Socialist Action /April 2002
Revolutions Brought Gains in Education
and Health Care
By PAUL SIEGEL
Following is the third chapter of a new pamphlet by Paul Siegel on
the theory and practice of socialism. It is available from Socialist Action
Books for $3.
It is noteworthy that the Soviet Union, China, and Vietnam all made great
strides forward after their revolutions in the vital fields of health care
and education but swiftly retrogressed on turning in the direction of capitalism.
However, Cuba, which made even greater strides forward, was able to retain
and even extend its gains while permitting carefully controlled foreign
investment in the last 10 years.
"By international standards, the Soviet Union," says the United
Nations Human Development Report for 1996, "achieved many impressive
advances in basic human development over much of the 20th century."
This refers, although the report does not explicitly say so, to the achievements
of the Russian Revolution in free education and health care, full employment,
and guaranteed subsistence needs, which persisted, although attenuated and
overwhelmed, under the brutal Stalinist reaction.
Since the break-up of the Soviet Union, however, continues the report,
"Russia's growth and human development have plummeted. Deep recession
and hyperinflation sharply increased unemployment and poverty and exacerbated
income inequality. Life expectancy, mortality, and morbidity have worsened
dramatically."1 There has been little if any improvement since then.
The Chinese Communist Party, trained in the school of Stalinism and militarized
in the process of coming to power at the head of a peasant army, established
a regime that was bureaucratically authoritarian from the beginning. The
revolution nevertheless freed China from imperialist domination and transformed
society, smashing the power of the feudal landlords and the agents of foreign
capital and beginning the process of industrialization.
In doing so, despite the errors and crimes of the Mao government that
resulted in famine during the Great Leap Forward period and social turmoil
during the Cultural Revolution, it brought much longer and much improved
lives for the Chinese masses.
The improvement was so great that the World Health Organization representative
in China stated in 1991 that with regard to life expectancy and infant mortality
China far surpassed other developing countries. So too the New York Times
of March 30, 1991, reported, "China has made enormous strides in medical
care in the four decades since the Communist Revolution. ... The World Bank
lists life expectancy among Chinese at 70 years, compared with 76 in the
United States and 58 in India." Similarly, the revolution brought China
a great advance in mass education.2
The era of "market socialism" brought rapid economic growth,
but at the same time many losses of the revolution's accomplishments. The
New York Times reporter who commented in 1991 on the remarkable advances
in medical care since the revolution added that "the gains in health
care have slowed in the last dozen years. ... The main reason ... appears
to be the collapse of the commune system, which used to provide rudimentary
health care, usually free of charge, throughout rural China."3
The story is the same in education. Han Dongping, a Chinese expatriate
scholar living in the United States, returned to his home country for the
purpose of research. In his 1992 study he found that peasant access to education
had declined markedly since his time.
"The village education system supported by the collective fund before,"
he stated, "had suffered a great deal. Without financial help from
the collective, village schools have had to charge the villagers a high
price for the education they offered to survive. Many farmers did not want
to pay the price."4
Vietnam suffered a similar experience. After 30 years of an immensely
destructive war against French colonialists, the Japanese invaders, the
Americans, Pol Pot's Khmer Rouge, and the Chinese, it was subjected to a
punishing embargo by the United States and its allies.
In these desperate circumstances the Communist Party turned in 1986 to
the "free market" as a way of breaking out of the embargo.
It was able to effect this change in policy without opposition because,
overwhelmingly supported by the peasantry though it was in its resistance
to foreign imperialism, its leadership was not democratically accountable
to either its members or the people.
As elsewhere, "structural reform" and "privatization"
brought a great increase in wealth for a few, the growth of poverty among
the many, and the drastic reduction of social welfare provisions. According
to a UN Development Program report, North Vietnam had once been among the
first in life expectancy and among the last in infant mortality among the
countries of the "developing world."5 Now, a 1993 World Bank report
stated, "despite its impressive performance in the past, the Vietnamese
health sector is currently languishing."6
From 1954 to 1972, the number of elementary and secondary school pupils
in North Vietnam increased from 700,000 to nearly 5 million. UNESCO in 1980
estimated that it had a literacy rate of 90 percent and a school enrollment
that was among the highest in Asia and the Third World generally. By 1992,
with the privatization of education, there were 750,000 children less in
the schools although the number of school-age children had grown.7
The Cuban Revolution was different than the Chinese and Vietnamese revolutions
in that it was made under a leadership that was not Stalinist. The Cuban
revolutionary leaders began by seeking only radical reforms but found that
in doing so they were confronted by U.S. imperialism, which wished to retain
Cuba as its vassal state. In the struggle that ensued, the expropriation
of American property and the logic of events drove the revolution in the
direction of socialism.
Committed to the welfare of the masses, the Cuban revolutionaries transformed
a society in which health care and education had been confined to the rich
and well-to-do in a comparatively short time.
A Reuter's report from Havana in the London Times of Dec. 30, 1983, describes
the changes: "Official statistics, backed by United Nations specialists
working here, illustrate the transformation that has taken place. ... The
average life expectancy of a Cuban born in the 1950s was around 50 compared
with 75 today, while infant mortality has been slashed from about 60 per
1000 births to 16. ... Cradle-to-grave benefits ensure ... equal access
to medical treatment and schooling."8
The Cuban revolutionaries had the immense advantage of their nation not
having undergone the years of devastating war that the Soviet Union, China,
and Vietnam had undergone. Although subjected almost from its inception
to a strangulating U.S. embargo, revolutionary Cuba was sustained by its
trade with the Soviet Union and Eastern Europe. This, however, had its downside
in that it suffered various pressures from the Stalinist bureaucracy.
When this bureaucracy turned towards the restoration of capitalism, Cuba
lost 75 percent of its foreign trade in a year. The shock to the economy
was tremendous. Cuba entered an extremely difficult period of great scarcity,
from which it has in good part emerged at the price of the development of
differences in well-being between those who have access to foreign currency
through the flourishing tourist industry and through remittances from the
United States and those who do not.
These differences and the penetration of foreign capital are producing
distortions in Cuban society. The bureaucratic tendencies against which
the Castroists have had to struggle since the inception of the revolution
are bound to triumph, as they triumphed in the Stalinist regimes, unless
the revolution is extended to other countries, particularly to advanced
capitalist countries.
What is remarkable, however, is that even through this period Cuban advances
in health care and education have continued. The World Bank's 2001 edition
of "World Development Indicators" states that the infant mortality
rate fell from 11 per 1000 births in 1990 to seven in 1999. Cuba now is
sixth in the world in this respect, the first five countries being advanced
industrial countries. The average for Latin America and the Caribbean was
30 in 1999.
The Cuban mortality rate for children under five fell from 13 to 8 per
1000 over the course of the decade. This is far lower than those who came
closest to it in Latin America. The average for the entire region was 38
in 1999.
Cuba's educational system is as outstanding as its health care system.
Jo Ritz, the World Bank's Vice President for Development Policy and the
former education minister in the Netherlands, said of it, "[I]n education
performance, Cuba is very much in tune with the developed world, and much
higher than schools in, say, Argentina, Brazil, or Chile."9
The record of Cuba and the other post-capitalist societies demonstrates
the potential of socialism. Compare this record to that of underdeveloped
countries elsewhere, as given in the "United Nations Human Development
Report 1996." The advance of medical science resulted in significant
gains in infant mortality and life expectancy, despite pharmaceutical monopoly
prices, and physicians catering to the rich few rather than tending to the
poor multitudes, but nevertheless the mortality rate for children under
five in underdeveloped countries was nearly six times as much as that of
industrialized countries.
Some semi-industrialized countries greatly increased the number in primary
and secondary schools, but nevertheless 130 million children at the primary
level and 275 million at the secondary level were out of school. The education
of those who were in school was impeded by the fact that a third of the
children were malnourished.
The gains that had been made, the report went on, were precarious. For
one thing, the more than a billion people who live in overcrowded houses
with poor sanitation and the 100 million who are homeless are subject to
contagious diseases that rapidly become epidemic. These diseases can overwhelm
all the gains made through immunization and other health measures and can
spread throughout the world.10
"The United Nations Human Development Report 1998" repeated
this warning and pointed to the HIV/AIDS epidemic.
In 1996, 22.3 million people were living with HIV; at the end of 1997,
nearly 31 million were doing so. Such epidemics, from which rich countries
cannot insulate themselves in this era of global travel and mass immigration,
threaten "not just the health of the world's people but the achievements
in human development."11
Yet, stated the report, human development could readily flourish if proper
goals were set and the world's resources were properly allocated. Only $40
billion or 0.1 percent of world income would be needed yearly to bring basic
education, clean water and sanitation, and basic health, nutrition, and
family-planning services to every one in the world.12
The difference between what could be achieved and the actuality is also
great for advanced capitalist countries. This can be seen in the "human
poverty" index for industrialized countries of the "UN Human Development
Report 1998," which measures deficiencies in health, education, and
other conditions of human welfare.
Ranking 17 industrialized countries, the report finds (p. 29) that, although
the other industrialized countries have themselves been cutting social services
since the 1970s, "the United States, with the highest average income,
has the highest population share experiencing human poverty."
Thus, among the 17 countries, the United States, with 13 percent of its
people not expected to survive to age 60, came in last in this respect.
With 20.7 percent of its population between the ages of 16 and 65 functionally
illiterate, as measured by an international literacy survey, the United
States did more poorly than any other country except Ireland and the United
Kingdom. It also had the grossest maldistribution of income.
That the richest country in the world has so large a portion of its population
living so poorly in vital respects indicates how far not only the unindustrialized
countries but also the industrialized countries are from what could be achieved
if we were living in a rational world.
We live, however, in an irrational world in which what looms before us
is overwhelming catastrophe. Epidemics are only one form which this catastrophe
can take.
1 United Nations Human Development Report 1996, (Oxford
University Press, 1996), p. 84.
2 Robert Weil, Red Cat, White Cat: China and the Contradictions
of "Market Socialism" (Monthly Review Press, 1996), pp. 241-42,
246.
3 Weil, pp. 241-42.
4 Weil, p. 249.
5 John Pilger, Hidden Agendas (New Press, 1998), pp.
333, 389.
6 Pilger, p. 333.
7 Pilger, pp. 332-333.
8 Ralph Miliband and Marcel Liebman, "Reflections
on Anti-Communism," p. 6.
9 Socialist Action, July 2001.
10 United Nations Human Development Report 1996, pp.
20, 24.
11 United Nations Human Development Report 1998, p.
34.
12 United Nations Human Development Report 1998, p.
37.
Socialist Action /April 2002 |