Capitalism, the state and health care in the age of austerity:A Marxist analysis

The capacity to provide satisfactory nursing care is being increasingly compromised by current trajectories of healthcare funding and governance. The purpose of this paper is to examine how well Marxist theories of the state and its relationship with capital can explain these trajectories in this period of ever-increasing austerity. Following a brief history of the current crisis, it examines empirically the effects of the crisis, and of the current trajectory of capitalism in general, upon the funding and organization of the UK and US healthcare systems. The deleterious effect of growing income inequalities to the health of the population are also addressed. Marx’s writings on the state and its relation to the capitalist class were fragmentary, and historically and geographically specific. From them, we can extract three theoretical variants: the instrumentalist theory of the state, where the state has no autonomy from capital; the abdication theory, whereby capital abstains from direct political power and relies on the state to serve its interests; and the class-balance theory of the state, whereby the struggle between two opposed classes allows the state to assert itself. Discussion of modern Marxist interpretations include Poulantzas’s structuralist abdication theory and Miliband’s instrumentalist theory. It is concluded that, despite the pluralism of electoral democracies, the bourgeoisie do have an overweening influence upon the state. The bourgeoisie’s ownership of the means of production provides the foundation for its influence because the state is obliged to rely on it to manage the supply of goods and services and the creation of wealth. That power is further reinforced by the infiltration of the bourgeoisie into the organs of state. The level of influence has accelerated rapidly over recent decades. One of the consequences of this has been that healthcare systems have become rich pickings for the evermore confident bourgeoisie.

New Ways of Looking at the State Apparatus and the State Archive in Nineteenth Century Ireland: Curiosities from that Phonetic Museum - Royal Irish Constabulary Reports and their Political Uses, 1879-91

This essay seeks to contextualise the intelligence work of the Royal Irish Constabulary, particularly in the 1880s, in terms of the wider British and imperial practice and, as a corollary, to reflect upon aspects of the structure of the state apparatus and the state archive in Ireland since the Union. The author contrasts Irish and British police and bureaucratic work and suggests parallels between Ireland and other imperial locations, especially India. This paper also defines the narrowly political, indeed partisan, uses to which this intelligence was put, particularly during the Special Commission of 1888 on 'Parnellism and crime', when governmentheld police records were made available to counsel for The Times. By reflecting on the structure of the state apparatus and its use in this instance, the author aims to further the debate on the governance of nineteenth-century Ireland and to explore issues of colonial identity and practice. The line of argument proposed in this essay is prefigured in Margaret O'Callaghan, British high politics and a nationalist Ireland: criminality, land and the law under Forster and Balfour (Cork, 199

The State, Compartmentalization and the Turn to Local Community: A Critique of the Political Thought of Alasdair MacIntyre

Alasdair MacIntyre condemns modern politics, specifically liberalism and the institutions of the liberal state, as irredeemably fallen. His core argument is that the liberal state encourages a disempowering ‘compartmentalization’ of people’s everyday roles and activities that undermines the intersubjective conditions of human flourishing. MacIntyre’s alternative is an Aristotelian politics centred on the notion of “practice.” Defined by justice and solidarity, this politics can only be realized, he claims, within local communities which oppose and resist the dictates of the administrative state and capitalist market. Here it is argued that MacIntyre’s notion of “practice” represents a compelling ethical-political ideal. However, the belief that this ideal is best realized within local communities is rejected. In privileging local community, MacIntyre relies on a reductive view of modern states and overlooks the institutional conditions of a just polity. Against this, it is argued that a politics of human flourishing cannot succeed without an emancipatory transformation of large-scale, trans-communal institutions, in particular the state.

Recognition and Redistribution in Theories of Justice Beyond the State

We consider here how cultural and socioeconomic dimensions of justice beyond the state are related. First we examine cosmopolitan theories that have drawn on John Rawls's egalitarian liberal framework to argue that a just global order requires substantive, transnational redistribution of material resources. We then assess the view, ironically put forward by Rawls himself, that this perspective is ethnocentric and insufficiently tolerant of non-liberal cultures. We argue that Rawls is right to be concerned about the danger of ethnocentrism, but wrong to assume that this requires us to reject the case for substantive redistribution across state boundaries. A more compelling account of justice beyond the state will integrate effectively socioeconomic and cultural aspects of justice. We suggest that this approach is best grounded in a critical theory of recognition that responds to the damage caused to human relations by legacies of historical injustice.