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PREFACE N eoliberal globalisation, a predominant theme of the Socialist Register over the past 15 years, is brought into focus in this volume in relation to its impact on the most important area of human life: health. All the elements of public health, from a balanced diet to decent housing, job security and job satisfaction are crucial in determining how well and how long people live. This is partly a matter of giving the human body what it needs to reach its full physical potential, but also a matter of preventing disease and, to a lesser extent, a matter of curing illnesses. The turn that capitalism has taken in recent decades has, in both these respects, been replete with morbid symptoms – the title of this volume, the Register’s 46th, on health under capitalism. A vast amount has been written about health, but very little from a systematically critical standpoint. The path-breaking work in the political economy of health begun in the 1970s by pioneers such as Lesley Doyal, Vicente Navarro and Julian Tudor Hart has been too little followed up by others, at least in the English-speaking world. This is all the more remarkable, given the size and scope of the global health industry and its growing centrality as arena of capital accumulation. Our goal in preparing this volume was to help develop the historical materialist analysis of health under capitalism, focusing on the economic, social and political determinants of health in the neoliberal era; and on health care as an object of struggle, between commercial forces that seek to make it into a commodity and popular forces trying to make (or keep) it a public service and to reduce the current gross inequalities of access. It is crucial for the Left today to address, in particular, the marketisation of public health services, and the way the pharmaceutical, insurance, medical technology and healthcare corporations push to make health care everywhere into a field of capital accumulation and expand the consumption of medical commodities – services as well as goods. Many of the morbid symptoms flow directly from this, including the corporate control of medical research and training, the misuse of scientific data for commercial gain, the generation and mistreatment of an epidemic of mental illness, and the newest frontier of capitalist accumulation – the 2 SOCIALIST REGISTER 2010 turning of genes into commodities. In most societies today health and health care are rarely out of the news: the spectre of new epidemics, or the return of old ones; the food industry’s production of both obesity and hunger; the emergence of ‘superbugs’; lapses in hospital care; breakthroughs in medical research or surgical techniques; new ‘wonder drugs’; and, of course, ever-present hand-wringing about ‘runaway’ healthcare costs. It is in the rich capitalist countries that resources exist for increasingly sophisticated and costly biomedical research and medical technology; and as the range of medical knowledge increases, so does the range of possible medical interventions, and with this, the demand for still more resources for research and treatment. Most of these countries also have healthcare systems funded by general taxes or social insurance which at least in principle treat everyone alike, without reference to ability to pay. This involves a transfer of income from rich to poor (who have worse health) and makes public hospitals and clinics some of the few places in these classbased societies where there is relatively little class distinction – no separate ‘business’ and ‘economy’ cabins. But this also helps explain why there is capitalist and state support in these countries for the drive by the global private healthcare industry to get access to the rich pools of public revenue out of which public health systems are funded. They energetically promote the call for costs to be cont