Human Rights as a concept of universal freedoms and securities to which every homo sapiens is entitled, regardless of biological, economic, or political prerequisites, stands at odds with the core characteristics of the capitalist system. Perhaps the most exemplary illustration can be witnessed in the treatment of healthcare systems. The contrasts between the capitalist model as seen in the United States and the humanist model viewed through the diligently anti-capitalist Chiapas are stark; If Chiapas is a living, entangled, and inclusive representation of the possibilities for health, then the US system is its morbid, segregated, and discriminatory counterpart. The commodification of healthcare creates death, not the “right to life, liberty and security of person” proposed in the Universal Declaration of Human Rights.
Healthcare came to international attention in the West during the first Geneva Convention in 1864. Limited to wounded combatants, this treaty promised aid of the sick and wounded during warfare. After several subsequent agreements, it was not until 1949 that this grace was extended to civilians. Even after 85 years of health services being available to soldiers, prisoners, and healthcare workers, treatment of civilians was not all-inclusive. Article 4 of the fourth Convention demonstrates an explicit set of requirements defining which civilians should be protected. Instead of protecting people as defined solely by their existence, International Humanitarian Law determines aid by an individual’s affiliation to an institution or power, stating that only those in conflict situations who are citizens of countries (and their allied countries) that ratified the Convention will be honored. In short, one’s support of, or perhaps sheer luck in being associated with, those in power qualifies an individual to receive healthcare.
The Universal Declaration of Human Rights, however, made an effort to broaden the category of those qualified for receipt of rights to “everyone … without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status … political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.” While the rhetoric of Article 2 seemed to shed the restrictive elements of the Geneva Conventions, this Declaration and its authors neglect to acknowledge the power relations to which it and the world at large are subject. The Declaration’s ideals were noble, but without sufficient thought aimed at attainment of rights in the reality of dominating, oppressive institutions, it falls short of offering any more life than its precursors. The notions put forth were ineffectual suggestions, serving it seems as an obsolete, utopian reminder of the naïve perspectives systemic exploitation requires to “keep calm and carry on.”
Until the UN identifies and formulates a stance against the powers that systemically cause death and illness (be it authoritarian or emancipatory), the Western world is largely left to bear those structures as a sort of life support, even if the cost is the barrier to health itself. The US system has more than a few examples to demonstrate. Government officials are granted free, “universal” healthcare, a reward for their compliance and support of the exclusive, synarchistic status quo. Employees are given insurance based on their relationship to the employer. Part time, new, underaged, or independent workers—candidates for exploitation and disposal—are denied benefits. Meanwhile, since a steady, semi-skilled labor force is needed to provide obedient workers and another market for domination, employees with more experience, skills, or prestige are rewarded with insurance packages, their compliance procured.
Those in power determine the beneficiaries and the terms under which they qualify. In the case of healthcare in a capitalist system, this is never more obvious than in terms of economy. Those with more wealth control the health insurance premiums, cost of medical equipment, and educational requirements and availability for physicians (Never mind the political decisions and public opinions crafted by those with the resources to empower themselves for quick and easy domination). Capitalism breeds inequality. This manufactured scarcity is essential for upholding the current hierarchy. Scarcity creates a need for competition—that would otherwise cease to be purposeful—as individuals in a capitalist system are faced with choices between survival or cooperation, the ruthless ambition needed to gain access to wealth or death. Those who lack wealth are severely disadvantaged in the US healthcare system, unable to afford oftentimes the most basic of treatments. Since markets do not actually expand infinitely and resources are in fact limited, as the rich get richer, so the poor become more and more desolate. As Primo Levi observed, “Privilege, by definition, defends and protects privilege.” 1
Commodification of the healthcare system assists in expanding wealth for power elites and draining it from those under their domination. By limiting the number of physicians and medical facilities, healthcare corporations (the term “healthcare provider” in the US is often misleading, when used to describe the multi-billion dollar industry) create the limited supply needed to justify rising costs and discriminatory practices. The prices of medications and medical services cater to the budgets of the wealthy, while most working and middle class Americans can rarely afford them.
Even the goals of the healthcare system, once commodified, directly oppose the goals of the sick. The ill individual seeks health and wellbeing, while the commodified health system ultimately craves profit. The two are so alienated that it is not out of the question to propose that the more sick there are, the more wealth there is to be derived from those who seek health—to a degree that commodification of healthcare is detrimental to health itself, if not all universal human rights. Many might say that there is ample availability of healthcare in its commodified state primarily via emergency room visits. However, given the exorbitant price of such a visit, for the average American to pay for this visit often entails the denial of other human rights, for example, food and shelter. By alienating the patient from the healthcare system and creating scarcity of available resources, commodification of treatment straitjackets the ill to multiple inadequate options.
The Mayan communities in Chiapas are well aware of the discrepancies between rights and commodities, life and exploitation. As Farmer notes, a common observation among Chiapans is the idea that “Chiapas is rich; Its people are poor”. 2 Having witnessed the manufacturing of scarcity and redistribution of wealth throughout local history, the people have begun to stand against the commodification of rights by creating an entangled, inclusive, and cooperative model of treatment. “Prosperity of the few cannot be based on the poverty of the many,” states EZLN spokesman, Marcos.2
While Chiapas does not receive much aid from the Mexican government, donations have provided some access to medical training and equipment. Rather than sewing the seeds of scarcity by limiting knowledge to the few, local “health promoters” share information and work with formally-trained physicians to reach those in need. Similarly, health promoters define themselves as “multiethnic,” demonstrating their inclusion of others.2 Likewise, the women’s movement in Chiapas has focused on healthcare for women, but acknowledges that the movement includes the community as a whole, emphasizing that women’s health is inseparable from the wellbeing of their children, fathers, spouses, and the entire society.3 In the incorporation of and cooperation with their communities at large, Chiapans have developed a rich healthcare system wherein the goals of the system coincide with those of the society it serves. This differs significantly from the US model, where profits take priority over wellness.
Bryan Turner writes that “rights are merely ideological notions if they are not supported by real social and economic resources.” 4 The commodification of rights limits these resources by privileging those in power and disadvantaging the poor. This creation of inequality promotes illness, not health, and alienates the ill from actual healthcare solutions by seeking first wealth and the power it accompanies. Conversely, a model that embraces health as a systemic goal without seeking profit, such as that of Chiapas, Mexico, reconciles the sick and their right to healthcare.
- Levi, Primo
1986 The Drowned and the Saved. Summit Books. [↩]
- Farmer, Paul
- Villarreal, Gina
2007 “Health Care Organized from Below: The Zapatista Experience.” Nacro News Bulletin. 11 January 2007. [↩]
- Turner, Bryan
2006 Vulnerability and Human Rights. The Pennsylvania State University Press. [↩]