Thoughts about socialism

When socialism emerged as a political force, about a hundred years ago, it embodied a twofold promise of liberation from basic needs and unnecessary and unpleasant work. Although poverty still exists in many parts of the world, even in some countries where the majority of the population is rich, the first promise has been fulfilled. The per capita income of a citizen in the year 2000 will be four times greater than that of the year 1950.

Between 1870 and 1979, production per worker became 26 times greater in Japan and 22 times greater in Sweden. In the whole world it is now double what it was in 1962. However, millions of people in the world see liberation from work, made possible by rapid technological and organisational progress, as a privation. Only in the 23 countries of the OCDE there are about 35 million unemployed and, although exact figures are not known, this figure must reach hundreds of millions in the rest of the world. If productivity continues to increase at the same rate, in 2030 it will be possible to produce at the same level as we are producing now but with only half the workers. That is why, even if per capita income grows to the historical level which we have seen, unemployment will continue to grow.

Can full employment be reached? Is this desirable?
We must face the fact that the unemployment problem will not be solved even if everybody is employed. Neither should this be done. Making people work unnecessarily would be the same as substituting one privation for another. The possibility of liberation from unnecessary work is a great historical opportunity, and we should therefore find the way of putting an end to the sufferings derived from unemployment and of enjoying the freedom of free time.
Specifically, we must find the way to 1) separate income security from paid employment, 2) develop social integration mechanisms other than employment, 3) put an end to the cultural disgrace that falls over any kind of activity which does not generate income. A type of minimum wage system is required to provide material security and to favour job mobility. Socially organised activities are necessary because they impose a structure and a discipline on the life of the individual which help maintain social integration. Finally, a great cultural change which may revalue those activities which do not generate income is also necessary.

Objectives which society can choose
Capitalism is a system in which most of the means of production are in private hands. In capitalism, property is institutionally different from the political authorities: this separation is necessary for the existence of a market. As a result, there are two mechanisms by means of which resources can be allocated to different uses and then distributed to different homes: the markets and the State.
The allocation of resources which would result from a liberalised market may be different from that which would result from a democratic process, because people’s objectives may be different when they act as market agents. The preferences expressed in the political process may be different to those expressed in the market because of justice considerations. The distribution of income which results from the market depends on the initial conditions and can be collectively considered unjust. In the same way, security may be another point of divergence. Markets do not and can not provide security against risk. People might prefer to have more security than that provided by the market. Solidarity could be another reason.
As justice, security and solidarity are some of the collective objectives which the market can not satisfy, there is no reason to limit the objectives to the strictly economical. Beauty is as legitimate an objective as justice: as citizens, the people may prefer to keep the opera, even if economic agents do not want to pay its cost. The opera can be an ecological good: a cultural legacy which people might wish not to lose, so that it can be enjoyed by future generations. Justice, security and beauty are aims which people can decide to pursue independently of market profitability.

Majority government and individual rights
Popular sovereignty clashes with individual rights. Not all verdicts which result from the people’s will, expressed in the democratic process, should be feasible. Democracy must not be based on the majority principle alone, but also on protecting the rights of the minorities.
Even with the support of the majority, as socialists, we must respect the right to religion and to individual autonomy. Government intervention must be limited by its commitment to individual rights. Constitutional principles are necessary in order to limit the field of action of the Government. The State must not only be efficient and feasible, but also limited. However, limited does not mean small.

Is there a socialist economic alternative?
The traditional socialist economic alternative has failed. However, it is very important to distinguish between types of русское порно and mechanisms to allocate resources.
Types of ownership. The question of ownership is still open. There is no reason why types of owmership should not include public companies, which belong to the employees, and companies which belong to investors. All developed Western countries have mixed types of ownership: the most important insurance company in the United States is a consumer co-operative and the most important airlines belong to the employees, whereas the State is the most important land owner. There are enough reasons to believe that the type of ownership does not have an influence on the efficiency of the company, even if co-operative property reduces differences in income and promotes income flexibility.

Mechanisms to allocate resources. In any complex economy, individuals know better than anybody else what their needs are and what they can do. When this knowledge is private, the State can not give a centralised order to allocate resources. This is why we will continue to live in economic systems where the greatest part of the resources are assigned by the market, regardless of who owns them.

The neo-liberal project intends to put an end to State intervention by cutting down its functions to a minimum and limiting the economic policy to, for example, balancing the budget or delegating this to organisations which are in no way related to the political process, such as central banks. Sometimes markets fail to allocate resources efficiently, not only because of traditional failures of the market, but precisely because a great part of the information is private and because some markets are missing, especially risk markets. Only workers know how much they can produce. Only salespeople know about the quality of a second-hand car, only the unemployed who live on a subsidy know whether they can really find a job or whether they prefer not to do so. When different people know different things, market prices do not inform about opportunities. On the other hand, when there are no risk markets, people refuse to run risks which benefit society. The allocation of the market is, therefore, inefficient.

State intervention can improve the market allocation of resources, even if the Government has no more information than market agents. Even if State intervention can not solve all the problems, an economy in which the State has an active role can be superior to a deregularised market economy.

What kind of State will do what it should?
Thus, the State has an important role to play organising, directing and correcting the markets. However, there is nothing to guarantee that State intervention will be beneficial. Civil servants work with limited information and under the pressure of special interests, so they may not know how, or they may not want to undertake actions to promote general well-being, instead of their own well-being or that of their associates. The question lies in knowing what type of State will do what it should and not what it should not. The aim of State reform should be to create institutions which will provide it with the necessary instruments to intervene efficiently, making civil servants work for the general interest.

Some of these initiatives can be taken from the internal organisation of the government: brakes and equilibriums, evaluation of policies by the opposition, incentives to civil servants. It is not, however, enough. For the government to work, bureaucracy must be supervised by elected politicians who, in turn, must be responsible before the citizens. In particular, politicians must use the knowledge that citizens have of the way the Administration works to control civil servants, whereas citizens must know who is responsible and punish them accordingly, so that those Governments that work well stay in power, and those that do not, lose it.

What makes democracy effective?
The quality of public policies depends on the quality of democracy but, what makes democracy effective?
Participation. Democracy is a system which guarantees citizen rights, but it does not automatically generate the social and economic conditions which are necessary for these rights to be exercised effectively. While social and economic inequalities which limit the access to the political system continue to exist, participation can be limited to the perpetuation of class relationships. Democratic participation requires a better distribution of the goods which will encourage people to exercise their citizenship and better regulate the access of politicians to public funds.

The financing of political parties and election campaigns is the main mechanism through which economic inequality appears in the political environment. In order to counteract the effect that money has on political inequality, financing should be limited to public funds and members’ contributions. Public financing should favour new and small parties to help them enter the electoral field.

Responsibility. Participation is not enough. If participants can not control the way institutions work and they do not have the means to reward or punish them, participation will carry on being symbolic. It is more important to know whether Governments can be controlled than to know who exercises that control. The control which citizens can exercise presents problems because of differences in information about the conditions in which Governments implement their policies and about their effects on the issues that people care about.

If citizen control over the Government is to be effective, the electorate must be able to clearly define the responsibility of the Government and to take power away from those who do not fulfil this responsibility. Governments in power must have incentives in order to seek re-election. The opposition must control the work of the Government and inform the citizens. The mechanisms of responsibility must not be ‘vertical’ only (of the politicians with respect to the voters), but also ‘horizontal’ (between the different Government departments). Parliament must have an active function in the discussion and formulation of policies. The Executive, in turn, has to be able to control the Administration, and an autonomous body should be able to supervise the media.

Elections are insufficient as a control system: the electorate can only make one decision with respect to the whole programme of a party. Citizens must have some institutional means of having an influence on politics and controlling the Government in different fields. These institutions can count on the participation of NGOs in the political areas in which they specialise, on a de-centralised government in which citizens can have a say in legislation, on Complaints Commissions armed with independent powers of investigation. Alternatively, citizens may be allowed to rebuff the decisions of the Administration in court or in administrative courts, which is a common practice in the United States.

What kind of equality do we socialists want?
The allocation of the market is not only often inefficient: it is also unfair. The income generated by the market is related to opportunities which it has not itself generated . It does not depend on effort alone, but also on luck. We, the socialists, have always fought for equality. But, what equality? Equal possibilities to choose the life one wants? Equal opportunities? Income? Happiness? Material security?

Equal opportunities are impossible in practice, and insufficient in view of justice criteria. We will never know what all the elements which have an effect on opportunities are, that is, even if we make things as equal as possible, random changes will always take place. Two people can make the same effort, but one of them can be unlucky. We can also find people who are disheartened because they did not make the most of the opportunities they had. Two children can have the same education, but one of them may be lazier, not finish their studies and miss the opportunity of finding a job. Can we abandon them because their poverty is a consequence of their actions? Or must we, on the other hand, guarantee equality in the field of material security as well as in the field of opportunities?

Can a universal welfare system be only a security system?
The welfare state can be a security or a solidarity system. If the risks which threaten some social groups or categories of individuals are known, those groups which are not as threatened exert political pressure to separate themselves from the rest. Some people are against the existence of an unemployment benefit as soon as they know who is likely to lose their job and who is likely to keep it. In France, for example, there is an unemployment rate of 10% amongst the native population, whereas it is 24% amongst immigrants. There are people who are against the existence of social security when they know who will need medical assistance and who will not. Therefore, if the welfare state wants to stay universalised it must be based on principles of solidarity and not only of security.

Solidarity. With whom?
We can feed the whole planet. We are capable of it. But we do not do it.
Why? Partly because solidarity costs money. It requires some people giving up part of their income to give it to others. Furthermore, it is often said, rightly or wrongly, that taxes and transfers discourage people from looking for or keeping a job. Another reason would be that the costs of the transfers are seen as a waste. Also, when they are conditioned, the values of the donators are imposed on the recipients: they are patronising. And when they go beyond the national boundaries, they often find the interests of the receiving Governments, disguised as a so-called national sovereignty reason.

Social policies as an investment
There are about 800 million people in the world who eat enough to survive, but not to work. From certain points of view, subsidising their food would increase the net income of the poorest country in the world by 18.3%, and that of the world in general by 3.1%. According to the Nobel Economics Price Robert Fogel, 30% of the economic growth of the United Kingdom since 1780 results exclusively from the improvement in the diet.

Education, and especially primary education for women, is of vital importance for the increase in per capita income. This is one of the reasons why: an Indian who wishes to have a 90% probability of his son surviving until he is 60, must have more or less 6.3 children, the birth rate in India. Educating women would mean that a surviving daughter could fulfil the same aim, thus reducing the birth rate by 50%.
Preventive health programmes reduce health costs. The lack of micro-nutrients can mean a loss of 5% of the GDP in human lives, disabilities and productivity. Solving the problem would cost less than 0.3% of the GDP. In the United States, for every dollar spent on maternity 11 dollars are saved in post-natal care.

From an economic point of view, using resources in order to increase the productivity of physical or human capital must be considered an investment. This is not new: socialists have long since understood that many social costs are not only a way of protecting those in greatest need, but also an investment in the common future.

Effects of globalisation
The globalization of the economy has reduced the economic barriers that checked mobility. In the past, the frontiers between states were strengthened by the costs of trade in goods, people, capital and ideas. As barriers have disappeared, many people from poor countries are afraid that globalisation will increase inequality, while in rich countries they fear a fall in their standard of living. Both effects are impossible simultaneously, which comes to show that we do not really know what the effects of globalisation are.
Is it true that globalisation makes nations lose part of their sovereignty or is it just that Governments lose control? Obviously, greater freedom of movement and international economic integration limit the autonomy which Governments have to implement economic policies which control social conflicts and regulate political conflicts. But this also opens the way to ideas, and to capital and labour markets. It allows poor countries to compete with rich countries. Despite their rhetoric, protectionism is typical of developed countries. The losses of the less developed countries, caused by the restrictions of the richer countries, is equivalent to the money they obtain as external help.

It is important to take these facts into consideration because many of the arguments heard against globalisation are concealing nationalist and racist feelings.

Can international government be democratised?
The rapid increase of economic interdependence makes it necessary to create international mechanisms to regulate the international economy, the environment and political relations on a world-wide level. The government systems referred to by some as ‘international regimes’ have made their appearance in some fields, from trade to environment, including human rights. But there are problems with execution, transparency and democratic control in these regulation mechanisms. Their capacity to comply with international decisions depends on the interests and the will of national Governments, which makes it harder and weakens the possibilities of agreements being kept. The United States, for example, for internal policy reasons, have flagrantly disregarded their obligation to contribute their quota to the UNO, as well as towards the trade agreement of which they have been the main supporters. The greatest secret surrounds the work of the public international financial institutions. Also, the only mechanism of democratic control is the control which can be exercised by Governments, many of which do not take responsibility before their citizens.

Which are the socialist forces?
Any debate on the future of socialism must face the question of agents.
The syndicates? The socialist system, as it was developed in Eastern Europe, was, to a great extent, a workers movement which was organised in syndicates. The syndicates were the organisations which promoted and created solidarity. But economic changes have reduced the numerical importance of industrial workers. The syndicates are weak in most countries, and in those countries where they were strong they are weakening. Then they turn to defend small corporate interests. Thus, we are facing the task of moving forward with socialist policies without the support (and sometimes with the opposition) of the main historical protagonist.

The parties? The electoral success of socialism in developed democratic countries has given socialist parties a special character. A hierarchy of leaders and followers has appeared and the progress of socialist ideas has been left in hands of the leaders. From the initial demand that it was necessary to obtain political power to protect the movement from repression, the socialist parties moved on to limit this movement to a quest of power. They de-mobilised all those (co-operatives, councils and communes) who could not be used for electoral purposes. They withdrew their support from all measures of popular rooting which could be tried and developed autonomously, and they adapted all new movements to their electoral strategies. All issues which did not have an electoral response were disposed of and socialist issues were reduced to those which could result in victory.

The purpose of debate
The purpose of debate, at least my intention, is not to create a programme, a collection of practical solutions, but to extend the debate to all official channels, bring it into the work place, into the homes, into the bars, into everyday conversations. The renewal of socialist ideals can not come from socialist parties. It can only be the result of the contributions of all those who wish to live in a fair and rational world, who wish to live as they like, but with others. It can only come with young people’s demands for things which are almost impossible, by putting our commitment to the principles which we boast about to the test and making us answer for the future we are preparing for them.

Stem cell hope for urinary incontinence

Women’s own bodies may hold the key to their recovery from incontinence, researchers say. In a small study presented November 29 at the Radiological Society of North America annual meeting in Chicago, Austrian researchers successfully used their patients’ own stem cells to treat urinary incontinence.
The therapy is a potentially long-lasting one, with patients remaining continent one year after treatment.

Although the technique needs to be studied in more women and for longer periods of time, Dr Joe Littlejohn, a clinical instructor of urology at Columbia University College of Physicians and Surgeons in New York City, called the results “very promising.”

Stem cells are unspecialised cells that eventually grow into the myriad specific cells the body needs for specific functions.

Stress incontinence, the form of incontinence treated in this study, affects almost 15 million people worldwide, most of them women. Often the condition is a result of childbirth or ageing. It occurs when problems with the urethra or the sphincter muscles that help open and close the urethra cause urine leakage. Current therapies range from pelvic floor exercises to collagen injections to surgery, Littlejohn said.

These researchers built on preliminary studies already conducted, which used adult muscles derived from stem cells to reconstruct the lower urinary tract.
For this particular study, the authors removed stem cells from the arms of 20 females, aged 36 to 84, who were experiencing stress incontinence. The stem cells were cultured, producing tens of millions of new cells, then injected into the wall of the urethra and into the sphincter muscle.

“The good thing about this new procedure is it’s less invasive and the stem cells are harvested from the patient’s own body, so you don’t have to worry about rejection,” Littlejohn said. The cells also stayed where they had been injected and, when enough muscle had been formed, stopped growing.

All the women in the study experienced enhanced muscle mass and contractility of the sphincter and a thicker urethra. The procedure, which was done on an outpatient basis, took 15 to 20 minutes to complete. At one year after the initial procedure, 18 of the 20 participants remained continent.
The researchers are still following the participants with the longest follow-up, who were treated as far back as October 2002. “We still have good results,” study author Dr Ferdinand Frauscher said.

Frauscher, head of uroradiology at University Hospital in Innsbruck, Austria, said his team has plans to start using this technique at other centres. “Next year we will start in three centres in Austria, two in Germany, one in Switzerland and one in the Netherlands,” he said. “We are also planning to perform this in the USA.”

To become widely available, centres would need to be able to perform ultrasounds to help determine where to place the stem cells as well as a lab for stem cells to be cultured.

Frauscher said the procedure has also been tried in a few men after prostate surgery. “It should work well, especially after radical prostatectomy, because the sphincter is one of the most important muscles for maintaining continence,” he said. “However, if there are large video porno gratis, this might be a limitation.”

Frauscher is a consultant for InnovaCell, which produces the stem cells. Two other authors of the study are owners of the company.

My dexa scan experience

I lie down on a bed, wearing a knee-length, fleecy gown and underpants. The room in the radiology centre is warm enough, though the day outside is cold. Not knowing what to expect, I wonder what the bone density scan, for which I’ve paid $80, will involve.

I had assumed that all I would have to do was take off my shoe, and put my foot into some sort of bone density measuring device. But there are, in fact, several types of density tests, and I am being given the one that is the most relevant for a pre-menopausal woman like me checking for signs of osteoporosis.

I had tried to side step the referral process and make a scan appointment myself, but these radiology people like a doctor involved in case there’s a need for follow-up treatment. So I phoned my GP’s practice and he faxed a referral to the radiology centre I had selected – it was near home.

Luckily the type of scan I had is reputedly the most accurate indicator of bone mass – the DEXA scan, which stands for dual-energy x-ray absorptiometry.

The young radiographer who had earlier directed me into the changing room appears again and shows in into the room where I will have the scan. I scuttle in before anyone can see me looking like a half naked bag lady!

From here on it is a dream, really: the most painless and least invasive medical procedure I have ever had. I almost fall asleep.

I do have to ask questions, but they are answered adequately. The scan uses very low radiation, so the radiographer can be in the same room without wearing protective clothing.

She asks my weight (there are scales in the room if you need them) and height. My age is on the referral form.

The DEXA scanner is different from x-ray and ultrasound machines. You lie on you back the whole time, and a long, thin metal arm reaches across the bed, about 0.5m above your body.

First, the spine picture. The radiographer asks you to lift your legs so she can put a large, square cushion under your knees, which keeps your thighs up, almost at right angles to the bed.

Operated from a desk in the corner of the room, the machine arm then slowly slides the length of the bed above your torso, making a bit of a racket as it moves.

Then you have to move your feet apart while the radiographer places a thin metal plate between your legs, in the knee/thigh area. All done matter-of-factly; she’s done this a thousand times. Then, asking you to relax with your legs out straight, she puts a soft strap around each ankle, and yanks them gently to turn your legs at an angle that apparently “opens out the hip joints” for a good picture of the bones. It’s not as embarrassing as it sounds.

After two more minutes of the machine gliding back and forth above you, you’re getting dressed again. The whole procedure took only 20 minutes.

The scan is evaluated by a doctor (radiologist) later that day. The next day a copy is mailed to my GP, and I also receive one.

But I have to confess that when I see my results they don’t mean much – they look are like in a foreign language, lists of figures and pictures that mean nothing to me, plus a summary sentence that gives T-scores and recommends another scan in two years.

The radiology centre cannot find a staff member to explain the results when I phone, so I surf the net to discover how to interpret them. I decide I’m disease-free, and will have another scan in two years.