There is a widespread belief that capitalism is responsible for the huge improvements in health that have occurred over the last century and a quarter. Capitalism is seen as the supreme engine of growth, and growth is seen as the crucial condition for health improvement. But it is not. Poor countries can and sometimes do have better health than rich ones. The US is held up as a ‘world leader’ in medicine when it is really a world leader in healthcare market failure, spending almost a fifth of its huge national income to produce overall health outcomes little better, and in some respects worse, than those of neighbouring Cuba, with a per capita income barely a twentieth as large. ‘Breakthroughs’ in health science and technology – in nuclear medicine, genetic medicine, or nanotechnology – are treated as triumphs of capitalist investment in research. But most innovative medical research is actually done in state-funded medical schools and research laboratories.