Sickness & struggle, part 3
Soviet medicine—a workers’ health plan
Published Aug 31, 2009 12:00 AM
The 1917 Bolshevik Revolution overturned capitalist property relations, smashed
the Russian state and brought a workers’ party to power for the first
time in history. This historic achievement by the working class laid the
foundation for the formation of the Soviet Union and the subsequent socialist
The revolution brought with it the radical reorganization of society, including
agriculture, industry, education and medical care. The elimination of usury in
the countryside and collectivization of agriculture was accomplished alongside
rapid industrialization in the cities.
The modernization of health care facilities and the establishment of a
comprehensive system of free universal health care accompanied these broader
Soviet health care provided for local hospitals, factory clinics, industrial
hygiene programs and neighborhood polyclinics at no cost to the patient. The
Soviet system was recognized for the great strides it made in battling
infectious diseases—such as tuberculosis and typhus fever—which had
periodically ravaged workers and peasants in czarist Russia.
In 1932 Sir Arthur Newsholme, former principal medical officer of the Local
Government Board of England and Wales, and John Adams Kingsbury, former
commissioner of public charities for the City of New York, traveled to the
Soviet Union to examine firsthand that country’s socialist health care
system. Their observations were published in 1933 as “Red Medicine:
Socialized Health in Soviet Russia.”
Their trip to the Soviet Union and the publication of their findings took place
at a time when workers in the United States and Western Europe were suffering
terrible unemployment and hardship in the midst of the Great Depression.
Newsholme and Kingsbury preface their work with this statement: “When a
Russian becomes ill the Government does something about it. In fact, Government
has already done something about it, for Soviet Russia has decided that the
health of the individual is the concern of society as a whole. Indeed, the
Soviet Union is the one nation in the world which has undertaken to set up and
operate a complete organization designed to provide preventive and curative
medical care for every man, woman, and child within its borders.”
This sweeping opening statement is backed by the account of their voyage across
the Soviet Union. The class character of the new Soviet state was also apparent
in the rights gained by workers and other formerly exploited classes to access
a number of programs and facilities designed to promote longevity and healthy
living. Sports and cultural clubs, groups for dancing and singing, and parks
and gardens for recreation were all made available with priority for workers
and poor peasants.
Similar improvements were noted in access to quality medical facilities. The
revolution saw the confiscation of the palaces and magnificent homes of the
pre-revolution aristocracy. Many of these grand estates were converted by the
Soviet state into sanatoria and rest homes for ill and disabled workers in need
of medical assistance and peaceful recuperation.
Modern hospitals and clinics were constructed and equipped with the most recent
medical technology. These facilities were staffed with highly competent doctors
and nurses with an orientation toward providing medical care as a right, not a
means to making profit.
The authors described the great gains made by women as a result of the
revolution. Equal pay was given for equal work with no distinction between men
and women in sickness insurance benefits. Public laundries, dining centers and
nurseries freed women from household bondage and paved the way for fuller
participation in industrial and political activities.
Women’s health benefits were supplemented with maternity benefits which
provided for full wages during absence from work and money allowances to
mothers on leave to nurse their infants.
In 1920 the Soviet government had repealed existing laws against abortion and
established guidelines for the procedure—the first country to do so.
Abortions were largely performed free of charge by licensed surgeons in state
hospitals with a division for that specific purpose.
In their chapter on Russian medical history and health care training, Newsholme
and Kingsbury point out that, “Priorto the Revolution, Russia was
extremely backward in its medical provision for the mass of the people. Since
that time a vast advance has been made [and] the wide sweep of the newly
organized medicine of Russia presents features from which other countries may
derive important lessons.”
The progress made by the Soviet Union in devising a real workers’ health
plan experienced a partial deterioration later as Cold War pressures strained
the Soviet economy and bureaucratic privilege became entrenched. However, these
setbacks were minimal compared to the full-blown health crisis that was forced
on the workers with the dissolution of the socialist system and the return to
The counterrevolutions that swept across Eastern Europe and the Soviet Union
from 1989 to 1991 and restored capitalist property relations also reversed the
gains workers had made in health care. The 1991 defeat of the Soviet Union
presaged a widespread health care crisis in Russia and other former Soviet
A report published earlier this year in the British medical journal The Lancet
detailed the toll capitalist restoration has taken on the health of workers.
The report, “Mass privatization and the post-communist mortality crisis:
a cross-national analysis,” was prepared by bourgeois academics at some
of Britain’s most prestigious universities. These researchers discovered
that health standards in Russia and Eastern Europe had plummeted in proportion
to the degree of capitalist reintroduction.
In capitalist Russia, the death rate of working adults rose by 18 percent and
the average life expectancy fell by five years. The death rate overall for
Russia and Kazakhstan increased by 42 percent in the early 1990s. The United
Nations estimates that, in all, the deaths of 10 million people can be
attributed to the transition away from socialism.
Next: U.S. health reform struggle during the turbulent 1960s.
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