By Paul Theerman, Associate Director, Library and Center for the History of Medicine and Public Health

Last month marked the 100^th anniversary of the Great October Revolution, whereby the Bolsheviks in Petrograd overthrew the Russian government and took power.[1] Immediately after, the Revolution’s leader, Vladimir Lenin, consolidated his rule by suppressing competing political parties; withdrawing Russia from World War I; and fighting a bitter Civil War. By the early 1920s, the country had obtained a modicum of peace, albeit isolated from the rest of the world. Through wars and purges, technological advance and political suppression, the Bolsheviks, renamed the Communist Party, held control in Russia for almost 75 years.

Lenin was aware of Russia’s backwardness compared with the West. He saw Communist rule as a way to make up for that deficiency. His oft-cited definition of communism made this belief explicit: “Communism is Soviet power plus the electrification of the whole country.” Soviet power meant political rule that flowed from ostensibly democratic workers’ councils (the Russian word for “council” is “soviet”), with the aim of basing governance in the working class; electrification meant providing the latest means of technological development. Soviet rule and technological development, together, would enable the country to leap-frog its capitalist neighbors and become the vanguard for humanity’s future development, both social and economic.

The socialist left hoped this vision would be realized. Early accounts were enthusiastic—sympathetic American journalist Lincoln Steffens gushed in 1919: “I have seen the future, and it works!”

By the 1930s, as the United States and Europe slid into the Great Depression, Soviet Russia was held out as a more workable and more equitable society than those in the West. In the field of medicine and public health, two observers set out to see if that were true. Sir Arthur Newsholme (1857–1943), and John Adams Kingsbury (1876–1956), a Briton and an American, traveled through the Soviet Union in August and September 1932.[2] Their account was published the following year as Red Medicine: Socialized Health in Soviet Russia.[3]

Newsholme and Kingsbury travelled over 9,000 miles throughout the Soviet Union. Entering Russia from Poland, the two traveled to Moscow, took a trip up to Leningrad and back, and then headed east to Kazan, south to Samara and Stalingrad, and jogged back to Rostov-on-Don before journeying to Tiflis (Tbilisi) in Soviet Georgia. They traveled back to Moscow by way of Sochi, Sevastopol (in Crimea), and Kharkov in Ukraine, and from Moscow, they returned to Poland. Their book chronicled their trip with an overlay of commentary. It was in part a look at Soviet institutions, such as residential and non-residential treatment, physician training, maternity care, and tuberculosis sanitaria. Beyond this, the authors provided social and political observations on life in the Soviet Union, with chapters on “The Background of Russian Life,” “Stages in the Introduction of Communism,” “Women in Soviet Russia,” and “Religious and Civil Liberty and Law.”

Though clear-eyed about the authoritarian nature of the Soviet government, Newsholme (the acknowledged author of most of the work) nonetheless focused on one question:

Does the Soviet organization—including all that is implied in the unification of financial responsibilities and control of the entire resources of the country—assist to an exceptional extent a complete medical and hygienic service for the entire community? To this question we can at once give a definitely affirmative answer. [4]

Though the “civilized countries” had variously tended toward socialized medicine, he thought that the U.S.S.R. had surpassed them all, both in delivery of health care and in prevention, in social services as well as medicine more narrowly defined. As one reviewer of Red Medicine understood Newsholme’s claim:

“[In the] organization and practice of medicine . . . the present government has made truly great progress, and seems to have only fairly gotten under way. The authors clearly perceive that Russia has laid a more adequate basis for up-to-date public health than any western nation; also, that we have arrived at a stage of cultural development when medical services must be provided on a sound basis for all, regardless of ability to pay.”[5]

This level of public support was seen as the inevitable goal of social development, so much so that, as Newsholme put it, “Even if the Communist experiment fails, Russian government cannot be expected to revert entirely to capitalist conditions.”

Did the Soviet experiment work? The new system of medicine and public health was initially very successful in dealing with infectious disease and extending care more widely through the country. Nonetheless, as Newsholme had envisioned, the initial impetus could not be sustained. Fifty years after Red Medicine, the system was broken; while citizens could usually get access to health care, quality lagged. After the collapse of the Soviet system in 1989–91, the new Russian government attempted reform and adopted a mixed public-private economic model, mandating compulsory health insurance while continuing a guaranteed right to free care. Fifteen years on, though, an OECD report concluded that “Russia continues to struggle with a health and mortality crisis.”[6] One could fairly state that our country faces such as crisis today as well, and in both cases, the resolution is yet to come.

A note: Red Medicine includes several photographs by noted photojournalist Margaret Bourke-White, taken during her own 1932 trip to the Soviet Union, and provided freely to the authors for their use.[7]

Endnotes:
[1] Yes, it took place in November! In 1917, Russia still used the Julian calendar, according to which the day of the Bolshevik coup was October 25. The rest of the West, using the Gregorian calendar, called that day November 7. Most of Catholic Europe had switched to the Gregorian calendar in 1582, with the Protestant countries adopting it in the 17th century and the British domains in 1752. Russia made the change in early 1918, one of the last countries in Europe to do so.

[2] Newsholme was an eminent British public servant and advocate of state intervention in public health, while Kingsbury, a Fellow of The New York Academy of Medicine, was formerly Commissioner of Public Charities for New York City, and at that time, Executive Director of the Milbank Fund, a foundation supporting research in health policy.

See “Sir Arthur Newsholme, K.C.B., M.D. (LOND.), F.R.C.P.,” American Journal of Public Health 33(8) (August 1943): 992–94; John M. Eyler, Sir Arthur Newsholme and State Medicine, 1885–1935, Cambridge History of Medicine (Cambridge: Cambridge University Press, 1997); Arnold S. Rosenberg, “The Rise of John Adams Kingsbury,” The Pacific Northwest Quarterly 63(2) (April 1972): 55–62; “Biographical Note,” The John Adams Kingsbury Papers, Manuscript Division, Library of Congress, accessed November 7, 2017.

[3] Sir Arthur Newsholme and John Adams Kingsbury, Red Medicine: Socialized Health in Soviet Russia (Garden City, NY: Doubleday, Doran, 1933). Note that, despite the title, the work was about more than Soviet Russia. The two men’s travels took them to the Georgian and Ukrainian Soviet Republics as well.

This work was conceived as in some ways completing Newsholme’s previous three-volume survey of medical practice in Europe, which he undertook with the support of the Milbank Foundation: Medicine and the State: The Relation between the Private and Official Practice of Medicine, with Special Reference to Public Health. London, Baltimore: George Allen and Unwin, Williams and Wilkins; 1932. The Academy Library holds the third volume.

[4] Newsholme and Kingsbury, Red Medicine, “Concluding Observations” (for this and subsequent statements).

[5] Frank H. Hankins, “[Review of] Red Medicine: Socialized Health in Soviet Russia. By Sir Arthur Newsholme and John Adams Kingsbury,” Social Forces 14 (1) (1 October 1935), 155–56, accessed November 7, 2017. Hankins (1877–1970) was a prominent American sociologist.

[6] William Tompson, “Healthcare Reform in Russia: Problems and Prospects,” Organisation for Economic Co-operation and Development, Economics Department Working Papers, No. 538 (Paris, January 15, 2007), 5.

[7] Gary D. Saretzky, catalog for “Margaret Bourke-White in Print: An Exhibition at Archibald S. Alexander Library, Rutgers University, New Brunswick, New Jersey, January–June 2006,” item 23, Red Medicine, accessed November 7, 2017.