I'm new to the concept of anarchism, at least as a vision of society that actually has had thought put into it, so my apologies if this question seems stupid of self centered.
Risking losing context as I ask this, I'm curious about how advanced medicines like insulin (things that aren't small molecules, require rDNA, multinational logistics, supply chains and quality assurance, etc) would work and be distributed. What about advanced medical devices like insulin pumps, subcutaneous glucose monitors, etc?
I know there are some types of anarchist who would say those things wouldn't be needed without industrialization (im not going to gratify that take with a reaponse), but I suspect most still recognize the need for things like this, since millions of people would die without them.
I guess the root of my question is what the motivation would even be for someone to work on projects like that. Type 1 diabetics make up ~0.1% of the population at the highest, and a major hurdle from my perspective would be getting people to work on something needed by so small a population, but requiring such intensive resources to produce. And especially in any kind of transition period, I find it basically impossible to imagine the able bodied revolutionary actually giving a shit whether people like me live to see the "after."
I've done some looking and it seems like broadly, the attitudes range from "you'd make it yourself and its okay because you'd have time to if all your basic needs are met" to "well surely someone would do it altruistically." I also found a few people who just said "people die, get over it," and "the real problem is you should've died when you were 7 but we played god," but I have to assume (hope?) that such ideas are fringe. I'm hoping especially to hear from someone who actually understands why insulin (and pumps and CGMs and all that) are complicated, hard things that probably won't get made purely by volunteer labor at the huge scale needed. Like, it's not one of those things you can whip up at a local pharmacy, its far too complex for that.
I guess in all, I like the idea of a society without hierarchy, where self determination and community engagement become the de facto environment...but from my admittedly novice perspective, it sure doesn't feel like much thought has been given to how those of us with extremely short expiration dates should stability evaporate actually survive the transition.
Over the last week that I've been reading and thinking about this, I keep coming back to the inherent (though hopefully temporary) loss of stability that comes with any revolution. In that kind of scenario, I just...die. Along with millions like me. Either from supply chains failing during transition, or my own bullet because I'm staring down the barrel of an agonizing final week that ends with me dehydrated, starving, vomiting blood and gasping for air. From here it's really hard to see a place for me in an anarchist future.
Sorry, I recognize thats a little dark. But its something im finding myself having to think about more and more as collapse seems to draw ever closer.
Just hoping anyone has insights to share. And if i respond in the comments and i seem a little forceful, I promise I'm not trying to be a dick, its just that this is kind of existential for me, so I am probably going to be prone to pushing back or really pressing on certain aspects. If im being rude, please dont hesitate to tell me and I'll try to reframe to avoid that. It's neither the goal nor the intended process.
None of this is anarchism. While no one can lay out in detail exactly how complex manufacturing & medical care will work, the principles of it would be
I am not in medicine or pharma production, so maybe you can help me think of how to arrange a system along these lines?
We already have medical associations, unions of nurses, and university & hospital affiliations. What would those look like without capitalism or other hierarchy weighing them down?
Are there less exploitative ways to manufacture drugs and distribute them to all, where there is no need to distribute profit to shareholders or goose the share price, because the company is now a bunch of cooperatives?
We need you, the medically trained folks, to help us think about how we can provide care and medicine in an anarchist way.
I have no doubt that professional associations could work the way some open source projects do, with equal contributors who merely have different roles. I also have no doubt that such institutions would arise and be well staffed with people who really care about doing that work. And there are plenty of consortiums that are capable of designing standards independent of states, so an easy model exists for working groups like that.
This is the part of your response that hits the closest to what concerns me, I think. The answer is "I don't know." And that's because I see work like assembly line or factory work as about as far from humanizing as possible. I don't think anyone would do it without some external motivation. The day to day work of producing stuff I use isn't the kind of thing there's typically a lot of passion for. The design? Sure. Engineering? Absolutely. But like...extruding the thousands of miles of tubing, or inspecting box after box of insulin, it's not...really that. And I did some temp work in a factory a long time ago, so I speak from some experience there. It's something you do to make money, not because you deeply care about it. Everyone I worked with would rather have been doing anything else, and I can't blame them.
So if you asked my uneducated ass what a more equitable version of that would look like, I'd say that person inspecting boxes should get all of the fruits of their work, and they should be compensated well for that work to acknowledge how much it sucks and how much that bit of themselves is valued. Without an external motivator, why would anyone put themselves in that environment? And that's not a rhetorical question (well, ok, I guess it sort of is also that), but an earnest one. Doubly so if the environment is toxic but still ultimately necessary (some medical things just absolutely have to be single use plastics -- something that has eaten at me for a long time as I see the pile of extra refuse created by just a year of keeping me ticking). The fear is that since nobody has to do it, the only people who care enough to do it will be people directly affected by it, and at population densities that low, we're too rarified to just do it ourselves. In my entire life I've met...two others out in the wild (as in not in the waiting room at the endo's office).
Maybe I'm baring a little much for a question like this, but when I try to reason through how things would function the thing it seems to point back to is "you're supposed to have died a long time ago, your survival is a weird fluke of a particular set of incentives" and I guess I'm struggling to see through a lens other than that, which is why I came asking for help looking at it differently.
Am I just crazy? Is this a set of concerns so out there that it's not even wrong? I just can't build a mental picture of what this looks like without having to invoke scifi tech to fill in gaps.
You are kind of contradicting yourself. Either it is super specialized work that can't be done part time by people that need it to be done for their other work (researchers, medical professioals etc.), or it is repetitive factory work a partimer like you could do.
I am well aware that this isn't glamourous work, but so are many other necessary things. And in general Anarchists do not advocate against division of labour, but rather that you shouldn't coerce people into slave like conditions to do certain jobs. I don't think the latter is necessary at all for many factory jobs if you limit the hours people do them.
I don't really see it as a contradiction because it's both. At different parts in the process that gets it from the vat into a person, and sometimes they both overlap at some stages of the process.
Your latter point is actually very well taken, though. I guess my perspective on a lot of that kind of labor is overly colored by doing it 8 hours at a time. That's the kind of obvious-but-not-obvious thing I was looking for.