More on Those Pesky Social Services

Apparently my reprint from the Workers Solidarity campaign on state Medicare has stirred up a hornet's nest from the fringe element. For the more rational among my regular readers it is simply a statement of fact that the state sponsored health services as in Canada are far more effective in dollar terms and outcomes ( infant morality,etc.) than the bureaucratic mess in the United States. That doesn't mean that social anarchists in this country are in favour of leaving the system as it stands. I've said before that welfare states are no guarantee of civil liberties as experience in the United Kingdom (in particular) has demonstrated. Still even syndicalists are forced to negotiate with employers whether in the state or private sectors. The "relationships of production" are not really changed in those circumstances they are simply ameliorated. In other words sometimes you take what you can get. Of course for some "libertarian" capitalists private employer/employee relations are not considered exploitative. Yeah right ... get a real job, Mac. There is a great deal more to the "state" than just taxes. If that were the only problem we might have gotten rid of this albatross a long time ago. Sometimes you have to negotiate with the other side. Perhaps I'm just being fatalistic (in which case I blame it all on age and experience) but what part of obvious don't some people understand? (Ask any welfare recipient being bullied by social workers what oppression really is!) Anyway rather then endlessly repeating the obvious here again is part of the comment trail from that article mentioned in Carnival of Anarchy in response to one of the "purists" . These remarks were made by myself in addition to those borrowed shamelessly from Larry Gambone of Porcupine blog. I have edited all of these a little for clarity. The originals, references, and other contributions can be seen here .

" Putting ideology ahead of peoples real needs is the first step taken to the killing fields. The people must come first. It is better to have state provided medicine than none at all. State provision of services is after all, only a warped form of the social aspect. Strip these services of their statism and authoritarian hierarchical management and you have anarchist medical services. Medical care is also an extension of freedom. As a Canadian I have never had to worry about being financially ruined by ill health - unlike Americans. This is an increase in freedom for me. It is regrettable that this freedom must come via the state, but that is the real world, which is messy and contradictory and not a pure and simple ideological fantasy."

"I have worked both in corporate and govt fields and find the latter to be somewhat (but only quantitatively) better than the former. You also assume that this (state medicine) is what anarchists seek to maintain as a permanent solution, rather than a stop gap measure until our movement is strong enough to convert the state system into a stake holder coop system."

"I think a case could be made that the present bureaucracy in the United States is even worse than a single payer system which would, at least, be "up front" in it's structure and intentions. Cooperative medicine existed both in England and Western Canada before the state systems "took over". As I said in my original posting a welfare state can co-exist both with fascism and parliamentary "socialism". As in a real war sometimes we have to make compromises with an enemy. It is not the best solution by any means but sometimes there is not much else we can do."

"The bureaucracy of American medicine means that 15% of their GDP is spent on this area. So the "massive new pillar"(of bureaucracy) is already there. Nothing is really being added, if anything the process is considerably simplified. In Canada we pay a great deal less for a better although not perfect service. "Smash the dominance of the AMA" ... and just who is going to do the smashing? That sounds like the kind of garbage we hear from chiropractors and naturopaths and other practitioners of "alternative" medicine. The cure sounds worse than the disease. It's true that people should be able to buy whatever drugs they want even if these might kill them or that "must treat" rules such as psychiatric "intervention" are bogus. But the notion that employers should not provide health insurance is pretty ridiculous. That is one of the reasons that people form unions. People ARE oppressed by capitalist outfits. I work for one of them five days a week. The idea that anyone can just walk out the door and "go work for the competition" is a fantasy."

This final comment from Larry Gambone I think summarizes the social anarchist position in much of the western world.

The reason why social anarchists assert the need for positive freedoms is that in the real world we can't wait around until the perfect stateless – and therefore classless - society comes into being. In the real world people have needs and these must be met, if they cannot be not through mutual aid due through state-enforced economic inequality, then through government. To destroy social welfare – as well as protective legislation like the 8 hour day, or vacation time – and leave the rest of the state – and therefore class society with all its vast inequalities intact is to condemn the vast majority of the people to Third World misery. It needs to be pointed out as well, that [mutualist] Kevin Carson sees the need for a selective or top-down dismantling of the state with those aspects which benefit the capitalists and state bureaucracy going down first. The social welfare measures last, being converted into mutual aid systems or stakeholder coops. Thus, there is no real difference between communist or syndicalist anarchists and mutualists on this issue. The real bone of contention lies between capitalist libertarians and traditional anarchists. Social welfare – those aspects that actually help the people in some manner are a state-perverted form of the social aspect that lies at the root of our humanness. It is thus something good that has been twisted or has a contradictory aspect. Leaving people to die in the street because they have been denied by state-enforced inequality the resources to help themselves, is simply evil through and through. It also needs to be pointed out that even in an anarchist society a significant minority of the population will have to be subsidized or supported in some manner think of the aged, sick, those with mental health problems etc. In a free society – and therefore one without the present vast inequality of wealth, and the resulting culture of narcissism and sociopathology – this could be done by mutual aid. In the meantime, and I have been discussing this for years, we can work to democratize, mutualize (de-state) existing social welfare measures. For example, Unemployment insurance should be run not by the state but be set up as a cooperative along the lines of a credit union. All workers become members of this coop and elect a board of directors for their city or region. Hospitals should be taken back by the community and run by elected boards representing the user population and the work force etc.