From The Pages Of "Workers Vanguard"-Health Care Tussle: Workers and Poor Lose-For Free, Quality Health Care for All!

Click on the headline to link to the International Communist League website.

Markin comment:

I place some material in this space which may be of interest to the radical public that I do not necessarily agree with or support. Off hand, as I have mentioned before, I think it would be easier, infinitely easier, to fight for the socialist revolution straight up than some of the “remedies” provided by the commentators in these entries. But part of that struggle for the socialist revolution is to sort out the “real” stuff from the fluff as we struggle for that more just world that animates our efforts.
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Workers Vanguard No. 1005
6 July 2012

Health Care Tussle: Workers and Poor Lose-For Free, Quality Health Care for All!

Last week’s 5-4 Supreme Court decision sanctifying the constitutionality of the Affordable Care Act (christened with racist intent by its opponents as Obamacare), while unanticipated by many, was hardly earthshaking. Chief Justice John Roberts, normally a member with Scalia, Alito and Thomas of the court’s right-wing bloc, joined with the nominally liberal justices in issuing the majority decision. Although not a few Tea Party types now see him as a traitor, the decision simply asserted that the government has the power to levy taxes on the populace, a commonplace that does not suggest that Roberts was possessed by the ghost of Lenin.

With Republicans declaiming against the act as an insidious introduction of “socialism,” their Speaker of the House John Boehner promised to rally the electorate to destroy it, including even its popular components, such as barring denial of coverage for preexisting conditions and extending it to dependents up to age 26. For his part, Obama used the occasion of the Supreme Court ruling to modestly offer himself as a fighter for what is good for the American people, untainted by the quest for political power. As we wrote when Obama announced this plan (WV No. 943, 25 September 2009):

“With the official unemployment rate crowding 10 percent—and double that when the underemployed and those who have stopped looking for work are added in—the number of those with no health insurance increases day by day. Obama invokes the plight of the uninsured, with promises of a level of care not much above a pledge to pick up the dead bodies, in order to massively cut health care costs. Some $600 billion in savings is to come from reducing government spending on Medicare and Medicaid. Also being eyed for the ax by the health reform executioners are the now non-taxable employer-paid health programs won through the hard-fought union battles of the past.”

Today, liberal pundits and the AFL-CIO trade-union tops are seizing on the court decision to induct Obama into the pantheon of such Democratic Party “progressives” as Franklin Delano Roosevelt, Harry Truman and Lyndon Johnson. These efforts to resurrect the halcyon days when the Democratic Party was the putative champion of the working class and poor are but camouflage for perpetuating the rule of decaying U.S. imperialism. From World War II, which established the military and economic dominance of the American empire, through the Korean and Vietnam wars and the more recent occupations of Iraq and Afghanistan—these Democratic Party “progressives” have engaged in whatever savagery was deemed necessary to maintain the supremacy of U.S. imperialism.

Reforms enacted under their regimes—from FDR’s “New Deal” to LBJ’s “Great Society” programs—had nothing to do with the virtues attributed to the Democratic Party. On the contrary, they were the by-products of mass social struggles, from the class battles of the 1930s that forged the industrial trade unions and the giant strike wave following World War II to the civil rights and Vietnam antiwar movements.

Although modest in scope, these were nevertheless real gains for the working class, black people and the poor. Not so the Affordable Care Act. With its individual mandate requiring those not insured by their employers or qualifying for Medicare or Medicaid to buy health insurance or pay a substantial fine, the biggest beneficiaries of this “health care” bill will be the profit-gouging health insurance giants and pharmaceutical companies. The medical profession and hospitals will also be enlisted as the overseers of “cost containment.” The Hyde Amendment denying federal monies for abortion was reaffirmed by an executive order issued by Obama. In the bill, undocumented immigrants are proscribed from receiving any of the act’s benefits. Union workers with so-called “Cadillac” health plans will shoulder a portion of the costs of this “reform” through proposed new taxes.

The poorest layers of society were supposed to receive coverage under this law through an expansion of Medicaid. Now state governments, beginning with Florida and South Carolina, have announced that they will opt out of this expansion after the Supreme Court ruled that they cannot be penalized for doing so. It is no coincidence that this revolt begins in the states of the former Confederacy. The very fact that the U.S. is the only major industrial country on the face of the planet without a national health system is testament to the brutal racial oppression of black people.

The color bar has historically served to divide and weaken the working class, impeding the development of class consciousness and the formation of even a reformist workers party. The existence of such parties in Europe, together with the militant struggles and socialist aspirations of advanced layers of the proletariat, led to the creation of nationwide health care, pensions and other programs. In contrast, in the U.S. many such benefits were the product of individual union battles. Correspondingly, the dearth of strikes in recent decades has led to the butchering of health care, pensions and other union gains by the bosses. They have overwhelmingly gotten away with it thanks to the acquiescence of the trade-union bureaucrats, who are committed to preserving the “competitiveness” of American capitalism.

Private-sector unions having been ravaged, including much of what existed of guaranteed health and pension benefits, Democrats and Republicans alike are carrying out wholesale attacks on such remaining plans for public workers unions. The capitalist politicians are whipping up a public outcry against these workers for supposedly living high off the hog at the taxpayers’ expense. In racist capitalist America, the reactionary myth that social programs are merely a drain on the income of hard-working people has long been wielded to shred benefits for the ghetto and barrio poor. Now these guns are being turned on what benefits remain for the working class as a whole.

Republicans promote the idea that the answer to societal decay is to further increase the massive transfer of wealth and income to the 0.01 percent of the population that constitutes America’s ruling class. The Democrats propose to put lipstick on the pig of social decay by “reforming,” i.e., decreasing, benefits available through such social programs as continue to exist. In either case, the result is the same: the continuing erosion of the living standards, and the very ability to live, of working and poor people in the U.S.

Free, quality health care for all is a burning need for the mass of the population. To win this demand would require a revival of working-class struggle. Such will not be forthcoming from the misleaders sitting atop the unions. Following the Supreme Court decision, AFL-CIO president Richard Trumka saluted Obama’s stand “for fairness and for working men and women,” declaring “the election this November provides a clear choice.” Subordinating the interests of the workers to their capitalist masters as represented by the Democratic Party has long been the name of the game for the union bureaucrats.

Last year, it was played to contain protest by tens of thousands of unionists, youth and others who had rallied in defense of Wisconsin’s public worker unions against Republican governor Scott Walker’s union-busting assault. Diverting this militancy into a recall campaign, the bureaucrats were handed a stinging rebuke when Walker beat his Democratic Party opponent for a second time. With union membership among Wisconsin state workers slashed by at least half since last year, Trumka declared that Walker’s “divisive agenda has been stopped cold”!

The workers would find plenty of allies if they waged some hard class struggle for health care, for black and immigrant rights and access to free abortion and contraception. But to wage such a battle means replacing the present sellouts—who peddle the lie that the workers have interests in common with their exploiters—with a leadership committed to mobilizing labor’s power in opposition to the capitalist class enemy. The workers need their own party, a multiracial revolutionary workers party that will fight to expropriate the health care industries as part of a fight to overturn the rotting American imperialist order through socialist revolution.

*Quackery Quack'd-Once Again, In Defense Of Science And The Scientific Method- A Short Note

Click on the headline to link to an American Left History blog entry, dated Thursday, August 12, 2010, From The Pages Of "Workers Vanguard"-Quacks And Their Defender-In Defense Of Science, that is referred to in this blog entry.


Markin comment:

Recently, in an entry entitled From The Pages Of "Workers Vanguard"-Quacks And Their Defenders-In Defense Of Science, dated Thursday, August 12, 2010 (see linked post above), I noted that we Marxists have stood on the historically hard-fought ground of science, and the battle-scarred scientific method, as humankind has tried to drive forward in the pursuit of knowledge and a better understanding of the universe, a universe we were not privy to making but we sure as hell have to exist in. I noted in that historic battle our main enemies have been organized religion and all manner of other superstitions, from quaint talismanic charms to belief in witchcraft. For a long time I believed that we were winning that battle, at least in high-tech, high science capitalist-driven societies, although, as I also noted, not without plenty of back-sliding. Now I am not so sure.

As the linked entry above demonstrates not only has there been a loss of working class political consciousness, especially in the post-Soviet landscape, over the past several decades, expressed most vividly in the overwhelming one-sidedness of the class struggle of late, but that retrogression has seeped in wildly exaggerated doubts about the validity of the scientific method as a means of understanding the universe, and conquering the unknown. And that among people who should know better, or be presumed to know better. No where is that notion more true than is the struggle for the scientific method in field of medicine, the care of the human condition. Quackery has always been with us, no question, but now quackery in pseudo-scientific form, from the ashram to the zodiac, has become epidemic. That it has spilled over into the consciousness of the “progressive” movement is not that surprising, if still annoying. After all that milieu is as fad-crazy as any other, perhaps more so, from the virtues of goat’s milk yogurt (fresh from the goat, non-machine set, non-pasteurized, thank you) to Obama-waving.

In the previous commentary I also mentioned that back in the heady days of the late 1960s, that side, the back-to-nature side, that fleeing from science to the occult side, had raised its head very strongly as those "holistic" Whole Earth Catalog therapies from meditation (fifty-seven varieties), moonstone (or birthstone, or some damn stone), mantra (om-om-om-ing Allen Ginsberg-channeling), mineral water (calorie-free, fresh from spring, no plastic-containers, please), micro-diet (Christ, how many variations on brown rice can you make?) , and add as many m-words, or any lettered words from antacids to zen as you want, bloomed. This reflected, I think, the retreat from political struggle in the face of the “monster’s” in- your-face willingness to leave us face down in some unnamed ditch if we continued in our opposition. Some people, as it turns out many people, were not up for that. But they were also not “up for” a full retreat back into the bosom of bourgeois society, at least for a while. I have, however discussed those issues elsewhere in this space and need not go through those details here. To finish up, I will end with an anecdotal piece of “evidence” about how the retreat from science hit close to home.

People I think, including at one point this “people”, me, have confused the chaotic, mainly privately-owned and funded, organization of Western medicine with the scientific pursuit of cures for what ails the human condition. This malady hit me square in the face when I had several major medical problems a few years ago and got no apparent relief from Western medicine, or rather the relief suggested was beyond what I was willing to undergo at the time (major surgeries and much time in recuperation). So, naturally, I, historical materialist or not, started “searching” for home-cures, or their equivalent.

Naturally, as well, in Boston, and in any major city (hey, out in the country too, think Vermont) all you have to do is step out the door and you will be run over by chiropractors (stone-chuckers, clickers, tickers, foot-stompers, your choice, I am not kidding), acupuncturists (Chinese, Japanese, big needles, small needles, hell, I bet, no needles, for the faint of heart), massagers (health massagers, of course, this is after all a commentary on medicine, the other kind you are on your own), homeopaths (water, colonic, homicidal (oops), etc., ad nauseaum), naturopaths (whatever that is), faith-healers, faithless healers, faithless faith-healers, snake-dancers, fire-eaters, fire-eating snake-dancers, and so on. I have not even included the myriad “alternative therapies” such as meditation, mediation, mood stone-wearing, zodiac-consulting (all twelve signs, no less), bead-thumbing, moxa-breathing, power yoga (and fourteen other brands, all with funny-sounding foreign names, okay, look them up on the Internet, they are there), and just plain talking through the pain (not for free talking through the pain, though) that are lined up on the streets, any streets, ready, for cash (or credit card) to take the pain away, or the promise of it in four (or eight or twenty) easy sessions.

That is the key, the promise to take the pain away. But, praise be, I got “religion” in the end. After some time at those pursuits, pin-cushioned, cracked-boned, hydro-this and that, yadda- yadda- yadda-the other thing, I had already spent more time, money and pain than if I had just taken my medicine, my scientifically-induced medicine, and got it over with. And I did so. Talk about using the trial and error method, the method of “high” science.

That brings me to my last point, a point I am very fond of using, and that brings us back to politics, Marxist politics. Isaac Deutscher, Leon Trotsky’s definitive biographer, once noted that Trotsky mentioned (I think in the final chapter of Literature and Revolution), that mankind faced three great tragedies in life-the struggles around hunger, death, and sex- and that the international labor movement, at least it radical end, had centered its efforts on relief of that first tragedy. Trotsky, as I recall no stranger to the medicos, medicine chest, and the hospital bed in his life, mused that, after we had conquered that demon hunger, under our communist future the other two would be confronted in a much better way than they had been faced previously. And after all what is the struggle for medical breakthroughs, for the triumph of the scientific method, than to keep death at a further than arm’s length. That is as good a reason to fight for our communist future as any you are likely to hear. And the banner- Free quality “real” health care for all!

*From The Pages Of "Workers Vanguard"-Quacks And Their Defender-In Defense Of Science

Click on the headline to link to the Workers Vanguard website for an online copy of the article mentioned in the headline.


Markin comment:

The question of health care and its alternatives has been much in the news of late. We, as Marxists, stand on the historically hard-fought battleground of science over religious and other superstitious means of caring for the human condition (a too often defensive battle as well against back-sliding as now, for those who think human progress is on an ever upward curve). I had not originally intended to post this entry but the above-linked article has required me to post it as of general interest. I would add that I am not surprised that even those who read leftist literature would be ensnared in touting their particular alternative "remedy". That side, the back-to-nature side, has been with us for a long time and raised its head very strongly in those "holistic" Whole Earth Catalog moonstone, mantra, mineral water, micro-diet, and add as many m-words, or any lettered words from antacids to zen as you want, heady days of the 1960s.

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These are the articles referred to in the linked post.

Workers Vanguard No. 947
20 November 2009

Medical Science vs. Homeopathy

(Letters)

23 September 2009

Dear comrades,

In the otherwise excellent Women & Revolution article “Wealth Care USA” reprinted in the current WV (No. 943), I have objections to the following:

“In 1847 a small group of physicians had founded the American Medical Association primarily as a means to combat ‘sectarians,’ that is, nontraditional physicians such as homeopaths, who were seen as a threat to the wealth and social position of the medical profession. (The AMA even denounced the Surgeon General of the U.S. for cooperating with a homeopathic physician to save the life of Secretary of State William Seward, when he was shot the night of Lincoln’s assassination!)”

First of all, there is a factual mistake; William Seward was stabbed, not shot, in the attempt on his life.

I’m disturbed by the implied defense of homeopathy and other “nontraditional” (i.e., non-scientific) medicine. Two main principles of homeopathy (invented by Samuel Hahnemann in the early 19th century) are: 1) Like cures like. A substance which causes a symptom (such as poison ivy for a rash, or caffeine for insomnia) can be used to cure it. 2) Dilution. Said substance is made more effective by dilution. The curative substance is diluted so much that the remedy does not contain even a single molecule. But the water somehow contains a spiritual “memory” of it. This is obviously at odds with science, which as Marxist materialists we are champions of. Not surprisingly, it has never been demonstrated to work beyond a placebo effect. (A good new book with a discussion of homeopathy is Superstition: Belief in the Age of Science, by Robert L. Park.)

When so-called alternative medicines are shown not to work in scientific tests, their proponents often cry that they are victimized by the scientific establishment. Other current examples include HIV denialists and anti-vaccination conspiracy theorists.

The problem with medicine for profit is not that quackery is kept out. (Indeed, increasingly it’s not, with hospitals opening up centers for alternative medicine. See the PBS Frontline documentary “The Alternative Fix” for chilling scenes of a so-called holistic healer sitting in on a consult as an equal with trained doctors in a consult about a seriously ill patient, and a hospital staff homeopath treating an autistic child.) Engels noted in The Condition of the Working Class in England (1845):

“Another source of physical mischief to the working-class lies in the impossibility of employing skilled physicians in cases of illness. It is true that a number of charitable institutions strive to supply this want, that the infirmary in Manchester, for instance, receives or gives advice and medicine to 22,000 patients annually. But what is that in a city in which, according to Gaskell’s calculation, three-fourths of the population need medical aid every year? English doctors charge high fees, and working-men are not in a position to pay them. They can therefore do nothing, or are compelled to call in cheap charlatans, and use quack remedies, which do more harm than good.”

A future international planned socialist economy will provide health care for all, and sweep away the material basis for the persistence of dangerous anti-scientific quackery.

Communist greetings,
Jeff T.

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6 October 2009

To: Editor, Workers Vanguard

In what was otherwise a pair of outstanding, accurate and refreshingly honest articles on health care in the USA and elsewhere in the Sept 25 Workers Vanguard, in the second article, (“The Great Health Care Debate/Wealth Care in USA”) was the following paragraph:

“In 1847 a small group of physicians had founded the American Medical Association primarily as a means to combat ‘sectarians,’ that is, nontraditional physicians such as homeopaths, who were seen as a threat to the wealth and social position of the medical profession. (The AMA even denounced the Surgeon General of the U.S. for cooperating with a homeopathic physician to save the life of Secretary of State William Seward, when he was shot the night of Lincoln’s assassination!)”

This paragraph is uncritical of homeopathy, and indeed arguably can be construed as suggesting homeopathy deserves a place in the rational practice of medicine along with scientific evidence-based, clinically-tested treatments.

I have little doubt the AMA’s primary motivation for attacking homeopaths in 1847 was to protect the profits and power of its membership, but it makes for a pretty poor condemnation of the AMA to accuse them of trying to “combat” and crush an organization of outright total quacks.

In the century and a half that has elapsed since 1847, there have been many hundreds of good (double blind, randomized, with meaningful sample size) clinical tests of homeopathy. NONE of them have found ANY homeopathic remedy to be superior in efficacy to a placebo. NONE. Homeopathy, as quackery, has been responsible for immense harm to health. This BOTH by turning people away from effective, science and evidence-based treatments, AND by the tendency of homeopaths to counsel parents against vaccinating children against childhood diseases. It was a mistake for Workers Vanguard to treat such a gross fraud in that fashion.

Homeopathy is most prevalent in India, in large part because quality evidence-based scientific medicine is not available to its population.

Any high school chemistry student can tell you what Avogadro’s number is: 6.02 x 10 to the 23rd power, the number of molecules in one “mole” [a mole is the molecular weight in grams of substance]. Knowing this, any high school chemistry student can calculate that at the dilution of its active ingredients specified for a large fraction of homeopathic remedies, it is highly unlikely a single molecule of that active ingredient remains. [Avogadro and Samuel Hahnemann (the latter being the man who founded homeopathy) were contemporaries.] Thus, most homeopathic “remedies” are nothing but PURE WATER, with NO active ingredient what so ever in the water. The “theory” of homeopathy is total crackpot nonsense in the light of current scientific knowledge of pharmacology and biochemistry. As such, one would expect to find homeopathy to be absolutely worthless. This is what a century of testing its specific remedies has confirmed.

As a scientist, a physician, and a Marxist, I share your contempt for the AMA, for most of the reasons you provided in the remainder of your discussion of the history of medical care in the USA. I never joined that organization, in part because I was well aware of most of what you presented. However, to repeat, attacking the AMA for its attack on quackery (regardless of its motivations for attacking quackery) is NOT an effective way to expose it.

A subscriber to Workers Vanguard since the early 1970’s, I note you have repeatedly (rightly and wisely) endorsed Enlightenment rationalism and evidence-based science, and (again rightly and wisely) repeatedly condemned superstition and faith-based beliefs. It is inconsistent with such a position to present so uncritically a mention of homeopathy.

You are rightly proud of the fact that, historically, you have rejected trendy and opportunistic “in” positions of liberals and the pseudo-left, taking unpopular but correct positions regarding feminism, black nationalism, the nature of the Cuban state, the Soviet intervention in Afghanistan in support of a secular government, and other important issues. Why now even appear to be capitulating to current ignorant and fuzzy-headed (but popular in a segment of the left) knee-jerk and wrong ideas about “alternative medicine”?

As a side issue, I do note that in 1847, even mainstream medicine had little to offer in the way of effective treatments, and in fact was not at that time solidly based on science, and employed many untested, ineffective, and in some cases (such as blood letting) harmful to lethal “treatments”. It is doubtful that anyone in 1847…whether a total quack such as a homeopath, or a respected mainstream physician…had much to offer William Seward beyond bed rest. With few exceptions, it was not until roughly a century later, at the time of the availability of penicillin to the masses in the mid to late 1940’s, that science and evidence-based medicine began to provide substantial numbers of proven and effective treatments. None of this excuses your uncritical mention of, and arguable implicit support for the total quackery that is homeopathy in your article.

This is NOT, as I hope you understand, a political criticism. I find myself entirely in agreement with the political observations made in both articles, including (as mentioned above) your strong criticism of the AMA.

This is a matter of scientific and medical fact.

It behooves Marxists, when they refer to issues of science, to get their facts right. Scientific method (that group of approaches to examining the world which endeavor to minimize as much as possible the bias of the investigator), the greatest achievement of the Enlightenment and greatest advance in human thought, is the bed-rock on which Marxism stands.

I would urge you, comrades, to print a clarification regarding the matter.

Respectfully,
Martin H. Goodman, MD

References:

The best article I have read on homeopathy...one that is exceptionally well-written, a delight to read, and extremely well documented with reference material
...is the chapter on homeopathy in the book “Trick or Treatment” by Edzard Ernst and Simon Singh, published in 2008. Pages 93-143. This book also has chapters on acupuncture, chiropractic, and herbal medicine and attempts to cover all of alternative and complementary medicine. It presents the most up to date hard clinical scientific evidence regarding the efficacy...or lack there of...of “complementary and alternative” medical disciplines. The book’s introductory chapter expounds brilliantly what evidence-based clinical science is, and the inspiring history that led to its being adopted by honest, caring, serious healers. It should be read by all.

[All brackets and ellipses are the authors’. —ed.]

WV Replies:

We thank our readers for pointing out the error in the article “Wealth Care USA,” reprinted from Women and Revolution No. 39 (Spring 1991) in WV No. 943 (25 September). This error is particularly unfortunate given the growing popularity of quack “medicine” today. In the 21st century, these snake-oil treatments—homeopathy, chiropractic, “New Age” spiritualism, herbal remedies, acupuncture—are international multibillion-dollar businesses. While some of these treatments may be relatively harmless and may sometimes have a placebo effect, more often they are dangerous both in themselves and because they divert patients from needed medical treatment.

The distinction between science-based, mainstream medicine and homeopathy is stark and irreconcilable, though in the early 19th century “mainstream” medicine embraced many of the same mystical concepts. As physicist Robert Park explained in Superstition: Belief in the Age of Science (Princeton University Press, 2008), vitalism was “the prevailing medical superstition of the time,” representing “the belief that life involves some spiritual essence beyond chemistry or physics.” Purging through violent emetics and copious bleeding were common treatments. George Washington is only the most famous American to be killed by his doctors: in the hours before his death, he was drained of half his blood!

As sociologist Paul Starr notes in his 1984 book, The Social Transformation of American Medicine, historians point out that homeopathy and other “medical” sects “grew in the mid-nineteenth century because of the inadequacy of contemporary medicine, particularly the disastrous errors of ‘heroic therapy,’ which emphasized bleeding, heavy doses of mercury, and other modes of treatment now believed to range from the ineffective to the lethal.” At that time homeopathic therapy may well have been better than mainstream medicine: a treatment that is pure water at least will not poison the patient, as did calomel, antimony and belladonna, all popular tonics of the time.

In fact, American medicine in the mid 19th century was far behind its British and other European counterparts. As Dr. Dan Agin points out in Junk Science (2006):

“In 1875, there were 460 ‘medical schools’ in the United States (nearly four times as many as now), most of them diploma mills whose main function was to collect tuition fees. Students took courses consisting of two four-month or six-month terms at approximately $60 a term, and often the second term was a verbatim repetition of the first term…. In 1869, the dean of Harvard Medical School explained that the medical school had no written examinations because ‘a majority of the students cannot write well enough’.”

In the early years of the American Medical Association, its opposition to homeopathy was primarily motivated by a search for higher prestige and income. Nonetheless, the AMA’s main purpose was to improve the wretched state of medical education. Such medical professionalization was important and necessary. At the same time, the class, sex and race bias of capitalist society also meant that women, blacks and others were kept out of the practice of medicine.

The AMA later reconciled with the homeopaths over the fight to establish government licensing laws and regulation on the medical profession, and the opposition to homeopaths joining the AMA was dropped. But political squabbles continued to consume the AMA, and in 1886 the more scientifically minded members split off to form a separate learned association. In the 1930s, the AMA and homeopathic practitioners joined in their opposition to social insurance for health care, as described by Dr. Stephen Barrett of Quackwatch.com, which exposes medical and pseudoscientific quackery.

With the establishment of medical science—especially with the discovery of the germ theory of disease—the distinction between homeopathic quackery and real medicine became abundantly clear. What we know today in terms of science and medicine far outstrips what was known a century ago, and there is much more to learn, understand and discover; doubtless the knowledge of scientists in the next century will far outstrip ours. That said, science-based medicine has already “revolutionized medical practice, transforming it from an industry of charlatans and incompetents into a system of healthcare that can deliver such miracles as transplanting kidneys, removing cataracts, combating childhood diseases, eradicating smallpox and saving literally millions of lives each year,” as described by Simon Singh and Edzard Ernst in Trick or Treatment: The Undeniable Facts About Alternative Medicine (W.W. Norton, 2008). Advances in public health such as immunizations, closed sewage systems and clean drinking water brought about enormous leaps in human health and longevity.

Any medical practitioner who professes to follow Samuel Hahnemann’s mystical principles of homeopathy is a menace to the public. Yet, astonishingly, homeopathic medications are protected under the federal Food, Drug and Cosmetic Act of 1938!

But scientific medicine is also not enough: Medicine for profit rations health care by class, race, sex and ethnicity, reserving the best care for the wealthy. The capitalist class can largely be blamed for the gullibility of the public: high costs place health care beyond the reach of many, and out of despair, many turn to something that promises miracles. Contributing to this problem is ignorance of the principles of science on the part of a population stripped of access to decent public education. As part of free, quality health care for all, a workers government would educate all in human biology and the principles of public health.

“Intelligent design” (i.e., creationism), medical quackery, anti-vaccine hysteria, religious delusions—these plagues are inherent to the capitalist order, which seeks to justify oppression and exploitation and to imbue the masses with superstition and submission to authority. As Marxists, we put forward a materialist understanding of reality, one based on scientific evidence and research. Marx famously called religion the “opium of the people,” and continued: “To abolish religion as the illusory happiness of the people is to demand their real happiness. The demand to give up the existing state of affairs is the demand to give up a state of affairs which needs illusion.”

Key to casting off such conditions is science. As Robert Park noted: “What science is learning about the laws that govern the universe gives us the power to transform the world into the closest thing to paradise that any of us will ever see. This knowledge did not come from sacred texts, or the revelations of prophets. Science is the only way of knowing—everything else is just superstition.” In a world communist society—where social classes and all forms of oppression are part of a distant, barbaric past—mankind will finally be able to put into place the power of science in the service of all humanity.

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Workers Vanguard No. 948
4 December 2009

In Defense of Medical Science

Capitalist Reaction and Anti-Vaccine Hysteria

Free H1N1 Vaccinations for All!

For Free, Quality Health Care!

Since the outbreak of “swine flu” or Novel influenza A (H1N1) in Mexico in April, the virus has spread to over 200 countries killing at least 7,800 people, according to the World Health Organization (WHO). In the U.S., as of mid-October at least 22 million have contracted the virus and some 4,000 have died, including 540 children, according to the Centers for Disease Control and Prevention (CDC). But in spite of the threat posed by the H1N1 virus, the capitalist rulers, indifferent to the health and welfare of working people and the poor, have dismally failed to provide the front-line measure against the epidemic—vaccination. Seven months after the initial outbreak, after numerous warnings by the government and media about the virus’s threat, thousands of anxious people across the country lining up for vaccination are simply told to go home because supplies have run out.

Meanwhile, anti-vaccine groups continue to propagate their fear-mongering and reactionary anti-science ideology against vaccination. When the New York State Department of Health briefly mandated seasonal and H1N1 flu vaccinations for health care workers—a measure we Marxists support—anti-vaccine groups seized on the objections of some unions to the mandatory vaccination, falsely claiming that this posed a threat to individual rights and that vaccines are dangerous.

The reality is that the influenza virus, which has a very rapid rate of mutation, poses a real threat to the life and well-being of people all over the world. During the 1918-19 worldwide flu pandemic, some 50 million people lost their lives. In the U.S. alone, about 36,000 die every year from the seasonal flu.

Unlike seasonal influenza, against which many people have some immunity, H1N1 is a relatively new virus to which most people have never been exposed, meaning most have little to no immunity. While healthy children and young adults are at risk, the virus is especially dangerous to pregnant women, the elderly and those with weakened immune systems or underlying disease conditions such as diabetes, asthma and heart and lung disease. Although the mortality rate of the H1N1 virus is thus far rather low, the virus has the potential to become far more lethal.

Priority of vaccination was set for these vulnerable sections of the population. But what is needed is production of ample amounts of vaccine to inoculate enough of the population to produce what public health professionals call “herd immunity.” The higher the proportion of immune individuals, the lower is the likelihood of the spread of disease. However, no H1N1 flu vaccine was available until the first week of October. Of the 195 million doses needed in the U.S. to effectively combat the H1N1 flu, only 51 million doses were available by the fourth week of November—this is in addition to substantial shortages of the seasonal flu vaccine. There have been cases of people lying about their age and women faking pregnancy in order to get vaccinated.

Under capitalism, medicine is driven by profit, not by the needs of society. Because vaccine production is not highly profitable, pharmaceutical companies are loath to invest in it. In 1967, there were 26 companies producing vaccines in the U.S. Today there are only four. Rather than investing in more efficient technology with a faster vaccine yield, these companies continue to use the same antiquated, low-yield technology that was used 50 years ago. Moreover, because many health insurance companies refuse to cover the cost of vaccinations, many pediatricians refer children to hospitals for immunization. At the same time, health delivery services are continually being slashed through budget cuts, layoffs of public health care workers and the closures of hospitals and clinics.

While research into vaccine development receives funding with an eyedropper, the U.S. imperialist ruling class pumps billions into germ warfare research and into fighting “bioterrorism,” which has been hyped up as part of the rulers’ reactionary “war on terror.” As journalist Arthur Allen wrote in his 2008 book, Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver:

“No price was too high to pay for anything that had the magic word ‘terrorism’ attached to it. Congress was willing to authorize $1.9 billion to build and maintain a stockpile of smallpox vaccine, and $1.4 billion to create and stockpile a new anthrax vaccine. From 2002 to 2006 it spent $33 billion on biodefense. Yet in 2003, the NIH [National Institute of Health] invested less than $70 million on influenza vaccine research.”

Under capitalism, while providing quality medical care for everyone is within the bounds of material possibility, the availability and quality of health care for working people are subordinate to the drive for profit, with health care rationed by class, race and sex. In New York City, vaccines were diverted from those in hospitals and schools who need them most in order to secure the health of the wealthy bankers of Goldman Sachs and Citigroup.

We stand for free, quality health care for all, including full access to abortion and contraception. We fight for socialized medicine—the expropriation of the parasitic health care and drug companies, which are an immediate threat to the well-being of just about everyone in this country. Our aim is the mobilization of the working class in a fight for these and other such demands as part of the struggle for socialist revolution against the decrepit capitalist order. A rational, internationally planned socialist economy would devote the resources necessary to ensure that the population receives vaccinations and quality medical treatment in a timely manner. Massive resources would be invested in scientific research, to the benefit of the whole of society.

Mysticism and the Anti-Vaccine Hysteria

Although medical science is far from being able to treat all diseases, it has made it possible to control, through vaccination, many of the infectious diseases that were hideous scourges in past centuries. Until vaccines were introduced to stop them, diseases like measles, polio, diphtheria and mumps rolled viciously around the globe. Before it was eradicated, smallpox threatened 60 percent of the world’s population, killed every fourth victim (some 500 million in the 20th century alone), scarred or blinded most survivors and eluded any form of treatment. In the U.S., the polio epidemic of 1952 infected some 58,000 people and killed more than 3,000, leaving behind a legacy of terror and paralysis. Until 1963, four million people contracted measles annually; hundreds died each year and thousands were disabled for life by measles encephalitis.

Vaccines have saved the lives of countless millions across the world. Such “miraculous” advances, achieved through science-based medicine, are a refutation of the basic tenets of the anti-vaccine movement, which is based on a reactionary and superstitious ideology. With their hostility to immunization, the anti-vaccine evangelists—groups such as Generation Rescue, Age of Autism, the National Vaccine Information Center and PutChildrenFirst.org—are perfectly willing to let millions of people in poor Third World countries die of preventable diseases. It is the same mentality as that of South African leaders, like former president Thabo Mbeki, who for years had criminally denied that AIDS is caused by a virus, advocating in place of anti-retrovirus medicines natural “remedies” in the form of herbs, vegetables and garlic.

To bolster their argument, anti-vaccine outfits claim that vaccines are ineffective and harmful to the body. They take their religious and anti-scientific cues from turn-of-the-century racists and anti-Semites like the mystic Rudolf Steiner, who established the Waldorf movement, and Reuben Swinbourne Clymer, who was vice president of the Anti-Vaccination Society of America in 1902. As Arthur Allen wrote in Vaccine, Steiner viewed “the body as a temple, the blood as a divine fluid, and vaccines as spiritual pollution.” He believed that “blond, blue-eyed people were disappearing from the world because they were ‘weaker physically and mentally stronger’ than ‘dark people’.”

Clymer’s 1957 book, The Age of Treason, a bible for medical quacks, is a harangue against vaccination, birth control, food additives, mood-altering drugs and “racial miscegenation”: “The enemies of God and mankind…have used or plan to employ inoculations for the purpose of destroying mental balance and making it impossible for the minds of children to develop beyond a more or less moronic or robot degree.” He put the blame of these “ills” on “militant socialists and the enemies of God and Man, many of whom are admittedly Jews.”

Anti-vaccine fanatics cite anecdotal evidence to falsely link vaccines to autism. They claim that vaccines are damaging to the immune system and that thimerosal, a mercury derivative that had been used as a preservative in multi-dose vials of vaccines, is the cause of brain damage in autistic children. The symptoms of autism, believed by many scientists to be a genetic disorder, become evident around the age of two years, which happens to be the same age children receive multiple vaccines. Credible scientific studies in several countries, involving hundreds of thousands of children, have found no link between vaccines or thimerosal and autism. Unvaccinated children developed autism at the same rate as the vaccinated, and the prevalence of autism remained the same after thimerosal was removed from vaccines in 2001.

The myth of vaccines’ link to autism is trumpeted by politicians of both capitalist parties, from Republican Congressman Dan Burton, an adamant supporter of “alternative medicine” quackery, to Democratic Senator John Kerry and Robert F. Kennedy Jr. Contributing to the crusade, the media has provided the anti-vaccine fanatics with forums to spew their poison. They want to create a “debate” where none exists, much like their promotion of proponents of “intelligent design” mysticism. Generation Rescue spokespersons Jenny McCarthy, whose son suffers from autism, and her boyfriend Jim Carrey, as well as National Vaccine Information Center president Barbara Loe Fisher have become fixtures on talk shows, from Oprah Winfrey to Don Imus and Larry King. Meanwhile, the influential Huffington Post Web site has become a repository of all kinds of medical quackery. To her credit, actress Amanda Peet has stepped forward in defense of childhood vaccinations, declaring, “I was shocked at the amount of misinformation floating around, particularly in Hollywood.”

Science as a Candle in the Dark

Apart from minor reactions, vaccines are quite safe. They are certainly never as dangerous as the highly contagious diseases that they prevent (and contrary to popular myth, flu vaccines do not cause the flu). There could be no better proof of the effectiveness of vaccines than the fact that many ruthless killers like diphtheria and the measles are rare and, in many cases, unknown to young parents.

Ironically, the virtual disappearance of such diseases has given the anti-vaccine zealots ammunition to prey on ignorance, falsely claiming that infectious diseases are not deadly and that vaccines pose a threat. Meanwhile, some 20 states have religious exemptions to childhood vaccinations. Ominously, because of declining rates of childhood vaccinations, many dangerous diseases are making a comeback. For example, the number of reported cases of pertussis (whooping cough)—a highly contagious bacterial disease that can be lethal to infants—jumped from 1,000 in 1976 to 26,000 in 2004, while there have been a number of fatal cases of meningitis in unvaccinated children in Pennsylvania and Minnesota.

Many today do not remember the scientists who developed life-saving vaccines. In the 1950s, when polio was wreaking havoc, Dr. Jonas Salk, the pioneering virologist who developed the first safe and effective vaccine against it, was rightly hailed as a hero and his name became a familiar household word. The grateful citizens of Winnipeg, a site of a major polio epidemic in 1953, sent him a 208-foot telegram with more than 7,000 signatures. Salk did not patent his vaccine, believing it should be available for everybody. When asked who held the patent, he replied, “Well, the people…. There is no patent. Could you patent the sun?” Salk was never awarded a Nobel Prize for his scientific breakthrough. But for his idealistic humanism, the FBI kept a file on him. Today, with most of these deadly diseases a distant memory, scientists like Dr. Paul Offit, an ardent defender of vaccines and co-inventor of a vaccine against rotavirus, a diarrheal disease that kills 600,000 children worldwide every year, have been targets of scurrilous attacks and death threats by opponents of vaccines.

Helping drive the anti-vaccine campaign are homeopaths, acupuncturists, chiropractors and other quacks who are opposed to science-based medicine. On its Web site, the International Chiropractors Association promotes a tract titled Vaccination: 100 Years of Orthodox Research Shows that Vaccines Represent a Medical Assault on the Immune System. According to Arthur Allen, when in the early 1990s the National Vaccine Information Center (then called Dissatisfied Parents Together) was about to go bankrupt, it was saved by a large donation from a chiropractors’ organization. What makes these quacks more dangerous is that they are at times more accessible than costly health care and are increasingly covered by insurance companies because they are much cheaper than real doctors. Sadly, these snake oil salesmen have become a source of “treatment” for a wide section of the population.

In its irrationality, fear mongering and anti-scientific backwardness, the hysteria against vaccines is reminiscent of the 1950s’ campaign against the fluoridation of public water, a measure to prevent tooth decay that was depicted as a Communist plot to control the mind and sap and pollute the “precious bodily fluids” of the population. Dr. Stephen Barrett of Quackwatch.org notes that “chiropractors have been in the forefront of political battles against fluoridation.” (Perhaps they think that tooth decay is susceptible to spinal manipulation!)

In the U.S., religion, promoted and embraced by whole sections of the bourgeoisie, supplies an ideology that attempts to harmonize conflicting class interests while keeping society firmly ordered: capital above labor, white above black, man above woman. It provides the breeding ground for backward anti-scientific ideologies, including creationism, which challenges the established facts of Darwinian natural selection as the motor force for evolution. Some 46 percent of Americans believe in the Biblical creation myth, while 79 percent believe in angels.

The rise of religiosity and anti-scientific attitudes is aided by the decline of education, especially in basic science, in public schools. The last time that the U.S. ruling class undertook a sustained effort to promote science education was after the Soviet Union launched its Sputnik I satellite in 1957. Fear of a Soviet lead in military technology led President Dwight Eisenhower to demand a billion-dollar program to improve science education and to enact the National Defense Education Act in 1958. Creationism was elbowed aside as the newly formed Biological Science Curriculum Study wrote evolution into new high school textbooks. But for decades, the U.S. has seen a growing tide of ideological reaction that became even more accentuated following the counterrevolutionary destruction of the Soviet degenerated workers state in 1991-92, which gave a major boost to all-around religious delusion.

The backward ideology that feeds the anti-vaccine movement is shared by opponents of abortion and genetically engineered crops. For years, the Catholic church’s hierarchy “debated” whether it was sinful to be inoculated with the vaccine against rubella, which was grown on a cell line obtained from an aborted fetus. On the same ideological basis, federal funding for potentially life-saving stem-cell research was banned in the U.S. until very recently. In Britain, Prince Charles, ranting about genetically engineered foods, once stated, “I happen to believe that this kind of genetic modification takes mankind into realms that belong to God, and to God alone.” In his opposition to a technology that yields qualitatively better and more abundant crops, this relic of medievalism is willing to starve millions.

Public Health and Individual Rights

Last August, the New York State health commissioner issued a directive mandating vaccination against seasonal and H1N1 flu for all health care workers by the end of November. Several health workers unions—including the New York State Nurses Association, 1199 SEIU United Healthcare Workers East and AFSCME District Council 37—objected to the mandate and some filed suits claiming that the order violated their civil rights. A judge put a halt on the directive, which the state later suspended because of vaccine shortage.

We would be in favor of this mandate—now unfortunately annulled—as a public health measure that would protect those receiving vaccines and prevent the further spread of disease, especially among hospitalized people whose underlying conditions are aggravated by infection. Because herd immunity cannot always be achieved voluntarily, public health measures are sometimes drastic and intrusive, but they are often necessary to achieve that level of immunity and save lives. There are often times when public health and individual rights clash. But getting vaccinated violates no individual rights except the “right” to spread infection. Appropriate measures such as hand washing and the wearing of gloves and masks have been standard mandatory practices in hospitals for decades. Every state already requires health care workers to be immunized against measles, mumps and polio. Quarantines are at times established for those with dangerous infectious diseases. Some of the greatest advances made in health were made through public health measures like clean drinking water, improved hygiene and vaccines.

There is more than plenty to distrust about the capitalist government. But the anti-vaccine hysteria has nothing to do with a “healthy” mistrust of the state. Rather, it is motivated by anti-scientific prejudices.

It is testament to the political bankruptcy of the trade-union bureaucracy that union leaders who have presided over concession after concession to the bosses on health and pension benefits, reopening and extending contracts, are now posturing as defenders of their members’ rights by mobilizing them for a reactionary campaign against vaccinations. Instead, the trade-union movement should be demanding that vaccines be made available for all health workers against the preventable diseases to which they are exposed. The unions should be calling for unconditional, unlimited sick leave for all workers at full pay beginning with day one of employment. They should be in the vanguard of the struggle for free health care for everyone, which would help revitalize the labor movement. Such struggles are part of the fight to forge a vanguard party of the proletariat that will strive to combat social backwardness within the workers movement and stand for the primacy of science over superstition.

Where there is a real clash between the principle of individual rights and that of public health, resolution can be achieved only by examining the particular health threat posed. In the early 1980s, as the deadly AIDS epidemic was spreading, public health officials proposed to close gay bathhouses in San Francisco. Our initial reaction was to demand: “Government Out of the Baths!” This was incorrect. The issue was one of life and death. You don’t cite the First Amendment when the fire department is hacking through your walls to stop a fire. The point of closing the baths was to slow down the already exponential spread of AIDS and alert the gay men who were most at risk. In reconsidering our earlier incorrect position, we wrote in “The Agony of AIDS” (Women and Revolution No. 35, Summer 1988):

“Like everything else in this capitalist society, ‘public health’ is infused with class, race and sex bias. Early in this century, health officials blamed immigrants and the poor for diseases like syphilis and gonorrhea, which they claimed (falsely) were spread through drinking fountains. But the extraordinary powers granted by law to departments of public health are necessary to fight disease. This fight can often involve quite brutal interference of the state into private life.”

Another example of such necessary intrusion occurred in 1967 when the World Health Organization launched a successful campaign to rid humanity of smallpox. For eleven years, health workers, armed with vaccine and bifurcated needles, scoured cities and remote villages throughout Africa and Asia for cases and contacts. They broke into houses and vaccinated families against their repeated objections. Nick Ward, a WHO official in Bangladesh, described his team as “a band of vigilantes, about forty-four white, foreign infidels who were not likely to be excessively worried about the finer points of Muslim beliefs…. We nearly lost some of our people, though. Somebody was killed with an arrow in India, and another had his head slit open with a cleaver” (quoted in June Goodfield, Quest for the Killers [1985]). Time was key to the campaign’s success, and in the face of resistance, force was fastest. By 1979, in one of the greatest achievements of the 20th century, the smallpox disease was wiped from the face of the planet.

Public Health and Government Manipulation

Control of disease is as much a social question as a scientific one. Under capitalism, the profits of pharmaceutical and insurance giants come before public health, which is indelibly imprinted with the reactionary bigotry of capitalist society.

In the infamous Tuskegee experiments, 400 Southern black men with syphilis, who were never told they had it, were left untreated for some 40 years and allowed to die so that “researchers” could watch the ravages of the untreated disease as it destroyed their bodies and minds. Right-wing bigot Norman Podhoretz railed against government expenditure on AIDS vaccination research, writing, “Are they aware that in the name of compassion they are giving social sanction to what can only be described as brutish degradation?” To this day, the federal government refuses to fund needle-exchange programs to help prevent the spread of HIV/AIDS among heroin addicts. For several years, conservatives have been waging a war to prevent mandatory vaccination of schoolgirls against human papilloma virus (HPV) because it “promotes promiscuity.” HPV is one of the most common sexually transmitted diseases and a primary cause of cervical cancer, killing some 5,000 women each year. The vaccine has proven to be exceptionally effective. The right-wing zealots are telling women: practice abstinence or maybe die.

Using the current “swine flu” pandemic as a pretext, governments around the world have manipulated public health measures for their own purposes. Several governments slapped irrational bans on imports of live pigs. In Egypt, the government slaughtered all the country’s 300,000 pigs, even though the virus is not spread by pigs. The culling of the hogs was part of the continuing oppression of the Coptic Christian minority, the only group that raises and consumes pigs. In the process, the Egyptian government actually created a public health disaster: garbage piled high on the streets of Cairo as the Coptic pig farmers, known as the zabaleen (trash people), who collected much of the city’s garbage could no longer do their work, because the pigs that devoured the collected organic waste were killed. Meanwhile, in Ukraine, the government has banned public gatherings and rallies for the period leading up to elections in January.

As historical materialists and scientific socialists, we fight for a world socialist revolution to tear the means of production out of the hands of the greedy capitalist class. On an international scale, this would lay the material basis for a communist world free of exploitation and oppression. Then, all the positive gains of modern science can be used to form the basis for a qualitative expansion of scientific research, technological development and production output, which would all be put to the service of humanity. And all the fake science that is used to justify and defend capitalist rule can be rejected. In a 1925 speech, “Dialectical Materialism and Science,” Bolshevik leader Leon Trotsky stated:

“For its needs, society requires knowledge of nature. But at the same time, society demands an affirmation of its right to be what it is, a justification of its particular institutions—first and foremost, the institutions of class domination—just as in the past it demanded the justification of serfdom, class privileges, monarchical prerogatives, national exceptionalism, etc. Socialist society accepts with utmost gratitude the heritage of the positive sciences, discarding, as is the right of inventorial choice, everything that is useless in acquiring knowledge of nature but only useful in justifying class inequality and all other kinds of historical untruth.”