Is there a class issue in medicine?
by Vic Williams
There is a class issue and class struggle in the medicine industry between the wage workers and the owners of the industry supported by the capitalist state.
But is there a class issue and class struggle between the pharmaceutical industry and the populations they claim to serve, in particular, but not only, expressed in the age old struggle between two systems of medicine, between a pharmaceutical-based approach and an approach of natural therapies, to state it in today’s terms. There are many aspects to this question and I seek to explore some of them in this article.
The existence of two systems of medicines runs through all class societies. In class societies the ruling class aim for the monopoly of knowledge and ownership of medicine as a source of power. They have used power and violence to stamp out knowledge of and competing use of natural therapies.
For Her Own Good by Barbara Ehrenreich and Deidre English told the story of the burning of witches. By the Fifteenth Century peasant women in Europe who were the healers, were using ergot to relieve pain, belladonna and digitalis and other herbs. St Hildegarde of Bingen (1078-1178) compiled a book of natural healing methods, documenting use of 213 plants and 53 trees.
University trained doctors used bleeding, leeches, treated leprosy with broth of black snake, and used incantations and quasi-religious rituals. The official text of the church stated: “The greatest injury to the Faith as regards the heresy of witches was done by midwives. Pain in labour was the Lord’s just punishment for Eve’s original sin. If a woman dare to cure without having studied she is a witch and must die.”
With the active support of the church, interwoven with the state, over a million healing women were burned as witches in two centuries in the interests of the medicine of the doctors.
Lenin stated that the use of the theory of class struggle gave scientific definition to the results of a wide variety of conflicting strivings, stemming from the difference in the position and mode of life of the classes into which each society was divided.
Indeed, today significant sections of the medical practitioners, especially the highly-paid specialists, are extremely conscious of a class divide and are eager to maintain it.
“Doctors like to present a solid front to laymen. They don’t want to be diluted, and the profession is always shaking its head over medical students and saying the quality is not what it used to be. In its evidence to the Pilkington Commission [the Royal Commission on Doctors’ and Dentists’ Remuneration in the UK in 1960] the Royal College of Surgeons talked about the need to maintain a nucleus of ‘students from cultured homes’ who had been ‘brought up to look upon medicine primarily as a vocation’. Medicine, said the Surgeons, in a written statement that a witness later agreed was meant to be scathing, would ‘lose immeasurably if the proportion of such students in the future were to be reduced in favour of precocious children who qualify for subsidies from Local Authorities and the State purely on examination results.” (Ferris, Paul The Doctors, Pelican Books, Great Britain 1967, p 13)
The initiators and users of natural therapies were in the main peasant women who were in the fields and forests, had their own organisations to spread that information and use, and continued it despite the widespread murders. The doctors came from the upper classes and were involved with the church and supported the ruling class and had a different position and mode of life from the peasant women.
The struggle between them and the peasant women was a class struggle focused on the different types of medicine. Whose knowledge and power would predominate, whose ideological supremacy would prevail, were the questions at hand, the form this struggle took.
A modern-day example can be seen in New Zealand.
Nexus, an internationally published health magazine, in its December 2006 / January 2007 issue, wrote of the findings of the Acting Chair of the Coroners’ Council, New Zealand, Dr Bain, of the comparative fatality of the two types of medicine.
It had become an issue in the New Zealand Parliament because of opposition to the passing of a bill to replace their current Medisafe agency with an Australian-New Zealand Therapeutic Products Authority. The New Zealand Government must have considered natural therapies to be dangerous and needing much stricter control.
The opposing parties, New Zealand First, Maori and Greens parties claimed the bill would decimate New Zealand’s natural health industry as had clearly occurred in Australia.
Dr Bain enquired from all coroners as to any instances of problems with any natural products from their inquests. The study returned a finding of no deaths from natural products. In contrast, deaths in 1998 from adverse reactions to pharmaceutical drugs killed 1,534 New Zealanders and deaths from medical injury such as mistakes by doctors and medical staff killed 4,222.
In July 2006 a study by Parliament’s Health Committee pointed to hospital infections, drug errors and mistakes costing New Zealand NZ$870 million a year.
This report recognised the existence of two types of medicine and conflict between their respective supporters that developed into political struggle. Dr Bain’s comment: “The law does not and should not concern itself with such trifles.” It would be interesting to know who forced the New Zealand Government’s hand.
World Without Cancer by G. Griffen told the Rockefeller story. When Rockefeller millions bought into the medicine industry, medicines became more obviously commodities for sale. Rockefeller made sure the drugs made by his scientists would flood the market. Trust money bought the schools for training doctors, ensuring they were trained to prescribe his drugs. He used his money power to ensure the media praised and advertised his drugs to convince the public of their necessity.
He used his money to control the organisation of doctors to deny licences to any rebels. Pressure was used to close down the schools teaching natural therapies, in the same way as the oil and car monopolies bought up and ripped up public tramlines. Most states ruled that practicing medicine without a licence from approved medical schools was punishable by prison sentence. In 1900 at least 50 per cent of babies were delivered by midwives. By 1930 midwives were totally eliminated, outlawed in many states.
The pharmaceutical monopolies used the capitalist state against those striving to use natural therapies, mainly migrant workers whose tradition it was to use such therapies. Many migrants came from peasant / farming backgrounds and it was the women in those communities who carried and passed on the knowledge and use of natural therapies. There was a clear difference in their position in society and mode of life between them and the class led by the Rockefeller-Carnegie group. It was class struggle in the area of medicine.
Today the conflicts between the makers and users of the two medicines has widened and sharpened. Lenin said “It (modern society) has added new classes, new methods of oppression, new forms of struggle in place of the old ones.”
The pharmaceutical transnationals have today set out to deny people free use of vitamins and natural therapies because the latter are increasingly invading their market for drugs. The three huge companies, Bayer AG, BASF, and Hoechst, spawned from the break up of IG Farben (financier of Hitler) are the central powers of the pharmaceutical transnationals. Germany is by far the largest exporter of pharmaceutical products. They flourished in the sixteen years of Chancellor Kohl who came from BASF.
In Germany the pharmaceutical corporations have been able to force restrictions over vitamins and nutrients, such as vitamin C, which is now limited to 500mg available under prescription.
Within months of the Swiss giant pharmaceutical Navortis moving into Norway, the same restrictions were applied.
In March 2002 the European Parliament passed its “Directive of Dietary Supplements” which became law in 2005. Except for certain supplements, all others were classed a drugs. Except for approved supplements, all others were banned from over-the-counter sales. The corporate drug interests had already pulled cholesterol-lowering yeast from the market, and banned the essential amino acid L-tryptophan, claiming it was linked to a deadly auto-immune disease, EMS. It transpired that a contaminated batch of the amino acid was the culprit, but none-the-less the ban remained. A Rutgers Law Journal article observed: “Political pressures have played a role in the Food and Drug Administration’s decision to ban L-tryptophan as well as its desire to increase its regulatory power over dietary supplements.”
In 1974, under pressure from drug companies, the US Government prohibited the sale of vitamins and natural therapies over the counter. But the making and selling and use of these therapies in small laboratories and backyards continued to function, despite raids and armed invasions. By 1994 the pressure was so great that the US Government passed the “Dietary Supplement and Education Act” once again allowing free access to vitamins, natural therapies and free distribution of health information on their method of use.
This was achieved by some long and persistent struggles, in the course of which a number of centres, institutes and foundations have been established, for example, the National Health Foundation, the American Preventative Medical Association, the Health Science Institute. Magazines and books reflecting such struggles today are circulating internationally.
These forces doing battle with the pharmaceutical transnationals have built a national network in the United States with political actions powerful enough to force the government to change the law. The people engaged in the struggle may not clearly see themselves as representing class interests, but they are certainly prosecuting a class struggle against the pharmaceutical transnationals, whose executive members have included such luminaries as Donald Rumsfeld, as well as the US Government. It is no coincidence that the same representatives of the class enemy surface in most other struggles of the US people.
An important part of the national network in the United States is the Rath Health Foundation, which in part is dedicated to the exposure of the pharmaceutical industry as the largest investment industry on earth. While pharmaceutical advertisements promise “health” the very market place of this investment industry is the existence and expansion of diseases, argues the Rath Foundation. Preventative medicine, root cause treatment and eradication of diseases threaten the pharmaceutical “investment business” and are therefore fought by the pharmaceutical cartels. In a public presentation in June 1997, Dr Matthias Rath, the Foundation’s founder, formulated for the first time the sobering analysis, that the very industry that claims the monopoly on global “health care” is by itself the biggest obstacle for the people of the world to enjoy a healthy life.
The Rath Health Foundation and others in this growing network argue that what is needed is a “New Global Healthcare System” that can be implemented simply and economically in any country, at the local level and right up to the level of national public health policy. Based on scientific breakthroughs in the areas of vitamin research and cellular health, it is already possible that cardiovascular disease, cancer, Aids and other common diseases will be largely unknown in future generations if this such a system is implemented now, they claim.
This primary goal has particular relevance to people in the developing world where the integration of natural health approaches into public health strategies will significantly improve the health and lives of millions of people, who may otherwise be unable to access any other forms of affordable healthcare.
Indisputably the turn from the second millennium to the third has coincided with worldwide changes in healthcare. Each day more and more patients and health professionals are taking advantage of the fact that most common diseases can be effectively prevented, and treated naturally, by vitamins and other natural therapies. This is why the pharmaceutical companies are so worried.
Health improvements achieved with essential nutrients are so superior to conventional medical approaches for cardiovascular diseases, cancer, Aids and other common diseases that major health insurance companies in Europe are now reimbursing the cost of these remedies. What we see in many advanced capitalist countries, where the western diet (high fat, high protein, high sugar) and lifestyle has taken a firm hold, is that despite record spending on health (otherwise known as exploding health care costs), the most common chronic diseases have reached epidemic proportions and they continue to spread. Among them are coronary heart disease, obesity, diabetes, high blood pressure, heart failure, osteoporosis, many types of cancer and Aids.
In 1963, the UN World Health Organisation and the UN Food and Agriculture Organisation jointly set up the Codex Alimentarius Commission to standardise and control vitamins and nutritional supplements.
One of the chief architects of Codex was Fritz der Meer who had formerly been on the board of IG Farben. Der Meer was sentenced at Nuremberg war crimes trials to seven years jail for slavery and looting. He was in charge of the IG Farben chemical plant in Buna near Auschwitz during the war. He was also on the board of Bayer AG from 1956 to 1964.
At a meeting in 2000, the German delegation to Codex (every nation belonging to the United Nations Organisation can send a delegation) aimed for:
A widespread ban on the dissemination of health information about the role of vitamins, amino acids, minerals and other natural substances in the prevention and treatment of diseases.
The sale of vitamins and other natural substances exceeding in quantity the arbitrary and low dosages recommended by the Codex Commission be forbidden worldwide.
Countries refusing to implement this bill shall be punished by means of international economic sanctions.
Such a bill could be enforced via UN sanctions, using the powers of the World Trade Organisation.
In 2000 the recommendations were defeated by the strength of an international campaign, including street demonstrations led by the Rath Foundation. The Foundation lobbied a number of countries, including Tanzania and Uruguay, who helped to defeat the plans of the German delegation.
Codex meets every two years to plan changes. In 2006 the Rath Foundation branded Codex (as a tool of the pharmaceutical companies) and as the greatest threat to the health of humanity. Once again meetings, rallies and demonstrations were organised on a greater scale.
The pharmaceutical industry, on a world scale is extremely profitable and highly monopolised.
Marcia Angell, a Senior Lecturer in Social Medicine at Harvard Medical School in the United States, and the author of The Truth About the Drug Companies: How They Deceive Us and What To Do About It (2004), has done much research on this issue and provides some startling figures:
“Although the pharmaceutical industry claims to be a high-risk business, year after year drug companies enjoy higher profits than any other industry. In 2002, for example, the top 10 drug companies in the United States had a median profit margin of 17%, compared with only 3.1% for all the other industries on the Fortune 500 list. Indeed, subtracting losses from gains, those 10 companies made more in profits that year than the other 490 companies put together. Pfizer, the world's number-one drug company, had a profit margin of 26% of sales.
“In 2003, for the first time in over two decades, the pharmaceutical industry fell slightly from its number-one spot to third, but this was explained by special circumstances, including Pfizer's purchase of another drug giant, Pharmacia, which cut into its profits for the year. The industry’s profits were still an extraordinary 14% of sales, well above the median of 4.6% for other industries. A business that is consistently so profitable can hardly be considered risky.
“Excess profits are, of course, the result of excess prices — and prices are excessive principally in the United States, the only advanced country that does not limit pharmaceutical price increases in some way. Of the top 10 drug companies in the world, five are European and five are American, but all of them have the US as their major profit centre. In the US, uninsured patients (of which there are many) are charged more for drugs than those who have large insurance companies to bargain for them, and the prices of prescription drugs are generally much higher to start with than in other advanced countries. Moreover, the prices of top-selling drugs are routinely jacked up in the US at two to three times the general rate of inflation.”
In the wake of the recent Vioxx scandal (in which Merck’s arthritis drug was linked to more than 27,000 deaths from heart attacks and sudden cardiac arrests) and an avalanche of lawsuits, the pharmaceutical companies are desperate to outlaw all non-patented natural therapies, which they see as a threat, especially to their profits. Alternative therapies have been more than successfully competing with pharmaceutical products on world markets.
This struggle has mainly been waged by an organised part of the middle class, against the pharmaceutical giants who have well-defined links with capitalist governments. There is a clear difference in their respective positions and roles in society and in their modes of life. It is a class struggle.
Lenin asked “Is it not evident we should not be fulfilling our task of developing the political consciousness of the workers if we do not undertake the organisation of the political exposure of the autocracy in all its aspects?”
In What Is To Be Done, Lenin reminds us that: “He is no Social-Democrat (communist) who forgets in practice his obligation to be ahead of all in raising, accentuating, and solving every general democratic question.” (p 82, What Is To Be Done, Progress Publishers, Moscow, 1978) .
Indeed a most necessary part of the struggle against the power of the big pharmaceutical transnationals is not just in the field of choice of medicines, but in choice of health philosophies. For progressive people the world over, a preventative healthcare system is most desirable.
The CPA Political Resolution, adopted at the 10th Congress in 2005, in Part 5, entitled “Issues for struggle”, under the sub-heading “Medicare and health”, says: “Priority to be given to preventative medical services including campaigns by governments to educate people about healthy lifestyles. Preventative medicine should also encompass restrictions on corporate advertising and on the production and sale of unhealthy products.”
The struggle for the rights of the working people in society to have a choice in their method of health care and not be dictated to by the profit-hungry pharmaceutical monopolies is today a legitimate part of the struggle for democratic rights.