Process
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Highlights
Time 0:09:13
1min Snip Transcript: Howard Waitzkin Classification of type of economy and includes the dependent variables that we consider in addition to that, which are health outcomes, educational outcomes, and a number of other Outcomes grouped under the Physical Quality of Life Index, which is an index that actually the World Bank and collaborators developed. So, we were simply taking data and decisions about how to classify countries from the World Bank. They didn’t call it socialist or capitalist. They called it market versus non-market or a similar set of terms. But these corresponded directly to capitalist versus socialist countries, with the exceptions of the recently post-revolutionary countries, most of which were socialists, but Hadn’t been in existence long enough to see any impacts of the changes in social policy. So we considered that as a separate category. And then there was another group of countries that were countries that basically produced petroleum and so were very wealthy countries, but not in the sense of sharing the wealth
Time 0:14:23
1min Snip Transcript: Tony Given this data, what were the conclusions of the study, and what do they tell us about the multitude of actually existing socialism nations as they were in the 1980s, and also just socialism In general? Howard Waitzkin I think you’ve touched on the main conclusions and the way you summarized it, which was an excellent summary. I could add that for me, I was quite shocked by these results, even though I was very supportive of what was happening in multiple of the socialist countries for various reasons. I actually didn’t expect that it would be so clearly shown when the comparisons were made in this way. We didn’t do a multi-method study. So we didn’t, for instance, have qualitative information about the policies that existed in each country to accomplish this. But in our study of those countries, not that we published, but our personal study, it was clear that essentially all of the socialist countries had very clear, well-worked out policies, Delivering health services, training health professionals, maternal and infant care programs to address
Time 0:15:26
1min Snip Transcript: Howard Waitzkin Out policies, delivering health services, training health professionals, maternal and infant care programs to address infant mortality and child mortality, nutritional programs That also help with those things, very extensive changes in the educational systems to address illiteracy and other problems related to undereducation. So that’s what we presume was the mechanism by which these dramatic differences occurred. Tony It sounds like you were surprised by the data that was collected in the findings, but was there a specific piece of information that you came across that was specifically surprising To you? Howard Waitzkin The information about nutrition was probably, I would say, the most surprising because multiple of the countries were actually dealing with major challenges in terms of food accessibility, In terms of weather, they were going through some famine conditions from time to time, and also lacked infrastructure for farming that was in any way comparable to the higher income Countries.
Time 0:21:58
1min Snip Transcript: Howard Waitzkin Has been accomplished. But there was actually no way feasibly to do that at the time. So anyway, I have to disappoint you, and then I have very little to say about criticisms, which was very, very surprising to us at the time. Tony Would you say that you’ve heard of any common misconceptions about interpreting the findings? Do people sometimes overstate the findings or maybe understate the findings? Have you come across that at all in discussions about the paper? Howard Waitzkin Occasionally, I’ve had feedback from comrades, let’s say, on the left, it doesn’t address the problems of some of the socialist countries in terms of becoming state socialist or state Capitalist countries. So this is a common criticism of the Soviet Union, for instance, how it actually, by preserving the capital system, it actually became in many of the same ways that happened in capitalist Countries. The emphasis on productivity, for instance, led to major environmental problems, occupational health problems,
Time 0:22:50
1min Snip Transcript: Howard Waitzkin Actually, by preserving the capital system, it actually became in many of the same ways that happened in capitalist countries. The emphasis on productivity, for instance, led to major environmental problems, occupational health problems, and so forth. So we didn’t get into that in the article, and it’s been pointed out that we should have been more critical of some of the socialist countries than we were. Again, I hesitated at that time to go there. Oh, and let me say also, and then there was a whole issue of Stalinism. Here’s a presentation of the good outcomes in the Soviet Union, but not addressing the problems of Stalinism. That was another critique. I was hesitant to go there, and I still am, because of the constant attack that was underway about all those countries from the beginning of their trajectories as socialist countries. So you had massive destabilization efforts affecting the Soviet Union and the countries in Eastern Europe and the so-called Soviet bloc,
Time 0:23:47
1min Snip Transcript: Howard Waitzkin Of their trajectories as socialist countries. So you had massive destabilization efforts affecting the Soviet Union and the countries in Eastern Europe and the so-called Soviet bloc, and orchestrated military and economic And other destabilization efforts choreographed by the CIA and other intelligence agencies from Britain and elsewhere in Europe in the lower and low middle income countries. What happened, let’s say, in Stalinism or in state socialism, there also is a context that that needs to be considered. And what happened afterward, of course, was that some of the advances that we reported on deteriorated. A good example was Vietnam, for instance, where it was said, and still is said, that Vietnam won the military war and then lost the war to the World Bank, because, you know, essentially All the socialist countries were confronted with the same problem that Lenin described, which is the problem of socialism
Time 0:24:44
1min Snip Transcript: Howard Waitzkin The military war and then lost the war to the World Bank, because, you know, essentially all the socialist countries were confronted with the same problem that Lenin described, which Is the problem of socialism in one country or the problem of trying to advance economically and in terms of human services and education and all the rest, when there wasn’t a large enough Group of countries to actually collaborate and exchange trade and exchange technical resources and so forth. The ability to maintain a strictly socialist system changed a great deal during the late 70s, the 80s, and 90s because of a number of those factors. Tony I think that analysis you just provided is incredibly important to understand because the history of socialist countries, particularly in the West, is presented in such a way that All conflicts that occur within socialist countries or any negative impact on the citizens of those countries is the sole result of socialism itself. And meanwhile, the inverse or the
Time 0:28:33
1min Snip Transcript: Tony And socialist nations, but I’ve never seen another study like the one you’ve done. Why do you think that is? Right. Howard Waitzkin So there are various political economic variables that continue to be studied. For instance, the role of government in organizing national programs of health services. And there was actually a systematic review of those that came out in the American Journal of Public Health a couple of years ago, you know, that basically showed that countries that Have strong political and economic policies favoring the delivery of services, as far as possible, in a unified health system that isn’t organized according to different types of Services for different people. Those countries actually had much better outcomes. But the reason that you haven’t seen any studies like it, and the reason that I haven’t tried to replicate it, unfortunately, very unfortunately, Shirley passed away shortly after The article was published. I’ve tried to figure out how to do it again. What happened is that the World Bank, shortly after the study was published, changed the way that they presented these data.
Time 0:29:27
1min Snip Transcript: Howard Waitzkin Very unfortunately, Shirley passed away shortly after the article was published. I’ve tried to figure out how to do it again. What happened is that the World Bank, shortly after the study was published, changed the way that they presented these data. So, for instance, the classification according to market versus non-market kind of changed. And the whole thing became much more oriented to development level than political economic system. And so it’s really hard to get data as systematically and extensively available now from the World Bank or any other source than it was at that time. And the other reason was because, you know, some of the socialist countries have arrived at forms of political economic organization that can’t be neatly classified in the same way. Let’s take China, for instance, or Vietnam, for that matter. So these are countries that have substantial parts of the economy that are in the private sector and run by markets.
Time 0:30:32
1min Snip Transcript: Howard Waitzkin Of the economy that are in the private sector and run by markets. And they’re essentially capitalist sectors of the economy, plus huge public state sectors. They’re actually bigger than the private sectors. And the leadership of those countries try to use the income generated and the wealth generated by the capitalist sectors of the economy to basically redistribute wealth. And for example, in China, under this policy, there’s been the most massive change in the distribution of wealth in the history of the world, essentially the elimination of extreme Poverty from China in a period of 20 years. And I’m not expressing my enthusiastic support for that approach at all. Countries with a combination of a capitalist sector within an officially socialist regime. Now, the interesting thing historically about that is that this was actually part of Lenin’s plan. So Lenin is often misconstrued as saying that, you know, through the dictatorship
Time 0:32:03
1min Snip Transcript: Howard Waitzkin Markets in particular, community-based markets, and an effort to decentralize the command structure of the economy. So this was a Leninist idea. And actually, its history to me has been very interesting. I’m not an expert on it. I did discover at one time that Che Guevara’s economic writings, which have yet to be published in English, they’re basically called the economic manuscripts. And they consist of a very strong critique of Stalinism in terms of economic policy. And it focuses on exactly this situation of over-centralization, too much command structure within the national economy, lack of adequate decentralization, and a lack of freedom Of people at the lower level to carry on their own market-based activities, which is not to say they’re capitalist activities, just because they’re market-based. In other words, they don’t involve the extraction of surplus value from workers. In other words, capitalists sit around, and no matter how nice they are, they
Time 0:41:56
1min Snip Transcript: Howard Waitzkin But it’s been accomplished and verified in North Korea. Now, what I’m saying to you was absolutely astonishing to me. I was not expecting to find any of this. And so, you know, what happens when you actually take the time and energy to look into it, you know, it’s pretty amazing what you can find in terms of who has better outcomes. Now, I’m trying to, with a couple of colleagues, trying to do something similar in terms of how the pandemic has been handled and what the outcomes there have been. So we have a number of the so-called ex-socialist countries that are actually officially socialist countries with capitalist sectors of the economy like China, Vietnam, and so forth. And you have regions like Kerala state in India, which is basically a left-wing socialist run state. And then you have Cuba, and then you have Venezuela and Nicaragua, and so forth. And when you look at what actually has happened in those countries, all
Time 0:44:35
1min Snip Transcript: Howard Waitzkin Much gave up on its epidemiological accomplishments during the Omicron phase. So it’s actually the worst phase of the whole pandemic that’s going on now here. And the most deaths in a day for the whole pandemic happened two days ago here. But in general, the numbers of deaths and cases are a fraction of what they’ve been in the vast majority of other capitalist countries. And the reason that’s happened is also by community-based mobilization in South Korea. It’s done because there’s a well-organized public health structure in every county. And the whole pandemic has been managed at the county level here. Testing, diagnosis, interventions, home visits. So it’s not just the central government in the officially socialist countries now, or the central government in capitalist countries like Korea, that are actually accomplishing The much better processes and outcomes in those countries. It actually has to do with community-based mobilization, which is part of