Socialism Is Much Better Than Capitalism, And Communism Will Be a Far Better World

PART 15: The Cultural Revolution: Health Care and the Economy

Health Care

Let’s look at health care during the Cultural Revolution. Let me put it in simple terms. Maoist China, which was not a rich country, was able to create what the U.S. hasn't come close to having: a universal health care system. Health services were provided free or at low cost, and the health care system was guided by principles of cooperation and egalitarianism.

The emphasis in Mao's China was on prevention, hygiene, and other mass, public health measures. During the Cultural Revolution, the focus of health care expenditure and allocation of resources shifted to the countryside, even as overall health care improved in the cities. Even in the country’s remote areas, some medical services were made available.

In the countryside, each commune had a health network, which included a large clinic or hospital, health stations, and medical rooms at the village level. The average yearly cost of medical services for peasants was $1 to $2. One of the most exciting developments of the Cultural Revolution was the “barefoot doctor” movement. These were young peasants and urban youth sent to the countryside who were quickly trained in basic health care and medicine geared to meet local needs and who were capable of treating the most common illnesses. Doctors from the cities would go the rural areas—at any given time, a third of the urban doctors were spending time in the countryside.

And health care improved in the cities as well. By the early 1970s, Shanghai had a lower infant mortality rate than New York City at the time. And as I said at the start of this talk: life expectancy under Mao doubled from 32 years in 1949 to 65 years in 1976.

You hear all these charges about how many deaths Mao was responsible for. But the fact is that tens of millions of lives were actually saved by socialist revolution. Let’s add up all the premature and avoidable deaths caused by malnutrition, poverty, lack of basic medical care, lack of preparedness and institutional ability to respond to natural catastrophes. There's no comparison.

Amartya Sen, the Nobel Prize winner, points out that in 1949 China and India had striking similarities in their social and economic development. But, Sen goes on to say, over the next three decades, “there is little doubt that as far as morbidity, mortality, and longevity are concerned, China has a large and decisive lead over India.” As a result, Sen estimates that close to four million fewer people would have died in India in 1986, if India had had Mao’s health care system and food distribution network.1

Noam Chomsky made an interesting calculation using Sen’s data. There is this anticommunist study called The Black Book of Communism. It talks about what it calls the “colossal failure” of communism and accuses communism of having caused the deaths of 100 million people. Now even if that number were true, which it is not—still, as Chomsky puts it, and let me quote: “in India the democratic capitalist ‘experiment’ since 1947 has caused more deaths than in the entire history of the ‘colossal, wholly failed…experiment’ of communism everywhere since 1917: over 100 million deaths by 1979, tens of millions more since, in India alone.”2

Economic Transformation

In terms of the economy: Maoist China scored impressive successes. It achieved rapid development in agriculture, industry, transport, and construction. Industry grew at an annual average rate of 10 percent during the Cultural Revolution, which is high even by capitalist standards. China built a modern industrial base, combining heavy and light industry, without relying on foreign loans or investment. Agriculture grew by some 3 percent a year, keeping pace with population growth. The gap between town and country was narrowed, and the all-around welfare of peasants improved.

And, as I said earlier, by 1970 China was able to produce and distribute the food needed to prevent starvation and malnutrition. This was accomplished through a centralized planning system in which industry was oriented towards serving agriculture; a system of collective agriculture that promoted grassroots mobilization; flood control; steady investment in rural infrastructure, and the equitable distribution of food to peasants and rationing of essential foods so that all people were guaranteed their minimal requirements. This was a radical break with China's past.

In a world where close to a billion people suffer from malnutrition and starvation, the lessons are very profound.

Maoist China took a unique road of economic development. A process of industrialization was taking place that was not at one and the same time a process of chaotic and unplanned urbanization. Conscious efforts were made to restrict the growth and size of cities and to develop small and medium-size cities. Industry was decentralized to overcome regional inequalities. Resources were channeled to poorer regions. There was emphasis on tractor and machine technology appropriate to rural conditions. All this holds very important lessons for today's world.

Socialism is criticized for producing hyper-bureaucratized planning systems. And, yes, that was a danger that had to be recognized and restricted. But in Maoist China, a more flexible approach to planning was able to combine centralized coordination with local initiative and control. Industrial and agricultural enterprises cooperated with each other. Health, environment, and worker safety were concerns of local planning. When natural disasters struck, the proletarian state marshaled resources and mobilized people to act together and carry out coherent plans.

Economic development in Maoist China was based first and foremost on the masses, armed with political understanding of the goals and contradictions of socialist revolution and with a sense of their decisive role in remaking society.

This system of centralized planning guided by socialist principles is a world apart from the capitalist economy. Under capitalism what gets done and how it gets done is guided by profit. Private units of capital, each pursuing its own interests, compete on a huge scale with one another. In this anarchic system, there is and can be no rational, society-wide planning for social need.

And look at the world capitalism produces. I am talking about the intensifying gap between rich and poor… I’m talking about the megacities of the Third World with their rings of squalid shantytowns… I’m talking about vast new zones of exploitation created to serve transnational corporations… I’m talking about the relentless commodification of nature—from the corporate patenting of seeds and natural herbicides to the privatization of water in parched African countries. Maoist China was going in an entirely different direction.

Next Week: The Defeat of Socialism in China and Lessons for the Future

1. Jean Dreze and Amartya Sen, Hunger and Public Action (Oxford: Clarendon Press, 1989), pp. 205, 214. back to article

2. Noam Chomsky, “Millennial Visions and Selective Vision, Part One,” Z Magazine (January 10, 2000). back to article

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