Prefer revolutionary health movements.

Organized collectivities asserting the legitimacy of their place in organizing their experience of the health system could provide energy towards further struggles in health and beyond. Along with patients, workers themselves have clear knowledge of the issues within the field which should be married to such a movement in discrediting the positions of management, capital, and the state. Workers movements should likewise contest more control over policy, direction and administration of health institutions, and do so under self-organized workers councils allied with organized communities. This could take the form of combative communal structures uniting neighborhood, municipal, and regional community councils with horizontal workplace councils which expropriate and demand wealth from both the state and capital, and challenging the control of existing public decision making bodies.

Most importantly there is an opportunity to change what is considered a part of health. Health is not merely treating existing diseases or avoiding potential disease. Human flourishing is an expression of good health. It is also something that societies can inhibit or promote. Many things that have been constructed as natural are in fact socially shaped illnesses. For example, suicide, traffic fatalities, and concentrated urban violence represent challenges to the capitalist city and of course are significant causes of morbidity and population health burdens. Such phenomena have deep impacts on multiple points of the health system. A robust health movement could challenge urban space, transit, education, and even the type and availability of work itself in the medium term. Bringing these issues under debate and organizing actions around such, patient and workers movements could further weaken the enemies of public health and broaden the appeal of a direct action movement aimed at the welfare of society as a whole.

The automation revolution underway threatens to make our bodies mere appendages with sedentary work becoming the norm. The pantheon of chronic diseases associated with inactivity have an inherent connection to these capitalist led shifts in the production process. It is another point for a liberatory health movement to demonstrate the connection between systemic exploitation and epidemics. Liberation of time for physical activity and the fight for more human scale work that incorporates the needs of bodies could be a powerful challenge to narratives try to put the blame on individuals.

Growing social isolation is a recognized health danger and obviously connected to broader social ills. Massive resources are poured into creating infrastructure for commerce and consumption, whereas much of social planning overtly tries to minimize social interaction. This has in turn been internalized to an extent with a culture in the US of anxiety towards social interaction. Yet there is already a current underfoot of people longing to connect and interact with others outside of their chosen social circles. Health advocates can demonstrate the impact of organized social isolation arising from the priorities of the planners, legislators, and capitalists who organize collective resources in the interests of the powerful. Part of our fight is to assert new ways to utilize the time and spaces available to us for restorative and necessary social experience, and to fight for expansion of those basic human desires. As capitalism seeks to harness our time and bodies towards profit alone, such a movement can raise awareness of that tension and counterpose it to a society based on solidarity and collective enjoyment of what can be developed in common.

These few examples are far from a comprehensive list of what might be raised in a thorough rethinking of our health. But what about our long term goal? What is an alternative view of health if not a private or state-led system? We should not put too much stock in speculation and crafting blueprints. Any society-wide plan could only be created through the experimentation, input, and crafting of countless individuals. That doesn’t mean we couldn’t or shouldn’t propose broad outlines that can serve as inspiration and ethical guides. The basic functioning of any health system is to help individuals and populations achieve the greatest capacity their bodies and minds can attain. Health in short would be one portion of our quest for meaningful lives. A true alternative to the present would be a system that seeks to mobilize resources on the basis of social solidarity toward maximal expansion of individual development. This would require orienting towards health demands of the population rather than a supply oriented system such as those we see at present.

What this looks like is actually relatively simple. Workers and the community make the decisions over how to produce and distribute health resources. Workers would organize how they produce, but under the priorities and direction of community needs. Health resources would be distributed based on the needs presented with changes coordinated in realtime by workers councils and effected communities. This system would eliminate the administrative infrastructure and replace it with self-organized communal and workplace structures. It would likewise cut the vast waste and harm from unnecessary treatments aimed at profit, insulate the public from the machinations of power which today operate through money and control over hierarchies within the state and health institutions, and could provide society in general with a thriving population with positive ramifications throughout. We also have historic models we can look such as the CNT’s health services during the Spanish revolution of 1936 which approximates such in key ways.⁠19

A revolutionary health movement’s job is to put things like this one the table. Inherent to this is the fight to social space for living and play, meaningful social lives, the capacity to build families and circles, to be able to use our bodies each day and not merely for those who have time and money to afford it, and to develop our full mental and physical capacity to our own self-chosen ends without the exploitation of our bodies by workplaces, businesses, and governments. We are living in a time of unparalleled opportunity for this movement. The challenge is to now find ways in our daily lives to bring together others into an organized force that can disrupt the grip the powerful hold over health, and coalesce into a movement for more fundamental change.