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Evolution or Revolution: Lessons from Chile¹

by Howard Waltzkin & Hilary Modell

‘Science for the People’ Vol. 6, No. 6, November 1974, p. 6 – 13

This account is based on available written sources as well as observations of Chilean citizens and foreign visitors. One of us (Hilary Modell) worked from 1971 to 1973 as a member of a health team in Chile under a program sponsored by the UP [UNIDAD POPULAR] government; she was present in Chile during the September coup. Current information depends largely on foreign journalists and observers, as well as witnesses who left the country after the coup.

With the military coup d’etat of September, 1973, 41 years of constitutional democracy in Chile came to an end. The purpose of our paper is to analyze (1) some of the changes that occurred in the Chilean health system during the government of Salvadore Allende, (2) the political and economic constraints that limited the viability of the socialized health system in Chile, and (3) the dismantling of the health system that has occurred under Chile’s present totalitarian regime. The implications of the Chilean experience for health care and social change in the Third World are clearly evident: health care is inextricably linked to a nation’s political and economic systems; conflicts within the health system mirror the inherent conflicts of a stratified society; and incremental reforms in the health system have little meaning without basic change in the social order.

Achieved Reforms

Health programs instituted by Allende’s government were consistent with the World Health Organization’s unified concept of health: “The concept of health has been defined as a state of complete physical, mental, and social well-being of the individual, and not only as the absence of disease.” All children and pregnant or nursing mothers received 0.5 liter of free milk per day. The government instituted public educational campaigns, informing families about the nutritive value of milk.²^,³^,⁴^,⁵ To reduce Chile’s high rate of infant and prenatal mortality, the government established a system of maternity clinics in small towns and worked to institutionalize the principle of free medical care in all hospitals. Recognizing the importance of environmental health, the government began aggressive programs to improve housing conditions and sanitation, and to require innovation in copper mining and similar industries to reduce the incidence of occupational diseases like silicosis.⁶

Facing a severe maldistribution of health care, which favored wealthier areas in cities while rural areas and low-income urban districts suffered from shortages of facilities and personnel, the government tried to increase inpatient and ambulatory services in rural provinces. A government sponsored “health train” toured the southern provinces, treating 30 thousand people.

Democratization and Decentralization

None of these or other similar health reforms were particularly threatening to the Chilean medical profession. However, Allende also encouraged changes in the health system that supported increased worker and consumer control. These modifications aroused the anger and opposition of health professionals that ultimately crippled many of the more politically neutral reforms.

Even before the UP government took office, the Ministry of Health (NHS) had established a system of hospitals each of which served an area further broken down into neighborhoods; each neighborhood was served by a Neighborhood Health Center (NHC). Part of the UP program was to decentralize and democratize medical care by putting greater emphasis on NHC’s. To this end, Local Health Councils (LHC) were formed by representatives of all organized groups in the community (unions, schools, women’s groups, youth groups, etc.), the union of nonprofessional health workers (aides, janitors, etc.), the union of professional health workers (laboratory technicians, social workers, psychologists, etc.) the separate category of medical professionals (physicians, dentists, and pharmacists), and the medical director of the NHC. The tasks of the LHC were to discuss the health problems of the community, suggest solutions, cooperate in the promotion of health campaigns (anti-diarrhea, bronchopneumonia prevention, garbage collection, etc.) and act as an advisory link between the NHS and the community.

Still on the NHC level, a second council acted as an executive body (paritario). This group included representatives elected from the LHC, in additon to the director of the NHC. The purpose of the paritario was to act upon the suggestions of the LHC, although ultimate decisions remained in the hands of the medical director. Analogously, at the area hospital level, parallel councils (consejos locales del area) and executive groups (paritarios) were also established, with similar tasks and advisory functions.

As a supplement to the LHC’s, the NHS also initiated a Program of Sociocultural Development. The Program provided for an integrated health team to work with community members in identifying each locality’s basic needs. This team encouraged collective action to combat diverse problems facing local residents, offered health information, emphasized people’s direct participation as knowledgeable LHC members, and attempted to raise the level of medical and political consciousness among the people.

One clear weakness of the LHC’s and health teams is that they did not provide a real change in power relations. They remained basically advisory in nature, the actual decision-making power remained with the medical directors of the NBC’s. In spite of this weakness, the LHC’s became increasingly viable forms of popular power in late 1972 and early 1973, by integrating themselves into broad-based organizations concerned with food distribution, transportation, local security, and industrial production. These groups provided a basis for the massive efforts needed to maintain health care during the periodic strikes and boycotts by the medical profession.⁷^,⁸^,⁹

Paralleling these changes on the neighborhood level, comparable democratization of decision making occurred in many large hospitals, especially those affiliated with the medical colleges. Within each specialty department (medicine, surgery, pediatrics, etc.) a governing council was formed. This council included elected representatives of nonprofessional workers (such as janitors, aides and orderlies), as well as health professionals (doctors and nurses). The governing council made administrative and staffing decisions that had formerly fallen under the exclusive jurisdiction of high-ranking professionals. The influence of the departmental councils extended to the governance of the hospital as an institution, since the departmental councils elected representatives, including nonprofessional workers as well as physicians, to the council that made policy for the entire hospital. The restructuring of power relations in the hospitals reflected the conscious thrust toward democratization that occurred also in other Chilean institutions such as industrial enterprises and the universities. These attempts to reduce professional dominance¹⁰ ultimately led to organized opposition against the UP regime by a majority of the Chilean medical profession.

The Political Reality

In contrast to other countries with socialist governments, Allende made no direct attempt to suppress private practice, by either legal or economic means. Since the establishment of the NHS in 1952, physicians could choose to work for the NHS, to remain in full-time private practice, or to pursue private practice in addition to their employment in the NHS. Under certain circumstances, doctors could use NHS hospitals or clinics on a fee-for-service basis. The Chilean government continued to underwrite medical education, providing free tuition for medical students, but did not require any standardized postgraduate period of national service. Compulsory measures were applied only to the distribution of pharmaceutical supplies. In reality, the failure of the NHS was so widely acknowledged that separate health services were established for the armed forces, the railroad industry, and white-collar workers such as teachers, lawyers, and bureaucratic officials (empleados).¹¹ The NHS itself developed a huge bureaucracy, which became notorious for its size (by 1967 there were 40,656 administrative employees as compared to 6487 medical professionals¹²) and severe inefficiencies in delivering needed services. Despite the government’s public intention to restructure the health system, little change occurred in the day-to-day details or control of private practice.

Although fundamental changes in private practice remained more a fear than a reality, physicians became increasingly anxious about the general democratization and decline of professional dominance that the UP regime encouraged. The LHC’s and hospital councils in several instances requested the removal of physicians employed by the NHS, on the grounds that these individuals’ private practices outside the NHS interfered with their NHS duties. Doctors feared that the NHS would exert tighter control over the proportion of private patients they could see, especially within NHS facilities. The government’s intention of training more paraprofessional health workers also potentially threatened professional dominance. In late 1972, some community organizations began training their own members in various medical tasks. Organized medicine, viewed this democratization of expertise with great apprehension. Moreover, within the curriculum of Chile’s medical schools, aided by the support of the UP government, the social sciences came to occupy a more prominent place. Because the social sciences fostered a deeper social consciousness and more critical attitude in young professionals, established physicians feared that their younger colleagues would provide an impetus toward more fundamental changes in the organization of practice.

Physicians’ irritation with the UP regime, however, transcended these prospective and largely hypothetical changes that might affect medicine per se. As members of Chile’s middle and upper classes, physicians suffered from the same shortages of goods and services that plagued the entire country during the last part of the UP government. As members of the privileged classes, physicians perceived these shortages as intolerable. In 1972 the Chilean Medical Association began a vigorous campaign against the UP government. Although approximately 30 per cent of the profession continued to support Allende’s goals, the Medical Association released a series of public denunciations. During the paralyzing “strike” of October, 1972, which began as a lockout by the owners of the trucking industry, the majority of physicians refused to see NHS patients except on an emergency basis. The work stoppage by physicians led to a severe tension between professionals and paraprofessionals that persisted for the duration of UP government. During the weeks immediately preceding the military coup of September, 1973, a doctors’ strike organized by the Medical Association incapacitated the Chilean health care system.¹³^,¹⁴ The medical profession, threatened by a redistribution of power and inconvenienced by economic instability, helped lay the groundwork for military dictatorship.

Chilean Totalitarianism and Its Implications

With the military coup of September, 1973, Chile has entered a period of totalitarian rule that eyewitness observers liken to fascism.¹⁵^,¹⁶ Although information has been limited by the dictatorship’s censorship and restrictions on travel, several outcomes of the coup — verified by multiple written accounts and personal eyewitnesses — no longer remain controversial.

The dictatorship has reversed almost all the changes in the medical system that occurred under Allende’s government. In the poblaciones and in rural areas, the new regime has closed nearly all NHC’s and has transferred their functions to hospitals that are frequently located at great distances. As a result, low-income Chileans again experience severe difficulties in obtaining needed care.¹⁷ The LHC’s and consumer-worker councils that governed hospital departments have been disbanded. Control of the nation’s hospitals has returned formally to the Chilean Medical Association, which consistently has supported the junta. Most of the preventive health programs (such as free milk distribution to children) have been discontinued or taken over by private entrepreneurs.

The Junta’s Ministry of Health developed three categories by which medical personnel were to be classified: politically trustworthy; uncertain (to be judged by hospital boards); and politically dangerous (“irredeemable”).¹⁸^,¹⁹ The secretary general of the Chilean Medical Association has acknowledged that physicians supporting the Junta have participated in denunciations of their leftist colleagues.²⁰ Generally, denunciations are directed against physicians who opposed the doctors’ strike of August, 1973.²¹ In addition, there are numerous reports that some military physicians have co-operated in the administration of torture, particularly by supervising the use of drugs during torture sessions.²²

If for no other reason, the UP experiment was necessary to show that those who hold professional dominance (as well as economic and political dominance) will not permit a real redistribution of wealth and power without a fight. Though deeply disappointing to adherents of nonviolence, the Chilean experience documents that a medical elite generally will uphold orderly legal processes only while these processes do not threaten the elite’s dominant position in society.

Analysis: Health Care, the State, and Social Revolution

Three general themes emerge from the Chilean experience. These themes concern linkages between health care and a nation’s political and economic systems, the inherent conflicts of a stratified society that are mirrored in the health system, and the problem of incremental reforms in health care versus fundamental change in state power and the social order.

In the first place, in all societies, but especially in the Third World, health care is inextricably linked to a nation’s political and economic systems. Medical underdevelopment is a necessary feature of economic underdevelopment. Despite many progressive reforms in the health system, the UP government was continually hindered by the limited economic resources available for health care and other public-welfare functions. As several analysts have pointed out, Chile and similar countries could spend the same proportion of their wealth for health care as in a developed country like the United States, but the effect necessarily would be restricted by the underdeveloped country’s much lower level of wealth. One Chilean analysis concludes: “Consequently every health policy should be narrowly united with the general policy regarding development of the country.” In this view, the effectiveness of a socialized health system in Chile or other nations of the Third World depends in large part on the level of economic development.

A second general lesson from the Chilean experience is that conflicts within the health system mirror in miniature the inherent conflicts of a stratified society. Any socialist government must confront the problem of social class. Doctors, like bankers and corporate managers, possess economic advantages and customary life styles that they do not willingly sacrifice on behalf of the masses of people trapped in an existence of poverty. Besides economic interests, health professionals hold dominant positions in the institutions where they work. Because of their technical expertise, physicians believe that professional dominance over health policies is justified.²³ Any innovations that tend to reduce the profession’s power to control the conditions of practice are perceived as threatening.

Thirdly, and most importantly, the Chilean experience shows that incremental reforms in health care have little meaning without basic change in the social order. Since Allende had assumed the presidency through constitutional electoral procedures, he lacked true state power. That is, the coalition government remained heterogeneneous and did not hold statutory control over the military, judiciary, legislature, and professions.²⁴^,²⁵^,²⁶ In the case of medicine, the lack of state power left Allende and his admirers impotent in their attempts to restructure health care. Distributing milk to mothers and children falls far short of the structural alterations needed to assure adequate care. Allende and his advisors recognized the inherent inequities of the private-public duality, a schizoid arrangement that always favors the financially advantaged at the expense of the poor. But because the government lacked true state power, it made no real attempt to nationalize the health system. The government’s intentions of rectifying the inequalities of the private-public duality remained almost entirely theoretical.²⁷ It is difficult to see how Chile’s huge problems of maldistribution could be solved without some compulsory restriction of private practice. Similarly, equity could not be achieved without some requirement that all physicians devote at least several years of their careers to national service in urban or rural areas lacking needed personnel.

Ultimately, Allende viewed his presidency as a transitional period in which a series of reforms would culminate in a true socialist restructuring of society. The government encouraged the establishment of LHC’s, workers’ organizations, and other new groupings whose eventual purpose was a thorough transformation of power relations in Chilean society. With occasional exceptions, however, these organizations did not achieve their goals of power redistribution, since real decision-making power remained in the hands of the medical directors.

The experiment of Allende and the UP was truly unique. For the first time, a socialist government had been elected by constitutional and peaceful means in a major country of the Western Hemisphere. For leftists who espouse nonviolent methods, Chile held out the hope that the socialist revolution could be achieved peacefully.

As Paul Sweezy has pointed out, the overthrow of the UP shows that one no longer can realistically be both a revolutionary and a pacifist.²⁸ This lesson is particularly striking for health workers, since healing seems so basically contradictory to warmaking. Throughout the Indochina War, members of the Medical Resistance Union, Medical Committee for Human Rights, and other groups argued that participation in war was inherently inconsistent with the healing activities of doctors, nurses and other health workers. The experience in Chile, however, demonstrates that the type of revolutionary health system that many American health workers desire probably will not emerge through peaceful processes. Only in China and Cuba, which have attained socialist governmental systems through armed struggle, have health systems emerged that truly serve the people.

The result of pacifist actions for the health system, in general, are reformist and incremental in nature. Revolutionary change in the health system appears to accompany only a society-wide revolutionary struggle. Che Guevara noted that the health of entire peoples may ultimately depend on the destruction of smaller groups of people who themselves would use violence to prevent progressive change in society.²⁹^,³⁰ As a physician, Guevara chose armed struggle as the only possible road toward socialist revolution and a humane health system. Health workers in the rest of the Third World and in advanced capitalist countries now face a similar dilemma.

Reactionary versus Progressive Reformism

As described above, most changes in Chile’s health system that the UP government accomplished were incremental reforms, rather than fundamental structural modifications of the system. While improved nutrition, sanitation, occupational health, and distribution of clinics were all worthwhile in themselves, they did little to modify Chile’s multi-class health system with its private-public inequities. Worker-consumer councils did not effectively challenge professional dominance over the health system.

Many analysts, notably André Gorz, have discussed the problematic implications of reforms like those the UP government sponsored. Such reforms actually reinforce the current exploitative and stratified nature of society by providing small material improvements or establishing structures (like councils or committees) by which people can derive a sense of participation in policy-making. They leave the economic and political systems intact, while reducing opposition and thereby inhibiting progressive change. Hence they are reactionary reforms, or in Gorz’s words, “reformist reforms.”

A reformist reform is one which subordinates objectives to the criteria of rationality and practicability of a given system and policy. Reformism rejects those objectives and demands — however deep the need for them — which are incompatible with the preservation of the system.³¹

While the general thrust of UP-sponsored health reforms was “reactionary” in this sense, several developments during the UP period held a potential for true structural change in the health system. These innovations may be considered progressive reforms, since they implied an eventual end to economic exploitation in health care. Gorz describes this type of reform as follows:

… a struggle for non-reformist reforms – for anticapitalist reforms – is one which does not base its validity and its right to exist on capitalist needs, criteria, and rationales.³²

So in terms of socialist strategy, although we should not reject intermediary reforms (those that do not immediately carry their anti-capitalist logic to its conclusion), it is with the strict proviso that they are to be regarded as a means and not an end, as dynamic phases in a progressive struggle, not as stopping places . . . But this approach [peaceful democratic reform]should be adopted not because it is viable or intrinsically preferable, but on the contrary because the resistance it will encounter, and the limitations and impossibilities it will bring to light, are alone capable of demonstrating the necessity of a complete changeover to socialism to those segments of the masses which are not yet prepared for such a course.³³(emphasis in original)

Progressive reforms do not simply improve material conditions and permit token participation while accepting the exploitative structure of the present system. Instead, they provide the potential for mass political action to change the system. Rather than obscuring sources of exploitation by small incremental improvements, progressive reforms expose and highlight structural inequities. Such reforms ultimately increase frustration and political tension in a society; they do not seek to reduce these sources of political energy.

Strategies for Progressive Health Work

Chile’s failure might be less painful to ponder if it suggested a viable alternative political strategy. Unfortunately, this is not the case. For Third World health workers, the lessons of Chile may be fairly clear. In the Third World, the goals of mass mobilization, progressive reformism, and armed revolutionary struggle are more than theoretical concepts. In the United States and other industrialized countries — where the resources of communication and infiltration available to the capitalist state are infinitely more sophisticated and the inequalities of class structure are less stark — the strategic implications of the Chilean experience remain ambiguous. Nevertheless, it may be worthwhile to conclude with some further tentative comments on the relationships between health care and revolutionary strategy. We focus first on the Third World and then on advanced capitalist countries.

The Third World: At the present time it is difficult to understand how revolutionary health work in the Third World can be effective without attempting to build a liberated zone. Previously, left-oriented health workers have gone about their daily activities assuming that the limited reforms toward which they work in the health system will contribute eventually to the process of socialist revolution. The Chilean experience indicates that this is a mistaken assumption. Unless an entire geographical area of a country is liberated, including all the major institutions in that area, progressive health work in the Third World holds little potential for lasting structural change. Even if local consumers and workers became mobilized around health issues, as they did periodically in Chile, this mobilization has little meaning while the most powerful institutions of a society remain unaltered. With their wealth and weapons, the elites who control those institutions will always suppress peoples’ movements that threaten to achieve major success.

The “developed” world: The strategy of liberated zones is unrealistic when applied to advanced capitalist societies. In countries like the U.S., for the present, the ‘likelihood of successful armed struggle against the capitalist state is negligible. Revolutionary rhetoric cannot dispel the realities of a heterogeneous class structure, the technological and infiltrative capacity of the ruling elite, and the disunity and weakness of the left. Chile’s torment does not suggest a coherent strategy for health workers seeking progressive change in developed countries. Nevertheless, it may be possible to derive some very limited strategic implications for progressive health work in capitalist nations.

First, health workers can seek to clarify the distinction between reactionary and progressive reforms. Furthermore, they can try to shape their own actions to oppose reactionary reforms vigorously while supporting reforms that have the potential to change the political and economic structures of the health system. For example, current proposals for national health insurance (NHI) in the U.S. will not reduce the inequities and exploitative nature of the private-public duality. If enacted, these proposals for NHI would facilitate fee-for-service medicine and would benefit the private insurance industry, but would not correct the severe maldistribution of health personnel and facilities throughout the country.³⁴^,³⁵

Similarly, the current trend toward the establishment of health maintenance organizations (HMO’s) does not promise structural change in the health system. By establishing HMO’s, physicians may be able to practice medicine with greater economic efficiency, and medical schools and hospitals may be able to use affiliated HMO’s to attract additional sources of funding and new patients during a period of declining patient censuses at many hospitals.³⁶ But that is all.

More importantly, by introducing slight improvements, NHI and HMO will probably reduce the current popular frustration and dissatisfaction with health care in the U.S. Hence both are reactionary reforms and should be opposed by health workers who seek progressive change.

True structural modifications in the health system of capitalist societies generally result from measures that explicitly restrict private, fee-for-service practice. Eventually, it will be necessary to nationalize the medical profession, under the auspices of a national health service (NHS). Since physicians under an NHS are employees of the government, they can be assigned to areas of need, often on a rotating basis. In many countries where health personnel and facilities previously were maldistributed or too costly for low-income patients, an NHS has greatly increased the availability of medical services. Unlike the proposals for NHI and HMO’s, the establishment of an NHS implies a structural re-organization of the health system. Clearly, the existence of an NHS alone does not provide comprehensive solutions for a nation’s health problems. For example, the co-existence of private practice and an NHS permits the inequities of the private-public duality to persist. This was the principal defect of Chile’s NHS; similar inequities remain in Great Britain, Sweden, and other countries that have nationalized the medical profession while retaining capitalist economic systems and while allowing private practice to continue. In socialist countries that have suppressed private practice, the private-public duality no longer threatens the viability of the NHS. Therefore, nationalization of the medical profession, in the direction of an NHS that restricts and gradually eliminates private practice, is a progressive reform and deserves the support of health workers who are involved in local political struggles and who are attempting to educate the public.

“I don’t see why we need to sit by and watch a country go Communist due to the irresponsibility of its own people.”
— Henry Kissinger, defending CIA involvement in Chile, as quoted in the New York Times.

“I don’t wield economic power.”
— Nelson A. Rockefeller, at his Congressional confirmation hearings.

A second strategic lesson for health workers outside the Third World pertains to the nature of effective organizing. Numerous situations in the U.S. and other countries offer the potential for effective coalitions between health workers and consumers similar to the LHCs and consumer-worker councils in Chilean hospitals. In many cities, medical centers are attempting to expand into urban residential areas. This expansion often involves the planned destruction of low-income housing. Frequently the medical elites who desire to expand medical centers cannot justify this process when the health needs of the community are carefully assessed.³⁷ In several localities, active community groups have arisen in opposition to expansion and have been particularly effective when they have united in political struggle with workers inside the medical centers. In some cases, these coalitions of community residents and health workers have moved beyond the expansion issue to attack other local problems. In other instances, community residents have supported attempts by hospital workers to build unions or other worker organizations whose goals include meaningful control over the work process and improved patient care, as well as material benefits for workers.³⁸ This type of political effort can lead to concrete progressive changes on the local level. It represents coalition politics that, as in the Chilean example, contains the potential for significant popular mobilization.

Third, and most importantly, we must be serious about winning. We must develop strategic goals that can be realistically attained. Concerted political actions directed toward limited goals at the local level can succeed. Such actions can lead to lasting progressive changes that sensitize people to their own potential power and modify the insitutions in which they work or receive health care. Nationalization of the medical profession — like the advent of socialism or the end of U.S. imperialism — probably is not an attainable goal in the near future. Although health activists should help clarify and raise to consciousness the long-range societal goals of current struggles, they also should be satisfied to wage more limited battles that can be won. For the present, victories are possible by organizing in specific health institutions and in the communities that those institutions claim to serve. The cumulative effect of many small victories in many parts of the world will give Chile’s torment new meaning.

>> Back to Vol. 6, No. 6 <<

References

Condensed from “Medicine, Socialism, and Totalitarianism: Lessons from Chile,” The New England Journal of Medicine, July 25, 1974, Vol. 291, No.4, pp. 171-177; and from “Medicine and Socialism in Chile,” Berkeley Journal of Sociology, Vol. XIX, 1974-75
Debray, R., The Chilean Revolution- Conversations with Allende, New York, Vintage, 1971, pp. 63-66, 84.
Morris, D.J., We Must Make Haste -Slowly: The Process of Revolution in Chile, New York, Vintage Books, 1973, pp. 125, 143-145, 157-175, 195, 217, 240-242, 297.
Feinberb, R.E., The Triumph of Allende: Chile’s Legal Revolution, New York, Mentor Books, 1972, pp. 81, 187, 240.
Belnap, D.E., “Chile Maps Plans to Get Citizens to Drink Milk,” Los Angeles Times, March 15, 1971.
Diuguid, L., “Chile’s Copper Towns Struggle into a New Era,” Washington Post, May 9, 1971.
Morris, D.J., We Must Make Haste -Slowly: The Process of Revolution in Chile, New York, Vintage Books, 1973, pp. 125, 143-145, 157-175, 195, 217, 240-242, 297.
Kandell, J., “Giant Rally Marks Allende Anniversary,” New York Times, September 5, 1973.
Simons, M., “Allende opposition may impeach his aides,” Washington Post, September 7, 1973.
Freidson, E., Professional Dominance. New York, Atherton Press, 1970.
Hall, T.L., Diaz, P.S., “Social Security and Health Care Patterns in Chile,” Int. J. Health Serv., 1:362-377, 1971.
Morris, D.J., We Must Make Haste -Slowly: The Process of Revolution in Chile, New York, Vintage Books, 1973, pp. 125, 143-145, 157-175, 195, 217, 240-242, 297.
Kandell, J., “Giant Rally Marks Allende Anniversary,” New York Times, September 5, 1973.
Simons, M., “Allende opposition may impeach his aides,” Washington Post, September 7, 1973.
“Kennedy Says U.S. Confirms Wave of Killings in Chile,” New York Times, February 4, 1974.
Barnes, J ., “Slaughterhouse in Santiago,” Newsweek, October 8, 1973.
Kandell, J., “Chile Replacing Local Marxists,” New York Times, October 17, 1973.
Argus, A., “Medicine and Politics in Chile,” World Medicine, April 10, 1974, pp. 15-24.
Schester, Cortes A. (military physician), “Policy to Be Followed with Members of the Popular Unity (UP).” Santiago, October 11, 1973.
Kandell, J., “Thirteen Doctors in Chile Reportedly Slain After the Coup,” New York Times, April 8, 1974.
Argus, A., “Medicine and Politics in Chile,” World Medicine, April 10, 1974, pp. 15-24.
Ibid.
Freidson, E., Professional Dominance. New York, Atherton Press, 1970.
Zimbalist, A., Stallings, B., “Showdown in Chile,” Monthly Review 25:1-24, October, 1973.
Steenland, K., “Two Years of ‘Popular Unity’ in Chile: A Balance Sheet,” New Left Review 78:1-25, March-April, 1973.
Sweezy, P.M., “Chile: The Question of Power,” Monthly Review, 25:1-11, December, 1973.
Modell, H., Waitzkin, H., “Medicine and Socialism in Chile: Implications for Current Health Proposals in the United States,” Berkeley Journal of Sociology (in press).
Archive Editor’s note: a footnote is referenced here in the original text but was missing from the list of printed references
Guevara, C., “Revolutionary Medicine,” in Gerassi, J. (ed.), Venceremos, New York, 1968.
Harper, G., “Ernesto Guevara, M.D.: Physician-Revolutionary Physician- Revolutionary,” New England Journal of Medicine, 281:1285-1289, 1969.
Gorz, A., Strategy for Labor, (Boston, 1967), p. 7.
Ibid.
Gorz, A., Socialism and Revolution (Garden City, 1973), p. 148.
Waitzkin, H., Waterman, B., The Exploitation of Illness in Capitalist Society, Indianapolis, 1974, pp. 67, 86, 113-114.
Kotelchuck, R., Bodenheimer, T., “National Health Insurance: The Care and Feeding of Medi-Business,” Ramparts, 12(12): 26-28, 54-57, July, 1974.
Waitzkin, H., Waterman, B., The Exploitation of Illness in Capitalist Society, Indianapolis, 1974, pp. 67, 86, 113-114.
Waitzkin, H., “The Expansion of Medical Institutions into Urban Residential Areas,” New England Journal of Medicine, 282: 1003-1007, 1970.
Metzger, N., Potter, D.D., Labor-Management Relations in the Health Services Industry (Washington, 1972).

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