7.5 Human development: Health and well-being in a green social democracy

"In place of the old bourgeois society, with its classes and class antagonisms, we shall have an association in which the free development of each is the condition for the free development of all"

Karl Marx and Fredrick Engels (1848), Communist Manifesto

More than one and one-half centuries ago, Karl Marx and Fredrick Engels had already foreseen capitalism's replacement by a society characterized by an association in which the free development of each would be the basis for the free development of all.

Two things stand out. First is their reference to an association of people, no longer divided by class antagonisms. Second is their goal of the free development of each, understood as a condition for the free development of all. Realistically, if our species is to survive beyond capitalism, we are likely to require still another half-century to achieve a human association fully free from the debilitating vestiges of class antagonisms, one in which the free development of all might be characteristic. To get there, we need to begin sooner, rather than later.

The green social democracy envisioned in this work is a practical means of transition from the extreme inequality and alienation that has become characteristic of contemporary capitalism to a society that begins to move in the direction of the one envisioned by Marx and Engels. But green social democracy is a much preferable alternative, even if it falls short of the ideal, to otherwise being sucked into the black hole capitalism is taking us towards.

Human development, in which all participate, is the goal of a green social democracy. This has two overlapping aspects, which for practical purposes are treated here separately. One is personal health and well-being; the other is education. Achievement in these spheres would be among the principal measures of the success of a green social democracy.

Creating the conditions for healthy people in a healthy society

Pre-requisites. Ending poverty, providing healthy food, creating a healthy natural and social environment, making ready access to natural settings a reality for all, including inner city dwellers, ensuring adequate leisure time and opportunities for physical recreation, making health care and well-being a unifying theme throughout elementary and secondary education and making health care knowledge freely and publicly available are among the most important steps any society can take to improve people's health and well-being.

We address the health care challenge here by first identifying policies directly concerned with the provision of health care, but with the cautionary note that without implementation of the pre-requisite policies for a healthy society and natural environment, health care costs would otherwise inevitably grow while outcomes would be more likely to deteriorate.

Universal comprehensive health care. Universal comprehensive health care is the morally appropriate alternative to private and multi-tier health care systems which exclude people on the basis of their inability to pay. By including everyone in the full range of health care services, making the health care system a fully social one, universal comprehensive health care is also a means to achieve better care at a lower cost.

By comprehensive, we have in mind making all health care services free and accessible as part of the public sector of the economy:

  • including ambulance services, paramedical services, nursing care, maternal care, mental health care, sexual health care, pharmacare, dental care, vision care, hearing care, nutrition counselling, physiotherapy, addiction rehabilitation, orthopedic care, chiropractic care, speech therapy, homecare, care from podiatrists/chiropodists, geriatric care, long term care and all other forms of health care with demonstrated positive health benefits;
  • removing private profit from health care;
  • making the provision of all goods and services required for health and well-being, including healthy nutritious food and well-researched pharmaceutical products affordable to all, in some cases free;
  • supporting best practice health care;
  • promoting comprehensive community-based health care centers as the core of the health care system with an emphasis on patient education, disease and injury prevention, disease and injury management, and home care;
  • making public investment in health care education a major component of the health care budget;
  • translating advances in labor productivity into more time available for voluntary participation in the social economy, including education and health;
  • recruiting and training health care volunteers; and
  • measuring progress in achieving better health and well-being.

Evidence for universal comprehensive health care

The evidence in support of this program is already in. Greed as a motivation for providing health care and related goods and services creates higher costs and poorer outcomes than systems where greed plays a smaller role. The best is ahead of us - provided we make the necessary social changes before the results of current practices overwhelm society. (See: Richard Wilkinson and Kate Pickett (2010, Bloomsbury Press) The Spirit Level: Why equality makes societies stronger).

If service, rather than profit, becomes our cultural expectation and practice, expected outcomes include greater availability and relative affordability of healthy food choices, more education and support for healthy lifestyle choices, a more prominent role for evidence-based health care practice and safer, lower cost pharmaceutical treatment based on evidence of safety and effectiveness.

The evidence is also in that community health care centers as the core of the health care system reduce the costs and improve the outcomes, particularly when they emphasize prevention, disease management and education. On location presence and collaboration of the full range of health care providers is one of the keys to these results. Making these teams responsible for results rather than for number of consultations and treatments is another key. Ideally these centers would include the full range of practitioners and services, such as pharmacists, nutritionists, physiotherapists, optometrists, dentists, hygienists, nutritionists, midwives, nurses, psychologists, family doctors, psychiatrists, cardiologists and other medical specialists. All this to be supported by pre-service and continuing education to ensure up-to-date knowledge and renewal of personnel. (See: www.nachc.com/research-data.cfm).

The more efficiently that we work and study, the more time we should have left to care for ourselves and others. Even more time could be made available for these purposes if the time and resources now spent on less necessary goods and services were reduced. To this potential can be added the free time of students, retirees and other persons who may elect to work as volunteer health care workers. These volunteers should be included in educational programs that develop their related knowledge and skills and be integrated into the health care system with support from experienced mentors.

Instead of greater emphasis on such needed programs as those we have just outlined, we are faced by the incessant drive of capital to privatize health care, making it based on ability to pay at a time of growing wealth and income inequality, environmental degradation and corresponding insecurity for a growing majority of people. The fight for the right to a healthy future joins all the other struggles that lead away from capitalism, whether consciously or not, and adds to the definition of its alternative.

Welcome!

This website was launched September 1, 2010 in support of a green social democratic alternative to neoliberal capitalist policy and practice. The primary result is a work by Charles and Karen McFadden of seven chapters, grouped under the title, Towards a Green Social Democratic Alternative to Capitalism available here in pdf and html formats.

Below under the heading What’s New can be found the most recent materials posted on this website, including opinion pieces, book reviews, articles and selections from the 2017 edition of the main work.  For the interest of new and returning visitors, new materials will be included quarterly.

What's New

NEW & REVISED

Authors' Preface

1.6 The epochal nature of the period we are entering

6.0 The socialism we need against the "socialism" of the 20th century

6.8 Additional concerns about 20th century variants of "socialism"

6.9 The people united!

7.1 Policy alternatives and political movements to advance them

OPINION

Charles and Karen McFadden, Is revolutionary transformation on the agenda

Charles and Karen McFaddenHumanity on the Brink

Charles and Karen McFaddenMovements of Resistance to Movements for System Change

Charles McFaddenTranslating Green Principles into Education Policy and Practice

Charles and Karen McFadden, The Role of Revolutionaries in the Labor Movement

REVIEWS

Charles McFadden, The People United for a More Just Sustainable Future

Karen and Charles McFaddenCan emergent early 21st century neo-fascism be defeated without coming to grips with late 20th century restructuring of capitalism into a global system

Karen and Charles McFaddenA Dominant Capitalism or a Sustainable Environment? Why we can't have both.

US CORNER

William I. RobinsonThe Crisis of Global Capitalism and Trump's March to War

William I. RobinsonTrumpism, 21st Century Fascism, and the Dictatorship of the Transnational Capitalist Class

CANADA CORNER

George HewisonWINNIPEG 1919 & THE COLD WAR

George HewisonArt Manuel - "Unsettling Canada

George HewisonThe NDP and LEAP

RECOMMENDED

Albert Einstein, David Swanson, Jill Stein, Chris Hedges, William I. Robinson, and others Selected articles for Winter 2018

FEATURED WORK

ECONOMICS

1.7 The dynamics of capitalism as a system and the limits of single issue reforms

2.11 The economy in transition towards a new deal for labor and the community

3.1 The challenge of a moribund economic system

3.7 Public banking: A cornerstone of a green social democracy

4.7 Economics and culture

6.5 Using the non-market economy as an opportunity to begin moving beyond capitalism

HISTORY

1.6 The epochal nature of the period we are entering

2.0 Theoretical Perspective: Defining Green Social Democracy

2.5. Socialism and green social democracy in historical materialist theory

4.3 Culture in historical perspective

5.1 Contrasting a green social democratic world with the currently prevailing, but challenged neo-liberal one

6.2 Socialism and capitalism as coexisting social systems

LABOR

2.11 The economy in transition towards a new deal for labor and the community

5.7 Defeating neo-liberal capitalism: The role of social movements

7.3 Justice: Creating a just society, based on the right of all to a dignified, secure existence

Creative Commons License

Creative Commons License: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) applies to all work posted on this website except that which appears with authors whose last name is other than McFadden, in which case standard copyright should be assumed to apply.