[cs137]

Everything you're saying about the Soviet health system is true of capitalism's health system now. The difference is that, in the US, we go into debt for our mediocre care.

The main reason for the discrepancy in care quality during the midcentury is... drumroll please... that the Soviet Union was poor, due to initial conditions. It encompassed countries that had long been impoverished. The US had a middle class to build on; the USSR did not. It built a middle class where none had ever existed. Not to mention, the US was in the historically rare situation of winning a war (since, in economic and humanitarian terms, wars are negative-sum and most often only have losers). The USSR, on the other hand, consisted of nations that had taken a beating in World War II.

If you compare Kyrgyzstan to Alabama, the Soviet Union looks bad, but that's not really a fair comparison. Capitalism, as a sea empire, could dominate people from afar and keep them in nominally separate nations while exacting tribute; the Soviet system, as a land empire, could not. It had to integrate them. That's a harder problem. If you make a fairer comparison--say, if you compare Kyrgyzstan to Honduras or Haiti, the picture lines up a lot better. I imagine the quality of healthcare in the poorest countries under capitalism's thumb is even worse than it was in the poorest SSRs as of 1989.

This isn't to say the USSR was great. It was an authoritarian regime, and it launched some really ugly wars (such as the one in Afghanistan). It remained poor (relative to the West) throughout its lifespan because, ultimately, there is no magical economic system that guarantees 12% annual GDP growth--doesn't exist, never has. Socialism solves one set of problems--and a big set of very ugly problems--that capitalism lets fester, but does it automatically bring about utopia? No, not even close. On the other hand, socialism iterates toward a better standard of living for the common people; capitalism, unless heavily checked (as it was in the Cold War) iterates toward a worsening standard of living. So, on that dimension alone, capitalism loses. Everything said above about shortages and nosocomial infections and substandard care applies to capitalism's medical system today.