Conclusion

In this paper we have shown how concepts from the political economy of health literature illuminate how capitalist structures and processes adversely affect health. We have also detailed the apparent reluctance of many of the contributors in this field to call for the radical transformation or replacement of this problematic economic system. ¹

We do not have such reluctance but recognize, as does McBride, that reform within existing economic and political structures would provide some short-term but limited improvements. 107 Moving liberal political economies such as Canada, the USA, and UK towards the arguably superior governance models common in the social democratic and conservative nations would promote health equity. Yet, there is now a literature about the inability of even these welfare states to manage the contradictions between capital accumulation and social reproduction. 210– 213 Even when managing capital accumulation within a nation, the adverse effects of Norwegian capital accumulation, as one example, on other nations are ignored. 214,215

We cannot be sure of what a post-capitalist socialist society will look like. Yet, the well-documented adverse health effects of neoliberal global capitalism require that we nevertheless move towards that goal. 216 For Harvey, we have no option, as the inherent contradictions of capitalism will lead to its demise. 217 Kovel argues that these contradictions are leading to the end of a livable planet. 218 We agree with Meiville, who in a discussion of the impending climate catastrophe – with relevance for the polycrisis in social determinants of health and health care -- states: “Socialism, wherein the astonishing scientific and technical powers of humanity are harnessed to need, for all the uncertainties and errors that would occur, would give an infinitely greater likelihood of sustaining a habitable world than more of the same system that got us here.”215,218,219 (p. 161)

Footnotes

1. Beyond the immediate scope of our paper yet relevant to promoting health equity are Wright’s six means of moving beyond capitalism: smashing capitalism, dismantling capitalism, taming capitalism, resisting capitalism, escaping capitalism, and Wright's preferred option and eroding capitalism. 116 We favor the electoral approach provided earlier. Flanagan and Raphael explore how credit unions could begin a transition to a post-capitalist society by providing a model of member-controlled non-profit institutions focused on community wellbeing rather than profit making. 219 ↩