ABSTRACT
This chapter discusses the assumptions underlying Ivan Illich’s ideology and analyzes the degree to which they provide valid explanations of the actual situation in our Western developed countries and in our health services. It presents alternate explanations of the social problematique of our countries. Those are the reversal of industrialization, and the importance of self-reliance. The alienation of the producer from his work-his dissatisfaction-leads to the fetishism of consumption. He who resents the industrialization of all fetishism—including medicine—ends by fetishizing the process of industrialization itself. This fetishizing of that process appears, for example, in his analysis of the most important public health problem in the world: undernutrition. The experiences in both China and Cuba would seem to indicate that the type of industrialization that exists in developing countries is a symptom but not a cause of their problems. All societies, regardless of their political structure, will evolve according to the dictates of industrialization.
