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.
This passage suggests an assumption - that anarchist society is reached through a revolution that requires forceful action. Or maybe war. But, I must note - even in disputes that were settled with artillery, not all revolutionaries were able bodied.
However, if the previous assumption is true, the subsequent conclusion is indeed true. In a war, you can't depend on reliable supplies of medicine, fuel, electricity or even food and drinking water. A factory or warehouse may get bombed. A power plant may get bombed. A water treatment plant may get bombed.
Then again, I must remaind: states are quite and very capable of waging war, without any anarchist assistance. Yet people dare to live in states, despite risk that a local state will go crazy and attack others, or the risk that a foreign state will invade.
"We don't exactly have alternatives, Sherlock", one would surely counter. And indeed, most of Earth is owned by some state or another, except Antarctica. Lucky people can pick the flavour and intensity of statism they live under. Less fortunate ones dont' get a meaningful choice.
And indeed, a lot of people on Earth right know... would not have the option of getting insulin - despite living under a full blown hierarchy - not to mention accessing a tailor-made cancer vaccine (most of us on Lemmy don't have that option either).
What would anarchism change?
Well, for a start, it might be permissible to cook it up at home. Speaking as an ex-biologist: you need a bioreactor and purification process or animal organs and a purification process to get insulin. Once you start making it, there's no point making it for one patient only. There's no point in making antibiotics for one patient only. There's no point in making vaccines for one patient only.
So you industrialize and standardize the process. And I don't see anything in anarchist ideology saying "no, you shall not industrialize any process or announce a standard". I see critique of how resources are managed. Anarchism criticizes hierarchies of power (wealth == power). It does not typically critique medical or technical advancement, unless some form of advancement alienates people from their rights or concentrates power. Anarchism does criticize large organizations, but only a few tendencies of anarchism conclude that large organizations may not exist. Sometimes they're needed. Risks that they bring can be grounded in various ways.
...but getting back to the beginning, I think one should try to reach anarchy without war. War very much necessitates acting like a state to maximize chances of victory. It shouldn't be the first option for an anarchist, and might actually be a the last option to try (when a choice has been forced and nothing peaceful has worked).
From a personal perspective...
Emigrating from a place where violent conflict looks to be imminent, would be advisable if once needs advanced medical care.
Another place where my wording I guess gave the wrong impression. That wasn't meant specifically to address war (although I did expect to hear a more militant bent, which I'm heartened is not the case), but people who want radical change quickly. It's not that I don't understand wanting that, or being willing to sacrifice to get there, but I've seen enough people over the years just nonchalantly forget that people who aren't young, healthy firebrands are still going to need a place in the future they want to build. And not keeping them in mind specifically while you work toward that future means a lot of them won't make it there with you.
I'm less worried about that now than I was when I first asked this question. I needed a counterexample of people doing exactly the work of not forgetting the people most dependent on a system (not necessarily the current one, but they will need systemic supports to survive in any arrangement) and I got it.
Also, sorry, one last little thing I have to get on a soapbox about because people need to know it
This should not be considered an option in a world where modern biologics can exist. This is a red herring just like walmart R and N to trick people who aren't personally affected into believing there's an option available when the "fancy" stuff isn't on the table. Modern insulin analogs should be considered the only humane treatment until we get something better. There's literally no reason to settle for worse.
There is about as much reason to take insulin from animals as there is to engage in cannibalism, to drink your own urine, or to put someone in a prison cell. There can be scenarios where it's the best way out, but any effort spent preparing for that possibility is better spent preparing to avoid that possibility.