@redrozalia I'm going to have to give up for the day quite soon. I don't want to be Malthusian (racist) or Anarco-Primitivist (silly). I'm worried that you are showing me that I am both.
To come at this obliquely, I have been thinking about what decolonised medicine might be. This is through conversations with a Nigerian doctor friend. I'm going to use the MRI scanner as a symbol. There are, I think, three in all of Nigeria. You cannot treat hepatitis in Nigeria because you need to be able to monitor the liver with an MRI scanner. Even rich people can't have that. The former president, Buhari, was treated abroad because of the lack of facilities in the country.
Now you might think, well MRI's are expensive, but if we spent less money on F35s and taxed Elon Musk, we could have enough MRI's for everyone. It seems to me though that MRI's require more than the wires and magnets. They require a pharmaceutical industry, a massive university system for public research and that in turn requires a really well ordered, stable and materially rich society.
Here is where it gets handwavy. That localised stability requires enormous expenditures of energy. It is the inevitable fight against entropy. It requires massive degrees of social control and externalising the costs by extracting oil from the Niger Delta and coltan from Congo. That in turn requires dispossessing and dominating the people of the region. It may not need F35s and Musk, but it will always be the privilege of the few. You have to have a vast population of oppressed workers who are little more than slaves.
Beyond that it also requires massive levels of social control. Thinkers like Arendt and CLR James and artists like Bergman and Tove Jansson were acutely aware of the horrors of bureaucracy and the modern administrative state. Freedom, in the sense of control over the space of our lives, is sacrificed for the efficiency that allows the production of the MRI machine. Note that freedom and power are synonyms and understood not in the capitalist sense of getting what you want, but in the collectivist sense of being able to create, to do things. Because that requires others, no one will get what she wants other than the ability to direct her own life.
If we are to organise with our neighbours to control the space of our lives and to collectively decide on our own futures, there will be no MRI's. No one will agree to running a high speed train line through their community or giving up their home for a mine. We also won't be controllable. There is simply no way to run the kind of high tech, highly coordinated system that is required to make MRI scanners, without top down control.
I think that is OK. I will be dead. I broke my neck at 22. I was airlifted to a specialist trauma centre and put on a ventilator. I probably had an MRI scan, certainly a lot of CT scans. Skilled surgeons using mind blowing anaesthetics did their thing. I don't think that I can demand that you go down a mine in Congo or work in a sweatshop in Bangladesh so that I live. I also would rather, I think, have had a chance to be free, to share a world with you, than live, my admittedly very lovely life, in this one