China: Neoliberalism destroyed health service (Isabel Hilton)

From: Rakesh Bhandari (rakeshb@STANFORD.EDU)
Date: Fri May 30 2003 - 13:19:11 EDT

I would think that this would show that capital's attempt to maintain
profitability through an assault on the state and rapacious
exploitation explains the squandering of human life that yields the
labor shortage which in turn compounds the problem of
Capital does not confront an externally generated barrier in the
demographic conversion; it rather generates its own limits through
its unbridled orgies of exploitation in the territories which are
most recently opened up to capitalist production and the consequent
immense squandering of human life which only intensifes the shortage
of labor.


>  >,3858,4674373,00.html
>  >
>  > Comment
>  >
>  > Fatally wounded
>  >
>  > Economic liberalisation destroyed China's health service - now it must
>  > rely on police, not doctors, to fight Sars
>  >
>  > Isabel Hilton
>  > Thursday May 22, 2003
>  > The Guardian (London)
>  >
>  > The  early  morning  in  any Chinese park is the time and the place to
>  > track  the  private  fears  of Chinese citizens. Some come to rehearse
>  > their  enthusiasms  -  ballroom  dancing, calligraphy or martial arts.
>  > Others come to ward off misfortune. Even before the Sars outbreak, the
>  > fear  of  ill-health  was enacted in these dawn rituals. In one of the
>  > most common, a cheerleader leads a chant as his followers pat parts of
>  > their own bodies and urge them to stay strong.
>  >
>  > The  fear  of  illness  today is well founded. The provision of health
>  > services and social security to the mass of the population was perhaps
>  > the  Chinese  revolution's single most important achievement. But even
>  > at  the  height  of  the  communist  system there was never a national
>  > health service. The provision of medical care derived from a work unit
>  > -   a   factory,   a  school,  a  people's  commune  -  that  had  the
>  > responsibility  to take care of its workers and their families. It was
>  > an arrangement that covered most people, but with Deng Xiaoping's move
>  > to a market economy, the system was doomed.
>  >
>  > Economic  liberalisation  meant  the  end of most of those work units:
>  > state   industries   are  closing  down,  agricultural  communes  were
>  > disbanded  long  ago  and agriculture has been privatised. Nothing has
>  > taken  their  place,  and  the services the units used to provide have
>  > lapsed.  Responsibility for public health rests with local authorities
>  > which  do  not  appear  to  have  either  the funds or the interest to
>  > maintain it. Even in the cities, where two decades of economic reforms
>  > have brought a general rise in living standards, the burden of medical
>  > care is now largely a private responsibility that many can't afford.
>  >
>  > So despite increased prosperity, public health has declined. A service
>  > that  boasted  in  the early years of the Chinese revolution of having
>  > eradicated  venereal disease is now almost non-existent. Rural clinics
>  > have  shut  down. Barefoot doctors - primary health workers ubiquitous
>  > in  the countryside in the 50s and 60s - have largely been replaced by
>  > witchdoctors who dispense coloured water and spells.
>  >
>  > Scaling  back on health commitments was seen by China's reformers as a
>  > central  part of economic liberalisation. But, as the government found
>  > to  its  cost,  if  the state does not provide health security, people
>  > turn  to  any  promise of health, however implausible. Falun Gong, the
>  > religious  sect that exploded on to the national scene four years ago,
>  > and  which  the  Chinese  government  has been trying to suppress ever
>  > since,  owes  much  of its mass appeal to the belief that it conferred
>  > good health on its practitioners.
>  >
>  > F  or  a  people  who now regard the state as unreliable in matters of
>  > health,  the handling of the Sars outbreak has brought no reassurance.
>  > The  leadership seems nervous as it tries to recover from the official
>  > concealment  of  the  disease in the early months. As a rule of thumb,
>  > the   more   the  party's  propaganda  department  reaches  for  stale
>  > revolutionary images, the less people trust it, and the present crisis
>  > scores  high  on  the  hoary  revolutionary image index. Hu Jintao has
>  > threatened  that  the  concealing  of  Sars  cases  will  be  severely
>  > punished,  but the habit of official secrecy that dictated the initial
>  > cover-up,  and earned China a humiliating public rebuke from the World
>  > Health  Organisation,  is no more guaranteed to respond to exhortation
>  > than those body parts patted by believers in a Beijing park.
>  >
>  > The  still  bizarre  pattern  of admitted Sars cases suggests that the
>  > bureaucracy  is  embracing  transparency  with  less than wholehearted
>  > enthusiasm.  Shanghai  has  admitted  very few cases, Guangdong to the
>  > south  and  Beijing to the north have many; some provinces acknowledge
>  > that  the  million  migrant workers who have fled Beijing brought Sars
>  > with them, others do not.
>  >
>  > The  Chinese  are  less  likely to believe the official story than the
>  > versions  they  read  on  the internet or the messages they receive on
>  > their mobile phones: unofficial accounts of the extent of the epidemic
>  > circulating on both are now rigorously policed and censored.
>  >
>  > The  Sars outbreak has reminded the Chinese of what has been lost over
>  > more  than  two decades of sustained economic growth, as they discover
>  > that  dilapidated  public  health services are in no shape to fight an
>  > epidemic,  or even to report one consistently. Until Sars, though, the
>  > lack  of  care  for  the  rural  poor  was  no  more  important to the
>  > government than the appalling safety record of the Chinese mines. Even
>  > now,  it  is  the  fear  of international quarantine and the potential
>  > economic damage rather than the death rate that has prompted action.
>  >
>  > The Chinese government's available weapons against Sars are social and
>  > political  rather  than  medical. The state security apparatus, unlike
>  > the public health services, has maintained investment and is trying to
>  > enforce  travel  and  quarantine restrictions. But as far as reporting
>  > and  containing the outbreaks goes, Beijing knows that it cannot trust
>  > local  officials  either to act effectively or - even less likely - to
>  > acknowledge their failures.
>  >
>  > And  as  the  barriers that local people themselves have erected round
>  > their villages and neighbourhoods demonstrate, the people know it too.
>  >
>  >

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