If the free market has caused about one-third of all deaths, in market economies, over the entire period of their existence, then the market has killed hundreds of millions of people. More than all wars, and more than the impact of a one-kilometre meteorite. Probably, the shock of a transition sharply increases death rates, and the long-term market death rate would be lower. But in that case, sudden imposition of neo-liberal policies would increase market death rates, in countries which already have a free market.
Who did that, in the last generation in western Europe? Margaret Thatcher. And who let her get away with it? Tony Blair. The guilty do not need an amnesty, because they are in no danger of any legal process, and they have no punishment to fear. No investigatory tribunal has ever been established for the Thatcher period. No criminal procedure has ever been started against Thatcher, her ministers, or anyone responsible for implementing her policies. The British media ignore Thatcher's guilt, and treat her as a respected member of the House of Lords. That is a society which has closed its eyes: at least in Chile, everyone knows that Pinochet killed people.
It is a European problem, not a British one. It is not a crime in any EU state, to expose people to market forces, even if it kills them. Even if it kills millions of them. In a continent full of monuments, there is no monument to the victims of the market. If there was any widespread discussion of that crime, then probably a new category of historical denial will be created, in the style of Holocaust denial. And unlike Auschwitz, the free market is still in operation.
This cult of amorality is ultimately a moral choice in itself. Historically, it is part of the explicit anti-utopianism, anti-idealism, and anti-moralism of the European liberal tradition. However, this is such a fundamental difference in moral values, that it removes any basis for political community. Morality and Tony Blair do not fit in the same state, and neither do the free market and its victims. As Jews could not feel safe, in a political community founded on denial of the Holocaust, so the poor and the disadvantaged can never feel safe, in a nation which denies the lethal effect of the free market. A European Tribunal for Thatcher would be a sign, that Europe intends to remedy this defect of the British nation state. Such a tribunal should have the power to apply the death penalty, the most appropriate penalty for mass murder.
Excess mortality, inequalities in life expectancy, and health inequalities in general are an ethical time bomb, for liberal market democracy. When we think of Hitler, Stalin and Pol Pot as the greatest killers in all history, we have got the wrong men. Their symbolic importance for liberalism is that they are so clearly non-liberal: it is not related to any objective scale of death. The Belgian Congo Company, a business and not a state, killed about 10 million people: their brutality bears comparison with that of the SS. But that is not the killing that is remembered in liberal-democratic market societies. Their own accepted history presents these societies as the end of an 'age of atrocities'. That history is a fake.
Jacob Nell and Kitty Stewart (1994)
Death in transition: the rise in the death rate in Russia since 1992
UNICEF International Child Development Centre. Innoccenti Occasional Papers, EPS 45.
- Only 37% of additional deaths from 1989 to 1993 can be attributed to changes in size and structure of the population.
- Of 349 000 additional male deaths in 1993, only 91 000 can be explained by changes in population size or structure.
- In one year, from 1992 to 1993, male life expectancy fell by 3 years: from 62 years to 59 years.
- The rise in mortality affects men more than women: in Russia in 1993, female life expectancy was almost 14 years longer than male life expectancy.
- The rise in death rates affects mainly the population of working age.
- Alcohol poisoning, suicide, and murder account for 14% of the rise in death rates from 1989 to 1992.
- More Russians died in 1993 from suicide, murder and alcohol poisoning, than in the 11-year Afghanistan war.
- In one year, from 1992 to 1993, male deaths from alcohol poisoning rose by 69%, and female deaths from alcohol poisoning rose by 90%.
- Excess mortality profiles for British unemployed, and for Russia since 1992, are comparable.
Timothy Heleniak (1994)
The projected population of Russia in 2005
Post-Soviet Geography 35 (1994): 608-614.
- Russian Federation projections of population decline include a "pessimistic variant", a decline of 16,8 million from the 1992 population.
Timothy Heleniak (1995)
Is Russia's demographic situation improving?
Post-Soviet Geography 36 (1995): 644-646.
- A natural increase of 333 000 in 1990, turned into a continuing natural decrease: of 220 000 in 1992, 750 000 in 1993, 893 000 in 1994, and 830 000 in 1995.
- Russia has the lowest "rate of natural increase" (in fact decrease) in the world.
- In 1995 death rates began to fall, but were still 4 points above 1989.
Michael Ellman (1997)
Transformation as a demographic crisis
in Lessons from the Economic Transition: Central and Eastern Europe in the 1990's, edited by Salvatore Zecchini: 351-371.
- From 1989 to 1994, crude death rate increased by more than 20% in Russia, Latvia, Moldova, Ukraine, Estonia, Belarus, and Lithuania. It increased by more than 10% in Azerbaijan and Armenia, and more than 5% in Bulgaria, Georgia, Romania and Albania.
- Death rates in western countries also rose during past market crises, at the height of the Depression (1933-1936) by 8% in the US, and by 5% in Germany.
- "Russian statistics.... show a sharp increase in anaemia in pregnant women, a sharp increase in the proportion of babies born ill or who fall ill shortly after birth, and a steady growth in the 1990's of the proportion of low birthweight babies."
- "Experience in 1989-1994 corroborates the traditional view that revolutions are costly. Transformation has turned out to be a demographic crisis. Important features are....a sharp increase in mortality"
Roland Scharff (1998)
Transformation und Bevölkerungsbewegung in der Russischen Föderation
Osteuropa-Wirtschaft 43, 3: 255-268
- "Als vorläufiges Fazit bleibt festzuhalten, dass sich während der fünf Reformjahre (1992-1996) ein Natürlicher Bevölkerungsverlust in einem Umfang von 3,5 Mio. "toten Seelen" aufsummiert hat."
Philip McLoone and F A Boddy (1994)
Deprivation and mortality in Scotland, 1981 and 1991
British Medical Journal 309 (1994): 1465-1470.
- "In Scotland relative deprivation increased between the 1981 and 1991 censuses and was mirrored by a worsening of relative death rates"
- "Changes in relative mortality were explained by differences in the decline of death rates according to the affluence of an area; among men the decline in deprived areas was only about half that in deprived areas and among women it was only about a third."
Andrew Sloggett and Heather Joshi (1994)
Higher mortality in deprived areas: community or personal disadvantage?
British Medical Journal 309 (1994): 1470-1474.
- Higher death rates in deprived areas are not related to the area itself. Deprived individuals have a higher risk of death, wherever they live. Some areas have higher death rates, because more deprived individuals live there.
- In England in the 1980's, unemployed males aged 16-70 had 1,24 times the death risk of employed males from the top three socio-economic groups.
- In England in the 1980's unemployed females aged 16-70 had 1,48 times the death risk of employed females from the top three socio-economic groups.
- In England in the 1980's males (16-70) living in rented housing without car access had 1,54 times the death rate of males living in privately-owned housing with car access. For females the extra risk was similar: 1,56.
- In the 1980's males (16-70) in the North of England had 1,17 times the death risk of males in the South. For females in the North the factor was 1,12.
- In the 1980's, living in the North of England reduced male life expectancy after 25 by 1,8 years.
- In the 1980's, living in the North of England reduced female life expectancy after 25 by 1,3 years.
- In the 1980's being unemployed reduced male life expectancy after 25 by 2,4 years (compared to employed males).
- In the 1980's being unemployed reduced female life expectancy after 25 by 4,3 years (compared to employed females).
On the contrary, evidence is accumulating, that liberalism - and the liberal free market which it promotes - form a killing machine. The evidence from Russia suggests that it is primarily the market which kills people, not a liberal political system. On the other hand, the triumph the modern free market depended on the victory of the liberal ideology: that was certainly the case in Russia. No liberals, no market. Before modern liberalism emerged in the 18th century, the modern free market did not exist: it is not a natural phenomenon.
In the long term, the global market economy seems not only to increase inequalities, but to systematically worsen the conditions for the weakest populations. All research shows huge global inequalities in health, almost always to the advantage of the market democracies. There is no doubt that there is a huge excess mortality at global level: about 13 million from preventable infectious diseases alone, according to the World Disasters Report 2000.
Inside western societies, health inequalities appear permanent - unaffected by changes of government, beyond the reach of health policy. The evidence is relentless: the poor live shorter lives in worse health, socially disadvantaged groups are also disadvantaged in health and mortality, and so are disadvantaged ethnic minorities.
The inequalities are persistent. Three studies in Amsterdam showed higher mortality rates in the poorest neighbourhoods. That was in true in 1972-1976, true again in 1977-1983, and true again in 1986-1991. Another study found the same pattern in the four largest cities of the Netherlands: mortality rates in prosperous neighbourhoods were as much as 24% under city average, mortality in the poorest neighbourhoods was up to 32% above average. Probably these inequalities are much older. Amsterdam statistics for infant mortality can be related to social class, as far back as 1854. Although perinatal and infant mortality fell sharply, the inequalities remained.
The inequalities in mortality reflect the multiple inequalities in liberal market democracies - income and poverty, social class, unemployment, successful and declining regions. Researchers who use new indicators find new matches, between inequality and mortality. In Spanish cities, for instance, inequalities in education are reflected in dramatic differences in mortality. Lack of education seriously damages your health. In fact it drastically shortens your life and increases your risk of dying.
The inequalities in mortality are extreme, for specific groups - just as extreme as the social inequalities themselves. The Madrid/Barcelona study found that some disadvantaged groups were 7 times more likely to die.
Within the free-market societies, the differences in life expectancy are substantial. They are at least as great as the difference among their national averages, which range between 75 and 80 years. The Madrid/Barcelona study found a 6-year gap, according to educational level.
The excess mortality - the most significant for the historical comparisons - is substantial. Is it not a statistical triviality. For the entire population of western liberal market democracies, about one-sixth of global population, it is certainly measured in millions. And that is only the internal excess mortality, without counting any deaths in Africa, for instance. Another study in Spain compared mortality rates in 2220 geographical areas, and estimated excess mortality at 10%, or 35 000 deaths a year. If these were sustained rates, Spanish market democracy has killed more people than the Spanish Civil War. (During the entire period covered by the study, Felipe González was Prime Minister).
Even this is probably an underestimate, since it is a comparison of areas, not of social groups. The comparison can not be complete, unless each zone is inhabited by one social group only. This study, incidentally, allows a first estimate of the excess mortality under Thatcher. The population of the United Kingdom is about 50% greater. Without correcting for age structure, assume the absolute excess mortality before Thatcher was simply 50% higher in the UK, about 52 000. Assume that excess mortality worsened due to transition effects, in the 10 years of the Thatcher government, and the estimate exceeds a half-million. Only the largest extermination camps under the Nazi regime (Belzec, Treblinka and Auschwitz) exceeded this scale of death. A full research programme, by demographers and epidemiologists, could improve on this type of first estimate. But who would pay for a research programme, that compared Margaret Thatcher to Eichmann?
International Federation of Red Cross and Crescent Societies
World Disasters Report 2000
- "Data in the report shows cases where basic health care has been sacrificed for the sake of economic restructuring. A 1995 World Bank survey of 53 countries showed a 15 per cent average decline in the health spending per person following structural adjustment...While infectious diseases claim the most lives, they are also the most preventable disasters. The report says that most of last year's 13 million deaths from infectious disease could have been prevented at a cost of US$ 5 per person."
Harvard School of Public Health
The Global Burden of Disease and Injury: Summary
- "A baby girl born in Sub-Saharan Africa faces a 22 per cent risk of death before age 15. In China the risk is less than 5 per cent and in the Established Market Economies the risk is just 1.1 per cent."
- "The peoples of Sub-Saharan Africa and India together bore more than four-tenths of the total global burden of disease in 1990, although they make up only 26 per cent of the world's population."
S.A. Reijneveld (1997)
Sociaal-economische verschillen in de gezondheid van de Amsterdammers
Gemeentelijke Geneeskundige en Gezondheidsdienst Amsterdam: Afdeling Epidemiologie, Documentatie en Gezondheidsbevordering.
- "Stadsdeel Westerpark kent in deze periode [1986-1991] de hoogste sterfte, 36% boven het Amsterdams gemiddelde, Buitenveldert de laagste sterfte, 29% onder het Amsterdams gemiddelde..."
- "De absolute sterftekans per leeftijdsgroep is sterk afgenomen in de afgelopen decennia. De relatieve verhouding in sterfte tussen buurten van verschillende welstand is echter weinig veranderd. Wat betreft zuigelingensterfte geldt dat zelfs voor een periode van ruim 150 jaar."
I. Haverkate et al. (1993)
Sterfte per buurt naar sociaal-economische status: een vergelijking tussen de vier grootste Nederlandse steden
Gemeentelijke Geneeskundige en Gezondheidsdienst Amsterdam.
- "De resultaten van dit onderzoek laten in alle steden een significante relatie zien tussen de sterfte (SMR) per buurt en sociaal-economische status, gemeten met inkomen en werkloosheid. Hetgeen uit de literatuur consistent naar voren komt is ook in deze studie bevestigd: in buurten met een gemiddeld lagere sociaal-economische status is de totale sterfte hoger dan in buurten met een hogere SES."
C. Borrell et al. (1999)
Inequalities in mortality according to educational level in two large Southern European cities.
International Journal of Epidemiology 28 (1999): 58-63
- "...the illiterate and those with no education have higher mortality and a lower life expectancy than people with secondary or a higher education."
- In Barcelona, males with no education lived 5,2 years less than males with secondary of higher education (life expectancy at age 25).
- In Madrid the effect was greater: males with no education lived 6 years less than males with secondary of higher education (life expectancy at age 25).
- In Madrid, the relative risk of death was 7 times higher for males between 25 and 34 with no education, compared to males in the same age group with secondary or higher education.
- In Barcelona, the relative risk of death was 6 times higher for this group, again compared to males in the same age group with secondary or higher education.
Juan Benach and Yutaka Yasui (1999)
Geographical patterns of excess mortality in Spain explained by two indices of deprivation.
Journal of Epidemiology and Community Health 53 (1999): 423-431
- "Excess number of deaths in the most deprived geographical areas account for 10% of total number of deaths annually."
- "Total annual excess of deaths was estimated to be about 35 000 people in Spain"
- "...other factors might lead to underestimate the association between deprivation and mortality in Spain. For example, some of the zones studied were large urban areas in some of which mortality inequalities have been reported."
- "Historical evidence shows that ignoring mortality inequalities will not make them disappear or decrease. If more deprived zones are associated with poorer mortality indicators, efforts to correct these inequalities should involve a positive discrimination of resources."
Richard Mitchell, Daniel Dorling and Mary Shaw (2000)
Inequalities in life and death: What if Britain were more equal?
Policy Press / Rowntree Foundation
- "Annually, some 7,500 deaths amongst people younger than 65 could be prevented if inequalities in wealth narrowed to their 1983 levels."
- "Some 2,500 deaths per year amongst those aged less than 65 would be prevented were full employment to be achieved. Two-thirds of these would be in areas which currently have higher than average levels of mortality, preventing 17% of the 'excess' deaths in these areas."
Research projects on health inequalities and mortality take several years. The British studies listed above refer to the period of Conservative government. But the last one (Rowntree Foundation) is making policy demands on the Blair government - demands it refuses to implement. Blair is being asked to reverse Thatcher's 'modernisation' of British society, which he has often praised. In his language: he is being asked to take money away from talented and productive creators of wealth, the hope for Britain's future. He is being asked, to give their money to the lazy unemployed, to people who make no effort to increase their employability, to drug addicts who beg on the street. It would be against all his political principles to redistribute wealth or income in this way.
Ultimately, both Blair and Thatcher regard the lives of the poor as a necessary sacrifice: neither of them would simply abandon their policies. The results of Thatchers attitude are visible in the research results, and the statistical verdict on Blair is now available. He kills the poor too.
Department of Health (2002)
Tackling Health Inequalities: Summary of the 2002 Cross-Cutting Review
- In Manchester, boys can expect to live almost eight years fewer, and girls almost seven years fewer than their contemporaries in Kensington, Chelsea and Westminster.
- Life expectancy for males in social class V is over 7 years less than for professional social classes: 71.1 years compared with 78.5 years. For women the gap is over 5.5 years.
- Some populations in this country have the same levels of early death as the national average occurring in the 1950s.
- Babies with fathers in social classes IV and V have a birthweight that is on average 130 grams lower than that of babies with fathers in classes I and II. Low birthweight is closely associated with death in infancy, as well as being associated with coronary heart disease (CHD), diabetes and hypertension in later life.
- Research shows that lower birthweight and father's social class can both increase your chance of dying of CHD over and above the impact of your own income and social class.
That is why there will be no trial of Margaret Thatcher, or any of her ministers. If Tony Blair allows a tribunal for Thatcher, then soon he will face a similar tribunal. One by one, the political leaders of western Europe would face such a tribunal. Perhaps there is no evidence against them yet, but it will come. Apparently, all new research uncovers new excess mortality. On the basis of the consistent pattern found so far, it is safe to say, that all western governments are slowly but systematically killing the weakest sections of their own population. In eastern Europe things are worse. And in Africa they are far worse. Collectively, if the liberal market democracies are seen as a single historical phenomenon - the grand project of European liberalism - it is probably the worst 'mortality event' in human history.