I Can't Afford a Doctor

The Precariousness of the Working Class

It is ironic that in the richest country in the world, teeming with billionaires and undreamt of wealth, many workers cannot afford a doctor. Millions of workers in the United States cannot afford healthcare coverage; they are on low pay and high job insecurity with few if any protection from the vagaries of capitalism.

The appearance of the pandemic coronavirus has only made matters worse for workers in the US. It is disproportionately killing the poor, the elderly and the vulnerable. In April the dead, of over 2000 in one day, surpassed the deaths in any other country. Tens of thousands have died. The world's highest death toll, with more than 21,300 fatalities recorded (INDEPENDENT 13 April 2020).

The "lock-down" and subsequent unemployment have badly hit millions of workers. One worker, interviewed in the Guardian newspaper, said:

"I can apply for food stamps and unemployment, but it won't pay the rent. I'm really afraid of what happens when I get sick. I will just have to stay at home. I can't afford to pay for a doctor" (GUARDIAN 10 04 2020).

There are two classes in the United States, as there is elsewhere in the world. First there is the capitalist class, served by President Donald Trump and other politicians, both Republican and Democrat. This class lives off the unearned income of rent, interest and profit. Capitalism is their system. The capitalists own the land, the oil, the factories, the communication and transport system and the distribution points.

And then there is the working class majority who have no direct access to what they need to live on, and who are prevented from producing what they need and for whom by the restrictions imposed by the private ownership of production and distribution. The profit system rules, and as a result tens of thousands of workers are dying unnecessarily of a pandemic which would be treated so differently in socialism. The rich can afford health protection. For many workers who drop through the tattered net of social security they just fall into mass graves hastily dug by state contractors.

What the pandemic also illustrates is the disproportionate number of black Americans who die of Covid-19. They are more likely to live in extreme poverty, overcrowding, lack of health care and discrimination. In Louisiana 70 per cent of the deaths were among black Americans, although they only make up 30 per cent of the state's population (GUARDIAN 10 04 2020)

The Need for Trade Unions

The importance of trade unions in the class struggle has become more apparent to workers. It has always been apparent to socialists. We have always acknowledged the usefulness of trade unions to protect, as best they can, their members from the extent and intensity of class exploitation.

On a day-to-day basis, trade unions have to protect their members from bullying managers, from unhealthy and dangerous working conditions and from attacks upon their terms and conditions of employment. They also have to struggle to protect pay levels and to get a few extra crumbs from employers in higher pay, when economic conditions permit.

As for Trump: he may be selfish, unable to empathise and is grossly incompetent but we should avoid the easy "blame game" and the worthless argument of the "lesser of two evils". Trump blames everybody and everybody blames Trump. Trump may be a clown and a buffoon, but blaming him alone lets capitalism off the hook. It is capitalism the attention of workers should be drawn.

No doubt Trump's family will have their snouts in the trough of the $2 trillion bail-out. This tough represents their taxes and their plundered surplus value. Far more important for workers is class unity and workers globally acting as a "class for itself". Socialism is the only way out of this pandemic crisis and its social and economic consequences.

Fighting Back

Workers have fought back. In New York, Instacart employees have formed Gig Workers Collective and are demanding access to hand cleaners and disinfectant wipes in addition to danger money. So far, this has forced Instacart to negotiate with workers, resulting in an offer of a one-time bonus, a month's paid leave to those diagnosed with the virus and the introduction of automatic tipping. Workers were also successful in having hand sanitisers being made available.

Further strike action in New York is taking place against Amazon, owned by the multi-billionaire Jeff Bezos, where workers are struggling for better protective equipment and danger money. More than 100 Amazon workers walked off site on March 30 in the hope that the company will shut down the plant and have it properly cleaned following accusations from Chris Smalls (who organised the strike) that Amazon are not taking the threat of infection by the virus to workers seriously. Smalls was sacked by Amazon following the strike, but workers in other Amazon warehouses are beginning to organize against the conditions they have to work under.

According to the GUARDIAN:

"Strikers at the JFK8 warehouse in Staten Island demanded Amazon temporarily shut down the large facility for cleaning, after reports of multiple employees testing positive for Covid-19" (GUARDINA 31 March 2020).

Nevertheless trade unions can do nothing about mass redundancies. Trade Unions have severe limitations placed upon what they can and can't do under capitalism. This was explained by Marx in his lecture to the General Council of the First International in 1865 and published in the pamphlet VALUE, PRICE AND PROFIT. Trade Unions can only deal with the effects of capitalism not the cause. He recommended that workers should organise to politically and democratically abolish the wages system. It still remains the socialist conclusion today.

To illustrate how the movement of capitalism is out of the hand of trade unions we only have to look at the Coronavirus pandemic. As a consequence of the virus, the US, along with most other capitalist countries in the world, had to introduce an economic "lock-down". Aeroplanes could not take off, most manufacturing and business had to shut, followed by the isolation of millions of workers. The "lock-down" has bankrupted tens of thousands of companies and made millions of workers redundant.

Whereas some capitalists and their political supporters wanted to pursue the policy of "herd immunity", the capitalist state could not afford to take the gamble and harm the goose that lays the golden egg. Unlike most recent pandemics there is no quick fix. There is no cure to the virus. Antidotes are a long way off. Capitalists need workers to exploit and make a profit from. That is how wealth is created under the profit system. Workers produce more social wealth than they get back in wages and salaries.

As a consequence of the "lock-down" unemployment in the US has risen rapidly with predictions being made by economists that as many as 15% of the work force could end up unemployed. More than 6.6 million American have lost their jobs in the first week of April 2020 as the coronavirus pandemic has bought the US economy to a virtual standstill.

The redundancies started in the restaurant and leisure sectors and have now spread out to include manufacturing, construction and healthcare. Unemployment offices have been unable to cope (Unemployment soars in US as 15% could end up jobless, GUARDIAN 11 04 2020).

Workers find themselves in this precarious position because they do not own and control the means of production. They do not control land, minerals, oil, gas, factories, transportation, communication systems, factories and distribution points. Workers are only employed when it is profitable to do so. And in a "lock-down", when employers cannot sell their commodities and services for a profit, workers are sacked, fired, and shed like leaves.

What of Socialism?

What of socialism? Why would things be different in a socialist society if faced by a pandemic?

Socialism will be a world-wide social system in which production and distribution would be to directly meet human need. There would be no capitalist government balancing the interest of the capitalist class and their need to make profit with health considerations. Nor would there be the lack of preparedness, care and empathy towards human beings. Would a socialist society treat front-line doctors and nurses so disinterestedly by supplying them with inadequate protective clothing? Of course not: the equation "profit or health?" so worried over by capitalism's economists would not exist.

In Socialism, a pandemic would have been adequately planned for, and sufficient ventilation machines, drugs, hospital clothing, testing equipment would have been stored. If self isolation existed, people would still carry on having direct access to what they needed to live without the rationing imposed by the wages system. Unemployment would not be a problem. In socialism there would be no employees, no buying and selling of people's ability to work and no job market.

This is how capitalism deals with a crisis:

"In Wisconsin and Ohio, farmers are dumping thousands of gallons of fresh milk into lagoons and manure pits. An Idaho farmer has dug huge ditches to bury 1 million pounds of onions. And in South Florida, a region that supplies much of the Eastern half of the United States with produce, tractors are crisscrossing bean and cabbage fields, plowing perfectly ripe vegetables back into the soil" (NEW YORK TIMES 12 April 2020).

In Socialism, fruit, vegetables and milk would not have to be destroyed to retain price levels. Socialism would not be constrained by commodity production and exchange for profit. Workers would not have to worry about losing their livelihood. Hospitals would not be faced with an unhealthy working class living in poverty and carrying all the negative health problems associated with poverty.

The aged would not be locked away in homes out of sight and out of mind to die in the company of ill-equipped carers risking their lives for strangers. The kindness of strangers. Compassion will be the hall mark of socialism not health care on the cheap and Gradgrind utilitarianism for the old and frail.

And the co-operation, kindness and sociability of millions would be an expression of socialism rather than an oddity in a system that praises above all else, competition, greed, selfishness and class exploitation.

For human beings to survive a pandemic first requires the establishment of the common ownership and democratic control of the means of production and distribution by all of society. As one wit ironically put it: "It is the virus that makes you ill but capitalism that kills you".

Back to top

Object and Declaration of Principles


The establishment of a system of society based upon the common ownership and democratic control of the means and instruments for producing and distributing wealth by and in the interest of the whole community.

Declaration of Principles


1. That society as at present constituted is based upon the ownership of the means of living (ie land, factories, railways, etc.) by the capitalist or master class, and the consequent enslavement of the working class, by whose labour alone wealth is produced.

2. That in society, therefore, there is an antagonism of interests, manifesting itself as a class struggle, between those who possess but do not produce and those who produce but do not possess.

3.That this antagonism can be abolished only by the emancipation of the working class from the domination of the master class, by the conversion into common property of society of the means of production and distribution, and their democratic control by the whole people.

4. That as in the order of social evolution the working class is the last class to achieve its freedom, the emancipation of the working class will involve the emancipation of all mankind without distinction of race or sex.

5. That this emancipation must be the work of the working class itself.

6. That as the machinery of government, including the armed forces of the nation, exists only to conserve the monopoly by the capitalist class of the wealth taken from the workers, the working class must organise consciously and politically for the conquest of the powers of government, national and local, in order that this machinery, including these forces, may be converted from an instrument of oppression into the agent of emancipation and the overthrow of privilege, aristocratic and plutocratic.

7. That as all political parties are but the expression of class interests, and as the interest of the working class is diametrically opposed to the interests of all sections of the master class, the party seeking working class emancipation must be hostile to every other party.

8. The Socialist Party of Great Britain, therefore, enters the field of political action determined to wage war against all other political parties, whether alleged labour or avowedly capitalist, and calls upon the members of the working class of this country to muster under its banner to the end that a speedy termination may be wrought to the system which deprives them of the fruits of their labour, and that poverty may give place to comfort, privilege to equality, and slavery to freedom.