How to interpret facts

Louis Proyect lnp3 at
Sun May 6 13:16:19 MDT 2001

George Snedeker:
>I do agree with Louis that the conditions of the working class has worsened.
>I only meant that "facts" will not settle this argument. the argument is
>based more on assumptions than facts. after all, to quote Nietzsche, "that
>are no facts outside their interpretation." on this point, I think Marx
>would agree. Julio is making a formal argument based on logical premises.

Actually, facts are insufficient as well. We went through nearly a week on
PEN-L trying to figure out whether the world is getting better under
capitalist "globalization" even if it is nasty around the edges. Henwood
cited United Nations Human Development Indicators showing that life
expectancy and other such data had been improving in Argentina, when
anecdotal evidence from Nestor and newspaper reports described the worst
calamity outside of the former Soviet bloc. So what were the facts?
Moreover, if the facts are not in dispute, how should one analyze them. I
gave a clue to how to do so from a book on Chile that was written to debunk
the myth of free market success under Pinochet. This was what I posted:

Joseph Collins and John Lear, "Chile's Free-Market Miracle" (Food First
Books, 1995):

The declining infant mortality rate so celebrated by the dictatorship is
attributed by its neo-liberal policymakers as proof that focusing the
government’s health care resources "works." But they gloss over the fact
that, in the face of the deterioration in living conditions of so much of
the population due in no small measure to free-market economic policies,
major governmental efforts were mobilized to insure that more infants did
not die. As Clara Haignere concludes from her study of health and
free-market economics in Chile, ". . . infants from low-income families
have been kept off the coroner’s books not by ‘sound capitalistic economics
but by expanded and new ‘socialistic’ maternal and child health care

The government’s focusing of its reduced health budget on impoverished
infants and mothers is only one of several important factors in the decline
in infant mortality.

Most fundamentally, many health experts who have analyzed the decline in
infant mortality in Chile during these years view it as part of a long-term
trend since the 1920s (especially rapid during the years of the Frei and
Allende presidencies). They attribute this trend primarily to the expanding
coverage of health services, free for blue-collar workers, that is, to the
legacy of government-supported interventions highlighted earlier in this
chapter. They point also to the tradition of publicly funded universal
basic schooling, even suggesting that the effectiveness of the neo-liberal
government’s stepped-up programs targeted at poor mothers was greatly
boosted by the legacy of public schooling among poor women and of a network
of publicly financed health services facilities.

Another factor in Chile’s declining IMR was that in the 1980s in Chile (as
in so much of the world) there was a baby boom among the yuppies which
would tend to improve the infant mortality figures since a greater portion
of babies were being born to families with significantly better incomes and
therefore healthier living conditions.

Some of these health experts also call attention to the fact that from 1983
on infant mortality virtually ceased to decrease. This underscores, they
argue, the limits of narrow technical interventions that address the most
glaring symptoms of impoverishment rather than its roots in the inequitable
distribution of economic resources. These underlying causes are pointed to
by the fact that, despite the focusing of publicly funded health services
on the poorest infants and their mothers, the infant mortality rate near
the end of the Pinochet regime (1989) was more than three times higher in
Santiago’s poorest neighborhoods than in the ritziest. For instance, the
rate in Cerro Navia was 23.1 while in Providencia it was only 7.5.

A number of the health professionals we spoke with charged that the
proponents of infant-mother targeting seem willing to sacrifice everything
else. Luz Ramirez, a social worker for 13 years attached to the public
clinic in the población of Lo Prado, in the course of giving us an overview
of the serious health problems of the neighborhood exclaimed, "What we’ve
been through here is excessive targeting! They targeted infants and
low-weight pregnancies but abandoned the old, the chronically ill, the
well. No preventive care. No dealing with the rampant alcoholism even among
the young. They’re interested only in small children and only once they are
sick. This isn’t health care; it’s just recuperation "

Children only somewhat older than the infants who were the focus of the
government’s nutrition and medical care programs (children aged one to
four) failed to show a comparable decline in mortality rate and suffered
from increased illness. Accidents and poisoning during this period emerged
as leading causes of death for children, greatly increasing for small
children; this is due, some researchers think, to a wide range of
heightened "hazards confronting children in poor families — unsafe
neighborhoods, increased alcohol and drug abuse, overcrowding, fragmented
families, family violence." A new phenomenon has been the death of young
children, locked in their houses by parents working or looking for work,
from fires and other accidents.

As will be discussed below, while the public sector in health services
suffered severe cutbacks and the focus narrowed largely to infants, many
infectious diseases in Chile showed marked increases, especially those
diseases against which there is no "one-shot" immunization but are
engendered by the severe deterioration in nutrition and living conditions
suffered by so many Chileans.

Manifestly what is not the case is what the Pinochet dictatorship and its
free-market cohorts would have the world believe, namely, that the decline
in the percentage of infants dying demonstrates that the Chilean people
have benefited from the neo-liberal approach to health care. What is
demonstrated by the experience of Chile is that it is a mistake to use
infant mortality as the sole yardstick to measure a nation’s health
services let alone its people’s well-being.

Louis Proyect
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