KADUNA STATE UNIVERSITY

Faculty of Social and Management Sciences

Department of Sociology

Course: SOC 809- Advanced Theories of Health and

Illness

Assignment Question: The Marxist views of Health and Illness

SUBMITTED BY

HARUNA ABUBAKAR KASU/MSC/SOC/20/0006

UBANI DAVID NUHU KASU/MSC/SOC/20/0003

TO

Jacob Gandu Phd

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 INTRODUCTION

Karl Marx (1818-1883) was a German philosopher, critic of political economy,

historian and a sociologist. Marxism is a social, political and economic theory

originated by Karl Marx which focuses on the struggle between capitalist and the

working class. Marx wrote that the power relationship between the capitalist and

workers were inherently exploitative and would inevitably create class conflict.

Marx most popular theory was historical materialism, arguing that history is

the result of material conditions, rather than ideas. Marxist theory has been used to

explain a wide range of social phenomena, including wars, revolutions, poverty,

discrimination, illness and domestic violence. It ascribes most of the fundamental

developments in human history, such as democracy and civil rights, to capitalistic

attempts to control the masses (as opposed to a desire for social order). Central

tenets of Marxist theory are the concepts of social inequality, the division of

resources, and the conflicts that exist between different socioeconomic levels of

the society.

Marxist studies of medical care emphasize political power and economic

dominance in capitalist society. The health system mirrors the society's class

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structure through control over health institutions, stratification of health workers,

and limited occupational mobility into health professions. An assumption here is

that the problems of the health system reflect the problems of our larger society

and cannot be separated from those problems.

Marxist views on Illness and Disease

Marxist theories of health and medicine grew from critiques of the works of others.

For a start, there were many medical theories of diseases in use during the mid-

19th century, with no particular theory dominant. It was a period well-prior to the

establishment of the biomedical orthodoxies of the 20th century, where successful

claims for disease as a physiological or biological phenomenon were in place by

the 1930s in many Western countries

Thus Marx and Engels were arguing for a new theory of disease which was

radically different from those popular at the time: liberal theories, where disease

results from the ‘inherently weak’ bodies of the poor; medical theories, where

disease stems from a fixed, natural entity or pathogen; and the evolutionary

theories of Social Darwinism, where diseases are natural and inevitable,

eventually eliminating the weaker races and ‘improving’ the human species (Marx

and Engels, 1976)

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MARXIST CONTRIBUTIONS TO HEALTH

The beliefs system of the society has a great impact of

CRITICISMS OF MARXIST CONTRIBUTIONS TO

purpose is profit making rather than provision of quality medical care. In a socialist

state where the government is responsible for the provisions services to the people,

the government will be more concerned with the number of people who will be

able to access drugs and medical care rather than the exploitative motive of profit

making of capitalism.

Marxist studies of medical care emphasize political power and economy

dominance in capitalist society. The state intervention in health care generally

protects the capitalist economic system and the private sector. Medical ideology

helps maintain class structures and patterns of domination.

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  The role of power

Marxist theorist such as Navarro, in his analysis believes that the power

structures of any society cannot be separated from the nature of its health

care delivery system. The kind of people in power will determine the nature

of health care delivery system of any given society.

 Economy system
Marxist views the society as a capitalist society. It also sees health care as a

product of the highest bidder. The economy system of a society is

significant in determining the nature of its health care delivery. In a

capitalist economy society, not everyone has equal access to health care

delivery because medical practices and pharmaceuticals companies are

geared towards profit making. Investors in health care are more concerned

with the rate of sales and not the numbers of people who are able to access

health care or drugs.

 Ideologies

Historical Materialism, Capitalism and the Healthcare Industry

Marx and Engels’ commitment to historical materialism provides us with a crucial

means to understand health, healthcare and healthcare systems in the contemporary

context. Unlike other methods of analysis, this insists on recognizing the historical

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nature of current systems of healthcare, the way these have been produced through

struggle and conflict, and how they continue to change with such developments as

new production methods or forms of exchange and new technologies.

While other medical sociologists take the clinic and the patient-doctor relationship

to be the central concern of modern healthcare, Marxian inspired sociologists focus

on the production of ‘health’ through the formation of a capitalist, healthcare

industry. They seek to demonstrate the healthcare system as a site for commercial

transactions, a market place and a site for the production and consumption of

capitalist commodities. Marxists believes that the state's intervention in health care

generally protects the capitalist economic system and the private sector.

The growth of Marxian analysis in the sociology of health and medicine

challenged prevailing functionalist analyses debating the basis of power of the

medical profession and its changing relationship with other occupations and the

nation state. Moreover, under a capitalist system, it is the elites and the middle

class that benefit most from healthcare services: capitalists make profit on the

stock exchange or in the ownership of businesses (including medical practices and

hospitals), and managers, doctors, social workers, politicians and teachers make a

good living from selling their ‘expertise’ as professionals. From this perspective,

the central aim of capitalist medicine is profit, not the creation of good health

(Lawrence, 1994).

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Poverty, Poor Living Condition and Illness

Marx and Engels acknowledged the ‘stagnant pools’ and ‘putrefying vegetable and

animal substances’ that’ give off gases decidedly injurious to health and poison the

atmosphere’ of the working people’s quarters in the big cities (Engels, 1969). Yet

the lack of drainage, garbage collection, and poor design of the houses were

associated with disease and ill-health (Engels, 1969).

Like their contemporary (Florence & Rosenberg, 1992), Marx and Engels

challenged theories that were individualistic and reductionist, seeing these as

obscuring the true nature of the problem and justifying a lack of political action to

prevent disease. Instead Marx and Engels argued that ill-health and disease is a

product of the way humans organize and act on their social world as they go about

working and living in a particular kind of society.

The more prevalent view at the time, particularly among the elites, was that

poverty was the product of the weaknesses and inabilities of the poor themselves

(Marx and Engels 1976).

They also took on Malthus as a representative of the bourgeoisie for his ‘Open

declaration of war on the proletariat’, for Malthus voiced the ideology of Social

Darwinism, proposing that the poverty and starvation of the working class are an

inevitable consequence of the laws of nature (Engels, 1969).

Health and Illness as Commodities

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Contemporary Marxian analysis has also focused on the buying and selling of

healthcare services and organizations (including hospitals, clinics and diagnostic

laboratories) in both national and international markets.

Over the past four decades, medical sociologists inspired by Marxian analysis have

been exploring the form of medicine developed under capitalism. The general

consensus is that capitalist medicine is characterized by a focus on cure, rather than

the prevention of disease, and it is ‘objectified’ medicine, that is, it focuses on

specific parts of the body – an organ, limb, the lymph system – thus separating the

‘social individual’ from the physical body, often leading to complaints from

patients about the loss of identity as they become ‘the cancer’ or ‘heart attack’, and

obscuring the social determinants of ill-health.

Moreover, with commoditization, health’ itself becomes a commodity to be

bought and sold, relationships between professionals and patients are purchased on

the market, and new ‘needs’ are continually created in the pursuit for

profit(Marshall and Daar 2000).

In recent decades, the commoditization process has been extended from the

production of basic commodities, such as medicines and machines, to the

commoditization of body part sand even body itself. In this process, people and

bodies are transformed from a human category into objects of economic desire.

Human organs, for example, form the basis of a world-wide trade in transplantable

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body parts, where commoditization has created two classes of people: organ buyers

and organ sellers. Research has indicated that the trade in body parts (where living

persons are used in clinical trials or research experiments), follows class lines. It

relies heavily on the use of poor and marginalized populations as subjects and

donors, while the profits and the benefits of the trade are expatriated to wealthy

countries and population groups (Nguyen and Peschard, 2003).

In this process the body is reduced to a ‘source of raw material for saleable

products’ and yet the cruelties and inequalities of organ exchange and the

commoditization process are obscured by a rhetoric of ‘gift exchange’ (Andrews

and Nelkin, 1998).

Conclusion

In conclusion, Marxist approach believes that the health system mirrors the

society's class structure through control over health institutions and that the

problems of the health system reflect the problems of our larger society. So also

poverty and poor living condition of masses as well as monetization of the health

care services have created two classes of people. . Moreover, under a capitalist

system, it is the elites and the middle class that benefit most from health services.

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References

 Engels, F.(1969) The Condition of the Working Class in England

(introduction by Eric Hobsbawm) Panther Books: St Albans.

 Lawrence, C. (1994) Medicine in the Making of Modern Britain,

1700–1920. New York Routledge.

 Marx, K. (1975) ‘Economic and Philosophical Manuscripts of 1844’

in Karl Marx: Early Writings (introduced by L. Colletti and translated

by R. Livingstone and G. Benton) Penguin. pp. 429-432.

 Marx, K. and Engels, F. (1976) [written 1844-6, first published whole

in 1932] The German Ideology Progress Publishers: Moscow.

 Marx, K. and Engels, F. (1960) [1848] Manifesto of the Communist

Party International Publishers: New York.

 Nguyen, V-K. and Peschard, K. (2003) ‘Anthropology, Inequality and

Disease: A Review’ Annual Review of Anthropology 32:447-74.

 Marshall, P.A. and Daar, A. (2000) ‘Ethical Issues in the International

Development of Human Organ Replacement Technologies: India and

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the Commercialization of Kidney Transplantation’ in Whiteford, L.

and Manderson, L. (eds) Global Health Policy, Local Realities: The

Fallacy of the Level Playing Field Lynne Rienner: Boulder, pp. 205-

232.

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