Do Communist-Led States Protect Public Health Better Than Capitalism?

By Stephen Gowans

May 5, 2021

Had all capitalist countries managed the Covid-19 pandemic as effectively as the Communist-led countries of China, Cuba, and Vietnam, nearly 147 million people would have been spared illness and over three million lives would have been saved, according to projections based on data from Our World in Data. These projections are based on applying the number of cases and deaths per million for the Communist world to the world as a whole.

Taken together, the Communist countries have limited the spread of the novel coronavirus to 134 cases per million, compared to 24,058 cases per million in the non-Communist world. At the same time, communist countries have held Covid-19 deaths to four per million, while in the capitalist world, the death rate per million has been well over a hundred times greater.

What’s more, according to reports from The New York Times and The Wall Street Journal, North Korea has likely been as successful as its Communist cohorts in protecting public health in the face of the worldwide coronavirus emergency.

Clearly, compared to the capitalist countries, the Communist-led states have not only done a better job of protecting their citizens from the dangers of Covid-19, they have done a supremely better job.

Continuity

In 1986, sociologist Shirley Ceresto and physician Howard Waitzkin published research in the American Journal of Public Health comparing the performance of Communist-led states and capitalist countries on physical quality of life indicators, including six public health measures: infant mortality, child death rate, life expectancy, population per physician, population per nurse, and daily per capita calorie intake. Using World Bank data, the researchers found that when comparing Communist-led countries with capitalist states at the same level of economic development, the Communist countries came out ahead on all six public health measures.

Waitzkin told The Los Angeles Times that he believed the Communist-led countries fared better because they considered health care to be a basic human right. Ceresto added: “The first thing a country does when it becomes socialist is improve the health care and education and feed the people.” This, she said, “is their goal: To feed their people and get them health care and education.”

In 1992, sociologist and political scientist Vincente Navarro published in The International Journal of Health Services a continent by continent survey of the performance of socialist and capitalist countries in their response to the health needs of their populations. Navarro concluded that socialism and socialist forces [had], for the most part, been better able than capitalism and capitalist forces to improve health conditions.”  

Among other comparisons, Navarro contrasted China with India, showing how life expectancy in the Communist country lagged India’s by seven years when Mao’s forces came to power in 1949. A quarter of a century later, life expectancy had increased by 35 years and was 12 years greater than in India, where life expectancy had increased only 17 years. Today, China continues to lead India in life expectancy at birth.

Navarro concluded that “the socialist experience … has been more frequently than not more efficient in responding to human needs than the capitalist experience.”

Communist Countries Today

As was true in the 1980s, today’s Communist-led states outperform capitalist countries on various measures of public welfare, including life expectancy, hospital beds per thousand, extreme poverty, as well as scoring higher on the human development index, a composite measure of income, life expectancy, and education.

Table 1 shows that average life expectancy is five years greater in Communist countries than capitalist states (77 vs. 72). The lead is even greater in Cuba and Vietnam (seven years), comparing these countries with capitalist states at the same level of economic development.

Table 2 shows that Communist-led states have close to twice as many hospital beds per 1,000 people as capitalist countries, with Cuba having over three times more beds per 1,000 people than capitalist countries at the same level of economic development.

Table 3 shows that the percentage of the population living in extreme poverty is lower in the Communist-led states (for which data are available, namely, China and Vietnam) than in the capitalist world as a whole, or in capitalist countries with a similar GDP per capita.

The idea that extreme poverty is greater in the capitalist than Communist world challenges the myth, industriously cultivated in the rich countries, that capitalism means wealth and development while the Communist countries are uniquely poor. While it is true that some capitalist regions are very wealthy, specifically, those with an imperialist past and present (North America, Western Europe, and Japan), they comprise only a small part of the world’s population, about ten percent. The Communist countries comprise a further one fifth. That leaves the bulk of humanity—seven of every ten people in the world—living within less developed parts of the capitalist sphere. The capitalist norm, then, is not one of wealth and development, but of poverty and underdevelopment.

Capitalism has two faces. One is the face of great wealth. The other is the face of poverty, agony of toil, brutality, and foreign domination. For most human beings, capitalism has showed, and continues to show, only one of its faces: that of poverty, misery, and imperialism. It is from, and against, this sphere that the Communist countries have emerged.

Table 4 shows that the Communist countries have a higher level of human development (the index ranges from 0 to 1, with 1 as the highest level) compared to the capitalist world. The Communist advantage is particularly evident in the cases of Cuba and Vietnam, where human development in these countries exceeds that of capitalist states with roughly the same income per capita.

Managing the Covid-19 Pandemic

Given that the data indicate that Communist-led countries are more responsive to the human and health needs of their populations, we might expect that the Communist-led countries have also been more effective in protecting their populations from the Covid-19 pandemic. The next two tables confirm this expectation.

Table 5 shows the number of infections per million has been considerably lower in the three Communist-led states than in the capitalist world.

Similarly, Table 6 shows that the Communist countries have significantly outperformed capitalist states in limiting the number of Covid-19 deaths per million.

Note that the difference between the Communist and capitalist worlds is not trivial. The infection and fatality rates in the capitalist countries have been, respectively, 180 and 127 times greater than in the Communist states.

Capitalist Exceptions

Some capitalist states have performed better than others. Unique among the capitalist countries in pandemic management are Japan, South Korea, Australia, and New Zealand, which have not only achieved infection and mortality rates well below the capitalist average, but have done better than Cuba, as Table 7 shows.

However, while the performance of these capitalist countries has been very good relative to their capitalist peers, as Table 8 reveals, it has nevertheless been less effective than that of the Communist-led states as a group.

The achievement of the capitalist quartet in limiting infections and deaths challenges the belief that infection control is only possible in Communist-led countries and is not possible in liberal parliamentary states. Moreover, all four countries had a low rate of vaccination as of the end of April, refuting the notion, widely promoted in the Western news media, that vaccines are the sole route to managing the pandemic.

Had all countries performed as well as these four, 121 million people would have been spared illness and 2.6 million lives would have been saved. While these numbers represent a substantial improvement over how the world has performed, they are nevertheless not as substantial as the gains that would have been garnered had all countries performed as effectively as the Communist-led states.

The Confucius Hypothesis

Some analysts have attributed China’s stellar pandemic performance to the country’s Confucian culture rather than its Communist politics, pointing out that other countries with strong Confucian influences, namely Japan and Korea, have also stood out in the degree to which they have effectively managed the virus. These analysts argue that Confucian values of duty, obedience, and social solidarity, have predisposed the populations of the Confucian-influenced countries to more fully comply with government directives on infection control than is true in countries in which individual liberties are valued over the collective needs of the community. 

While there may be some merit to this argument, it is still the case that within the Confucian trio, China has performed the best, and significantly better than its capitalist counterparts, as illustrated in Table 9. This suggests that China’s nature as a Communist-led country has conferred an advantage in pandemic control greater than whatever advantage it has reaped from Confucian values.

China vs. India

It is illuminating to compare China to India, a fellow Asian behemoth which differs from China in having rejected a development path under the red flag of Communism. On all seven human welfare and health indices in Table 10, India lags China, including on the number of physicians per 1,000 people; hospital beds per 1,000 people; ICU beds per capita; and health spending as a percentage of GDP.

Coincident with its poorer performance in meeting the health needs of its population, India has also failed to effectively manage the coronavirus pandemic, severely underperforming its Asian neighbor. To be fair, India’s GDP per capita is less than half that of China’s. However, the gulf between China and India in satisfying their respective population’s health needs is so great that even correcting for the income difference would fail to eliminate the gap between the two countries. On grounds of human development and health, if one had to choose between the two countries as a place of residence, Communist-led China is clearly the better choice.    

Southeast Asia

Southeast Asian countries have also performed better than the average at curbing the spread of the coronavirus and limiting deaths, though not better than the Confucian trio. Within the Southeast Asian group, Vietnam’s performance is unparalleled. Again, inasmuch as Vietnam and China belong to regions with superior pandemic performance, regional factors have likely contributed to their successes in limiting infections and deaths. However, within both groups, the performance of the Communist-led countries has been ne plus ultra, pointing to their politico-economic orientation as an additional factor explaining their superior pandemic control.

Caribbean and Central American Region

The Caribbean and Central American region has performed less effectively than the rest of the world in checking the spread of the coronavirus and limiting fatalities. While Cuba does not lead the region, as its Communist-led cohort countries do theirs, it has performed much better than the regional average and more effectively than the average of all other countries. Moreover, at 0.58 percent, Cuba is second only to Saint Vincent and the Grenadines in case fatality rate, compared to 1.99 percent for the other regions, and 4.64 percent for the Caribbean and Central American region as a whole. Cuba’s low case fatality rate likely reflects the Communist state’s strong emphasis on universal access to a health care system which boasts among the highest number of physicians and hospital beds per capita in the world. Table 2 showed that Cuba not only leads capitalist countries at the same level of development in hospital beds per 1,000 people, but leads capitalist countries in the aggregate.

Table 13 shows health spending as a percentage of GDP among Caribbean and Central American countries. Cuba allocates more resources to health as a percentage of GDP than any other country in the region, demonstrating the Communist-led country’s strong commitment to meeting the health needs of its citizens.

North Korea

Publicly available data for North Korea is scarce if not altogether absent, but there are indications that the DPRK’s performance in checking the spread of the novel coronavirus is consistent with what one would expect of a Communist-led country with strong Confucian influences. Some news reports in Western mainstream news media refer to Pyongyang implementing vigorous measures of pandemic control. For example, The New York Times’ Korea specialist Choe Sang-Hun reported on July 25, 2020 that “North Korea has taken some of the most drastic actions of any country against the virus, and did so sooner than most other nations.” It is clear from the example of China, that countries that have prioritized public health, and have acted quickly and decisively to curb the spread of the coronavirus, have achieved impressive levels of infection control. Additionally, The Wall Street Journal reported on February 26, 2021, that “Alexander Matsegora, Russia’s ambassador to North Korea, said on the embassy’s Facebook page earlier this month that ‘thanks to the most severe bans and restrictions, [North Korea] turned out to be the only country which didn’t get the infection.’”

Given these reports, along with North Korea’s unquestioned ability to manage crises, including the collapse of its foreign markets in the early 1990s, flood- and drought-induced famines in the same decade, and the unremitting threat of US aggression, it seems highly likely that the DPRK has responded to the threat of Covid-19 with a high degree of competence, likely on par with that of its Communist counterparts.

Capitalist Incentives Foster Irrational Public Health Choices

It is instructive to consider that infection control as good as that achieved by the Communist-led countries would have necessitated a departure from capitalist logic in the capitalist countries.  

First, it would have required the temporary closure of a greater percentage of business establishments than most capitalist governments were prepared to tolerate, and for longer periods. Since the shuttering of businesses has deleterious consequences for the profits of business owners, capitalist governments acted to limit business closures in three ways: Shutting down a bare minimum of businesses, allowing many non-essential businesses to continue to operate; re-opening businesses before local infection rates had been brought under control; and failing to require adequate infection control measures for employees in businesses that were allowed to remain open.

Second, to approximate Communist country-performance, capitalist governments would have had to have quickly mobilized substantial public health resources to undertake large-scale screening and robust contact tracing. However, rather than implementing this public solution to a public problem—one which offered no benefit to private investors (except in the UK where contact tracing was handed to a private firm which immediately botched the job)—the leading capitalist governments chose to subsidize major businesses to compensate owners for their pandemic losses and to invest untold billions of dollars in vaccine development or pre-payment of vaccine doses or both, creating a pandemic bonanza for the biopharmaceutical industry and its major shareholders. This is not to say that investing in vaccines was unnecessary or undesirable, but that the timing was driven by capitalist incentives rather than public health rationality.

The leading capitalist countries declined to address the worldwide public health emergency by mobilizing resources for “shoe-leather” epidemiology to bring the pandemic quickly to heel, with the consequence that the emergency worsened. The worsening emergency was then used to justify the roll out of vaccines under emergency use authorization before they had been adequately safety-tested in fully completed Phase III trials.

The winners in this scenario have been the investors whose business interests have been protected from the effects of pandemic disruptions by government subsidies, as well as those wealthy enough to reap the benefits of substantial investments in the biopharmaceutical industry. The losers are the 150 million people who became ill or died unnecessarily and could have been protected from the ravages of the pandemic had their capitalist governments chosen to prioritize the health of the public over the health of their business communities’ bottom lines. Business that were able to remain open to satisfy the demand for goods that shuttered businesses would have provided, Amazon, for example, were also winners.

The leading capitalist governments could have mitigated the emergency to manageable levels, equivalent to those achieved by the Communist-led states, and then worked on the development, testing, and dissemination of vaccines. This would have saved millions of lives, and spared countless millions the potential hazard of being inoculated with vaccines which may or may not be harmful over the long term. This approach, however, would have meant spending public funds on “shoe leather” epidemiology, an investment which offered no profit-making opportunities of consequence to the business class favored by capitalist states. Plus, it would have required the closing of a large proportion of businesses for a month or more, attenuating profits—an anathema in capitalist society.

From the perspective of a capitalist logic, the course chosen was far more desirable, even if it meant more illness and more deaths. Limit business closures to a bare minimum to protect profits. Channel resources into subsidies for major businesses hurt by the pandemic. Make vaccines the main plank of the pandemic management strategy. These were the choices made by capitalist governments guided by capitalist logic. Vaccines offered an alternative to business closures and public expenditures on mass screening and contact tracing—an alternative with the promise of vast profits for those wealthy enough to get in on the action in a consequential way. 

The capitalist governments could have made the public health-friendly choices above to mitigate the emergency, prevent sickness, and save lives. They could have, but had they, they wouldn’t have been capitalist governments.

Conclusion

Capitalist society exists to protect and expand the interests of capitalists, not the interests of those who work for them. Capitalism may or may not exist in Communist society, but where it does exist, it is yoked to the people-centered aims of Communism, not the aims of capitalists. In Communist states, capitalists do not have political mastery.  

The degree to which Communist countries have eclipsed capitalist states in protecting their citizens from Covid-19 is substantial, and is evidenced in this: Had all capitalist countries managed the pandemic as effectively as the three Communist-led states, nearly 147 million people would have been spared illness and over three million lives would have been saved.

This conclusion is arrived at in the following way: At the end of April, 2021, approximately 147.8 million people had tested positive for Covid-19. Assuming a world case rate of 134 cases per million, equal to that of the Communist-led countries, the total number of cases in the world would have been 134 x a world population of 7.7 billion x 1/1 million, or approximately one million cases. Hence, 147.8 million less one million, or 146.8 million people worldwide would have avoided the illness. By significantly reducing infections, the pandemic may have been effectively extinguished, and the circulation of the virus sufficiently retarded that it could have been held in check by wide-reaching screening programs and robust contact tracing. This would have provided breathing room for a more deliberate and careful pace of vaccine development, thereby obviating emergency authorization of vaccine use prior to the collection of sufficient safety data.

Communist-led countries limited Covid-19 deaths to four per million. This fatality rate applied to the world as a whole would have produced a little over 27,000 deaths globally, compared to the 3.1 million who have died to date. In nearly a year and a half, a capitalist logic that discouraged temporary business closures, adopted non-pharmaceutical interventions with great reluctance and abandoned the few that were adopted much too early, and by its very nature favored the profit-making opportunities inherent in the pharmaceuticalization of public health, has cost the world over three million lives to date. Many more needless deaths will follow.

The Catastrophes of the Pandemic are the Catastrophes of Capitalism

Make no mistake: Business interests trump public health.

Abstract: For capitalist governments, maintaining conditions conducive to the profit-making interests of business owners and investors is the top priority; public health, only so far as it is necessary to maintain an adequate supply of labor, is not. Understanding this helps explain (i) why many capitalist governments have, in the face of the coronavirus pandemic, exhibited a high tolerance for public health catastrophes that could have been averted if only even mild measures had been taken to temporarily subordinate business interests to the public good, and (ii) why countries led by people-centered governments have performed better in protecting public health against the pestilence of COVID-19 than capitalist governments as a whole. This article demonstrates the second point empirically, via an analysis of cross-sectional country-level data bearing on the performance of people-centered vs. capital-centered governments in protecting the health of their citizens in the face of the coronavirus pandemic.  

Stephen Gowans

April 21, 2021

For days, doctors and scientists in Canada’s largest province, Ontario, had offered the government the same advice: close non-essential businesses for a few weeks to avert a looming public health crisis. Coronavirus infections were spreading rapidly in the workplace, in factories, in warehouses, and on construction sites. Workers who were infected on the job, were bringing the virus home to their loved ones. With new cases growing daily at an accelerating rate, hospital beds filling up, a backlog of surgeries growing ever larger, and COVID-19 therapeutics becoming scarce, the public health care system teetered on the edge of an abyss. Strong measures were needed.

The government acted.  It prohibited virtually every activity that could potentially create a super-spreader event—except one, the most significant: employees of non-essential businesses co-mingling at work. This was the engine of the new third wave. And yet the government refused to turn the engine off.

Critical care physicians, ICU nurses, and epidemiologists were bewildered. Why had the government ignored their advice to shutter non-essential businesses? Why was it refusing to implement measures to prevent suffering and save lives?

The director of the committee the government had set up to make science-based recommendations said he was “at a loss” to understand why the “government announced a suite of measures that didn’t account for his group’s advice.” Another panel member said “he was dumbfounded by the government’s rejection of science and common sense.” A third said “she and her colleagues were stunned.”

One critical care physician, interviewed on TV, said that she had been “reflecting on why this happened  and one thing that occurred to me is that the role of government is to protect the citizens.” Why, then, was the government failing to do so?  

Incompetence?

Governments are often accused of ineptitude when they behave in ways that lead to catastrophe. The disastrous handling of the COVID-19 pandemic by the Trump administration in the United States, and the botched response of the Johnson government in the United Kingdom, are often attributed to mismanagement. It’s as if some governments don’t know what they’re doing.

But the only way to know whether a government is incompetent, is to evaluate its actions against its goals. If you say my weight loss plan is a masterpiece of ineptitude because I’ve gained ten pounds, you’re right, assuming my goal is to lose weight. But if my goal is to manage my weight as best I can while gorging on pastries every day, your assessment is off the mark.

The trouble with declaring a government inept is that we may be mistaken about what the government is truly trying to achieve. Too often we make the wrong assumption about the goals that guide a government’s actions.

The critical care physician mentioned above assumed the public health goal of the government was to protect its citizens. And all the advice she offered took this assumption as its starting point. The obvious dissonance between protecting public health as a goal and the government’s failing to do what was necessary to achieve this goal, left her dumbfounded.

One way she could have resolved her puzzlement was to ask whether the government was pursuing a different goal. In fact, at one point she conceded rather tentatively and with much reluctance—as if the thought was too unsettling to contemplate—that maybe the government was more committed to the interests of business owners than to the welfare of the larger community.

As unthinkable as the thought may be, could it be that the true role of government in capitalist society is not to protect its citizens, but to protect what lies at the very heart of capitalism itself: profits? If so, then what seems at first to be government ineptitude, may, to the contrary, be government acting as it ought to act (or must act) within the framework of a capitalist logic.

It would hardly be surprising to discover that the Ontario government has a strong affinity with the business community. Its members are part of that community, and came to power on a platform of catering to its (and their) interests. They promised citizens they would deliver jobs and prosperity in return for allowing businesses to generate handsome profits.

For the head of the government, profits are not only critical, but personal. He is the co-owner of a manufacturing firm—one of the non-essential businesses that scientists advised him to temporarily shutter. Heeding their advice and ‘following the science’ would have had a direct and unwelcome effect on his bank account.

Members of his cabinet are no less married to profits. They include: a former investment banker and insurance company executive; the founder of an advertising business; a corporate/commercial lawyer; a former chamber of commerce president; and a financial analyst, the daughter of a former CEO, prime minister, and member of multiple corporate boards; she is married to an investment banker who is the scion of a wealthy publishing family. One would hardly be going out on a limb to suggest that this group might have a greater preference for keeping the profit spigot open than keeping the polloi—with its lowly factory, warehouse, and construction workers—safe from a pandemic.

It’s also probably safe to assume that the cabinet members are all ambitious people who hope, when their political careers are over, to secure lucrative positions in the C-suites or on the boards of major corporations. They know their ambitions are more likely to be realized if they have acquitted themselves admirably in government as able defenders of the business community against the democratic demands of the public.  Sacrificing profits to public welfare could not possibly recommend them to high-level, munificently remunerated private sector opportunities.

This is not to say that the Ontario government is indifferent to public health, only that public health comes second, and not at all, if one must be sacrificed to the other. The metaphor of sampling delights at a local bakery (protecting profits) while paying some heed to weight-management (protecting public health) illustrates the relationship. Capitalist governments like to say they’re protecting public health, and they are, to a point, but they’re only doing so, so far as they don’t endanger the health of the most important patient—profits.

Who gets harmed by a business-first, public health-second policy? In the case of the Ontario government, not its cabinet. After all, its members have been vaccinated, and have access to private medicine or connections that allow them to get priority access to the public health care system, even one under stress. And while the people who go to work every day in factories, warehouses, and construction sites will, along with their families, bear the brunt of the escalating crisis, what does it matter from the perspective of the business community and their representatives in government? In a capitalist system, factory, warehouse, and construction workers exist for one purpose: to promote shareholder value. Those who the virus ushers along the path from workplace to sick bed to cemetery, to no longer serve their useful function as means to shareholder ends, are easily replaced. The business-friendly fiscal, monetary, and immigration policies of the Ontario government’s federal counterpart have seen to that; they have underwritten a reserve army of potential replacement employees, ready to rapidly fill whatever void the virus creates.

From this perspective, the decision of the government to ignore its science panel’s advice to close non-essential businesses makes perfect sense. Seeing the logic in the decision requires that we ask: Government for who? Policy for who? Democracy for who? If the pandemic policies of the Trump and Johnson governments were disasters, who were they disasters for? They may have been catastrophic for the bulk of US and British citizens, but were they disasters for major investors and shareholders?

In a multitude of ways the interests of private profit-making enterprises, and those of the public, are antithetical. Businesses have an interest in paying their employees as little as possible, and employees have an interest in resisting their exploitation, and eliminating it altogether. The public has an interest in clean air and water, and polluters have an interest in shifting the costs of remediating pollution to the public. Employers have an interest in making their employees work under unsafe conditions if it means healthier bottom lines, and employees have an interest in safeguarding their health.

 In competitions that pit investors and shareholders against employees and consumers, businesses often come out on top. Their ownership and control of the economy equip them with the resources and leverage they need to ensure their policy preferences are transformed into policy directives—not always, but most of the time. They do so by ensuring their representatives are elected to public office, by funding think tanks to propagate their policy preferences, and by lobbying governments to adopt policies that are congenial to corporate aspirations. 

Moreover, the business community sets the ideological tenor of the times. It influences public opinion through its ownership of the mass media and influences the academic agenda by endowing university chairs and funding research programs. As a result, a pro-business ideology is instilled in politicians long before they arrive in government.

In an analysis of over 1,700 public policy issues, political scientists Martin Gilens and Benjamin I. Page concluded that “economic elites and organized groups representing business interests have substantial impacts on government policy, while average citizens and mass-based interest groups have little or no independent influence.” [1]

In other words, the demos, the ordinary people referred to in the word ‘democracy’, have virtually no influence on public policy, while wealthy business people and their lobbies and representatives in government, who constitute only a tiny fraction of the population, have substantial sway. G7 countries, and many others in the world, are not democracies, but plutocracies, countries ruled by the wealthy. And the public health policy of a plutocracy is one which, not always, but for the most part, addresses the concerns, interests and aspirations of the country’s financial and business center, not Main Street.

If government policy makes no sense within the logic of public welfare, but makes perfect sense within the logic of capitalism, the reason why is plain; it’s not incompetence that leads governments to stumble into public health catastrophes; it is capitalist logic that produces public health catastrophes as a by-product of the pursuit of capitalist interests.

A publicly-owned and publicly-directed economy is preferable to one predicated on a capitalist logic, for three reasons.

#1. A public system is specifically designed to redress the capitalist shortcomings and inequities that affect the lives of the majority.  

#2. Democracy. Capitalism, by definition, is a system for privileging capitalists, an infinitesimally tiny elite, at public expense. In contrast, a public system—which is accountable to the public at large rather than a small minority of private business owners—is democratic, by definition.

#3. People matter more in a public system. This can be seen in the superior pandemic performance of countries that have moved, to varying degrees, toward the ideal of public-ownership and planning of their economies, namely, Cuba, North Korea (DPRK), China (PRC), and Vietnam—countries led by what I’ve called Communist, or people-centered, governments. While none of these countries has achieved the ideal, they are the furthest along the path. 

In the graph below, I’ve shown per capita fatality rates for four Communist countries, as well as for major capitalist powers. I’ve also included capitalist countries and jurisdictions in East Asia and Oceania which have performed well in pandemic management. Since a country’s ability to manage a public health crisis ought to vary proportionally with income, I’ve juxtaposed fatality data against GDP per capita.

The graph shows that countries with higher incomes (Italy, France, the UK, and the USA) have performed poorly in protecting the health of their citizens, while the four Communist countries have performed well, despite having considerably lower incomes and therefore fewer resources for pestilence-management. The graph also shows that with the exception of Cuba, the best performers have been the East Asian and Oceanic countries, both capital- and people-centered.

The graph below shows that the three East Asian Communist countries have performed better than South Korea (ROK), Japan, and Australia, but only as well as Taiwan and New Zealand. However, the region’s people-centered  countries have achieved comparable levels of pandemic management despite lower per capita incomes than their capitalist regional counterparts.

The final graph compares the four people-centered countries with the capitalist world as a whole. Clearly, the East Asian and Oceanic capital-centered countries are anomalies, and the performance of the capitalist countries as a category has been significantly worse than that of the Communist countries in protecting their citizens from COVID-19.

Moreover, the superior public health performance of the people-centered countries has been achieved with significantly fewer resources than are available to capitalist countries, which have higher incomes per capita, and therefore more resources to protect public health if they choose to allocate their resources to this project. This finding suggests that Communist countries are not only more committed to safeguarding the health of their citizens, but do so with greater efficiency, since they have achieved better outcomes with fewer resources. This is consistent with the well-established finding that public systems deliver better public health outcomes at lower cost than private systems.

The graph also demonstrates that the idea that the public health role of government is to protect its citizens, while valid in connection with people-centered countries, is invalid as a description of capital-centered countries as a whole. Clearly, in the capitalist world, business interests trump public health.

Together, the graphs also show that public health disasters and recurring waves of infection are not inevitable outcomes of the coronavirus pandemic, and that it is possible to provide a high level of public health protection against the dangers of COVID-19, even with limited resources. Given that the people-centered governments have performed admirably without wide-spread vaccination roll-outs, it can also be concluded that vaccination is not the sole route to public health protection in the face of a novel virus. It is widely believed in the leading capitalist countries that vaccines are the offramp from the pandemic, but the data  presented here suggest that it was capitalist logic that steered most countries onto the pandemic freeway in the first instance—a freeway on which the Communist countries have never travelled.

An objection to this analysis is that Communist China and Vietnam are not people-centered but profit-centered, since both have embraced capitalism. While it is true that these countries have flourishing private sectors, it also true that they have substantial and growing public sectors and significant state planning. Moreover, Communist parties remain in charge, and while China and Vietnam may appear, at first glance, to be Communist in name alone, the red flag continues to fly in Beijing and Hanoi. In Bright Red: The Chinese Communist Ideal, [2] French Sinologist Alice Ekman examines the Chinese Communist Party’s internal documents and concludes that China’s true color remains red. China’s orientation toward capitalism compared to that of the United States, in which there is no ambiguity about its capitalist identity, is perhaps best illustrated by the following observation from the Wall Street Journal. “A figure like [Apple’s Tim] Cook commands a great deal of respect, even deference, in Washington. In Beijing, he’s treated like any other business executive—as a supplicant, angling for favors to keep his market hopes alive.” [3] In other words, unlike in capitalist countries, where government is but the means to capitalist ends, in China, capitalists are but the means to Communist ends.

Pandemics are inevitable. Whether they become disasters is contingent on who is prioritized by the underlying logic of a society’s organization. As the data above suggest, it is in capitalist countries, where capitalist logic elevates the interests of a tiny minority of wealthy business-owners above public health interests, that the coronavirus pandemic has become a disaster. In contrast, in Communist countries, where capitalist logic has either been eliminated or subordinated to Communist goals, public health has been protected to a degree far in excess of what is true of capitalist countries as a whole.  Avoiding future pandemic disasters will depend on learning the lessons that the public health catastrophes of COVID-19 have been the catastrophes of capitalism, its successes the successes of people-centered Communism, and that a pandemic of catastrophes need not happen the next time a zoonotic pathogen breaches the species barrier. Whether we, in the capitalist world, meet the next public health crisis as effectively as China, Vietnam, Cuba, and North Korea have met the challenge of COVID-19, will depend on the choices we make about whether to transition to a democracy where our common interests are brought to the fore, or whether we continue to accept our subordination to a capitalist logic in which we are only the means to capitalist ends.   

Sources

GDP per capita (PPP), The World Factbook, Central Intelligence Agency.

“Mortality Analyses”. Johns Hopkins University, Coronavirus Resource Center, March 28, 2021. Accessed on 7 March 2014.

Notes

1.Martin Gilens and Benjamin I. Page, “Testing theories of American Politics: Elites, Interest Groups, and Average Citizens,” Perspectives on Politics, Fall, 2014.

2. English translation of the book’s French title, Rouge Vif: L’Idéal Communiste Chinois.

3. Andrew Browne, “China’s dream is Apple’s nightmare: US tech firms cave for Beijing’s rules,” The Wall Street Journal, August 8, 2017.

DPRK. While there are no solid COVID-19 data for North Korea, there are a number of indications that the country’s infection and fatality rates are low. First, we can assume that the factors that have uniquely contributed to the superior performance of East Asian countries in managing the pandemic also apply to the DPRK as a fellow East Asian state. Second, a number of news reports refer to Pyongyang implementing vigorous measures of pandemic control.  For example, the New York Times’ Korea specialist Choe Sang-Hun reported on July 25, 2020 that “North Korea has taken some of the most drastic actions of any country against the virus, and did so sooner than most other nations.” It is clear from the example of China, that countries that have prioritized public health, and have acted quickly and decisively to curb the spread of the coronavirus, have achieved impressive levels of infection control. Additionally, the Wall Street Journal reported on February 26, 2021, that “Alexander Matsegora, Russia’s ambassador to North Korea, said on the embassy’s Facebook page earlier this month that ‘thanks to the most severe bans and restrictions, [North Korea] turned out to be the only country which didn’t get the infection.’”

Given these reports, along with North Korea’s reported commitment to effectively managing the pestilence, and its unquestioned ability to manage other crises, including the collapse of its foreign markets in the early 1990s, flood- and drought-induced famines in the same decade, and the unremitting threat of US aggression, it seems highly likely that the DPRK has responded to the threat of COVID-19 with a high degree of competence. Accordingly, for this analysis, DPRK deaths per 100,000 were set to the minimum for all other countries.

Taiwan. While the analyses include Taiwan, the territory is not recognized here as a separate country, but as a part of China under the control of the government of the Republic of China. Since the ROC offers an example of a capital-centered government in contradistinction to the PRC’s more people-centered approach, its inclusion in the analyses as a separate jurisdiction was warranted.