Strictly speaking, the author stresses that the political form should be recognized in its manifestation and inner expression, but can only be identified, in a structural way, through its position in the totality of capitalist social relations. It is about conceiving State in its structural association with these relations. In short, it is possible to say that State, in its political form, presents relative autonomy to social autonomy, making the separation between political power and economic power explicit.
However, this autonomy is exerted in the entanglement of particular social relations, i.
It should not be forgotten that in the constitution of economic and political form - and in the intertwining of both -, there is a necessary involvement of history, class struggle, its movement. This does not mean that if the State has autonomy towards classes, it reveals no indifference to the social whole. In this sense, Mascaro is quite clear: "it is not the domination of State by a class what reveals its structural reason for being; is the form that reveals the nature of social reproduction" p.
To strengthen the argument already explained earlier, there is a relative autonomy of State, which is grounded on the structural and existential dependence on a certain type of social reproduction, the capitalist one. Let us insist, it is relative because it mirrors its own capitalist reproduction. Mascaro summarizes: "it is not because of the classes that dominate it, but because of the form, that the State is capitalist" p.
In this perspective, when referring to the nature of the capitalist crisis, it is possible to affirm that the State plays a fundamental role in its constitution, as is the form required by this model of capitalist social reproduction.
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As is known, capitalist economy is structured through the conflict present in the appropriation of capital and of exploited labor, and the State is in direct relation with the multiple economic and social contradictions. If State cannot be understood as an element able to save us from crisis, opposing capitalist logic - as many left-wing theories and visions still advocate, especially in the field of public health -, it can neither be understood as an element that hampers the perfect equilibrium of markets, as the neoclassical economic vision insists on spreading.
From to the current period, that is, in the time of neoliberalism, it has not been possible to identify a State withdrawal from economy; what was seen instead was a particular form of State "presence" in economy. Particularly in the current crisis of capitalism, we are witnessing the adoption of austerity policies by the State, with a reduction of social rights, including health policy, around the world and in Brazil. In addition, there is also the state permission for the appropriation of public funds by capital. To illustrate, in the context of the crisis of contemporary capitalism, under dominance of financial capital, the Brazilian government has continued to grant incentives to the private sector, imposing risks to universal health.
It is observed, on the one hand, the increasing transfer of public resources to the Health Social Organizations OSSs - privately owned - and the increase in tax breaks resulting from the deduction of expenses related to health insurance and similes in income tax and tax concessions to private non-profit organizations hospitals and to the chemical-pharmaceutical industry, weakening the Brazilian State capacity to collect taxes and damaging the financing of the Brazilian National Health System SUS Thus, one can observe the intertwining of the interests of capital and the State.
It is strengthened, then, the State's presence in strengthening the logic of capital appreciation that appropriates SUS financial resources. Thus, it is weakened the argument that restricts the neoliberal policy to removing the State of the conduct of public policies.
As starting point, we take the comprehension that the understanding of the economic crisis cannot be restricted to the vision of a State crisis, but to a structural crisis of capitalism. Again, it is considered important to emphasize the words of Mascaro :. The State is involved in the remediated, increased, or reworked crisis. The political form alters economic and social circumstances that, if enable new articulations, are almost always partial, keeping the general basis of the valuation of value" Mascaro, , p.
In this context, this article aims to analyze the trend of the Brazilian universal public health in the context of structural crisis of capitalism. Therefore, the article is organized into two parts, in addition to this introduction and final considerations. If there is something that marks the present, it is the problem of manifestation of the structural crisis of capitalism, in its mode of operation of the persistent tendency of falling profit rates and the dominance of the interest-bearing capital financial capital in the capital of the movement.
Multiple views of some leaders of capitalist countries and some economists have argued that the current crisis is of a financial nature, in which it is clear the contamination in the real economy and that European debt can be resolved through drastic reductions in public expenditure, especially in the expenditure of social policies It seems important to counter these approaches, noting that they do not understand the nature of the process experienced by the pattern of capitalist accumulation, especially in the last thirty years.
Furthermore, there also is a crisis of neoliberalism and its boom.
This was indeed the response to the crisis attempted by the ruling class. We believe that the foundation of structural crisis of capitalism lies in a broader context there are two main trends, hinged together, especially from the late s: the tendency of the rate of profit decline in capitalist economies, especially the US, throughout post-war; and in response to this trend, the capitalist system gets in the way of financialization in the interest-bearing capital financial capital , specifically the fictitious capital, has held leadership in the dynamics of capitalism in this period, being central in economic and social relations the world, especially after Chesnais, Thus, the dominant power of this capital, especially its assumed form, the fictitious capital cannot be taken as a lack or distortion, but above all as the meaning of this capital to seek insatiably their valuation - the retreat of context productive capital -, even though this valuation was fictional, without producing added value and functioning in a speculative and parasitic manner Carcanholo; Nakatani, It is a development of the logic of capital movement.
This development with the logic of capital sham recovery was not ever in the history of capitalism, because of controls imposed to him as a result of historical and specific circumstances, such as the period of the "thirty glorious years" If we come to think dynamically about capital appreciation, as developed by Marx, the current crisis refers to a capital crisis and not a crisis caused by a distortion whatsoever, be it lack of regulation of financial markets or the search exorbitant bank profits in recent decades.
The fact that the crisis began in the financial system does not mean that it was generated by it A full analysis of the current crisis requires understanding the more general argument of Marx on the capitalist crisis as a result of the contradictory dynamics of the capitalist mode of production. Capitalism has always developed accumulating contradictions, which periodically lead to crises Marx, This means that prolonged accumulation of capital, with technical progress of introduction, refers to the relative increase of the capital invested in means of production such as facilities and equipment and raw materials, i.
How profits come from the value added by the labor force, thus keeping the rate constant exploration, the profit rate measured by the ratio of profit mass and the amount of invested capital tends to suffer loss. By the time this drop occurs, there has been one overaccumulation crisis that is explained, not by insufficient effective demand, but by the absence of profits.
In turn, the solution that the capitalist system itself provides to this problem from the very crisis, mainly through three strategies: increasing the exploitation rate - forcing workers to accept lower wages and poor working conditions; the reorganization of new production lines; and the devaluation and destruction of part of the accumulated capital stock, that is, if there is no sufficient capital depreciation through bankruptcies, lower and the like, the result is the ongoing overaccumulation For Marx , the latter - devaluation - constitutes the main strategy for economy to overcome the crisis, increasing the mass of profits and decreasing the amount of capital, which would cause the increase of the profit rate and be directed to another period accumulation.
Of course, overcoming the crisis and the manner it will occur depend on several factors, including class struggle itself.
Marxism versus the mainstream: rethinking the economic crisis
In the Marxist literature, mostly Anglo-Saxon, emerging in the wake of the economic crisis that began in and , two large positions were evident. The first emphasizes the crisis erupted as a result of long-term trends within the capitalist production process, from the decline in the rate of profit in the postwar decades and which was not subsequently fully reversed. The second position focuses specifically on the financial dimension of the crisis and normally minimizes the downward trend of the profit rate.
The work is in reference to Costas Lapavitsas et al. This is not to analyze in this article the contribution of each of these authors against capitalism contemporary crisis 27 , we just highlight the arguments of Kliman, in the following paragraphs, because we believe that this author has constituted one of the main advocates view on the crisis centered in the law of Marx about the trend fall of the profit rate, highlighting its decline since the post World War II period to the present day. In our view, this view summarizes the first tendency of capitalist accumulation that contributes to understanding the crisis of contemporary capitalism.
According to Kliman , the recovery of profit rate, even if not in a strictly economic manner, occurred after the end of World War II Faced with the massive destruction of assets that occurred before and during the years of this world war, it was established after the war a substantive growth of accumulation and savings that raged for about twenty-five years. However, this growth in the period detracted from their livelihoods. This is because, at the time the capital was accumulated, there was a steady decline in the rate of profit, resulting in progressive loss of economic growth itself.
The main argument of Kliman points to the historical and persistent trend of profit rate fall in the US economy throughout the postwar period. The following graph, compiled by Kliman, shows the evolution of the profit rate of the corporate sector of industrial and financial companies of the US economy when the stock of fixed capital is measured at historical cost and profit is estimated as the sum of all property income. In this Graph 1 , the profit rate, in deflated values, presents a clear downward trend throughout the post World War II period. Source: Kliman As the logic of capital accumulation process, previously commented on Marx, so that the profit rate not declined steadily from to would have required the existence of an accumulated capital of mass destruction in the form of fixed assets 29 and in the financial form, which did not occur.
Particularly from the s, as observed in Graph 1 , there is a slight recovery of profit rate, but far from sufficient to restore the level recorded in Kliman argues that the US economy remained unstable and not recovered from the crisis, due to the fact that the destruction of capital regarded in the early s, was insufficient to recover the profitability and the economic dynamism of the main capitalist economy. For this author, the tendency to stagnation in the center of the capitalist system has to be understood as a result of chronic lack of profits and therefore the lowering of earnings expectations, which would be required to remunerate the capital then invested and the capital investment.
Indeed, the existence of a slight recovery of the profit rate after the s was due to neoliberal economic policies that, as known, decreased the workers' income and imposed far more precarious working conditions, by reducing public social expenditure.
Explaining the Crisis
Thus, it is understood that the crisis of capitalism is creeping ever since, as the neoliberal policies proved inadequate to restore profitability. In general, capitalism experienced its greatest period of expansion after World War II. However, this period ended in the s, making room for the ruling classes around the world adopt neoliberalism as a project to resume growth in the world economy, i.
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Thus they were triggered some action: attack on wages, social rights and states of Social Welfare, the re-concentration of income, market liberalization, privatization and globalization of the capital and its growth through the financial capital. Neoliberal economic policies have obtained several achievements. They managed to reduce wages and refocus income, with the fall of the former "Soviet bloc" and the reintegration into the capitalist world market of Russia and, especially, China. However, such a project could not recover the profit rate, keeping it limited, leading to the recovery of capital accumulation stay weaker compared the output of previous crises.
It can be said that this was due to the fact that the attack on wages was not sufficient to achieve a high rate of profit. As mentioned, it must also devalue and destroy capital stock. However, this was not carried out as governments, after World War II, always acted to reduce the depth of crises. The accumulation of capital had a rather slow pace in the capitalist core countries, being partly offset by a stronger accumulation in new centers of world capitalism, China and other Southeast Asian countries. Especially in the s and in the s, witnessed the compensation for accumulation of interest-bearing capital, in its fictitious way, with the explosion of credit and debt, primarily in Europe.
Strengthening of capital accumulation in China helped to offset the pace of accumulation of the core countries, landed new contradictions, stiffening competition on the world stage and raising the pressure on wages and on social rights in these countries It is on this background that we can understand the nature of the crisis of contemporary capitalism, intensifying the attacks and questions directed to the Welfare State, in a way reconfiguring them In relation to a second trend of capitalist accumulation in the last thirty years, which contributes to the understanding of contemporary capitalism crisis, there is the growth of the financial sphere, through the command of the interest-bearing capital financial capital in the general movement the capital.
This increase in financial orbit, called for "financialization", can be understood as a response of the capitalists and some states in seeking investment opportunities beyond the productive and non-profit economy. To understand what is at stake when discussing health, it should be noted that the standard of social protection, which ensured the right of public health universality in the country, developed in relation to developed countries, so "late", not only with respect to time, but especially in reference to the historical moment that was inserted, that is, in the financial capital dominance of times.
Quite differently than was done in the period in which the social protection of the European and American State of Welfare developed, it was no longer the industrial capital that led the movement of capital. Mainly from the s, we can see the resurgence of capital producer interest in a consistent manner, and he goes on to determine the economic and social relations of contemporary capitalism. In fact, the fictitious capital, to constitute the most complete form of interest-bearing capital, provides the capitalist relation achieve the more reified and fetishized form, as discussed by Marx.
It is important to resume what Marx , p. He says, "we have this form M - M', the money that generates more money, value that value yourself without the intermediate process that connects the two extremes", that is, without going through the production process, when referring the general expression of capital movement M - A - M'. Still referring to this aspect, Marx notes:. In M - M', we have the empty form of capital, the perversion, in the highest degree, the relations of production, reduced to something: a figure that bears interest, simple capital figure, in which he is a precondition of their own reproduction process; power of money, or goods, to increase the value itself, without relying on the production - the mystification of capital in the most forceful way Marx, , p.
From the study on the interest-bearing capital, Marx examines some possibilities for its course and its assumed forms, leading this capital to the fictitious capital performance. In this sense, it is interesting, now, to resume the argument of Carcanholo and Nakatani , already mentioned at the beginning of this section of this article.
The dominant power of interest-bearing capital in its particular form taken, the fictitious capital, cannot be understood as a distortion, but as part of a logical development by seeking capital appreciation that, although this appreciation is fictional, without the consideration of the added value production, operating by the speculative and parasitic form.