Since the will attempt to construe any move toward serious as a return of the great mustachioed Soviet monster, it is essential that those fighting t… - Kristen R. Ghodsee

Without an accompanying welfare state in which social programs funded by a progressive income tax redistribute from the rich to the poor, capitalism can be a deeply unfair system where a small, well-connected elite captures a majority of the wealth and power, and not necessarily through meritocratic processes.

Throughout much of the twentieth century, state socialism presented an existential challenge to the worst excesses of the free market. The threat posed by Marxist ideologies forced Western governments to expand social safety nets to protect workers from the unpredictable but inevitable booms and busts of the capitalist economy. After the Berlin Wall fell, many celebrated the triumph of the West, consigning socialist ideas to the dustbin of history. But for all its faults, state socialism provided an important foil for capitalism. It was in response to a global discourse of social and economic rights—a discourse that appealed not only to the progressive populations of Africa, Asia, and Latin America but also to many men and women in Western Europe and North America—that politicians agreed to improve working conditions for wage laborers as well as create social programs for children, the poor, the elderly, the sick, and the disabled, mitigating exploitation and the growth of income inequality. Although there were important antecedents in the 1980s, once state socialism collapsed, capitalism shook off the constraints of market regulation and income redistribution. Without the looming threat of a rival superpower, the last thirty years of global neoliberalism have witnessed a rapid shriveling of social programs that protect citizens from cyclical instability and financial crises and reduce the vast inequality of economic outcomes between those at the top and bottom of the income distribution.

In the mortality belt of the European former Soviet Union, an aggressive health policy intervention might have prevented tens of thousands of excess deaths, or at least generated a different perception of Western intentions. Instead, Western self-congratulatory triumphalism, the political priority to irreversibly destroy the communist system, and the desire to integrate East European economies into the capitalist world at any cost took precedence.