Soviet medicine—a workers’ health plan

The 1917 Bolshevik Revolution overturned capitalist property relations, smashed the Russian state and brought a workers’ party to power for the first time in history. This historic achievement by the working class laid the foundation for the formation of the Soviet Union and the subsequent socialist construction efforts.

The revolution brought with it the radical reorganization of society, including agriculture, industry, education and medical care. The elimination of usury in the countryside and collectivization of agriculture was accomplished alongside rapid industrialization in the cities.

The modernization of health care facilities and the establishment of a comprehensive system of free universal health care accompanied these broader economic developments.

Soviet health care provided for local hospitals, factory clinics, industrial hygiene programs and neighborhood polyclinics at no cost to the patient. The Soviet system was recognized for the great strides it made in battling infectious diseases—such as tuberculosis and typhus fever—which had periodically ravaged workers and peasants in czarist Russia.

In 1932 Sir Arthur Newsholme, former principal medical officer of the Local Government Board of England and Wales, and John Adams Kingsbury, former commissioner of public charities for the City of New York, traveled to the Soviet Union to examine firsthand that country’s socialist health care system. Their observations were published in 1933 as “Red Medicine: Socialized Health in Soviet Russia.”

Their trip to the Soviet Union and the publication of their findings took place at a time when workers in the United States and Western Europe were suffering terrible unemployment and hardship in the midst of the Great Depression.

Newsholme and Kingsbury preface their work with this statement: “When a Russian becomes ill the Government does something about it. In fact, Government has already done something about it, for Soviet Russia has decided that the health of the individual is the concern of society as a whole. Indeed, the Soviet Union is the one nation in the world which has undertaken to set up and operate a complete organization designed to provide preventive and curative medical care for every man, woman, and child within its borders.”

This sweeping opening statement is backed by the account of their voyage across the Soviet Union. The class character of the new Soviet state was also apparent in the rights gained by workers and other formerly exploited classes to access a number of programs and facilities designed to promote longevity and healthy living. Sports and cultural clubs, groups for dancing and singing, and parks and gardens for recreation were all made available with priority for workers and poor peasants.

Similar improvements were noted in access to quality medical facilities. The revolution saw the confiscation of the palaces and magnificent homes of the pre-revolution aristocracy. Many of these grand estates were converted by the Soviet state into sanatoria and rest homes for ill and disabled workers in need of medical assistance and peaceful recuperation.

Modern hospitals and clinics were constructed and equipped with the most recent medical technology. These facilities were staffed with highly competent doctors and nurses with an orientation toward providing medical care as a right, not a means to making profit.

The authors described the great gains made by women as a result of the revolution. Equal pay was given for equal work with no distinction between men and women in sickness insurance benefits. Public laundries, dining centers and nurseries freed women from household bondage and paved the way for fuller participation in industrial and political activities.

Women’s health benefits were supplemented with maternity benefits which provided for full wages during absence from work and money allowances to mothers on leave to nurse their infants.

In 1920 the Soviet government had repealed existing laws against abortion and established guidelines for the procedure—the first country to do so. Abortions were largely performed free of charge by licensed surgeons in state hospitals with a division for that specific purpose.

In their chapter on Russian medical history and health care training, Newsholme and Kingsbury point out that, “Priorto the Revolution, Russia was extremely backward in its medical provision for the mass of the people. Since that time a vast advance has been made [and] the wide sweep of the newly organized medicine of Russia presents features from which other countries may derive important lessons.”

The progress made by the Soviet Union in devising a real workers’ health plan experienced a partial deterioration later as Cold War pressures strained the Soviet economy and bureaucratic privilege became entrenched. However, these setbacks were minimal compared to the full-blown health crisis that was forced on the workers with the dissolution of the socialist system and the return to capitalism.

The counterrevolutions that swept across Eastern Europe and the Soviet Union from 1989 to 1991 and restored capitalist property relations also reversed the gains workers had made in health care. The 1991 defeat of the Soviet Union presaged a widespread health care crisis in Russia and other former Soviet republics.

A report published earlier this year in the British medical journal The Lancet detailed the toll capitalist restoration has taken on the health of workers. The report, “Mass privatization and the post-communist mortality crisis: a cross-national analysis,” was prepared by bourgeois academics at some of Britain’s most prestigious universities. These researchers discovered that health standards in Russia and Eastern Europe had plummeted in proportion to the degree of capitalist reintroduction.

In capitalist Russia, the death rate of working adults rose by 18 percent and the average life expectancy fell by five years. The death rate overall for Russia and Kazakhstan increased by 42 percent in the early 1990s. The United Nations estimates that, in all, the deaths of 10 million people can be attributed to the transition away from socialism.

Next: U.S. health reform struggle during the turbulent 1960s.

• Part 1: The urgency of reform
• Part 2: Cold War politics forced Truman’s hand
• Part 3: Soviet medicine—a workers’ health plan
• Part 4: Radical movements create context for 1960s health care reform
• Part 5: Cuban socialism builds model health system
• Part 6: Attacks on Obama plan mirror Clinton health debate
• Part 7: Corporate giveaway in the name of reform
• Part 8: The impact of technology on health delivery and access
• Part 9: The road to health care justice