Repost from the old site.
The success of Chinese Communism, particularly in terms of health care:
Between 1952 and 1982 [with most of the change happening before 1976], China reduced the rate of infant mortality from 250 to 40 deaths per 1000 live births, decreased the prevalence of malaria from 5.5 percent to 0.3 percent of the population, and increased life expectancy from 35 to 68 years (Hsiao et al 1996).
In 1949, under the Nationalist Chinese so beloved by Americans, fully 20% (!) of all Chinese babies died in their first year of life, an incredible statistic (Sidel & Sidel 1973). By 1976, when Mao died, the rate was down to 46 out of 1000 (Yu and Sarri 1976). Infant mortality had plummeted by 77% in only 27 years, probably one of the fastest declines in world history.
During the Cultural Revolution, Mao instituted the Barefoot Doctors program, serving the health care needs of 90% of the population (Hsiao et al 1996). It was hailed by the UN as one of the greatest public health programs of all time. Comparing the infant mortality rate of 1972 to the rate of 1949 shows that China under Mao was saving the lives of 3.9 million children every single year.
This is what I mean when I say that Mao was one of the world’s greatest humanitarians.
Some argue that some progress in infant mortality would have occurred even without Maoism. Given the horrific record of the semi-feudal Nationalists, that seems dubious, but just for the record, let us compare India to China in this regard. India’s infant mortality rate was an outrageous 139 per 1000 in 1972, and China’s was 60.
India had been ruled since independence by a nominally socialist party which had written into India’s Constitution that India was a socialist country. Surely, a rightwing India would have done far worse in this regard. Comparing India and China in 1972, we find that Maoism was saving the lives of 1.5 million babies a year compared to India.
The purpose of this simulation is to show that Maoism was saving the lives of millions of Chinese every single year.
It is possible that no system in human history ever saved so many lives so quickly as Maoism.
According to the US Census Bureau, by 1998, China’s infant mortality rate was the same as in 1976 at 45. Over 22 years, there had been zero progress at reducing infant mortality. In 30 poorest counties studied, the infant mortality rate actually rose during the 1980’s from 50 to 72 (Hsiao et al 1996). This is an example of the mass killing associated with China’s move towards capitalism.
That Maoism ruined the economy is a most peculiar statement. Industrial production grew at 10% per year all through the Mao years, even during the Cultural Revolution! Agricultural production expanded massively and grew at 3% per year. By the early 1970’s, for the fist time in centuries, or possibly in recorded history, the problem of hunger in China had been solved.
One of Mao’s greatest achievements was the reduction of the discrepancies, including life and death, between the cities and the countryside. This reduction was truly revolutionary in world historical terms. By 1979, rural infants were 70% more likely to die than urban infants. By 1993, they were 190% more likely to die (Liu et al 1999). The movement to capitalism has been a accompanied by a mountain of bodies.
Starting in the 1980’s, the government cut back on health care, and clinics began demanding payment from patients. Only 25% of patients now have health insurance (Hsiao et al 1996). This was down from 71% in 1981 (Liu et al 1999). Many or most patients could not afford to go to the doctor, so they just never went.
A study found that 30% of villages had no doctor, 28% were avoiding going to the doctor when sick due to cost, and over 50% of those advised to go to the hospital for treatment were refusing due to cost (Hsiao et al 1996). Health care was privatized. Recall that the market fetishists insist that this is a wondrous thing – for profits, perhaps, but for public health, surely no.
At the same time, the rural collectives were often broken up and replaced with private farming. What this meant was that one could no longer afford to be a barefoot doctor, so the barefoot doctors program disintegrated as barefoot doctors returned to farming to survive.
The number of health care workers in the cities increased, and the number in the countryside decreased by 36% in the 1980’s. During that decade, the number of clinics in the countryside declined by 14% (Liu et al 1999). Previously, the health care system had been organized around the rural collectives. That system collapsed.
In 1978, 85% of villages were in the program, and in 1993, that number was down to 14%. Clinics were forced to pay their own bills, and shady health care emerged, including overpresciption of for-sale drugs and unnecessary treatment (Bloom 1998).
- Bloom, Gerald. 1998. Primary Health Care Meets The Market In China And Vietnam. Health Policy 44: 233-52.
Hsiao, William C. L and Liu, Yuanli. 1996. Economic Reform and Health – Lessons from China. New England Journal of Medicine 335: 430-432.
Hsiao, William C. L. 1984. Transformation of Health Care in China. 310: 932-6;
Hsiao W.C., William C. L. 1995. The Chinese Health Care System: Lessons For Other Nations. Social Science and Medicine 41: 1047-55.
Liu, Yuanli, Hsiao, William C. and Karen Eggleston. 1999. Equity in Health and Health Care: the Chinese Experience. Social Science and Medicine 49: 1349-1356.
Sidel, Victor W. and Sidel, Ruth. 1973. Serve the People; Observations on Medicine in the People’s Republic of China. New York, NY: Josiah Macy, Jr. Foundation.
Yu, Mei-Yu and Sarri, Rosemary. 1997. Women’s Health Status And Gender Inequality In China. Social Science and Medicine 45, Vol 12: 1885-1898.