Personal protective equipment (PPE) for health workers, ventilators, Covid-19 test kits, and even hand sanitiser and paracetamol are in short supply in hospitals. Why?
Arguing that the then-common socialist demand that workers receive the “full fruits of their labour” was nonsense, Karl Marx explained that from the total social product must be deducted:
“First, cover for replacement of the means of production used up. Secondly, additional portion for expansion… Thirdly, reserve or insurance funds to provide against… calamities, etc”.
And further “the part which is intended for the common satisfaction of needs, such as schools, health services, etc. From the outset this part grows considerably in comparison with present-day society…” (Critique of the Gotha Programme).
A market-based system inevitably skimps on provision for calamities, because it generates no “market signals”. The workings of capitalism tend always to maximise the part of the “fruits of labour” grabbed by those who live from profit, at the expense both of wages and of social and reserve provision. The mottos are “cost-cutting” and “just in time”.
The National Health Service has been run on as near as possible the minimum to meet current demand, with scant reserves. When funds are available, their allocation will always be biased to meeting current demand, because that generates “market signals”, even if they are signals through a managed market run on public funding.
Campaigners have been sounding the alarm for years. The NHS has been running so close to capacity that even something much less dramatic than the Covid-19 epidemic — a slightly-harsher version of the constantly mutating flu virus, or just a cold winter — could overwhelm it.
Evidently the NHS’s reserve supplies, and its pre-planned capacities for boosting them in emergency, have been much less than we needed.
The answer is to requisition (i.e take into emergency public ownership) the whole pharmaceutical and medical-supplies industry, and run it under workers’ control with democratically-discussed reserve capacity and reserve stocks.