I'm not sure how or whether you are distinguishing Marxists from communists, but every marxist/comm. regime I know of is responsible for providing education, healthcare, and social support for everyone. One reason why ex-communist states are such juicy investment deals is because of the very high skill level of the population. One reason why life expectancy in the former SU declined by about 15 years (!!!) is because these services were taken away.
Me:
I don't think this is quite true, at least in Russia. Male life expectancy has declined about 10 years, but that's mainly due to massive increases in alcoholism (it was hard to be an alcoholic in the Soviet Union), murder, suicide and a huge, huge increase in stress-related diseases. Female life expectancy has only dropped about 2 years -- if it was due simply to collapse of the medical system (which is actually still free in Russia), you would expect a larger drop. Medical care in Russia is far from stellar, but it's really not that bad.
Chris Doss The Russia Journal