Dear Comrades,

The anti-capitalist and anti-statist position on health care is becoming more and more bewildering, even mysterious, to me as I consider what a banner like this could mean in the context of a pro-health care march in Seattle.

The IWW’s position on health care is that “capitalism cannot be reformed,” which, in the context of a pro-healthcare march could be construed as being in support of a single-payer, nationalized health care system. It could be seen as yet another argument against capitalism that a Trotskyist group put forth. If this means converting the current health care policy into a fully social democratic system, that is reformism, and not something the IWW would support. It’s safe to say the IWW is not arguing for the kind of health care the Democrats are arguing for. But could I be mistaken?

Health care in particular is a source of much confusion for anti-statists. But why? Why should the anarchist position that capitalism cannot be reformed have different advice to give depending on the particular government program in question? What makes health care so different than, say, infant industries, state-run banks, the army, or subsidized agriculture?

Of course, health care is perceived as a human right, and a basic need. Many of us believe everyone should have access to these services. But who as an anarchist would argue that this implies a role for national government? The IWW and other anarchist organizations push for health care provided in the work place (paid by the employer), and certainly want to see an extended system of mutual aid and healthcare for all people, but their ideology is at odds with the reformists and the Trotskyites who want to use the state to distribute health services.

What is more confusing is that at least some IWW members do appear to support nationalized health care systems. Why does health care, in particular, send mixed signals? At the risk of sounding fundamentalist, is it because anarchists are, in fact, willing to sacrifice some ideological ground so that the state can provide basic human rights to all people, right now? Because not supporting single-payer health care would seem cold-hearted?

But did I miss something important? Anarchist ideology could not support of a welfare state. Is it not completely at odds with that idea? I am only curious as to the justification. (I have heard no anarchists make the case for a theoretical “transitional phase,” where the state nationalizes all services, and then slowly the tiny groups of anarchists phase out the bureaucratic mediation in favor of mutual aid systems. That also sounds like a very complicated argument.)

Exactly how you can have anti-capitalism and anarchism and single-payer (the government) health care at the same time? What reason, if any, would lead you to justify supporting national single-payer health care if you are arguing for the replacement of work with mutual aid?

Thank you,

Utopia or Bust