ABSTRACT
Healthcare can be treated as a right or a commodity, but not as both. This chapter argues that the central purpose of healthcare – the promotion of the genuine wellbeing of the population – is subverted by capitalism. When healthcare is treated as an avenue for profit accumulation, a series of pernicious political-economic dynamics and incentives manifest that militate against a genuine spirit of health promotion. The combination of monopoly capital among the different subsectors of healthcare provision (such as insurance and the pharmaceutical industries) and patient vulnerability leads to capitalists extending their political-economic power in healthcare to exploit both. In turn, this leads to a ballooning of healthcare costs, medical debt and constricted accessibility. Accordingly, capitalism undermines population health by generating gargantuan inequalities, promoting monopoly formation, and exacerbating inequalities in access to essential services, by serving effective demand rather than absolute need. Capitalism in healthcare simultaneously leads to overtreatment for the well-insured and wealthy, and undertreatment for the poor and destitute – ultimately committing a disservice to both as patients and society as a whole.
