Thanks for this excellent explanation of anarchist thinking.
I think many of us already do this in self-organized groups. For example, I've often been involved in bulk food buying groups. I share the google doc and do the ordering, and others will pick up the order, then people pick up their food orders and pay me what they owe.
It's a lovely virtuous cycle, and no one is in charge, although I pay for the initial order which is delivered to my place, and people pick up from there.
And, with people so busy, it's a nice chance for a five or ten minute visit we wouldn't otherwise get.
You are very welcome. I do believe it is a natural inclination - to organise with friends, to show kindness, and to share - especially when we are not fearful or anxious or live in precarious situations, but even then many people still stubbornly (in the best way) still reach out and help.
A very thought-provoking read, and I'd say the arguments are compelling.
All of this made me think how would anarchist organisation of healthcare affect the abuse of power at the hands of medical professionals. This is a very specific example, but here goes. Violence against patients, and particularly obstetric violence, is rampant, yet it's an issue that isn't openly talked about in the society, IMO because the state naturally creates an almost mythological narrative of an untouchable class of experts who can't be questioned and uncomfortable truths must be swept under the rug to maintain hierarchical power. I was at the receiving end of obstetric violence (within NHS) and it resulted in life-changing C-PTSD. Birth trauma is an utterly devastating form of dehumanisation. I've spent the last 4 years bringing attention to this issue and participating in different forms of peer support for those affected. Nothing is changing, in fact, maternal mortality rates are rising in many countries, with BIPOC women being particularly affected.
The biggest problem is that those at the bottom, who hold no power, get sucked into upholding this system of respecting the golden calf of expertise no matter what. Most people run away or even scream at individuals who try to start conversations on obstetric violence and how the whole maternal healthcare system is riddled with people who readily lie to patients and coerce them into procedures without consent, during pregnancy and especially during labour. I can't even count the number of times I was directly told to shut up, stop exaggerating, stop "accusing" doctors and midwives, suck it up because women give birth every day and don't complain, and even openly accused of lying and inventing obstetric violence. This culture of power abuse and the culture of silence that upholds it directly result in an unhealthy society - some research suggests that up to 1 in 3 childbirths are traumatic!
This is what I think of when you say "hierarchical organisations often have structural incentives to overlook or protect incompetent people who maintain the right connections or serve the interests of those above them." I've abandoned any illusion that the healthcare system nowadays still primarily serves its Hippocratic function; lived experience of violence and stats on just how dysfunctional the healthcare system and its outcomes are tell me otherwise, that any Hippocratic function is but a remnant floating on top of a toxic vat filled with profit-making, life-destroying practices. I don't think most people enter the healthcare system with an intention to abuse people - but evidently, hierarchy can make swathes of people drunk on power to the point where they start exercising dominance and dehumanising people who are below them. In that sense, medical system mirrors the state itself.
I think your ideas of horizontal organising would eventually lead to a dissolution of these power trips and (after a couple of generations) there would be a real chance for healthcare based on mutual trust, compassion and morals where untouchable subjects and silencing don't exist.
Thank you for this insight. It is important to speak up for those who suffer under abuses of power and to challenge that power. My hope is that with people questioning that power that the process of fighting and defeating it can make progress, until one day it is considered a relic of the past.
If you get the chance to read Ancestral Night by Elizabeth Bear, I'd be interested to hear your opinion on the society described therein. It's one of my all-time favorite space operas and, in my opinion, provides an interesting reflection on how society could be better organized. I think the future she describes is somewhere between a direct democracy and a horizontal organization, though obviously it isn't perfect. It's still contrasted well enough with the more libertarian-inspired offshoot the antagonistic, lesbian space pirate love interest comes from. The person who reviewed it for Kirkus disagreed, so your mileage may vary, but given that I've seen you post about Le Guin before, I thought it was maybe worth the recommendation even if it isn't actually full-stop anarchist sci-fi.
It might be more aspirational than utopian, but certainly a wonderful exploration of potentialities. I'd also recommend Stealing Worlds by Karl Schoeder, or as a less sci-fi example The Lost Cause by Cory Doctorow and would love to find out more about the books you guys cover if possible! To me, science fiction and literature more broadly definitely provides one of the best avenues for exploring our current problems and imagining better futures like you said. Thank you!
Your section about decentralised healthcare made me think about Buurtzorg, I wondered if you know of them? They operate within a capitalist system and while they're non-hierarchical they do have a CEO/leader so it's not exactly what you were describing, but some of the benefits they feel they gain by operating in a decentralised way even within these constraints are really positive https://www.corporate-rebels.com/blog/buurtzorg
I know a lot of other countries including the NHS in the UK have been interested in trialling Buurtzorg's approach over the years, but I don't know if any have had the same success.
This is very interesting! I’ll make sure to look into this - I’m planning a more in depth article on decentralised non-hierarchal healthcare in general and this looks like it will get its own section! Thanks for sharing this!
I think this is the best thing I’ve read from you! This gets to the heart of what so many people get wrong about anarchism, and it’s written in a very easy to understand but still thorough manner.
Have you ever written anything similar differentiating property and possession? I bet it would be similarly awesome!
That’s high praise - especially considering I almost didn’t post it. It took a bit of work to put all the pieces into something coherent, but it’s always my hope that people wont need a politics degree to understand these concepts, so it seems I may have got it right this time!
I did draft an article on property / possession but didn’t end up finishing it when I saw these two were already written -
That's the most encouraging article I've read for a very very long time. I am tired of explaining that temporary arrangements don't stay temporary but gather dust that turns into concrete and become permanent and set in stone etc. etc. Unless we start as we intend to go on, it will be only too simple to lose the thread when things (including people) change. We will never have perfection. There is no utopia, that's a philosophical dream/nightmare, since yours and mine would never be the same. But what we could have is steady development, changes, improvements, if we are equal, using knowledge, skills, ideas, plans when and where we need them, without trying to climb up a ladder, set up a hierarchy, create masters, gods, monarchs or authorities of any over weaning and unwelcome nature!
I'm glad you found it so positive. A full overhaul of organisations and the way they are organised seems like a lot to ask for, but it has happened before. Sadly the shift has usually been in the wrong direction, but going the other way is possible if the power stays with the people and they share it. Even then it will be a continue process of renewing and challenging the tendency to fall backwards, to keep improving, but I believe it is possible.
Thanks much. You and https://substack.com/@complexsimplicity have hit me today with a one-two punch to shake me out of my stupor—the stupor of still thinking I can work within the US system to effect change.
Hiya, any discussion of health care, especially in the UK or US must also include the economy of prevention. The whole system is built on keeping a large proportion of the population fat, sick and on drugs and this is a major part of the economy. Anarchists, I presume, would focus on providing affordable and accessible organic and regeneratively grown fresh fruit and veg, clean air and clean water, indoor and outdoor exercise, community and purpose to all citizens. And no one would be coerced into vaccinations. Doctor's training and research wouldn't be funded by pharmaceuticals. This would very quickly ease a lot of the pressure on a healthcare system.
Very true - most bad health (or the factors that make it much worse) comes from bad conditions and bad incentives and lack of access to a good healthy diet, culture and environment.
But this article (which I didn’t intend to write but got carried away with a response) touches primarily on the organisational aspect of healthcare (& any organisations that require expertise).
I have been drafting one on Anarchist healthcare historically and in the future that will address those other aspects more fully.
I am so excited for that upcoming article! As someone who works in emergency services, the conditions I've seen some patients in are truly abhorrent, and honestly are largely attributed to lack of basic resources, like clean food, water, adequate heating, etc. The burnout aspect for a lot of providers is incredibly real too, because there is just such an vast number of people you have to treat who are just so ill all of the time. My love for medicine stems from a genuine desire to help my community, but being trapped in a vicious system that prioritizes profit over people's livelihoods takes its toll on me. I want to envision a world where not only do we genuinely want to help people simply for the sake of helping, no profit involved, but also a world where we have less sick people to begin with. People have a right to be healthy.
Medical technology in the US is dominated by the pharmaceutical industry. For example, one of the definitions of 'medicine' is 'a pharmaceutical drug'. This reinforces specialization of expertise, which makes medical doctors less competent (as the Chinese traditional practioner said, "Whole body connected! Take a look!"). For example, the riddle of the sphinx reveals that axial myopathy has plagued elderly humans for thousands of years, so that they need a cane to walk, but US medical professionals still don't know what causes it. It may be, in part, a side effect of a genetic mutation that makes humans more resistant to famine. In such a field specialization results in iatrogenic disease.
California has osteopaths in addition to medical doctors. Osteopaths practice holistic medicine. The California Medical Association attempted to end osteopathic medicine as a separate discipline, but in 1974 the California Supreme Court undid the CMA's efforts.
So, it is hard to imagine organization in contrast to hierarchy, but just like the body, in society we are all connected, and we need to "take a look."
Thanks for this excellent explanation of anarchist thinking.
I think many of us already do this in self-organized groups. For example, I've often been involved in bulk food buying groups. I share the google doc and do the ordering, and others will pick up the order, then people pick up their food orders and pay me what they owe.
It's a lovely virtuous cycle, and no one is in charge, although I pay for the initial order which is delivered to my place, and people pick up from there.
And, with people so busy, it's a nice chance for a five or ten minute visit we wouldn't otherwise get.
You are very welcome. I do believe it is a natural inclination - to organise with friends, to show kindness, and to share - especially when we are not fearful or anxious or live in precarious situations, but even then many people still stubbornly (in the best way) still reach out and help.
A very thought-provoking read, and I'd say the arguments are compelling.
All of this made me think how would anarchist organisation of healthcare affect the abuse of power at the hands of medical professionals. This is a very specific example, but here goes. Violence against patients, and particularly obstetric violence, is rampant, yet it's an issue that isn't openly talked about in the society, IMO because the state naturally creates an almost mythological narrative of an untouchable class of experts who can't be questioned and uncomfortable truths must be swept under the rug to maintain hierarchical power. I was at the receiving end of obstetric violence (within NHS) and it resulted in life-changing C-PTSD. Birth trauma is an utterly devastating form of dehumanisation. I've spent the last 4 years bringing attention to this issue and participating in different forms of peer support for those affected. Nothing is changing, in fact, maternal mortality rates are rising in many countries, with BIPOC women being particularly affected.
The biggest problem is that those at the bottom, who hold no power, get sucked into upholding this system of respecting the golden calf of expertise no matter what. Most people run away or even scream at individuals who try to start conversations on obstetric violence and how the whole maternal healthcare system is riddled with people who readily lie to patients and coerce them into procedures without consent, during pregnancy and especially during labour. I can't even count the number of times I was directly told to shut up, stop exaggerating, stop "accusing" doctors and midwives, suck it up because women give birth every day and don't complain, and even openly accused of lying and inventing obstetric violence. This culture of power abuse and the culture of silence that upholds it directly result in an unhealthy society - some research suggests that up to 1 in 3 childbirths are traumatic!
This is what I think of when you say "hierarchical organisations often have structural incentives to overlook or protect incompetent people who maintain the right connections or serve the interests of those above them." I've abandoned any illusion that the healthcare system nowadays still primarily serves its Hippocratic function; lived experience of violence and stats on just how dysfunctional the healthcare system and its outcomes are tell me otherwise, that any Hippocratic function is but a remnant floating on top of a toxic vat filled with profit-making, life-destroying practices. I don't think most people enter the healthcare system with an intention to abuse people - but evidently, hierarchy can make swathes of people drunk on power to the point where they start exercising dominance and dehumanising people who are below them. In that sense, medical system mirrors the state itself.
I think your ideas of horizontal organising would eventually lead to a dissolution of these power trips and (after a couple of generations) there would be a real chance for healthcare based on mutual trust, compassion and morals where untouchable subjects and silencing don't exist.
Thank you for this insight. It is important to speak up for those who suffer under abuses of power and to challenge that power. My hope is that with people questioning that power that the process of fighting and defeating it can make progress, until one day it is considered a relic of the past.
If you get the chance to read Ancestral Night by Elizabeth Bear, I'd be interested to hear your opinion on the society described therein. It's one of my all-time favorite space operas and, in my opinion, provides an interesting reflection on how society could be better organized. I think the future she describes is somewhere between a direct democracy and a horizontal organization, though obviously it isn't perfect. It's still contrasted well enough with the more libertarian-inspired offshoot the antagonistic, lesbian space pirate love interest comes from. The person who reviewed it for Kirkus disagreed, so your mileage may vary, but given that I've seen you post about Le Guin before, I thought it was maybe worth the recommendation even if it isn't actually full-stop anarchist sci-fi.
I'll put it on my read list and bring it up with the local utopian book club I'm part of.
We are all sharing our hopes and wonder through seeking better nows and possible futures.
It might be more aspirational than utopian, but certainly a wonderful exploration of potentialities. I'd also recommend Stealing Worlds by Karl Schoeder, or as a less sci-fi example The Lost Cause by Cory Doctorow and would love to find out more about the books you guys cover if possible! To me, science fiction and literature more broadly definitely provides one of the best avenues for exploring our current problems and imagining better futures like you said. Thank you!
I've enjoyed several Cory Doctorow books, another couple that fit into utopianism would be Down And Out In The Magic Kingdom and Walkaway.
Among the books we've read over the last few years are -
* A Country Of Ghosts - Killjoy, Margaret
* The Fifth Sacred Thing - Starhawk
* Infinite Detail - Maughan, Tim
* The Moon Is a Harsh Mistress - Heinlein
* A Psalm For The Wild Built - Chambers, Becky
* An Oral History of the New York Commune - O'Brien, M. E.; Abdelhadi, Eman
And here are some I plan to read -
* The Actual Star - Byrne, Monica
* Cassini Division, The - Macleod, Ken
* Centuri Device, The - Harrison, M. John
* Disnealand - Johnston, D. D.
* Fountain At The Edge Of The World, The - Newman, Robert
* Revelation Space - Reynolds, Alastair
* Steel Tsar, The - Moorcock, Michael
& the ones you've suggested
❤️❤️❤️❤️❤️
Your section about decentralised healthcare made me think about Buurtzorg, I wondered if you know of them? They operate within a capitalist system and while they're non-hierarchical they do have a CEO/leader so it's not exactly what you were describing, but some of the benefits they feel they gain by operating in a decentralised way even within these constraints are really positive https://www.corporate-rebels.com/blog/buurtzorg
I know a lot of other countries including the NHS in the UK have been interested in trialling Buurtzorg's approach over the years, but I don't know if any have had the same success.
This is very interesting! I’ll make sure to look into this - I’m planning a more in depth article on decentralised non-hierarchal healthcare in general and this looks like it will get its own section! Thanks for sharing this!
I think this is the best thing I’ve read from you! This gets to the heart of what so many people get wrong about anarchism, and it’s written in a very easy to understand but still thorough manner.
Have you ever written anything similar differentiating property and possession? I bet it would be similarly awesome!
That’s high praise - especially considering I almost didn’t post it. It took a bit of work to put all the pieces into something coherent, but it’s always my hope that people wont need a politics degree to understand these concepts, so it seems I may have got it right this time!
I did draft an article on property / possession but didn’t end up finishing it when I saw these two were already written -
See https://judgesabo.substack.com/p/property-is-despotism & https://audiopervert.substack.com/p/property-and-poverty
Having said that one of my next articles is on the theft of the Commons & Expropriation so I will touch on some of that subject.
That's the most encouraging article I've read for a very very long time. I am tired of explaining that temporary arrangements don't stay temporary but gather dust that turns into concrete and become permanent and set in stone etc. etc. Unless we start as we intend to go on, it will be only too simple to lose the thread when things (including people) change. We will never have perfection. There is no utopia, that's a philosophical dream/nightmare, since yours and mine would never be the same. But what we could have is steady development, changes, improvements, if we are equal, using knowledge, skills, ideas, plans when and where we need them, without trying to climb up a ladder, set up a hierarchy, create masters, gods, monarchs or authorities of any over weaning and unwelcome nature!
I'm glad you found it so positive. A full overhaul of organisations and the way they are organised seems like a lot to ask for, but it has happened before. Sadly the shift has usually been in the wrong direction, but going the other way is possible if the power stays with the people and they share it. Even then it will be a continue process of renewing and challenging the tendency to fall backwards, to keep improving, but I believe it is possible.
Thanks much. You and https://substack.com/@complexsimplicity have hit me today with a one-two punch to shake me out of my stupor—the stupor of still thinking I can work within the US system to effect change.
Hiya, any discussion of health care, especially in the UK or US must also include the economy of prevention. The whole system is built on keeping a large proportion of the population fat, sick and on drugs and this is a major part of the economy. Anarchists, I presume, would focus on providing affordable and accessible organic and regeneratively grown fresh fruit and veg, clean air and clean water, indoor and outdoor exercise, community and purpose to all citizens. And no one would be coerced into vaccinations. Doctor's training and research wouldn't be funded by pharmaceuticals. This would very quickly ease a lot of the pressure on a healthcare system.
Very true - most bad health (or the factors that make it much worse) comes from bad conditions and bad incentives and lack of access to a good healthy diet, culture and environment.
But this article (which I didn’t intend to write but got carried away with a response) touches primarily on the organisational aspect of healthcare (& any organisations that require expertise).
I have been drafting one on Anarchist healthcare historically and in the future that will address those other aspects more fully.
I am so excited for that upcoming article! As someone who works in emergency services, the conditions I've seen some patients in are truly abhorrent, and honestly are largely attributed to lack of basic resources, like clean food, water, adequate heating, etc. The burnout aspect for a lot of providers is incredibly real too, because there is just such an vast number of people you have to treat who are just so ill all of the time. My love for medicine stems from a genuine desire to help my community, but being trapped in a vicious system that prioritizes profit over people's livelihoods takes its toll on me. I want to envision a world where not only do we genuinely want to help people simply for the sake of helping, no profit involved, but also a world where we have less sick people to begin with. People have a right to be healthy.
Medical technology in the US is dominated by the pharmaceutical industry. For example, one of the definitions of 'medicine' is 'a pharmaceutical drug'. This reinforces specialization of expertise, which makes medical doctors less competent (as the Chinese traditional practioner said, "Whole body connected! Take a look!"). For example, the riddle of the sphinx reveals that axial myopathy has plagued elderly humans for thousands of years, so that they need a cane to walk, but US medical professionals still don't know what causes it. It may be, in part, a side effect of a genetic mutation that makes humans more resistant to famine. In such a field specialization results in iatrogenic disease.
California has osteopaths in addition to medical doctors. Osteopaths practice holistic medicine. The California Medical Association attempted to end osteopathic medicine as a separate discipline, but in 1974 the California Supreme Court undid the CMA's efforts.
So, it is hard to imagine organization in contrast to hierarchy, but just like the body, in society we are all connected, and we need to "take a look."