I'm new to the concept of anarchism, at least as a vision of society that actually has had thought put into it, so my apologies if this question seems stupid of self centered.
Risking losing context as I ask this, I'm curious about how advanced medicines like insulin (things that aren't small molecules, require rDNA, multinational logistics, supply chains and quality assurance, etc) would work and be distributed. What about advanced medical devices like insulin pumps, subcutaneous glucose monitors, etc?
I know there are some types of anarchist who would say those things wouldn't be needed without industrialization (im not going to gratify that take with a reaponse), but I suspect most still recognize the need for things like this, since millions of people would die without them.
I guess the root of my question is what the motivation would even be for someone to work on projects like that. Type 1 diabetics make up ~0.1% of the population at the highest, and a major hurdle from my perspective would be getting people to work on something needed by so small a population, but requiring such intensive resources to produce. And especially in any kind of transition period, I find it basically impossible to imagine the able bodied revolutionary actually giving a shit whether people like me live to see the "after."
I've done some looking and it seems like broadly, the attitudes range from "you'd make it yourself and its okay because you'd have time to if all your basic needs are met" to "well surely someone would do it altruistically." I also found a few people who just said "people die, get over it," and "the real problem is you should've died when you were 7 but we played god," but I have to assume (hope?) that such ideas are fringe. I'm hoping especially to hear from someone who actually understands why insulin (and pumps and CGMs and all that) are complicated, hard things that probably won't get made purely by volunteer labor at the huge scale needed. Like, it's not one of those things you can whip up at a local pharmacy, its far too complex for that.
I guess in all, I like the idea of a society without hierarchy, where self determination and community engagement become the de facto environment...but from my admittedly novice perspective, it sure doesn't feel like much thought has been given to how those of us with extremely short expiration dates should stability evaporate actually survive the transition.
Over the last week that I've been reading and thinking about this, I keep coming back to the inherent (though hopefully temporary) loss of stability that comes with any revolution. In that kind of scenario, I just...die. Along with millions like me. Either from supply chains failing during transition, or my own bullet because I'm staring down the barrel of an agonizing final week that ends with me dehydrated, starving, vomiting blood and gasping for air. From here it's really hard to see a place for me in an anarchist future.
Sorry, I recognize thats a little dark. But its something im finding myself having to think about more and more as collapse seems to draw ever closer.
Just hoping anyone has insights to share. And if i respond in the comments and i seem a little forceful, I promise I'm not trying to be a dick, its just that this is kind of existential for me, so I am probably going to be prone to pushing back or really pressing on certain aspects. If im being rude, please dont hesitate to tell me and I'll try to reframe to avoid that. It's neither the goal nor the intended process.
I'm fairly new to anarchism as well, and I can see why you have those concerns. I can also see why you're looking for concrete examples of how such a thing would look like in practice instead of just theory. I'd recommend that you read The Dispossessed. It is science fiction, and I am incredibly biased for this book, so take this recommendation with a grain of salt.
But regardless, a look into the worlds of this book is worth it. Here is a brief overview:
There is this pair of moons that orbit each other, Anarres and Urras
Anarres:
So for your example of insulin, in this fictional world of Anarres, it would be produced by a number of syndicates and stored/distributed across towns based on need.
The motivation is already there today. Many people find their field of study through passion, especially passion to help others when it comes to the health sciences. And even with the low rates of people who need insulin and the associated gear, there is still great value in creating it.
In order to make insulin, insulin pumps, monitors, syringes, and so on, you need complex production practices. You also need complex production practices to make scalpels, MRI machines, X-ray machines, wheelchairs, join replacements, aspirin, and pretty much all other forms of modern health treatments and tools. In an anarchist world, it is invaluable to have the ability to produce all of these things, because it means we are protecting humanity, our survival, our dignity, and our ability to further care for each other.
So if we're going to produce medicine for anyone, we must produce medicine for all. The pre-requisite production chains for diabetic treatments overlap with other pre-requisites for other medical issues. Producing for one produces for others.
Nation-wide transition periods are dangerous. I don't think you're wrong at all for being concerned on that front.
But I think there are two stipulations to keep in mind: