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Ideas and Opinions |

A Marxist View of Medical Care

HOWARD WAITZKIN, M.D., Ph.D.
[+] Article and Author Information

Grant support: in part by grants from the National Center for Health Services Research (HS-02100) and the Medical Clinics Complex Education Fund of the Massachusetts General Hospital.

▸Requests for reprints should be addressed to Howard Waitzkin, M.D.; La Clinica de la Raza; 1501 Fruitvale Avenue; Oakland, CA 94601.


Boston, Massachusetts


© 1978 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1978;89(2):264-278. doi:10.7326/0003-4819-89-2-264
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Marxist studies of medical care emphasize political power and economic dominance in capitalist society. Although historically the Marxist paradigm went into eclipse during the early twentieth century, the field has developed rapidly during recent years. The health system mirrors the society's class structure through control over health institutions, stratification of health workers, and limited occupational mobility into health professions. Monopoly capital is manifest in the growth of medical centers, financial penetration by large corporations, and the "medical-industrial complex." Health policy recommendations reflect different interest groups' political and economic goals. The state's intervention in health care generally protects the capitalist economic system and the private sector. Medical ideology helps maintain class structure and patterns of domination. Comparative international research analyzes the effects of imperialism, changes under socialism, and contradictions of health reform in capitalist societies. Historical materialist epidemiology focuses on economic cycles, social stress, illness-generating conditions of work, and sexism. Health praxis, the disciplined uniting of study and action, involves advocacy of "nonreformist reforms" and concrete types of political struggle.

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