Posts Tagged ‘England’

socialism

Every public opinion survey I’ve seen in recent years shows a growing interest in socialism, especially among young people.*

Socialism is an obvious solution to the most pressing economic and social problems threatening the world today, from growing inequality to climate change. But, as I’ve written before, socialism has many different meanings—both what it is or might be, and what it is not.

John Quiggin [ht: ja] suggests that what we need today is not “soft neoliberalism” (what I have referred to as “left neoliberalism,” of the sort that came to be articulated in the trajectory of the U.S. Democratic Party defined by Bill Clinton, Al Gore, Barack Obama, and Hillary Clinton and the Labor Party of Tony Blair and Gordon Brown), much less the tribalist politics of Donald Trump’s Republicans and Teresa May’s Tories, but a radically new vision—what Quiggin refers to as “socialism with a spine.”

I couldn’t agree more. Moreover, Quiggin is right to point out that,

As it is used today, the term socialism does not reflect a well-worked ideology. Rather it conveys an attitude that could be described as “unapologetic social democracy” or, in the US context, “liberalism with a spine”. It’s expressed in support for proposals that break with the cautious incrementalism of the past, and are in some cases frankly utopian: universal basic income, free post-school education, large increases in minimum wages, and so on.

That’s important, but a real alternative needs more than attitude and a grab-bag of policy ideas. After decades in which the focus has been on critiquing neoliberalism, the task of thinking about positive alternatives is urgent, but efforts in this direction are only just beginning.

But I’m not convinced by much of the rest of Quiggin’s argument, which is focused on looking backward to what he considers to be the “social democratic moment of the 50s and 60s” and forwards in terms of “a genuine sharing economy based on the internet and other technological advances.”

The backwards move uncritically celebrates the supposed successes of Keynesian macroeconomic management and, looking forward, narrowly focuses on the possibilities opened up by digital technologies.

While I’m all in favor of articulating a vision of a “genuine sharing economy”—because, if socialism is nothing else, it certainly means, as Jeremy Corbyn put it, “You care for each other, you care for everybody, and everybody cares for everybody else”—I think we can do better than limiting ourselves to Keynesian full employment and the production of information.

We have to remember that the middle of the twentieth century, which turns out to have been a unique period of sustained economic growth and full employment in developed market economies, also meant long hours of drudgery in factories and offices to the benefit of employers, who retained both the interest and means to evade and ultimately overturn the regulations that had been implemented during the first Great Depression. Which of course they did, culminating in the crash of 2007-08. Why would we want to repeat the mistakes of that period?

And, looking forward, the emergence of new digital technologies, by themselves, doesn’t make socialism any more possible than the waves of innovation we’ve witnessed in the past. And focusing on the new technologies just puts the idea of socialism beyond anyone who is not already enamored of digital connectivity and social media—and therefore all but the youngest members of the working-class.

The task, it seems to me, is to articulate a vision of socialism that is predicated not on a nostalgia for the past or the role of a particular set of technologies, but on the persistent and growing gap that exists between the conditions of contemporary life and the possibilities created by existing forms of economic and social organization.

Thus, for example, instead of railing against Wall Street and increasingly concentrated industries, why not imagine the possibilities that capitalism itself has created both to eliminate the need for capitalists and to easily administer large parts of the economy to the benefit of everyone?

By the same token, why not build on the idea that, today, it is increasingly recognized that decent jobs, healthcare, education, and retirement are rights, not privileges, but that those in charge prevent those rights from being fulfilled?

Socialism is born out of that yawning crevasse between reality and promise—by articulating a set of changes in the existing reality that move us closer to that real promise.**

And here I think Quiggin and I may actually be in agreement:

Socialists have always seen short-term political struggles as part of a long-term project of transforming society for the better.

 

*For example, according to the 2016 Gallup Survey, 35 percent of Americans have a positive view of socialism (itself a remarkably high figure, given the Cold War legacy in the United States), which rises to 55 percent for Americans age 18 to 29. And while only 13 percent of Republicans and Republican-leaners have a positive view of socialism, 58 percent of Democrats and Democratic-leaners view socialism in a favorable light.

**To be clear, it’s not just a question of defining socialism; we also need to discuss the strategic issue, of where and how a reborn socialist movement can build a political and social base. As Bill Fletcher explains, with respect to “the growth in interest in socialism, broadly defined, among a large number of people, particularly younger people.”

That is fantastic!  But it is far from clear that they are wedded to a class project, except in a very abstract sense. And that difference is fundamental. It’s not just an ideological question; it is also a strategic question.

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As I’ve been discussing over the course of the past week, the U.S. healthcare system is a nightmare, at least for workers and their families. It costs more and provides less than in other countries. Employees are being forced to pay higher and higher fees (in the form of premiums, deductibles, and other charges). And it relies on a private health-insurance industry, which is increasingly concentrated and profitable.

What about the other part of the system, the actual provision of health care? I’m thinking, in particular, of the pharmaceutical industry (which I focus on in this post) and hospitals (which I’ll take up in a future post).

According to a recent study by the Wall Street Journal, consumers in the United States nearly always pay more for branded drugs than their counterparts in England (39 higher and 1 lower), Norway (37 higher and 3 lower), and Ontario, Canada (28 higher and 2 lower). Thus, for example, Lucentis (which is used for the treatment of patients with wet age-related macular degeneration and other conditions) costs $1936 in the United States but only $894 in Norway, $1159 in England, and $1254 in Ontario. The same is true for many other drugs, from Abraxane (for treating cancer) to Yervoy (for treating skin cancer).

Part of the reason is that, in other countries, public healthcare systems have substantial negotiating power and are able to bargain with pharmaceutical companies for lower prices (or, in the case of Canada’s federal regulatory body, to set maximum prices). The U.S. market, however, “is highly fragmented, with bill payers ranging from employers to insurance companies to federal and state governments.” In particular, Medicare, the largest single U.S. payer for prescription drugs, is legally prohibited from negotiating drug prices.

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On the other side of the market, the U.S. pharmaceutical industry has become increasingly concentrated through a wave of numerous and increasingly large merger-and-acquisition deals. According to Capgemni Consulting, since 2010, approximately 200 pharmaceutical and biotech deals have taken place per year in the United States. 2014 saw several of the largest deals in the pharmaceutical industry to date, including the $66-billion purchase of Allergan by Actavis, Merck unloading its consumer health unit to Bayer, GSK and Novartis’s multibillion-dollar asset swap, as well as Novartis’s animal health unit sale to Eli Lilly.

Although high-profile, major acquisitions outweigh other deals by value, over 90 percent of deals were relatively small in size (less than $5 billion). Clearly, the motivation in these smaller deals is different.

Failure of bigger pharmaceutical companies to consistently develop new drugs and pressure from shareholders to deliver returns have forced large pharmaceutical companies to look outside for innovative drugs. This has resulted in new drug approvals emerging as a major trigger for acquisitions.

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The fragmented, unregulated system of drug purchases in the United States, combined with growing concentration of the pharmaceutical industry, means that health technology—with a 20.9 percent net profit margin—is now the most profitable industry in the country.

High drug prices are one of the key factors behind rising U.S. healthcare costs, and one of the main reasons why American workers pay more and yet receive poorer healthcare than in other rich countries.

Addendum

As if to confirm my analysis of the role of the pharmaceutical industry in creating a nightmarish U.S. healthcare system, we now have the examples of the Epipen and Pfizer.

As Aaron E. Caroll explains, the story of EpiPens is not just about how expensive they’ve become; it also reveals “so much of what’s wrong with our health care system.”

Epinephrine isn’t an elective medication. It doesn’t last, so people need to purchase the drug repeatedly. There’s little competition, but there are huge hurdles to enter the market, so a company can raise the price again and again with little pushback. The government encourages the product’s use, but makes no effort to control its cost. Insurance coverage shields some from the expense, allowing higher prices, but leaves those most at-risk most exposed to extreme out-of-pocket outlays. The poor are the most likely to consider going without because they can’t afford it.

EpiPens are a perfect example of a health care nightmare. They’re also just a typical example of the dysfunction of the American health care system.

And then we have Pfizer’s purchase of part of AstraZeneca’s antibiotics business, which doesn’t involve the development of any new drugs but (for $550 million upfront plus an unconditional $175 million in January 2019, and possibly a further $850 million plus royalties), Pfizer will have the right to sell three approved antibiotics and two drugs in clinical trials in most markets outside the U.S. and Canada, plus an additional drug (Merem) in North America.

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Jolly-OLD England. . .

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This particular protest dates back to 22 May 1816, in Littleport [ht: ja], when about 100 workers left The Globe armed with pitchforks, cleavers, and guns and smashed windows and broke down doors, stealing money, food, and goods from their wealthy neighbors.

The Littleport Riots were not isolated events, but part of “a wave of unrest” from 1815 onwards, according to Anglia Ruskin University historian Rohan McWilliam.

“There was economic dislocation after the end of the Napoleonic Wars and the introduction of the Corn Laws in 1815, which increased taxation on wheat,” he said.

“Labour wages weren’t keeping up with the cost of living, while poor harvests exacerbated the situation.”

Previously common land, on which labourers could grow crops or keep livestock to supplement their wages, was being enclosed by landowners.

Their employment conditions had also changed, said University of Hertfordshire historian Katrina Navickas, to “daily hirings instead of yearly hirings – in essence, the introduction of a type of zero-hours contract”.

This was exacerbated by a breakdown of the Poor Law, which was supposed to help the most vulnerable based on need with small sums of money and “in kind” goods such as shoes. . .

And then to tighten the screw still further, the Game Laws passed in 1816 restricted the hunting of game to landowners, with transportation the penalty for poaching – or even being found in possession of a net at night.

The disturbance broke out when a group of mostly unemployed men met at the Globe Inn, for a meeting of the village Benefit Club.

More than 300 people eventually participated in the riot, which spilled over into Ely and was put down on 24 July by the Cambridgeshire Militia and the 1st (Royal) Regiment of Dragoons.

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On 28 June 1816, five men were hanged, “having been convicted of divers Robberies” during the riots.

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Leicester City was not going to win the Premiership—not by a long shot. Nor was the Republican nomination supposed to be handed to Donald Trump. And Bernie Sanders, well, there was no chance he was going to give Hillary Clinton a serious run for her money (and machine) in the Democratic primaries.

And yet here we are.

Leicester City Football Club, as anyone who has even a fleeting interest in sports (or reads one or another major newspaper or news outlet) knows, were just crowned champions of the Premiership, the highest tier of British football, after starting the season at 5000-1 odds. There really is no parallel in the world of sports—any sport, in any country. (By way of comparison, Donerail, with odds of 91-1 in 1913, is the longest odds winner in Kentucky Derby history.) And the bookies are now being forced to pay up.

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Similarly, Donald Trump was not supposed to win the Republican nomination. Instead, it was going to go to Jeb Bush and, if he failed, to Marco Rubio. (And certainly Ted Cruz, the candidate most reviled by other members of the GOP, was not supposed to be there at the end.)

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Finally, Bernie Sanders’s campaign for the Democratic nomination was written off almost as soon as it was launched. And yet here is—winning the Indiana contest by 5 points (when it was predicted he would lose by the same number of points) and accumulating enough pledged delegates to be him within a couple of hundred of the presumptive nominee.

What’s going on?

In all three cases, the presumption was that the “system” would prevent such an unlikely occurrence, and that the pundits and prognosticators “knew” from early on the likely outcome.

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So, for example, the winner of the Premiership was supposed to come from one of the perennial top four (Manchester United, Chelsea, Arsenal, and Manchester City)—not a club that were only promoted from the second division of British football in 2014 and last April were battling relegation (they finished the season 14th).

Pretty much the same is true in the political arena: neither Trump nor Sanders was taken particularly seriously at the start, and along the way the prevailing common sense was that their campaigns would simply implode or wither away. The idea was that the Republican and Democratic parties and nominating contests were structured so that their preferred nominees would inexorably come out on top.

There are, I think, two lessons to take away from these bolts from the blue. First, the “system,” however defined, is much less complete and determined than people usually think. There are many fissures and spaces in such systems that make what are seemingly unlikely outcomes real possibilities. Second, our presumably certain “knowledges” are exactly that, knowledges, which are constructed—in the face of radical uncertainty—out of theories, presumptions, blind spots, and much else. The fact is, we simply don’t know, and no amount of probabilistic certainty can overcome that epistemological gap.

So—surprise, surprise—Leicester City and Trump won, while Sanders has put up a much more formidable challenge than anyone expected from a socialist presidential candidate in the United States.