Workers Voice

United States ☒
Vietnam ☑

By Gregory William

There is a crisis of rural health care in the U.S. Since 2005, over one hundred rural hospitals have closed across the country. Many more are on the verge. A study by the North Carolina Rural Health Research Program found that of the 89 hospitals that have closed since 2010, the vast majority (67) were in the South.

The authors of the Rural Health Research study note that the increase in closures coincides with the 2008-2009 recession, meaning that it is tied to the cyclical crises inherent in the capitalist system. Closures also accelerated in states that did not accept Medicaid expansion. In these mostly southern states, people also tend to be poorer, are more likely to be uninsured, and therefore cannot pay for care. Since our medical system is based around corporate greed and not people’s needs, the closure of hospitals and other healthcare facilities is unsurprising. In fact, the majority of hospitals that have closed are privately-owned, that is, for-profit hospitals.

It’s been drilled into our heads that the market always knows best, that if everything is privatized and for profit, things will run more efficiently. However, we see that the profit motive leads to extreme inefficiency and worse, hardship for the masses of people. How is this reasonable?

Communities across the U.S. lack hospitals and even basic clinics, and people cannot afford care. And yet, there is a parasitic class of “healthcare billionaires,” like Thomas Frist Jr., co-founder of the Hospital Corporation of America. His net worth is $11.6 billion, making him the wealthiest person in Tennessee. This is ironic considering that Tennessee had the highest number of hospital closures after Texas!

Of course, it doesn’t have to be this way. The U.S. has a GDP of about $20 trillion, almost 90 times the size of Vietnam’s GDP ($223.9 billion). Despite having a much smaller economy, Vietnam assures that every ward in the country (including in rural areas) has a clinic. When there isn’t a resident doctor in a village, the Ministry of Health assigns doctors to rotations. Vietnam is also on track to ensuring health coverage to all citizens.

This isn’t an accident. The fact is that Vietnam still has socialist, rational economic planning. Because they had a socialist revolution, the masses of working people have a real say over the direction of the country’s development (even if the government has allowed some capitalism to return).

The state still owns the oil and gas industry, and mostly controls banking, insurance, mobile service, construction, electricity production, ship-building, and many other industries. Land cannot be bought or sold because it belongs to the entire people. Because there is socialist, collective ownership in the economy (without profit being the only consideration), the government can make rational decisions about what to do with social resources. They can say,

“People in this area need a hospital, so we will build a hospital. This clinic doesn’t have a doctor, so we’ll assign one to work there.”

Again, all this is possible because working class and oppressed people fought for these things and won. Collectively, we too have to make the decision that our health—our lives—will not be a commodity. We have to organize to take power and overthrow the capitalist class so that we can pursue socio-economic development that meets the needs of the people and doesn’t destroy the planet.