While the development of center capitalism has evolved toward “the Welfare State” and a framework of liberal sociodemocracy, the “peripheral State” is generally characterized by nondemocratic forms of government. This bipolarity in the state structure between center and periphery is functionally related to the international division of labor and the unity of production and circulation on a world level. The programs and policies of the center Welfare State (health, education, social security, etc.) constitute an input of “human capital” into the high-technology center labor process. Moreover, welfare programs in center countries activate the process of circulation by sustaining high levels of consumer demand. In underdeveloped countries, the underlying vacuum in the social sectors and the important allocations to military expenditure support the requirements of the peripheral labor process. Programs in health in the center and periphery are related to the bipolarity (qualification/dequalification) in the international division of labor. The social and economic functions of health programs are intimately related to the organic structure of the State and the mechanics whereby the State allocates its financial surplus in support of both capitalist production and circulation.
Marxist Theories of Development, the New International Division of Labor, and the Third World
