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The Doctor’s Dilemma Resolved

I am a physician and a socialist. I always wanted to be a doctor, probably because my brother Ron was born with severe hemophilia for which there was no treatment at the time. To my young mind, doctors had the power to stop suffering, and I wanted that power.

I had the good fortune to be born at the right time. During the 1960s, the Canadian government subsidized children from the working class to go to university. My second stroke of luck was getting into medical school.

I soon discovered how powerless doctors really are. Most of my patients’ problems were rooted in social conditions that were outside my control. The best I could do was manage their symptoms.

Medicine radicalized me. I was a socialist because I came from a family of socialists. But I didn’t really understand capitalism. Like most people, I thought it was an economic system.

As a physician, I learned that capitalism is the system of social relationships in which we are all immersed. We are born into it; we are shaped by it; and we re-create it every day.

Capitalism is cruel and heartless and tears people apart, mentally, physically and socially. In order to survive, we must replace it with a completely different system based on equality and reciprocity, a socialist system in which we all share the world’s work and the world’s resources.

Until recently, my two identities of physician and socialist occupied separate spaces. At work, I tended an endless succession of wounded people. Outside of work, I struggled to change a heartless social arrangement that propelled the wounded to my door.

I wanted to connect these two activities, however, physicians tend to be a conservative section of the middle class, well-rewarded for managing the misery that capitalism creates. I could find no medical organizations that questioned this role, only reform groups offering different levels of misery management. I wanted the misery to stop so, in 2013, I retired from medical work to advocate full-time for a world that doesn’t make people sick.

I’ve worked as a physician primarily in Canada, but for a time I also lived in the United States. In both countries, medical services were traditionally delivered by small businesses. During the 1990s, large corporations (HMOs) cornered the American market by offering lower-cost medical services. It was a scam.

By 2005, 45 million Americans could not afford medical insurance, and medical bills had become a prime cause of financial ruin, even for those who had insurance when their problems began.

Canada’s medical system is also in crisis caused by decades of under-funding. In 2004, Canada’s Supreme Court declared that all patients cannot be assured of getting medically-necessary treatment.

Most medical professionals have jumped on the rationing bandwagon, echoing the cry that there’s not enough to go around. As I explain in Professional Poison, professionals are trained to manage capitalism, not to challenge it.

In contrast, most health workers believe that people’s needs should come first – our patients’ needs and our own. That belief compels us to organize with other workers against capitalism.

Organized health workers are the best defenders of medical services. I learned this in 1981, when the Canadian Union of Public Employees (CUPE) struck Ontario hospitals to protest cuts to staff and services.

For seven days, 13,000 striking health workers defied back-to-work legislation, media attacks, police harassment and the jailing of top union officials. Unwilling to mobilize an all-out public-sector strike to press their demands, union officials caved in.

The defeat was substantial. Thirty-five worker-activists were fired, and more than 9,000 were disciplined. My brother Ron Rosenthal was one of the fired activists, being the chief shop steward and picket captain for the Toronto General Hospital.

Eventually, all the activists were reinstated, but Ron had died by then, the one and only casualty of the strike. It wasn’t the strike that killed him, but the betrayal of union officials. In his pamphlet, Rank and File Rebellion: The 1981 Ontario Hospital Strike, Ron wrote,

“In the events leading up to the strike, during the strike and throughout the defense campaign, the union brass acted against the interests of the rank and file.”

This is Ron picketing outside the Toronto General Hospital on the first day of the strike.

Should society produce for profit or to meet human needs? Health workers face this question on the job every day. Every day, we are immersed in human suffering. And every day, we are denied the resources required to alleviate that suffering.

The only enduring solution is for the working class to manage society so that health workers can manage the health system. Until then, the business/profit model will rule, regardless of the harm it does to us and our patients.

Our first step is to build fighting unions, not talk-shops that build careers for professional union bureaucrats. And we need to organize across unions, as a class, to fight for a sane society that puts people first. That is what real socialism is – billions of people working together to take care of one another.

As a socialist, I have written many articles and several pamphlets, including Striking Flint, a narrative history of the GM sit-down strike. As a physician, I have explored the link between society and health in my newsletter, Trauma and Illness and in my second book, SICK and SICKER: Essays on Class, Health and Health Care (2010).

My first book, POWER and Powerlessness (2006), integrated my experience as a physician with my experience as a socialist. However, there is a Grand Canyon between theory and practice.

Capitalism has shown how ruthless it can be in driving down living standards in order to enrich a few. This will continue as long as workers are divided from each other and disconnected from the socialists who can help them rebuild class solidarity.

In January, 2014, I launched ReMarx Publishing to fill a void among left-wing publishers. There are plenty of books about capitalism, socialism, and working-class history. However,  many are long, academic,  and difficult to read. There is a reason for that.

As the capitalist class escalated its attacks against workers during the 1970s, many socialists sought refuge on university and college campuses. This strategy kept theoretical marxism alive, but the call to action got lost in abstract academic debates.

Today,  millions of people are looking for an alternative to heartless capitalism. They need shorter publications that are easy to read, get to the point, and offer a way forward.

No one can know the future; we can only choose what we do today. We can choose to despair, or we can choose to hope. We can choose to accept the world as it is, or we can choose to struggle against it. We can blame ourselves and each other for our misery, or we can join together to fight for a world free of exploitation, oppression, blaming, and shaming. We can exploit our individual differences to gain a personal advantage, or we can put class solidarity first.

What we choose will determine the fate of the world.

Ron and me in our backyard, 1956.

 

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