Rather Dismaying by Stephen Vaughn MD


I read a little excerpt from book written by a man whom I quite dislike, Vladimir Lenin. It is amazing how more sensible the thought of this awful man is, compared to the vanguard of the modernization movement in American medicine.

Lenin wrote during the revolution about a terrible problem – that great Marxist ideas often are useless when attempted in practice. That alone puts him head and shoulders ahead of our Medical Reformers in American medicine. Ideas, no matter how orthodox in a Marxist sense, might just be wrong, and the proof is in the product.

He realized that any movement of workers had an abundance of muscle, but a shortage of brains, especially trained ones. He apologized for having to take a right-wing approach to the reform of Russian industry – the Soviet Union needed experts, and very few experts come at to the attraction of honor and glory – most of them need to be paid well. He argued that paying expert scientists and engineers abundantly was a drop in the bucket compared to the waste that would be caused by their lack of guidance. Imagine that being discussed in Washington? That would be considered the Tea-Party loonies, although that VI Lenin put it to paper.

This problem of an overpaid expert class could be sorted out in the long run. The massive majority of Russians were peasants, and never had the opportunity to be trained to be specialists, scientists and engineers. The potential pool of university graduates was pre-determined by money, wealth, family ties and political pull. If the specialists could be drawn from all walks and classes of Russia – a huge population – then surely there would be plenty more of the best and brightest, and the need to pay the specialists so much would be watered down by supply.

If Lenin could have seen American medicine in the late 20th century, he might have seen the closest example of his dream put into practice. Universities, educating the brightest to be the intellectuals and specialists and movers and shakers, rather than those with ancient political connections and families. Imagine that!

There you have it – King Red understands the supply-and-demand curve of professional labor, and Washington doesn’t. His book on the Soviet Worker’s was on Google Books or some similar e-text; I’ve unfortunately lost the reference, I’ll get it. It’s full of the usual long-winded and blowsy language of the Professional Thinker, and somewhat dense and overly-thought-out; but not as bad as our modern intelligentsia’s bilge.

I think it was entitled “On workers’ control and the nationalisation of industry” and started around page 19 of the English translation.

Meanwhile, on marxist.org – you can guess the political leaning of the site – they bemoaned that
“The specialists in Russia 1917 were not like the specialists and technicians today. We will come to this more in a minute when we discuss Venezuela, but the technicians and specialists, lower-level managers and white-collar workers today have become more and more proletarianized. They face the same attacks, cuts and wage reductions as the workers do. It will be possible to bring them onboard, to convince them of our ideas and to win them over, as is happening in some cases in Venezuela today.” Yes, good luck with that. Lenin trusted only the $$ for impressing the professionals.

“Hence the Soviet state was forced to make a series of compromises, beginning by paying the technicians more than the average worker. Of course, a political commissar was put at their side to ensure their loyalty as they were sent to the factories to help in their operation, itself a brilliant measure of workers’ control, but nonetheless it was still a compromise. The Soviet state was faced with no other option – without the specialists industry would not run.” The division between the idealists – who don’t care if nothing really works – and the realists (like Lenin) who was bothered by the stagnation of intellectual purity – sounds like our local healthcare debate – but with very few realists left in the balance.

We can’t even invent new crappy ideas – we have to dredge up dreck, test-proven and evidence-based for the last century – to try one more time, in US healthcare. Sad.