. The return to the 40-hour week, demanded by the president of German Industry and Commerce, Hans Peter Stihl, would create more than 1,1 million more unemployed, according to the Business and Social Science Institute of the German trade union congress. In a public statement the unionists referred to this figure and said such a move is laborpolitically dumb and businesspolitically foolish.

Considering the higher and broader unemployment, a further shortening of the workweek is necessary, said the Institute. Particularly in East Germany where the end of the dismantling of industry is not yet in sight. According to the institute, the average workweek in the west is currently 38.1 hours per week.

3. The trade union at IG Metall is going to call strikes in every plant in the East which doesn't raise wages from [the present] 71% to 82% of those in the West by April 1, thereby following the agreed-upon stepwise plan. "Plant by. plant push and therefore struggle to maintain the agreed upon contracts." -- Klaus Zwickel. He doesn't think the current negotiations will bring any results. The trade union represents 750,000 members in the east of whom 300,000 still work full time. The trade union rejects any revision of the agreement. Steel capitalists complain that many eastern firms are slow to make the necessary adjustments and want to bold the COLA to only 9%. (The steel contracts are apparently negotiated collectively with a whole group of firms who are then expected to abide by the agreement there is some concern that, should the present talks on revision of the agreement fail, some firms will leave the group rather than abide by the agreement as it stands). If this occurs, the trade union will no longer be bound by any no-strike provisions and will resort to "fighting measures" if necessary! (Klaus Zwickel).

The chairman of the employers group, Dieter Kirchner, called Klaus Zickel's remarks an "irresponsible, threatening gesture". A strike would be, for a number of reasons, illegal. Besides, it would be inappropriate and would destroy the industry.

The Christian Democratic Union [Chancellor Kohl's conservative party] demands cuts in the basic wage agreement for the east and a slower rate of equalization with the West. They call on all parties to be "reasonable".

On Wednesday, 16,000 demonstrated against any take-back of the raise in the basic wage agreement

4. At the end of 1992 the basic income level in the east reached 73% of the level of that in the west. Wages and income rose 5.6% in the west and 25.9% in the east in the past year. In the east, however, they work an average of two hours a week more. In 1991 workers (actually, employees is more appropriate here) in the east earned 60% of the amount earned in the west. Most companies don't reach the average, however, with those in chemical,, woodworking, or cake and candy manufacturing earning 63%, while in construction they earn as much as 92%.

Two articles from Frankfurter Rundschau, Feb. 10:

1. Murder or suicide?

Death of a member of Socialist German Workers Youth group (youth group of the western revisionist German Communist Party), until now thought by authorities to be suicide, is now possibly homicide. The head of the district attorney's office in Meiningen says the Kriminalpolizei Kripo, the police who handle violent or otherwise serious crimes and/or investigations) are following leads concerning threats against Olaf H. from the far right scene. The results of the postmortem examination and inquiries have as yet: given no hint of foul play.

Near the impending end of the inquiry, the chairman of the Socialist German Workers Youth made a statement to the press. Olaf H., who was found hanged in his apartment Wednesday last week and buried last Tuesday, was a well-known "anti-fascist" in town and had been threatened many times. For that reason he had not lived in his apartment for some time. His parents and friend's saw no indication that he would kill himself. Though unemployed, he was to begin a new job shortly. (I hear that suicides among the unemployed in the east are becoming alarmingly common:) The Kripo now says they are following leads about threats--"we consider it a serious matter". But only now that, friends of Olaf made public the evidence and raised a. fuss. Regional district attorney Karge admits that without the intervention of Olafs friends and family the case, would have been closed relatively quickly. A rally for justice for Olaf H. was called on Saturday in Suhl.

2. The district attorney's office in Magdeburg is, pressing charges against a policeman who shot and killed a Romanian refugee on Jan. 22 behind the police station. The cop has been suspended. "Several refugees were arrested in the west for shoplifting." They, resisted being brought into police custody and tried to flee. That's when the officer used his gun.

A spokesman of the Social-Democratic Party accused police and the district attorney's office of issuing denials in order; to cover up the incident. The deadly shots were made public through local press reports.

An article from Frankfurter Rundschau, Feb. 16:

Police reserves in Berlin are a playground for ultra-rightists and criminals. Proceedings against weapons smugglers give way to investigation of volunteer troops with "shocking results."

Synopsis: The second half of article reviews the history of the police reserve in Berlin. It was formed in 1961 shortly after the wall went up--at that time a force of 6,000 who received, four weeks of training and whose purpose was to thwart a possible threat from the east. They found other little jobs over the years, such as security for the Shah of Iran in '67, or national guard catastrophe relief work. The current mayor of Berlin and a former Senator (both Christian Democratic Union) are both members.

After 1971, with only 2,400 members (mainly public employees) the reserve was given responsibility for various buildings in the public domain (security).

(They were also responsible for security at refugee centers.)

They earn DM 8 per hour, the yearly cost is over DM 7,000,000.

The main story is that these reserves are completely infiltrated with far-right wingers (Nazis and skins).

This came about through an investigation of a smuggling ring bringing weapons and ammunition in from Switzerland. They caught 12 of them--5 of the 12 were members of the reserves, 2 had applied but were rejected by the reserves, one was no longer a member. For the most part all of them, had a background of activity with the far right.

This led to an initial investigation of 200 police reserve members. They found that 89 of them had a past criminal record--250 felonies including theft, severe assault, and sexual abuse of children. They were all approved by the same two officers (who now face "disciplinary action").

These two officers also knew that some of the weapons-smuggling, police reserve members participated in the military exercises, (since the mid-80s) of the ultra-right "Freedom Workers Party".

A spokesman for the NPD (the old-line Nazi party, the Nationalist Party of Germany), said NPD members were sent into the police reserves in order to be better informed about police measures (tactics, plans).

A related point (not in the article): Many, refugees have complained about racist verbal and other abuse (rough handling) by those supposedly guarding refugee centers.

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More correspondence on the population bomb

Letter to the Supplement:

The population bomb

I read the articles by Steve and Don in the 12-20-92 Workers' Advocate Supplement with interest. I think both raised important issues, but I disagree with what I interpret to be major thrusts of each argument. I'm no expert on this subject but would like to add some thoughts.

I.

Several of Steve's points seem to indicate that he considers that population level and growth are not major factors contributing to the environmental disasters of today. His view that the earth's carrying capacity is not yet exceeded, seems intended to back up this idea. He states that even if population were reduced to 2 billion, life would remain hell for the environment if capitalism continued to be the social system. He states that socialist economy would provide abundance, without any comment on the issue of population level. Steve was quite agitated by Don's suggestion of the need to reduce human population and considered this to be the same as applauding starvation, and generally anti-people. Overall, I guess his opinion is that if capitalism were replaced by socialism, population growth would not be a big problem for the environment until some future period.

It seems to me that human impact on the environment is directly affected by the features of the productive processes we use and the level of population. Today, the combination of the current production and population is wreaking havoc. To an unknown degree, part of this damage is relatively irreversible. If one seeks a socialist society whose priorities include biodiversity and which is able to advance productive technique to reduce waste and pollution, it does not mean that population level is no longer a problem. For one thing, changes in the application of technology cannot take place overnight. For example, primitive agricultural technique is destroying rain forests' and arable land. Advancing the agricultural technique that today sustains millions of people is a big task. Energy use by advanced societies is causing a dangerous build-up of CO2 [carbon dioxide--ed:]. Changing the energy use patterns is no small task either. Changes in transport and land use patterns could cease the destruction of Wilderness areas by allowing the combination of dispersed population concentrations with protected wilderness areas. But this too is a long term proposition, even with a social system that desires it.

It is a valid question to ask what are the optimum population levels in various regions, from the standpoint of "biodiversity" and "quality of human life" (I will look into the meanings of these terms below). For a given level and extent of productive technique, and a reasonable projected advance of technique, this optimal level might be less than the currently existing amount in some regions. I don't think this idea is tantamount to supporting starvation or apologizing for capitalism. I think it is part of the issue of transition from blind to conscious development. The index of the Workers' Advocate Supplement lists this article series as, "Earth First! Demands 'fewer people.' " This strikes me as a smug comment from the perspective that something is obviously wrong with considering that population might be too high. If this is the view, I don't agree.

II

It may seem logical to presume that if current development is devastating the environment, then the problem is "overdevelopment," as Don says. But I think this is dead backwards for at least three reasons: a) Rapid application and development of technology is crucial to reverse environmental devastation, b) Rapid application and development of technology is essential to allow control of population levels, c) Reduction of population by itself, without the spread and advance of productive technique, cannot save the earth from human degradation of it. Let me explain.

a) One of the greatest sources of manifold environmental devastation--primitive agriculture--could be eliminated if the backward regions were advanced to modern levels of productive technique. There is no way that primitive extensive agriculture could ever be made non-polluting (unless population were tiny, something an agricultural society cannot maintain). One role of technology in saving the environment is the necessity of advancing productive technique in the backward regions of the world.

Now it's true that modern, intensive agriculture brings its own, serious pollution problems. The same is true of many other aspects of advanced production. But it is also true that technology can and has been developed that lessens the various sources of environmental damage. I believe that the role of technology is related to questions about the social system: 1) Can the social system be changed to allow a more rapid research, development and application of technology? 2) Can it be changed to allow conservation of the environment to become a strong priority influencing economic decisions? The practice of the Western and Soviet models is notorious on both of these matters (though the Soviet generally worse); any serious program to tackle pollution must deal with these two issues. (I think that Steve was striving to get at this with his talk about profits, capitalism, socialism, etc. However, without any ideas of how a socialist economy might organize differently, condemnation of profit-seeking is barren rhetoric.)

b) Spreading current technology and advancing it are also critical factors to allow control of population levels. For example, Steve's point on the oppression of women causing huge population growth. To control population it seems essential that productive technique advances so that women are brought into diverse forms of labor and cultural activity beyond the domestic ones. Women with interesting and challenging jobs generally don't want ten kids; their creative needs are met not solely in the realm of child-rearing. Other economic factors push population growth, such as the income and security needs of persons living under primitive agricultural conditions and other situations of poverty. Cultural attitudes towards sex are another big factor. Generally, advance of productive technique works in the direction of undermining provincial, ignorant, and prejudicial attitudes towards sex. And of course, the advance of birth control technology directly assists the transition from blind to conscious factors determining population level.

c) Don may or may not think that reduction of human population by itself could solve the pollution problem. Obviously, this would reduce the amount of pollution. But how long would this fix last without significant change from the current scope of application and level of development of modern technology? Human history has already demonstrated that the amount of enlightenment and the social conditions necessary to even start to think about regulating population growth can only come about with an advanced society based on modern technology. A world with the current technical and cultural level, even with a low population, would be unable to control itself and would rapidly repopulate the earth.

III

Don puts forward the view that other species and habitat should have equal footing with humans. Human consciousness has given rise to outlooks and practices that we are the center of the universe--a mistaken view that is arrogant, destructive, and potentially suicidal. Consequently, Don's view has a radical and even scientific sound to it. But I think that in practice this view turns out so vague that it doesn't answer any of the difficult questions.

Don didn't have the opportunity to elaborate this idea, but I have tried to think about it. What would this mean as a principle to guide consideration of what the human niche relative to other niches should be? Hunter-gatherers occupied one range of niches. Dynastic societies, with domestication of plants and animals, occupied another range. The capitalist industrial development has transformed the human niche again and continued-to. What sort of niche does Don advocate and what social system could bring this about? I can't see that the abstract statement of "equal rights" among components of the ecosystems gives any concrete guidance in practice.

Must human development be counterpoised to the maintenance of biodiversity? Not if we consider a socialist society. A central, positive goal of human development to be the rising productivity of human labor. This rise is a necessary basis for all humans to achieve a comfortable, diverse, and ever more aware, lifestyle. This rise should not be looked at merely in terms of labor saved today (which is a strong tendency of current societies). It must also consider the impact that the labor has on the environment, the long-term ramifications for the ecosystems. If one accepts this proposition as a positive human goal, a couple of implications towards the environment follow:

On the one hand, this rising productivity cannot occur without alteration of other species' niches. Everything from growing wheat to battling disease organisms to biotechnology confronts this issue.

On the other hand, humans are bound by the necessities of interactions with the rest of the ecosystems. If a sufficient level of biodiversity is not maintained, the quality of human life will suffer, or cease altogether. The determination of "sufficient" biodiversity, the bounds of presumed safe alteration of the environment at any particular time, is complex, to say the least. First of all, this would require scientific research that is greatly expanded and is not prejudiced by narrow capitalist interests. But even assuming this, the perspective must be realized that the best scientific knowledge would still be quite crude and partial compared to the complexity of the overall processes of nature.

Therefore, it would be necessary to make maintenance of biodiversity a high priority add pursue economic development accordingly, including restrictions on human production and consumption where necessary. A socialist society would require fundamental political economic changes so that environmental costs, as well as labor costs, are taken into account for economic decision making.

IV.

Among the establishment mainstream, a debate is often posed as "don't worry, technology always solves every problem" vs. "worry, population is now too big for technical solutions to work." Each side has grains of truth, but both miss a central point. Both technology and population are decisively influenced by the social system. I must admit that the track records of both the Western and Soviet models are not such to inspire confidence in the possibility of humankind giving rise to a society that would use technology for environmental goals. Nevertheless, such revolutionary change is needed. I think that environmental activists need to fight with political exposure and militant mass actions against pollution today, and also confront the issues of social system, of socialist alternative.

One other point. I think that the field of considering population, productive technique, and environment is a relatively primitive field of science. It is unfolding way too slowly, and this is mainly due to the impact of the vested interests of various establishments. I think that it is necessary for progressive people to recognize this situation and take an attitude of striving for further investigation.

Fred (supporter of MLP from Seattle)

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Socialism and the future of health care

Below is the second speech at this year's May Day meeting of the MLP-Detroit:

The first speech of this meeting [also printed in this issue of the Supplement] showed that the present crisis of health care is the crisis of medicine for profit. Marketplace medicine is going backward, and it is unable to deal with today's conditions.

The problem with marketplace medicine is not just the price, or even the lack of universality, but how it is carried out as well.

It is pretty good at solving certain emergencies where the doctor can recognize the problem and cut it out with a knife. It is pretty good at solving problems which respond to vaccinations or to pills.

But it has a hard time with many chronic conditions. Millions of people suffer chronic pain and various disabilities that the doctors have pooh-poohed. It comes out recently, for example, that the doctors haven't taken seriously many complaints of women, instead regarding women as complainers, nor have they have done studies of the effects of various treatments on women as opposed to men.

Moreover, the pursuit of profit has led marketplace medicine to one abuse after another. It has led it to a sea of unneeded operations, highly profitable for the doctors and hospitals but dubious for the patients. Almost one out of every four births is a cesarian; it seems unlikely that this many caesareans are needed or else human beings would never have survived to our present, infamous twentieth century. The rate of hysterectomies is astonishing high, and studies show little, difference in the health of neighboring towns where one has twice or three times the rate of hysterectomies as the other.

The elitism of the medical system causes major problems. The doctors are isolated on top, making gigantic salaries, while the vast wealth of experience of the nurses and other medical staff is left aside. This means that while a minority of doctors may have the people's interest in mind or even place themselves on the line for the people like the late Dr. David Gunn, the majority of doctors are cocksure overlords.

Moreover, the medical establishment is lethargic about a number of important issues affecting the people's health because they affect the profits of the ruling class even more:

There is the devastation of health by pollution.

There is the flood of workplace injuries that afflicts the working class.

And there is the extreme poverty of a section of the population, which has health conditions typical of an undeveloped country under a savage dictatorship.

The nature and limits of national health care

Can these problems be solved by national health plans, such as the Canadian plan, or even the more extensive Swedish system?

We stand for a universal health care, for a national plan, because such plans are a big advance on what we have today. They cut away certain layers of medicine for profit, such as the insurance companies. They suggest basic health care is a right of the people. They remove the decision to give basic care to the people from the realm of the marketplace. They ease conditions for the majority of the population.

It's still connected to profit

But^they are still not a full system of health care based on the people's needs; they are still not socialist plans. Despite what many reformists say, despite what the Detroit News and the conservative press shout every day, government programs are not socialism.

A national health care system is still connected to profit. Maybe not the immediate treatment, but the supporting industries, which are still run on a profit basis. In Canada, for example, the medical supply industries, drug industries, etc. are run for profit, and the national health plan feeds these industries. Drug prices, for example, are only low in Canada by comparison to those in the United States.

Moreover, the doctors remain a privileged elite, and the government bureaucrats maintain a series of cozy positions.

And the health system as a whole is run by the ruling class, so it is used to lower costs for the rest of the capitalist class. And it is prevented from infringing too strongly on the unhealthy practices of various capitalists, from pollution to workplace practices.

What is socialism?

Socialism isn't just a government program. The rule of the marketplace isn't eliminated by a government regulation; it is just restricted and channeled a bit. Socialism means eliminating the entire system of production for profit. It means that the affairs of society aren't just run by a government of the rich elite, but that a party of the working class takes over the government. And even more than that, it doesn't just mean technocrats administering a system, even socialist technocrats, but the population as a whole directing production and the affairs of society. And it means not just a change in government policies, but a transformation of the entire economy and politics, which will result eventually in eliminating all ruling parties, governments, and class antagonisms.

This type of socialism, workers' socialism or true communism, alone is compatible with mass involvement in health care and protecting the environment, not as an exception, but as a rule. It alone breaks down the barriers between the different medical personnel and between them and the people.

Let's take another look at some of the problems of modern health care I listed earlier, and see what a national system can do, and what a full system of health care for the people could do. Let's start with a few things that a national system could do.

Universality

Take the problem of providing universal health coverage. This is one thing that the national systems can accomplish. It means that workers can be freed of the fear of disaster from illness striking their families, freed from the worry that the company they work for doesn't offer a health plan, or of being caught with medical expenses while between jobs, or while moving to another city. But marketplace medicine in the U.S. is incapable of providing such assurance.

It can be noted, however, that the there is constant pressure on the universal nature of coverage by the capitalist governments. Now that there has been over a decade of economic difficulties even in the richest countries, social benefits are being cut back. In countries with national health care, the health system is so popular that it is political suicide to openly attack it. Yet the governments chop away at it around the edge. Productivity of the workforce increases, wealth increases, yet capitalism can't even provide universal coverage on a stable basis. The workers of Canada and Western Europe have to be vigilant or they are in danger of losing their prized accomplishment of universal care.

Preventive care

Next is the issue of preventive care. The national plans do far more. for this than marketplace medicine. They extend such care to everyone. Public health measures to deal with sexually-transmitted diseases, or contagious diseases like tuberculosis, require treatment for the entire population. The national plans do better at this than marketplace medicine.

However, the national plans can't necessarily deal with preventive care that infringes on the interests of the corporations. For example, we shall discuss separately workplace issues and environmental issues, but dealing with them is really a component part of preventive care.

As well, in this day and age of social cutbacks, the workers will have to be vigilant to ensure that any national plan that is now implemented provides adequate preventive care. The Democrats assure us that preventive care is cost-effective. But actually a preventive system costs money now, while the bad consequences of lack of care can always be put off to the future. Only a preventive system based on concern for health, not for the bottom line, can be reasonably complete.

Two-tier care

There is the problem of two-tier care: one treatment for the rich and another for everyone else. Under marketplace medicine today we even have three or four-tier medicine: lavish attention to the rich; moderate attention to workers with health plans; and emergency rooms at best for the poor. The national plans level out the treatment. However, under capitalism, the rich always leave themselves a loophole. The Canadian plan covers basic care, but presently leaves other important aspects including dental care to marketplace medicine. The German plan is something of a model for the Clinton administration; they start with the German plan and subtract anything reasonable from it. The German plan however has the wealthier 9% of its population outside its sickness funds and in private plans.

Even in a national plan that officially embraces everyone, the privileged are given red-carpet treatment. Nevertheless, such plans provide the closest to equal care for all that is possible under capitalist conditions.

In socialism, however, the whole basis of the division of the country into rich and poor is abolished. The extra privileges for the wealthy thus vanish too. Socialism also reintegrates mental and manual labor, thus eliminating another source of prejudice and privilege. When socialism reaches the point of a classless society, then the very nature of society is incompatible with two-tier medicine.

And these features, universal care and preventive medicine and a single standard for all, were the best features of national plans, where they shine. Let's look at some other features.

Elitism

The doctors are a privileged elite in this country. The average doctor in private practice makes almost $200,000 a year, after all expenses including insurance. Even a national system, when it is imposed after the doctors have become used to such a status, can usually do little. The Canadian doctors, for example, are only lower paid in comparison to American doctors, and they are not reconciled to their pay status.

This elitism affects the cost of the system. There is no way that health care won't bear heavily on the people if it is expected to continue to support the medical elite, both doctors and health industry management, in the lifestyle of kings. But moreover, it also affects the nature of health care, such as whether most doctors will have sympathy for working people, and what connection they, will have to other medical staff.

At present, there are experiments in this country in the use of nurse practitioners to do many medical tasks. But under the present system, this is an exception, and moreover it is connected with the idea of professionalizing some of the nurses rather than bridging the gap between doctors and all medical personnel.

Workplace issues

One source of misery and illness for the workers is the workplace. The ordinary disregard of the capitalists for the workers' health is being intensified in the productivity drive dominating most of the last two decades.

For one thing, speed-up has resulted in repetitive stress injury becoming a national epidemic. You can take any job, even those which might be rather pleasant in themselves, and make it a nightmare by doubling or tripling its speed. And, if the workers are still on their feet, combine the job with additional responsibilities. Then add computer monitoring of workers' performance, and even of whether they go to the toilet, and the stress itself will cripple.

No national health system will stop this speedup. So long as industrial production is for profit, a plague of injury and misery will be upon us. Only under socialism does the health of the workers figure in as a priority matter in deciding the methods of production. The integration of health care with the workplace is one of the important features of socialist care. But under capitalist production for profit, not only is industrial medicine often a joke, but it is often a way of deciding how much one can speed up the worker without having an injury that can be proved in court to be the responsibility of the employer.

Environmental pollution

Pollution is another factor of tremendous importance to health. Many health problems are related to it. Since the medical establishment doesn't want to trend on the toes of industry, it has pooh-poohed this. This has helped the exploiters impose bad environmental conditions, especially on the minorities and the poor. The rich hope that they can go live in clean neighborhoods, while the poor suffer the consequences.

As a result, not only is pollution rampant, but there isn't an adequate picture of pollution as a whole and its health effects. And even when a particular pollutant becomes a problem, the government drags its feet.

Take lead poisoning. For decades it has been known that millions of children (and adults too) have suffered from lead poisoning, which makes their lives miserable. This lead poisoning was particularly concentrated in the inner-cities. So what did the government do?

The government finally phased in non-leaded fuel for motor vehicles, so slowly that it was only in the early 1980s that the lead in air finally subsided. Meanwhile another source of lead poisoning is leaded paint. This was only banned for residential use in 1977, and just about all houses built before 1980 have leaded paint. As well, lead pollution continues through the water, and the soil.

The result? It is estimated that about one in eight children in Michigan has a dangerously elevated level of lead in their blood stream. And in Detroit? Our wonderful city government actually requires the use of lead solder in repairs to water mains, thus ensuring that the water will never lack for this poison. The streets may have potholes, the alleys may overflow with garbage, but the residents of Detroit will never lack for this valuable chemical, which will be stored in the bones of their children. But there's nothing to fear: the water department distributes brochures to homes with the helpful hint to let the water run for a full minute from a faucet before using the water for drinking or cooking. While requiring lead in plumbing is a particular stroke of genius of Mayor Young's minions, other cities too have lead problems and tell people to run their water before using it.

This is only one of many environmental problems. It will not go away with national health care. At best, we can expect better screening of children for lead poisoning, and more treatment of children, which presently means an oppressive and difficult system of injections.

It is only under socialism that environmental factors become important in the very planning of industrial production. Under socialism, medicine is fused with the workplace and industrial concerns, thus reaching a new level of effectiveness.

Anti-people ideology

Another issue is anti-people ideology. Since it is typical for the medical establishment and the ruling class to downplay environmental and workplace issues, some other way has to be found to explain health problems. So blaming, the people is typical.

Indeed, today there is a movement of companies to fine workers for life-style issues, under the pretext that the workers' poor lifestyle is responsible for their medical problems. It is just starting, but it seems to be spreading rapidly. According to these companies, is job stress a problem? Nah, if only the worker exercised every day (after his compulsory overtime, no doubt), it would be OK. And dangerous chemicals? The proper studies won't be complete on the chemicals for another twenty years, so maybe by then the chemical will be obsolete anyway. And the insecurity of life in a recession? Don't mention it.

So some companies are adding $100 a month to the health premium of workers who won't answer a detailed questionnaire on their life-style, or who give the wrong answers. If this is allowed to continue, we can expect to see it in "managed competition" some day too.

A socialist health system addresses workplace and environmental concerns, rather than seeking to blame the victims.

Poverty

Finally, let's note that poverty itself is one of the biggest causes of health problems. A national health plan could prevent impoverishment by medical premiums. But it could not eliminate the system of mass unemployment, discrimination against minorities, bad schooling, and other sources of mass impoverishment. This requires a social transformation of the entire society.

Workers must put their stamp on the system

A national health plan is thus not the same as a socialist plan. But a national plan would bring needed relief for the workers today. Yet, as we see by examining even the strong points of national health care, such as universality, it turns out that national health plans are unstable. The working class must organize in its own right to ensure that these plans live up to their promises. Whether on universality, workplace issues, fighting anti-people ideology, or other health issues, the working class must put its stamp on the health care system.

In socialism, there is no longer a division into workers and exploited, and the population as a whole will naturally take a hand in something that interests it so much as health care. But under present system, the rank-and-file workers must wage a struggle against their employers and the government in order to have their say. This struggle faces us today.

Or else universal care will always be a promise, not a reality.

Or else two-tier system will always come back in some form or other, with lesser care for workers, and hardly any care for the poor.

Or else workers will have no privacy and have their "life-style" at the disposal of others.

Or else there will be no check oh the privileged medical elite and the bureaucrats.

Today is the day after May Day. Originally, May Day stemmed from the 8-hour day movement. The 8-hour day was not brought to this country by leaders in Washington, by politicians, or by economic experts. It was demanded by the working class. And obtaining the 8-hour day, in so far as we did obtain it, was a victory of the economic views of the working class over the free marketplace fanaticism, the marketforce rhetoric, of the capitalists. It "told indeed upon the great contest between the blind rule of the supply and demand laws which form the political economy of the middle class, and social production controlled by social foresight, which forms the political economy of the working class"(1). That is how Marx referred to the limitation of work hours in Britain, and how undoubtedly it was in the U.S. as well.

And the 8-hour day is undoubtedly one of the things that helped increase the health of the working class. Today's erosion of the 40-hour week into a faraway dream for many, with the reality of overtime or even two jobs, is one of the factors making life a hell today, and undermining the people's health.

Today the workers are faced with winning a battle over marketplace fanaticism, not only to limit work hours again, but to get health care as an entitlement, as a right. They must limit the marketplace factors bearing on health care.

But moreover, we must organize to bring a new society to this country.

The health care crisis shows that the present system is, from the point of view of the structure of the economy, ripe for change. On health care, as on other fronts, capitalism is proving incapable of managing the gigantic forces of production that have been unleashed by human ingenuity in the past few centuries. More production, and it leads to unemployment. More technology, and it leads to crisis. More health care advances, and it leads to lack of coverage. And the only way out is going to a national system and restricting marketplace medicine.

The only lasting way out is eliminating the marketplace society altogether. Only then will there be socialist medicine. Only then will medicine for health rather than for profit become a true reality. Only then will the people look back to the health insurance company; the evaluator who denies health claims; the drug company that pushes pills; and the medical establishment that delivers up to one-fourth the babies in cesarian sections, as the barbaric tools of torture of a novel written by a future Stephen King.

(1) See Marx's Inaugural Address of the Working Men's International Association, which contains the passage:

"...This struggle about the legal restriction of the hours of labor raged the more fiercely since, apart from frightened avarice, it told indeed upon the great contest between the blind rule of the supply and demand laws which form the political economy of the middle class, and social production controlled by social foresight, which forms the political economy of the working class. Hence the Ten Hours' Bill was not only a great practical success; it was the victory of a principle; it was the first time that in broad daylight the political economy of the middle class succumbed to the political economy of the working class."

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Some health care terms

Below we define and comment on a few terms being tossed around in the current health care debates, which so greatly affect the workers and poor.

Traditional insurance

In return for monthly premiums, the insurance company pays for a greater or lesser part of the patient's expense for medical treatment. And it pays the doctor on a fee-for-service basis: that is, it pays for each individual treatment or test or procedure, rather than paying a lump sum per patient or per patient afflicted by some disease or condition. (Of course, it only pays for those treatments or procedures that are covered by the policy, and only up to the limit of the policy.) The insurance company does not have any role with regard to the subscriber's health except paying for each individual medical treatment.

Comment:

Originally, the insurance companies paid for whatever treatment was covered by the subscriber's insurance policy, generally according to whatever any licensed doctor said (the policies would differ as to whether various types of doctors were considered legitimate, such as chiropractors, for example). But over the last number of years, the insurance companies have become stricter in making their own estimate of whether treatment was needed, of what treatment. They may even hire special companies for the purpose of authorizing or denying treatment. This has resulted in often denying payment for treatment, and in creating a lot more paperwork for doctors.

There have also been escalating rate increases for people with health policies. Those who are sick, or whom the insurance companies expect to become sick face a especially difficult position. The insurance companies increase their rates each year so much (even doubling or tripling them) that many such people are forced to drop coverage.

And those applying for new coverage may find pre-existing conditions are either not covered, or else all coverage is denied. This is not something entirely new, but it is being applied in a stricter and stricter way. Indeed, the insurance companies have a more and more flexible definition of what constitutes a pre-existing condition, and they look more and more closely at any indication of future problems. There is worry that the insurance companies may go as far as requiring genetic testing.

Many workers are forced to stay at one job, because if they leave they will lose their medical coverage and be unable to find new coverage at a reasonable price.

The insurance companies spend large sums for evaluators to decide who to accept for coverage and at what price, for evaluators to decide what treatment to authorize, and for inflated salaries for armies of executives. All this expense is aside from profits.

Managed Care:

This usually refers to health insurance plans, such as health maintenance organizations and preferred-provide organizations, that regulate the type of care the patient gets. They supposedly aren't simply concerned with payin' for each individual treatment, but with having an overall picture of the care for each patient. This is supposed to control costs. Some of them may be available only for group purchasers (for example, for all the employees at a workplace).

Comment:

The managed care networks claim to take care of preventive care, promote regular checkups, etc. This is supposed to follow from their self-interest in trying to avoid paying for expensive medical bills later. While managed care groups are more interested in certain basic health measures than traditional insurance, that's not saying much.

Furthermore, the overview of health care by the managed care network may mean making it harder for the subscriber to get service. The subscriber may have to get permission for a medical procedure, other than just a reputable doctor's evaluation. For example, one generally has to be referred to specialists through a primary doctor. The final measure of the plan's effectiveness is how few services it has to give, which is often identified with the patient being in good health, although it is not necessarily the same thing.

If one has to buy a managed-care health policy individually, one faces all the same restrictions on pre-existing conditions that one faces in traditional insurance. Moreover, as health care costs have escalated, group plans are facing similar pressures as individuals. Insurance companies raise the rate for the whole group as individuals get sick: this is especially a problem for small groups, small companies, etc. but can affect even large groups as well.

It is claimed that these networks can achieve savings through group-discount rates from doctors. But to keep doctors in their networks, many managed care networks wind up paying them about the going rate, and they also pay such rates for medical supplies, etc.

Moreover, some managed care networks are owned by physicians and hospitals and aren't likely to change their practices.

PPO (preferred provider organization):

A type of health insurance in which the insurance company:

1) contracts with certain hospitals and doctors to provide services for its subscribers; and

2) subscribers' expenses are covered if they use these particular hospitals and doctors, and they have to pay a higher fee if they use any other hospitals or doctors.

HMO (health maintenance organization):

A type of group health coverage which generally has the following features:

1) particular hospitals and doctors are part of the HMO; and

2) the coverage only applies if the patient uses hospitals and doctors who are part of the particular HMO, else you pay most or all expenses yourself.

Comment:

Originally, HMO's sometimes had distinctive features, like centralizing doctors in a hospital or clinic, in which they may have been salaried employees, and which may have had some idea of comprehensive care.

But especially since the laws were revised in the 1970s, this has changed. Today an HMO need be nothing more than an insurance company contracting with a preferred list of doctors and hospitals and clinics, which the patient has to go to. This is about the same as a PPO, except that an HMO may make it harder to see a doctor outside the preferred list.

Some HMO's provide decent service, but other HMOs and PPOs make getting all but bare bones treatment into torture. For example, you have to see a gate-way doctor in order to see a specialist, and the HMO or PPO may put tons of obstacles and paperwork between the patient and the needed specialist.

There is much talk about how HMO's supposedly control costs/with preventive care preventing serious and costly health problems from arising. Sounds good, but the reality is not so grand, especially during the last decade during which many HMOs have deteriorated. They cut costs by increasing out-of-pocket expenses for the patient and placing restrictions on getting treatment.

Meanwhile, the emphasis on cost control procedures has ended up generating big costs, due to tons of paperwork and the hiring of fat cat administrators. This is to the tune of 10-18% of the cost of premiums. As well, the HMO's hire outside agencies which increase the red tape you have to go through to get treatment. Over $7 billion dollars goes to these outside agencies.

Managed competition:

A health care reform which involves maintaining the present private health system (marketplace or competitive medicine) with more systematic government regulation (the 'managed' part of "managed competition"). The main idea is that those who want health insurance will not pay the insurance companies directly but give it to new super-agencies who will then negotiate with insurance companies to obtain "managed care" health plans to provide coverage.

Government regulations at various points of this procedure are supposed to solve the ills of the competitive medicine: lack of coverage for tens of millions, no coverage or ultra-high costs for those who already have serious illnesses, etc.

Comment:

Clinton wants "managed competition." So do the big health-coverage monopolies because they don't want more radical reforms that will cut their profiteering out of the picture. The large insurance companies are interested in "managed competition" because a shakeout among insurance companies is expected (with or without Clinton's reform plans), and "managed competition" may give the larger insurance companies a leg up over other insurance companies in obtaining business on a large scale. Conversely, the smaller insurance companies are worried about "managed competition" and prefer simply pumping more money into the present setup.

Managed competition is often equated with providing health care for everyone. But this is only a promise: read the fine print. Clinton has often talked of only providing universal, coverage gradually with the money that will allegedly be saved by managed competition. So this coverage depends on the new system saving money, which then may go towards covering more people. Since the plan is based on the money-eating machine otherwise known as the medical system profiteers, there is little chance this plan will save much money.

The idea that purchasing through a big group, the super agency, will stem the profiteering of the medical establishment and save lots of money seems unlikely since this was supposed to be the virtue of the "managed care" networks themselves. Managed competition will now add another expensive bureaucracy to manage the managed care networks.

Single-payer system:

A health system where the government is the only payer of the people's medical expenses, or at least of much of their basic health care. In essence, the government is the insurer for the whole population. It eliminates private insurance for those medical procedures it covers.

Comment:

A real single-payer plan would be a step forward because it would eliminate the profiteering of the private insurance industry over basic health care (since private insurance would not be involved at all) and eliminate a good deal of the costly paperwork and bureaucracy in the medical system. It would also mean everyone would be entitled to basic health care as a right. Unfortunately, the meaning of the term has been stretched. Since the term "single-payer" has become popular, some supporters of "managed competition" claim this is a single-payer system. They say the regional super-agencies that contract with private insurance companies would be single payer. But the "managed competition" super-agencies simply direct the whole hodge-podge system of private insurance, rather than replacing it. "Managed competition" is actually an alternative to what "single-payer" originally meant.

Medicaid:

A program financed by federal and state funds that pays for some medical procedures for poor people.

Comment:

The Medicaid programs does not cover tens of millions of people who can't afford health insurance but are not poor enough to qualify. Doctors and hospitals increasingly refuse to treat Medicaid patients because they get higher payments from privately insured patients.

Medicare:

A federal program of health insurance for the elderly.

National health care:

This refers to the government ensuring a national system of health care. It can take many forms, ranging from the use of regulations and budget controls over a multitude of private "sickness funds" (Germany) to universal national health insurance (Canada) to nationalization of the medical care delivery system (Britain, Sweden).

The Canadian system:

A system of government health insurance that covers the whole population. The government is the "single-payer." The plan is administered by each province, according to national standards, and paid for with federal and provincial taxes. No private insurance is allowed for services covered by the provincial plan. Citizens are free to pick their own doctors.

Comment:

The Canadian system is superior to the U.S. system. The whole population is secure in the knowledge that if they get sick, they do not have to worry if they can afford treatment. They can also move freely from job to job, city to city, or province to province without losing coverage. By eliminating the army of private insurers, and due to the inherent simplicity of having one single agency handling the medical bills, administrative costs are about half of those in the U.S. Overall, the Canadian health system costs substantially less than the one in the U.S.

The quality of care is generally good but there are some gaps in what is provided, waiting lists for some procedures deemed not to be an emergency, and budget-cutting. The growing economic problems in Canada during the 1980s and 1990s have resulted in cutbacks for all social programs, including health. A new round of cutbacks is pending, as the federal government seeks to cut costs and provincial deficits of an unprecedented size face Ontario and some other provinces.

The German system:

The German system is based on a variety of "sickness funds" which everyone below a certain level of income is required to be in. These are private funds that have to meet many government regulations.

Comment:

The general concept of mandatory membership in these "social insurance" funds goes back to Bismarck in the 1880's. The government pays the cost of the funds for the unemployed and pensioners.

There is also regular private insurance available for the wealthy, thus a two-tier system exists. Presently about 9% of the population has private insurance.

Through the combination of sickness funds and private insurance, there is universal coverage.

The system is financed largely through payroll taxes paid 50-50 by employers and employees (presently equal to 6.5% each). Associations of the different parts of the health care industry negotiate doctor fees and hospital reimbursement. But they are limited by an overall budget cap imposed by the government which tries to keep expenditures at a constant percentage of wages. Over the last number of years the German government has imposed a number of restrictions and "reforms" in order to keep costs down. As the German economy totters along, more restrictions can be expected.

Socialist medicine:

Medicine in a socialist economy, which is run directly for the creation or provision of goods and services, rather than for profit.

Comment:

It is common in establishment and reformist terminology to refer to government programs as socialist. Nevertheless, it isn't correct. National health systems under capitalist governments are not socialist medicine, but still preserve many features of medicine for profit, such as the supporting medical industries being for profit, the system as a whole being run in the capitalist interest (such as cost cutting for the firms),'positions for government bureaucrats from the ruling class, an inability to vigorously attack health problems that affect capitalist profits, and severe limits on mass initiative.

(Nor was the medical system in the Soviet Union and Eastern Europe, or presently. China, Cuba, Vietnam and Korea, socialist. Despite the profound workers' revolution of 1917 in Russia, and the great reforms that followed it, Russia did not achieve socialism but degenerated into a state-capitalist country. Indeed, all these countries had become state capitalist countries with a revisionist ideology turning Marxism on its head in order to justify the bureaucratic tyranny of a new ruling class, and to present a class-divided society as socialism. Their economic systems differed from Western marketplace capitalism due to the greater role of the government and of the ruling party, but stayed within the limits of capitalist class society. They generally had comprehensive national health systems--Cuba has a particularly good one, and the East German system had been as good as the system in much wealthier West Germany--which often differed from the national systems in the wealthiest Western countries by the lower pay of doctors and the greater scarcity of resources, but they did not have socialist medicine.)

Socialist medicine requires a political and economic system where the working masses form the governmental machine, from top to bottom, and also manage the economy. It is the final replacement of medicine for profit with medicine for the people, with both direct treatment and the supporting medical industries no longer being on a marketplace basis. The rigid division of mental and manual labor has been broken down in the economy as a whole, and in medicine as well: no longer are the doctors a privileged elite, living like kings, and separate from the other medical personnel. Mass initiative on health matters, by the people in general as well as by all medical personnel, is now possible on a regular basis.

And for the first time a real flowering of the integration of medicine with preventive treatment, environmental concerns, and workplace issue is possible.

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At a Catholic college:

Right-to-lifer Scheidler mourns the decline of that old-time religion

Anti-abortion zealot Joe Scheidler was invited to speak at Chicago's Loyola University by the "Pro-Life University Students." When he arrived on April 5, he found the audience was mainly pro-choice Loyola students. They had decided to let him speak and then to debate him in the question-and-answer period, apparently unaware that Scheidler refuses to go toe-to-toe with opponents in open controversy.

Nevertheless, Scheidler dwelt so much on sin and some obscure religious stuff that he was laughed at, and a few students taunted him. Rattled, he complained that Loyola was supposed to be a Catholic school, yet at so-called Catholic schools the students have no respect for the church or her teachings, laugh at sin, etc.

Scheidler gave the usual anti-abortion spiel, and summed it up as killing a child is the worst thing. A Women's Action Committee activist yelled but "How about fucking a child?" referring to the mountain of child abuse cases involving the Chicago diocese and other priests.

Several people, including one pro-lifer, challenged Scheidler on why he's for coercion to stop abortion. He replied that he's never stopped a woman from going to a clinic. Someone from the Emergency Clinic Defense Committee shouted that his book instructs people how to do this. Scheidler is not big on honesty.

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Bellamy's utopia and what the society of tomorrow will look like

The following is based on the notes for the presentation given at a meeting of the friends of the Detroit Workers Voice/MLP on March 28. An earlier article about Bellamy's novel Looking Backward appeared in our Feb. 15 issue.

This forum is on visions of the future society, this time based on reading Bellamy's utopian novel of 1888, Looking Backward.

Today we are told that present-day society is just about as good as you can get. Why, just look at the technical marvels. Sure, the more marvels, and the more productivity advances, the more unemployment, and the more the cities decay, but, hey, that's life. Anything else is Soviet-slyle tyranny. At most, we are told, you can demand a few dollars for charity for the increasing victims.

But there are alternatives.

Socialist theory says that there will be a different society.

Usually we go into what forces can build this alternative society, and how they spring from the current economic and political conditions, and how the evils of this society require it being swept away, but in this forum we want to take time out from the capitalist horror of today and dream a bit. What would a future society look like? Can there be a society where you don't have to run faster and faster, and produce more and more, just to stay in the same place?

One way to inspire such dreams is by looking back at various pictures of the past drawn by writers of talent. Not just Marxist pictures, but other pictures of the future, and see what seems reasonable. It is time to free one's mind from the constraints of what's reasonable in today's political situation, what one can expect in the next year or two, or what's realistic politics, and instead ask, what would a good society be?

This is often done among the people through the reading of utopian novels, with their visions of the future. Bellamy's Looking Backward is one of the more widespread socialist utopias in this country. It sold over a million copies back in the 1890s, and it periodically has had small revivals. Ch. XXIII, "The Parable of the Water Tank", from his novel of 1897, Equality (the sequel to Looking Backward, which never obtained the popularity of the original: it was written near the end of his life, after the rise and fall of the "nationalist clubs", and was something of his political testament) was at one time made use of as a socialist agitational pamphlet.

In looking at his utopia, we are more concerned with ideas about the future than with a overall assessment of Bellamy. Our concern is to let our mind consider what the future might bring, not to wear "I love Bellamy" pins. A Bellamy doctrinaire might need to defend every aspect of Bellamy's conception, while we are free to snip and cut, alter and contradict. Nevertheless, a few words about Bellamy may be of interest, before we pass on our real subject, future society.

About Bellamy and the 'nationalists'

The rise of industrial society gave rise to a number of utopias. Bellamy's utopia differs from some of them in that he doesn't lament the rise of large-scale production, or look back longingly to the old days, but claims that it is the very development of large-scale production that opens up the possibility of freedom from misery, and of personal freedom as well. Charlie Chaplin's film Modern Times is a picture of the rat-race of large-scale production under private ownership. Bellamy's view is that this same large-scale production, when freed from private interests of all types, will in fact, bring in prosperity. In this, he is in agreement with Marxism.

But while there is much of interest in Bellamy, there are also some things that repel.

As to how to get to his utopia, Bellamy didn't believe in the class struggle. True, he was horrified at the exploitation of the workers, and thought their rebellion had a point, but he didn't see it going anywhere. A dramatic image of his ambivalence toward the proletarian revolt can be seen in his description of a future sculpture called "The Strikers". While supporting their struggle, he writes, in the words of one of his novel's character: "Look at these faces. Has the sculptor idealized them? Are they the faces of philosophers? Do they not bear out your statements that the strikers, like the workingmen generally, were, as a rule, ignorant, narrow-minded men, with no grasp of large questions, and incapable of so great an idea as the overthrow of an immemorial economic order?" (Chapter XXV of Equality) He adds, however, that they would awaken eventually, and that "In this slowness of awakening to the full meaning of their revolt they were precisely on a par with the pioneers of all the great liberty revolutions." He looked to this revolution as taking place not on a class basis, but as a moral revival of all society as a whole, and especially by what he regarded as the cultured sections. This is something he never gave up, even though his own experience and that of his "nationalist" movement swept against it.

His book Looking Backward being popular on a huge scale, "Bellamy clubs" were formed in many cities throughout the U.S. They were renamed as "nationalist clubs", reflecting their belief that the entire nation should run all the factories, mills, farms and means of production in general. They lasted several years and went through two phases.

At first, they were based on the magazine The Nationalist, which lasted from 1989 to 1891. Bellamy wanted to appeal to respectable society, including army officers and members of the theosophical society, and tried to keep out workers and Marxist activists, But left-wing elements entered his clubs anyway. They were attracted to what they regarded as the first socialist propaganda success on such a mass scale among those sections of the workers and other people who tended at the time to be indifferent to socialism, such as the native-born. Meanwhile, as time went on, the hopes that many "nationalists" entertained in respectable society, and in existing governments carrying out Bellamy-style reforms, were disappointed.

The subsequent founding of the more agitational New Nation, which lasted three and a half years, marked a split in the Bellamy movement. Especially with the rise of the Populist movement, Bellamy moved more to political alliance with the masses. He was now appealing to workers, as well as Populist-inclined farmers. And, in a departure from the non-political approach he favored earlier, he was appealing for a third party. But the Populists went into the Democratic Party, and it and Bellamy's movement collapsed.

In his political activity, he gradually put more emphasis on questions of democracy and political movement. But he never changed his basic idea that while the workers and small farmers revolt was justified, it wasn't going to lead anywhere. Instead eventually the people would establish his utopia pretty much out of whole cloth, and he had no real idea where this would come from.

This is one aspect of his vision of future society being a utopia, something detached from the process of how to get there. In so far as he outlined the possibilities brought about by large-scale production, he showed the society flowing from modern possibilities. But as to how to eliminate private interests, he was at a loss. For him, it didn't flow from a political movement, but a moral revival. Society as a whole would stand up and decide to put his plan into practice. Indeed, he even speculated on a mass religious revival, albeit one that would meet the resistance of most of the clergy. And he failed to have any real idea of the transition period between capitalism and classless society.

Moreover, in the details of his plan for the future, especially his ideas concerning the judicial system, the management of work, etc., he had a technocratic approach. This is why he called the universal labor service an "army" (later on he preferred to compare it to the civil service). He didn't believe that uniform conditions could be established throughout it except by appointing all officials from above, and only electing the very top officials, and this through a rather odd system.

He was criticized, and correctly, for some of these things. And he himself made several changes in his plan in his writings after Looking Backward, which is reflected in the sequel, Equality. But when this criticism went to the point of declaring that his utopia was a totalitarian, Soviet revisionist-line model, it was absurd. In this respect, it can be noted that, from the start, Bellamy also faced criticism of his utopia that consisted of the ordinary bourgeois complaints that, if you eliminate the division into worker and exploiter, you only have faceless bureaucracy and state tyranny; the buying and selling of labor power, the domination of the poor by the rich, is supposed to be the guarantee of all freedom.

In fact, one of the interesting things in his system was that his belief that common labor in large-scale production could preserve and enhance freedom and individuality, eliminating various intolerable interferences by present-day government and society. Meanwhile the repulsive features of his work are, as far as his overall conception of future society goes, in one sense details: they could be eliminated from the picture he draws, and replaced by others, without destroying the foundations of the utopia and having it fall to the ground.

The future

Now let's get to the fun part of the issue and start to dream about future society. Here we will deal mainly with the classless, communist society: not socialism, with its remaining class divisions and political antagonisms, as it emerges from capitalism and struggles to develop,, but a truly classless society, which has developed beyond the hostilities and class struggles of its birth. As we have said, there is no reason to be limited to Bellamy; we shall use him as a takeoff point.

Abundance

Bellamy predicts that abundance is possible. I believe that the experience of tie century has shown this to be the case. Large-scale production has brought wonders.

Take industrial raw materials. It was predicted sometime ago that industrial society would run out of raw materials, which would skyrocket in price. In fact, over the last decade or so, the prices of many basic raw materials has fallen and fallen, causing disaster for many of countries that depend on mining and raw material extraction.

It is true that the demand for these raw materials is held down by the large part of the world's population that is in poverty. If all countries were at Western European, Japanese or American standards, more raw materials would be demanded. As well, proper environmental protections still aren't taken. Nevertheless, the experience of the past period suggests that science and technology can make the same amount of products with less and less raw materials, and can find new sources of raw materials. So long as research and technical progress continues, it should be technically possible to provide abundance with the raw materials available on earth.

Many food prices have also fallen on the world market. Here too there is the issue of restricted demand, due to mass hunger around the world. And there is an even more serious issue of environmental degradation; the rape of the soil can't continue forever. The transformation of farming and shifting over to a proper 'guardianship of the soil, and of plant and animal life the world over, will undoubtedly absorb the rapt attention of a future society for a long time to come. Nevertheless, it is the division into rich and poor that is responsible for hunger and devastation, not the lack of technical possibilities.

Bellamy lists in detail the sources of waste in private capitalism. Some of this reminds me of the similar lists, updated according to modern conditions, that one can find in the speech The Technical and Cultural Basis of Workers' Socialism in The Workers' Advocate Supplement of July 20, 1991.

There are environmental concerns with large-scale production. But Bellamy was concerned with issues such as reforesting and the disposal of sewage, thus taking a certain interest in the environment. And here too, the way forward against pollution and environmental degradation is the further development of science and technology, freed from the constraints of the profit system.

Bellamy revels in the abundance that can be brought about by large-scale production in a rational society. He is not just concerned with quantitative abundance (more and more things), but in technological innovation, in changes in the ways of doing things, etc.

This belief in technological progress, and large-scale production, was opposed by some. The English communist artist William Morris is supposed to have written a counter-utopia to Bellamy's, called News from Nowhere. I haven't had a chance to read this yet. I presume that William Morris might know a good deal more about how a revolutionary movement actually works than Bellamy. But it is said that Morris idealized the old forms of production, and recoiled from modern large-scale production (perhaps in line with his Pre-Raphaelite preference in artistic matters). Some critics of Morris have had fun trying to calculate the humongous workweek that would be necessary if people tried to produce things according to Morris's artisan preferences. Bellamy on the contrary believes that modern means of production can insure abundance with a short workweek, and with a relatively short period in the workforce before people retire at age 45 to whatever activities suit them.

One additional point should be made about large-scale production. Today, it is clear that this doesn't necessarily mean larger and larger workplaces. The era of the truly gigantic factory is over for the time being. Modern production is linked together like never before, but the individual factories and workplaces today tend to be smaller than they were a few decades ago. They produce a great quantity of goods, and they are tied together often on a global scale, but the increase of production doesn't necessarily mean individual workplaces with more and more people. The fantastic increases in modern productivity have brought smaller workplaces, yet this is not a return to small-scale production, but another phase of mass production.

No money, and no wages

Bellamy paints one idea of what a society without money or wages looks like. You get an allowance for being a resident of this society. It is not based on the amount of your work, but on the fact that you exist. Bellamy makes a big point that the morality of the society is that each individual, woman, man, or child, has the means of sustenance because they exist; this is separate from the issue of providing a workforce.

Thus, Bellamy's individuals do have a certain allowance, which they call for historical reasons they measure in dollars. But he says it is not money. Is this so?

The main flow of dollars in his utopia is between the individual and the stores distributing goods. Production itself, and the flow of raw materials and semi-finished goods between factories, does not depend on these dollars. People do not use these dollars for almost anything but purchasing goods from the stores. You can't accumulate dollars, and what you don't spend by the end of the year is canceled. And Bellamy supposes that in practice the allowance is generous enough (and the society freed from the compulsion for obsessive accumulation) that most people won't actually spend their entire allowance, anyway.

In fact, this is not really money anymore. Engels, in Anti-Duhring, discusses that the existence of a labor certificate used for bookkeeping isn't necessarily the same thing as money. (See Part III. Socialism. Chapter IV. Distribution) And in Bellamy's society, the dollars are perhaps even more restricted than labor certificates.

When everyone has this allotment to live on, woman, man, or child, it provides a basis for freedom and security. No longer is there the need to be toady to anyone for fear of starvation, or of one's loved ones starving.

Moreover, it affects the whole society. In any society, people will be people. There will be frictions; controversies among the people in general; disagreements at the workplace, with coworkers and with people with authority, whether elected or appointed. But when no one expects to get more money from these disputes, or to live better, and when no one fears starving as a result or living worse, it puts a limit on what these disputes can become. It adds a dignity to society not seen, perhaps, since the days of certain of the indigenous peoples in the New World, before their societies were shattered.

Status of women

Bellamy devotes a good deal of attention to the effects of all this on women. He decries many of the problems facing women as due to their lack of independent status. In his society, women have an allotment to live on, just as much as men. (He talks of "to each man" all the time, but uses "man" as meaning man or woman, as was the custom when he lived. At certain points, he explicitly states that women receive their own allotment in their own right.)

The marriage relation will change utterly, he believes, when women are not dependent on men in general, or a single man in particular, for their livelihood or that of their children. To some extent, this already exists today among women who work. But in present society, not all women work or can find a job, and also their wages may be too low. In fact, while some women are independent today, there are many women who put up with abuse or end up having to search high and low for the few battered women's shelters that exist. Not only are these problems solved by women receiving their allotment, but as well, the ideology behind the allotments, that everyone, man or woman, is equal and deserving of respect would add to self-worth.

It might be pointed out that many women work today, but have a hard time with housework, which adds a second job to their burdens. Bellamy is enthusiastic that domestic work should be socialized. Take laundry. In Looking Backward, he stressed common laundry rather than doing it individually--once again, large-scale production to the rescue rather than individual effort. In Equality, he had a different idea, that seems odd to me but perhaps makes sense to others. He believes that clothes will be produced of a special material, and discarded when soiled, and the factories will recycle them, shredding them and remaking them into new clothes. Hence clothes, carpets, wall hangings, etc. will never be washed.

Similarly, he thought much cooking will not be done individually. Moreover, he thought this would dramatically improve the quality of meals.

Freedom

If society as a whole runs everything, won't this mean dictation and tyranny?

He answers no, it is consistent with freedom. Moreover, he repeats over and over, present society allows an astonishing dictation over people's lives that will be regarded as intolerable in the future.

One issue he discusses is publishing. Newspapers, for example, would not be run by the state. Associations of individuals would get together, decide on their editor, pay the state (from their living allotment) for removing him from the labor service, and then have their own newspapers.

Similarly, the state would publish whatever book or pamphlets were presented to be published. Authors would pay a small sum for the first run; and if the book was popular, the state would keep reprinting it, and the authors would be reimbursed for their original expense.

His view was also that the state stores would sell whatever commodity was demanded.

I have talked of communal household services. But these weren't compulsory. He believed inexpensive and high-quality restaurants would be available. But no one had to use them. He just thought it would be so convenient that just about everyone would.

What about choice of job? Would this be directed by the state? In order to distribute workers to all needed jobs, there being no capitalist labor market, did this mean some faceless bureaucrat would tell you what occupation to work in?

No. He thought people would select their professions. If there was an imbalance, certain perks of the jobs would be adjusted such as the hours of work. By just adjustments, more people would be attracted to the originally less-favored occupations, and less to the more-favored occupations. (The additional perks would not, however, involve one's livelihood: the yearly allotment is not based on one's job, hours of labor, etc., but is the same for everyone. It might however involve the hours of labor.) If some job was so repulsive that no one volunteered anyway, it would be done by rotation, but he thought there would probably be few such jobs.

As to the government, his main view is that government would be a pale shadow of its old self. He wanted the remnants to be representative of the people, but his description of what this would mean is truly marred by his technocratic bias. This bias comes out, for example, in his description of the administration of the universal labor service as we shall touch on again later on. With respect to the rest of the government, he introduced an elaborate system of referendums and other devices in Equality.

Mental and manual labor

Marx and Engels talked of integrating mental and manual labor.

What does this mean? This requires some thought. Obviously, some occupations require training.

Bellamy gives some examples that might inspire some thought about how this works out. He talks of everyone receiving a universal, not vocational education, until 21. Then they have three years of general labor, during which time they are introduced to many professions. Then they decide on an occupation, or to go to a professional school.

He believes people may change their occupation several times in life. As well, he holds that society will believe it is no sin to try a profession and fail. In fact, he points out, it is impossible to be certain in advance how suited one is for a certain occupation.

This scheme is a bit rigid taken in itself, since some people might want to specialize when young, and since education should involve knowledge of the different methods of production from the start (although, it shouldn't be narrow training for an individual job). But the spirit of Bellamy's views seems to be that everyone has a broad education as well as training in a particular profession.

Bellamy doesn't deal with the question of how some of the distinctions, at work at present time are artificial to a greater or lesser extent. Take the distinction between productive work and supervisory work. Some directing authority is needed for any large-scale production, but today it is taken to extreme, and the supervisors are separated off. Bellamy doesn't consider this. He only specifies that no one lives better because of their position at work, and that there is a free flow between positions due to merit. This is part of the answer to integrating mental and manual, supervisory and production work, but hardly the total answer.

Parties and government

Bellamy doesn't talk about the famous "withering away of the state". But it seems to be something that he is quite enthusiastic about.

He points out that with the end of private interests and money, most of the reason for laws, lawyers, and legal disputes, are gone. What's left for government to do?

In Looking Backward, he describes a Congress that meets once every five years (a rather odd scheme), and says that there are no state governments at all. Nor are there political parties.

Engels said of future society that "State interference in social relations becomes, in one domain after another, superfluous, and then withers away of itself; the government of persons is replaced by the administration of things, and by the conduct of processes of production." (From the last quarter of Section II Theoretical' of Part III 'Socialism') What does this mean?

Today, for example, there are many political questions. How do you raise money: taxes, user fees, etc. Who pays these taxes and who benefits is at the heart of politics. The building and maintenance of the school system is political, so is the health system, even the placing of a major highway. Indeed, where and when to fix a pothole is political: there are limited funds, do you fix the potholes in Detroit or in the suburbs, and which suburbs?

But when differences of class no longer exist, and when general prosperity exists, some issues will vanish and some will fail to be political. Taxes will vanish with the abolition of money. There will instead be a relatively simple calculation of how much can be produced, how much has to go to general uses, and how much is left for individual consumption. And potholes? When everyone is prosperous, that becomes simply the issue of making some rational schedule for when Jane or Joe is to go over and fill them. The political nature of it drops out altogether. Instead of an administration of people, one has a simple process of arranging productive work.

And with this replacement, the role of governments and parties drops out.

But the police? Most crimes either deal with property, or are a result of people living in utterly broken conditions. Bellamy holds that the police force then used for the state of Massachusetts would suffice for the whole country under a system of prosperity and no private interests.

Actually, insofar as a government exists in Bellamy's system, it is in large part just the administration of the labor service. Here, Bellamy doesn't see the role of the mass of workers in making decisions, and goes overboard with the appointive principle. He thinks this violates having uniform conditions for everyone. But this is not a necessary shortcoming of a universal labor service, but of Bellamy's understanding of one, of his tendency to elitism, and of his view of the relation of democracy and centralism. A different system of relations between workers could well be imagined. And if one considers how socialism will actually arise from a revolutionary movement of the workers, one would have good reason to believe that socialism will naturally result in a different set of relations among the workers than Bellamy imagines.

But back to the general question of government and politics. Does the end of politics means society ends up at a standstill? The shriveling of the government and the end of parties will not mean the end of social change. Looking Backward simply describes future society as having all the features he deems desirable, rather than showing society in motion; this is a failing typical of many utopian novels. But undoubtedly various social changes will continue, from the relations between women and men to the changes induced by new possibilities from new technology. It takes some time for a consensus to form on such issues, so they may give rise to mass movements of various sorts. Indeed, the population is likely to group together into a multitude of organizations, clubs, and associations of many sorts, with far more people able to participate than today. But without the sharp antagonisms and hostilities engendered by the class divisions and the fear of loss of livelihood, such movements will have a different character from the party struggle of today.

Innovation

Bellamy at one point deals with the problem of innovation. Is it really true that without private enterprise there won't be innovation?

Actually, private competition both inhabits and encourages innovation. Its incentives to innovation, such as large profits, are in large part needed to overcome its obstacles to innovation: fear of loss.

Bellamy believes that heroic efforts and innovation will be inspired by pride of work, and public recognition. He holds that the most creative people, the best workers and the most fearless innovators will not need special rewards, and will even disdain them. But, Bellamy thinks, a system of public recognition and minor perks will provide ample incentive to the bulk of people. Bellamy does not require that everyone become a saint to live in his system, but believes that his system will provide humane conditions for the human species as it presently exists.

Beyond the issues Bellamy is concerned with, it may also be added that central planning cannot mean that one and only one approach is dictated from a supposedly all-knowing center. Central planning requires the maturity from the planners to ensure the room, on most things, for a number of different approaches to be tried out, a number of different ideas. This doesn't require different corporations or private ownership, just a modern approach to industrial management.

This diversity can naturally arise from the different institutions and workplaces involved in an issue, if this diversity is not suppressed. There will always be people working independently on various problems, looking at them from different angles, and so forth. From universities to workplaces to people working on a problem as a pastime.

True, the rate of change in a future society may vary from what it now. Indeed, I hope it does. For example, today dozens of new chemicals are thrown on the planet each year without adequate testing, environmental studies, etc. One hopes that the classless society would continue research and innovation into chemistry, but change the pace of releasing stuff into the world. A future society might well want faster change on certain issues, and decide to be relaxed on others.

Slower pace of life

Finally, with no money, lesser hours of work, and so forth the pace of life may finally slow down.

A lot of things we do now are really superfluous and irritating: balancing the check book, buying auto insurance, life insurance, medical insurance, xyz insurance; worrying about state and federal taxes; arguing about which necessity to skimp on to ensure the funds to buy some other necessity. A whole series of financial worries can be eliminated, eliminating an astonishing amount of useless drudgery for the human species. Better schools, better child care, and more extensive socializing of housework will free additional time.

With more time, people, even parents, may actually have time to stop and smell the flowers. I call this a slower pace of life, but it should actually facilitate faster change in social life and technology when needed, and deeper knowledge about life and science among the population as a whole. Once the irrelevant and useless stuff is cleaned away, it will give people more time to consider things that really interest them. It will allow more mass interest in art, in history, in technology, in the environment, in learning about other peoples, etc. Not everyone will be interested in everything (each individual is finite, while the world has an infinite number of fascinating aspects), but for the first time everyone will have the opportunity to develop their interests and inclinations. A more secure life may be slower in one respect, but actually faster and more satisfying in the really human.and interesting parts of life. You no longer have to run to stay in the same place, so even those who walk will get a lot further.

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Around the world

Youth riot in France over racist police shootings

Hundreds of young people rioted in Paris the first week of April over the shooting to death of a Zairean teenager while he was being questioned at a police station. In clashes on the streets, 27 cops were injured and 18 people were arrested.

Protests also broke out in Turcoing, near Lille in northern France, where an Algerian youth was shot by a cop. The demonstrators set cars on fire and smashed store windows.

And police banned a protest march set for Saturday, April 10.

Activists in France think that police may have taken the victory of the right-wing coalition in recent parliamentary elections as a green light to brutalize minorities.

Japanese nurses strike

Some 100,000 nurses and other medical workers staged brief work stoppages in Japan on April 7. They demanded higher wages and better working conditions.

There is an acute shortage of nurses in Japan. As a result, nurses are subject to long hours and overwork. More nurses quit than are replaced. At least 200,000 more nurses are needed, according to their union.

Ford workers strike in Mexico

2,100 workers at Ford's Hermosillo plant struck the auto company for nearly three weeks in March in a dispute over mid-contract raises.

These workers make Escorts and Mercury Tracers for the U.S. market. The plant has won awards for quality, and it has matched U.S., levels of productivity. Yet the workers make about $2 an hour while comparable workers in the U.S. make $15 an hour. The Mexican workers think that the wage gap must be narrowed. They demanded a 35% wage hike.

Ford offered only 9.5%, and asked the Mexican government to declare the strike illegal, which would give the company the right to fire any workers who didn't return to their posts.

A tentative settlement brought the strike to a close on March 18. Details were unavailable.

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