Workers Vanguard No. 1171
6 March 2020
U.S. Capitalist Health Care Puts You at Risk
China Mobilizes to Contain Coronavirus
Public Health and the Chinese Deformed Workers State
Down With Anti-Chinese Racism!
MARCH 2—While it is too early, as we go to press, to know whether or not the coronavirus epidemic that broke out late last year in China has spread into a global pandemic, one thing is clear. While the outbreak created huge challenges for China, the largest and most powerful of the states where capitalism has been overthrown, that country’s push to contain the coronavirus underscores the vast superiority of a collectivized economy, however mismanaged by the ruling Chinese Communist Party (CCP) bureaucracy. In the U.S., where health care is subject to the blind forces of production for private profit, the capitalist rulers have dismally failed to take basic measures to control outbreaks of the disease, COVID-19. Not surprisingly, the virus seems to have been circulating for weeks undetected in the suburbs of Seattle and perhaps elsewhere in the country, endangering many lives.
The new coronavirus is the third of its kind believed to have made the jump from animals to humans in the past two decades, following the viruses associated with SARS (Severe Acute Respiratory Syndrome) in 2002 and MERS (Middle East Respiratory Syndrome) in 2012. Wild animal food markets are the suspected origin of both the SARS outbreak and the current one. Much about COVID-19 is not known. As of yet, there is no specific antiviral treatment, and the development, testing and production of a vaccine will likely take a year or more.
As of today, the disease has reportedly killed over 3,000 people worldwide and infected nearly 90,000, although the actual numbers, especially of the latter, are likely much higher. Most victims have been in the Chinese city of Wuhan, where the disease was first identified, and the surrounding province of Hubei. Despite initial bureaucratic inertia and outright cover-ups, Beijing has made Herculean efforts at containment through quarantines, a regional lockdown of some 60 million people, the severe curtailing of travel and the closure of factories and schools in much of the country.
China’s government has also allocated significant medical and other resources to fight the disease. These measures appear to have had some success, and the rate of new cases within the country has begun to fall. The head of a World Health Organization (W.H.O.) delegation that went to Wuhan and other cities in China praised its “all-government, all-society approach” as “probably the most ambitious and agile” in history. He declared: “The world is in your debt” (South China Morning Post, 24 February).
The logistics of controlling this disease would be very difficult for any country, no matter how wealthy. When epidemics strike, public health measures are required that are sometimes drastic and intrusive but essential to save lives. Especially when no vaccine or reliable treatment is available, measures like quarantine, the halting of transport and the cancellation of public events are the best available means to impede the spread of the disease. Thus, these measures taken by China to combat COVID-19, although belated, have been vitally necessary. So is the just-announced immediate and comprehensive ban on the wildlife food industry, valued at $74 billion.
COVID-19 Hits Capitalist World
The Chinese bought time for other countries to get ready to combat the disease. But as one U.S. “health security” expert acknowledged, “We didn’t make good use of that time and now we’re heading into a very dangerous situation.” In the event of a full-blown COVID-19 epidemic in the U.S., the country is poised to experience acute shortages of hospital beds, ventilators, surgical masks and other protective equipment. Already, problems with the manufacture and distribution of diagnostic kits has stalled testing for the infection and hamstrung treatment efforts. Unions representing hospital, airport and other service workers have raised demands for proper training and outfitting to reduce the risk of transmission. Yesterday, two health care workers in California tested positive after they were exposed to an infected patient.
Washington also displayed complete disregard for the threat of contagion when it evacuated 14 infected Americans from Japan on a commercial flight with hundreds of passengers. Those Americans had been onboard the Diamond Princess, a cruise ship put in quarantine in the harbor of Yokohama, only for Japanese officials to have the sick mix with the healthy, including crew members. Thus, dozens more were infected. Subsequently, all passengers were allowed to leave the ship even though they might later develop symptoms. Other capitalist governments have not done much better.
Thousands have lined up outside South Korean stores to buy surgical masks, which are not widely available due to hoarding and price markups by manufacturers. In Italy, which has also seen a scramble for supplies, the disease has broken out in areas near Milano and Venice, chiefly in hospitals. Nonetheless, health care personnel there are being refused testing unless they have spent at least one hour in close contact with someone known to have COVID-19. Last week, a planned press conference by the governor of the Lombardy region to announce a “return to normalcy” was canceled and the room evacuated when it emerged that his main aide had just tested positive and that the governor had decided to self-quarantine.
The outbreak in Iran will be particularly difficult to control, as draconian U.S. sanctions have devastated the economy and health care system. It certainly did not help matters when the reactionary Islamic regime made no attempt to shut down the shrines and gathering places in the Shia pilgrimage site of Qom, the country’s hub of the disease. Pilgrims from Qom are thought to account for most of those so far infected in Kuwait, Bahrain, Iraq and Lebanon.
COVID-19 infections have now been confirmed around the globe, including isolated cases in South and Central America and in Africa. If the disease becomes endemic in any semicolonial country—and especially those in sub-Saharan Africa—where modern health care systems are generally poor or barely existent, the number of victims would skyrocket. Responsibility for this loss of life would lie with the handful of imperialist powers, chiefly the U.S., that keep the underdeveloped world in destitution while pillaging its resources and labor. In the countries subjugated by imperialism, even eminently practical public health measures such as vaccines and clean water are unavailable to hundreds of millions.
Wealth Care U.S.A.
In the U.S., Democratic Party politicians have predictably pointed the finger at Trump for this public health disaster in the making. True to form, the Commander-in-Chief has downplayed the threat of an epidemic here in a bid to stem the stock market slide and shore up his political standing, while tapping religious wing nut Vice President Mike Pence to head up a coronavirus task force. Republicans are hardly the only ones who make a mockery of medical science, with Democrats having long pandered to the anti-vaccine quackery responsible for outbreaks of preventable diseases like measles. Neither is Trump unique among recent presidents to propose cuts to the Centers for Disease Control; Barack Obama did so too.
In the richest country in the world, millions go untreated or die every year because of medicine-for-profit. This system cannot even make certain everyone gets a flu shot, even as tens of thousands die of the disease annually. Behind such human suffering stands the reality that the control of disease is as much a social question as a scientific one. For example, the vaccine for human papilloma virus (HPV), the most common sexually transmitted disease, is known to provide substantial protection against cervical cancer, which kills over 4,000 women a year. But many youth in the U.S. still do not receive it due to the prevalence of anti-vaccine mysticism and social stigma against “promiscuity.” Four decades ago, in the early 1980s, the ruling class turned a blind eye to the AIDS epidemic, dismissing it as a “gay disease.” HIV has since killed tens of millions globally.
Anti-science attitudes and social backwardness combine with the material interests of the owners of the U.S. health care industry to produce deadly results for the general population. Driving down costs to boost profits is the name of the game, never mind investing in “excess” capacity like stockpiles of medical supplies, supplementary hospital beds and sufficient medical staff. As in manufacturing industries, hospitals are stocked with supplies on a “just in time” basis to avoid the expense of maintaining inventories. With many of those supplies, not to mention pharmaceutical ingredients, normally made in China and factories there now shut down or focused on production for domestic needs, shortages are already being felt in the U.S. Meanwhile, the hospitals are woefully understaffed.
Over the past decade, more than 120 hospitals, overwhelmingly in rural areas or the black and Latino inner cities, have been shut down because they were unprofitable. Given the dearth of hospital beds, in 2013 members of the government’s Hospital Preparedness Program proposed a health emergency policy of “reverse triage,” in which hospital patients would be sent home early to make room for the newly infected. In an epidemic, patients would be packed in hospital hallways, lobbies, lounges and waiting rooms.
The dire state of the country’s public health system is symptomatic of the deep racial and class bias that afflicts health care in this sick capitalist society. Investment in the health of the population as a whole is anemic unless the well-being of the rich and powerful is threatened or the owners of industry fear not having a sufficient number of workers fit enough to exploit. The rulers also worry about having healthy armed forces to deploy to defend their global interests. Meanwhile, working people are made to shell out a fortune on health insurance, prescription drugs and hospital stays. One Miami man who had developed flu-like symptoms after returning from China last month went to the hospital to find out if he had COVID-19 and was hit with a $3,270 bill. Medical price-gouging has driven many to ruin.
The labor movement must place itself in the forefront of a fight for socialized medicine, with quality health care for all, free at the point of delivery (see “For Socialized Medicine! Expropriate the Health Care Industry!” WV No. 1170, 21 February). Such a fight would take up other crucial demands, such as for unconditional, unlimited paid sick leave for everyone, as well as for union control of safety to ensure proper training and protocols in the face of new pathogens. This class-struggle perspective requires combating the policies of the trade-union officialdom, which subordinates the interests of workers to the needs of the capitalists and their political representatives, especially in the Democratic Party. What is posed is building a workers party committed to expropriating the health care and other industries through socialist revolution—the only road to building a society where medical science, technological development and all the productive forces would be put to the service of all.
Why We Defend China
While on balance the response of the People’s Republic of China (PRC) to the coronavirus has been very impressive, it has been hampered by the privileged bureaucratic regime sitting atop the workers state. The smashing of capitalist class rule through the 1949 Revolution laid the basis to establish and build a planned, socialized economy, which brought enormous gains for the workers and peasants. However, the parasitic CCP bureaucracy has from the start monopolized political power, deforming the workers state and undermining those gains.
In the case of COVID-19, the CCP bureaucrats initially tried to cover up the new disease, a disastrous step that severely impeded its containment. When medical professionals in Wuhan attempted to sound a warning to others in their field, they were detained and reprimanded for “spreading rumors.” Local officials passed the buck, professing that they could not share information about the virus without approval from above, i.e., from the central bureaucracy around party leader and Chinese president Xi Jinping. One of the doctors who tried to alert others, 34-year-old ophthalmologist Li Wenliang, later died of the disease, triggering an outpouring of popular grief and anger.
Faced with public outrage and growing evidence of the severity of the disease, the CCP finally moved to contain it. Chinese scientists were able to rapidly sequence the genome of the new virus and made it publicly available to researchers and health professionals throughout the world. Two new hospitals, one with 1,000 beds and the other with 1,600, were constructed in less than two weeks, a remarkable achievement. More than 41,000 medical and support personnel were mobilized from all over the country, including from the People’s Liberation Army.
With mass transit shut down in Wuhan, the salaries of cab drivers needed to transport sick people, food and supplies were doubled. The production of face masks in factories all over the country was put into overdrive and the workers were paid several times their normal wage. Fees have been waived for medical testing and treatment related to the disease.
Such measures speak to the immense advantages of a collectivized economy. It is impossible to imagine any capitalist country, marked by the relentless drive for profits, doing anything comparable. Notably, Vietnam, another bureaucratically deformed workers state, responded rapidly to contain a COVID-19 outbreak there with a community lockdown, enhanced testing and resource reassignment. These are graphic illustrations of why authentic Marxists, i.e., Trotskyists, stand for the unconditional defense of China (as well as the other workers states of Vietnam, Cuba, North Korea and Laos) against imperialism and capitalist counterrevolution.
This defense does not imply the slightest political support to the self-interested CCP bureaucracy, whose control over planning and the allocation of resources results in gross economic and social imbalances. The dismissal of local bureaucrats in Wuhan who initially tried to cover up the new coronavirus typifies how the bureaucracy works: lower-level officials are sacrificed to allay public anger, while the top bureaucracy pretends to be infallible. Such practices have become even more extreme under the Xi regime, which attempts to present him as an all-knowing leader.
From Mao Zedong to Xi Jinping, the CCP rulers have sown the illusion that China on its own can achieve socialism—a society of all-sided material abundance—if only given sufficient time. The corollary to this dogma of “socialism in one country” is “peaceful coexistence” with the imperialist powers. This nationalist Stalinist perversion of Marxism is both utopian and reactionary, opposing the necessary fight for workers revolution internationally in order to accommodate imperialism. A proletarian political revolution is necessary to replace bureaucratic rule with that of elected workers and peasants councils. Such a regime of workers democracy would strive to strengthen the collectivized property forms and would direct centralized planning, while promoting the fight for a world socialist order.
Medical Advances and Anti-Science Quackery
China’s health system has greatly improved since the 2003 SARS crisis. At that time, many millions were suffering from the dismantling of the “iron rice bowl” guarantee of basic medical care and other social security to the mass of the population. Those cutbacks were part of far-reaching “market reforms” introduced as a bureaucratic response to economic stagnation and an attempt to use the whip of the market to spur modernization and growth. The prospect of “free market” misery sparked widespread resistance, including strikes, by the Chinese proletariat.
Against this backdrop, we impressionistically endorsed the view that while China remained a workers state “it is wrong to say that the planned economy persists” in a letter reply headlined “China, Centralized Planning and ‘Market Socialism’” (WV No. 838, 10 December 2004). This position was later repeated in WV and other publications of the International Communist League. A meeting of the ICL’s International Secretariat last year concluded that this assessment was false. Despite the breakup of some smaller state-owned enterprises and reorganization of larger ones, as well as the growth of a private capitalist sector, China retains large parts of a (bureaucratically operated) planned economy while subjecting them to market mechanisms. This can be seen in the massive infrastructure development during the last world financial crisis and is today borne out by what China has done to rein in the coronavirus contagion, a centrally directed effort from top to bottom.
Some 95 percent of the population is now covered by state-funded insurance plans, and life expectancy in Beijing and Shanghai is higher than in New York City or Washington, D.C. Yet there are still great imbalances. These are mainly based on the fact that, even with all its economic advances, China remains poor overall in comparison to the advanced capitalist powers. But bureaucratic misrule compounds the problem.
Despite huge infrastructure expenditures since 2008, per capita spending on health care is a disgraceful 82nd in the world. In general, timely access to quality care still hinges on the ability to pay, which is no problem for wealthy businessmen and top CCP officials. Those who can afford private care don’t have to wait in line at overcrowded public facilities. For the masses, out-of-pocket payments normally have to cover about 30 percent of medical costs.
Beijing claims that the number of doctors relative to the Chinese population is fairly high by international standards. But roughly half of those do not even have a bachelor’s degree. Many were trained only at post-junior-high vocational schools. The disparity in medical training contributes to the country’s urban-rural divide in health care. Most well-educated physicians are concentrated in urban hospitals, while those lacking a bachelor’s degree are overwhelmingly found in rural areas. Furthermore, within the cities access to those well-trained doctors is unequal, with the well-to-do having the inside track. A longstanding shortage of nurses also hampers the provision of decent care.
Even worse, many Chinese doctors continue to practice so-called traditional Chinese medicine, which has no scientific merit. In this activity, they have the open support of the CCP regime. China’s National Health Commission has demanded that medical institutions actively promote this quackery. Xi himself calls for a “combination of western and traditional Chinese medicines”—as if science existed in regional variants—to be used in treating the coronavirus. The bureaucracy’s positive attitude toward traditional medicine goes back to Mao’s peasant-based CCP in the 1930s, which reversed the party’s early opposition to medical quackery (see “Pseudoscience, Snake Oil and Stalinism in China,” WV No. 1028, 9 August 2013).
Counterrevolutionaries in Hong Kong Run Amok
The spread of COVID-19 to the PRC’s capitalist Hong Kong enclave has again exposed the utterly reactionary nature of the pro-imperialist “democracy movement” there (see article page 4). Waving U.S. flags and chanting, “Liberate Hong Kong,” anti-China mobs have besieged sites designated for COVID-19 screening, and protesters threw a Molotov cocktail at an unoccupied housing project slated to become a quarantine center. Using the pretext of the coronavirus, in early February thousands of medical personnel in Hong Kong waged a reactionary one-week strike directed against the Chinese deformed workers state, demanding a full shutdown of the border with the mainland.
Imperialist poster boy Joshua Wong is among those who have demanded that W.H.O. director general Tedros Ghebreyesus resign due to supposed “unreasonable favoritism towards China.” Some have even insisted that “real” Hong Kongers, i.e., not Chinese from the mainland or migrant workers from elsewhere in Asia, must get priority in sales of face masks to protect against infection.
Hong Kong, which became an autonomous region of China after British colonial rule ended in 1997, remains one of the most unequal places on earth. Nearly 70 percent of low-income families cannot afford to buy masks or disinfectant. Under its “one country, two systems” policy, the CCP regime has criminally made itself directly responsible for maintaining a capitalist economy in Hong Kong. Upholding the interests of the Hong Kong bourgeoisie against those they exploit and oppress is a massive betrayal of the working people there and on the Chinese mainland. We say: Expropriate the Hong Kong tycoons!
U.S. Imperialism’s Anti-China Offensive
China’s battle against COVID-19 comes in the period of the U.S. trade/tariff war and stepped-up military provocations in the Asia-Pacific region. The ultimate aim, upon which Democrats and Republicans fully agree, is to promote counterrevolution that restores capitalist rule in China and makes it one giant sweatshop under the imperialist boot. The trade-union bureaucracy, with its “America First” protectionism and anti-Communist China-bashing, plays right into this reactionary campaign.
The bourgeois media in the U.S. has helped whip up anti-China sentiment around the coronavirus, with the Wall Street Journal running a February 3 opinion piece titled “China Is the Real Sick Man of Asia,” which sparked outrage in Beijing. Even though Trump praised the Xi regime’s handling of the coronavirus in his February 4 State of the Union address, some of the most fervid anti-China hawks in his administration have seized on the crisis to lash out at Beijing. Secretary of Commerce Wilbur Ross ghoulishly told Fox Business News that China’s economic slowdown due to the epidemic could “help to accelerate the return of jobs” to the U.S.
The medical emergency has indeed hit China’s economy hard, though the depth and duration of this blow cannot yet be predicted. China’s role in the world economy is vastly greater today than in 2003, with its share of global GDP rising four-fold to 16 percent. The disruption of international supply lines is reverberating worldwide. Wuhan is a major manufacturing hub, especially in auto and fiber optics; one local company is the largest maker of the cables that carry data around the planet. Meanwhile, industries based in the U.S. and elsewhere that sell to the vast Chinese consumer market are already taking a major hit.
In the name of curtailing spread of the disease, the U.S. and other countries have temporarily banned entry by Chinese citizens and foreign nationals who recently visited China. The U.S. has now extended a ban to Iran travel. The W.H.O., along with the Chinese government, initially opposed such bans. Since then, the W.H.O. has issued contradictory statements. Its February 29 update, while advising against travel restrictions, also acknowledges that they “may only be justified at the beginning of an outbreak.” Such restrictions “must be based on a careful risk assessment, be proportionate to the public health risk, be short in duration, and be reconsidered regularly as the situation evolves.” One reason for caution is the lack of adequate screening mechanisms, particularly for asymptomatic carriers of the virus.
We are in no position to judge the public health merits of the travel bans and thus take no position for or against them. However, we recognize that the restrictions imposed by capitalist governments like those in the U.S. and Australia are motivated not only by medical concerns but also by racial bigotry and national chauvinism. The U.S. has a long history of anti-Asian racism, exemplified by the Chinese Exclusion Act of 1882 and Japanese American internment camps during World War II. A century ago, Asian immigrants in the U.S. and other imperialist countries were reviled for supposedly being bearers of syphilis, malaria and other diseases.
Today, racist abuse against people of Chinese descent is on the rise. In Los Angeles, an Asian American middle schooler was beaten up after students accused him of having the virus. Asian immigrants traveling through the Midwest were barred from two hotels in Indiana. Restaurants, shops and cafes in Italy, Japan and South Korea posted signs denying entry to Chinese people. Anti-Chinese racism has been particularly virulent in Australia, where newspaper headlines warned of a “Chinese virus” and ordered “China kids stay home.” In France, where one paper ran an editorial titled “Yellow Peril,” postings on the Twitter hashtag #JeNeSuisPasUnVirus (I am not a virus) have exposed multiple instances of racist taunting in schoolyards and of subway passengers moving away from people who appear Asian.
Helping to prepare the ground for this “yellow peril” racism, the FBI has for years been smearing Chinese scientists, professors and students in the U.S. as potential spies for Beijing. Last year, the Feds, together with officials at the National Institutes of Health, compelled a renowned cancer hospital in Houston to fire three scientists allegedly with ties to China. Dozens of similar investigations are said to be underway nationwide. Such witchhunts are the antithesis of the international collaboration and coordination that is a wellspring of scientific advance.
Such world cooperation is crucial to expediently address the problems presented by infectious disease, which know no boundaries. But this need is severely impeded by the capitalist-imperialist system. Capitalism has created a world market, but the domination of that market by the advanced capitalist countries produces war, massive inequality and poverty. The means of production must be torn out of the hands of the capitalist class on an international scale through a series of proletarian revolutions. This will lay the basis for an internationally planned, collectivized economy, which will unleash the productive forces to satisfy want.
All aspects of human health would make a great leap, with poverty, homelessness and starvation eradicated from the earth. Among the many decisions to make through considered debate will be how much to invest in supplementary public health resources in order to maximize readiness for the inevitable arrival of new pathogens. It is the purpose of the International Communist League (Fourth Internationalist) to forge the vanguard workers parties that are necessary to lead the proletariat, at the head of all the dispossessed and oppressed, in fighting for a socialist future.