Health: a Spanish lesson

The picture that concentrated Franco's mind so wonderfully

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An American reader familiar with Spain asked me what possible relation there could be between the American situation and the Spanish one, where, as she pointed out, public health care predates Democracy. I thought it such an interesting question that I decided to answer her here.

Many years ago I worked on a project for a large American, family owned corporation with manufacturing facilities in Spain. They wanted to close a factory and they were amazed at the penalties they would have to pay to shut the thing down. They demanded a detailed history of Spanish social legislation, which I helped to research.

I speak from memory, but I seem to recall that we discovered that almost all the Spanish welfare state dated from when it became obvious that Hitler was going to lose the war. The idea of the victorious allies charging over the Pyrenees and Nuremberging him concentrated Franco’s mind wonderfully.

Franco, brutal victor in the recent civil war was always a practical and expedient fellow, so he threw the defeated working class a fish. Providing health care, protecting jobs and paying the summer and Christmas bonuses helped the police state keep control of the defeated working class during those black years before prosperity arrived, with the tourists, in the 1960s.

Basically then, Spain had some sort of health system under Franco because he was afraid of hanging by his feet in a gas station like Mussolini.

Until the Socialists reformed it in the 80s it was a very, very half hearted, half assed system indeed. And it was the fear of Spain going Communist after the death of Franco that allowed the reformist Socialist government of Felipe González which had been previously "restructured" under the guidance of Willy Brandt's SPD to finally take power and, once they agreed to stay in NATO, receive the blessings of the US as the lesser of many possible evils.

In a sense the entire European welfare system was put in place because the elites were afraid of the working class going with the Communists in the late 40s and early 50s. In the democracies the pressure was expressed in the ballot box, in Spain by police informers relaying the mood of the population. What is necessary today in America is to produce that same unease at the top of the American system. The civil rights struggle shows that this is as possible in the USA as in Europe.

If the Republican Party and the American conservatives in general were still more or less normal, like they were under Eisenhower or even Nixon, they would probably do like Franco and throw the fish. They showed that sort of pragmatism when confronted with the reality of "burn baby burn". But I think the Ayn Randies, the Norquististas, the Cato Instituters and assorted Reaganites, are a bunch of real Talibans and will fight this thing to the death and that will be the transformational struggle. Just like during the civil rights movement, there have to be people in the streets and a change or heightening of consciousness to bring about this transformation.

There would be two good things in this: one, the people would finally get health care and two, the struggle itself would change their consciousness. Thus, the unyielding resistance of the American Reaganite conservatives to any state health care system is fundamental to the final transformational effect. If any of them were half as intelligent as Franco was there would be no transformation.

As Democrats are not really people of the left they don’t seem to understand that politics like the rest of life is a constant, shifting, conflict of contradictory entities with contradicting interests and that these different interests struggle continuously among themselves and that this struggle produces what the Hindus call "Maya” or what the rest of us call “reality”: something of only apparent solidity, something which is constantly in flux.

To transform reality it is important first to understand the dynamics of these contradictions and to know when it best to push one place or to not push on another. This dialectical approach is very foreign to American politics. It would be easier for an American psychotherapist to understand the dynamics of transforming political reality and the value of the process of transformation than for the average American political commentator. A therapist easily understands that the process of becoming is as important as, or more important than the becoming itself, since in fact, everything only exists in the act of becoming and never really finally becomes, except, perhaps, when it dies.

Health care obviously wouldn’t be “transformational“ for Spanish politics because health care already exists in Spain. It was precisely Franco's readiness to concede it that kept it from becoming transformational. To create such a system in the USA would transform America because health care doesn’t exist and, given the rigid ideological stance of American conservatives, it probably would take a huge struggle to get it to exist. Since there are 40,000,000 people without coverage, this would constitute a formidable army in this battle. The struggle is just as important as the final result or to put it another way, the struggle is the result. DS