Guest: Beatrice Adler-Bolton, an expert in health under capitalism. Topics: Critique of health capitalism, struggle for universal healthcare, history of the asylum system, understanding madness as a political category, reclaiming language, threat of pharmaceutical companies, health capitalism, surplus populations, potential of health communism in leftist movements.
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Quick takeaways
Health communism challenges the capitalist framework that determines access to healthcare and views health as a commodity.
Health intersects with capitalism beyond the fight for universal healthcare, impacting societal norms and individual well-being.
Pharmaceutical companies wield significant influence in global public health, and dismantling their power is crucial for equitable access to care.
Deep dives
The Impact of Health Capitalism on Society
Health capitalism, the dominant political economy of health, often goes unnamed, projecting a sense of timelessness. Health communism challenges this ideology, aiming to name and oppose the current system. It argues that health is central to political power, economic control, and the vulnerabilities of capitalism itself. The danger lies in viewing health as a commodity and profit-driven industry, where access to care is determined by social and economic value. Health communism calls for a different approach, an international struggle against the dominant system to ensure that everyone receives the care they need.
The Intersection of Health and Capitalism
Under capitalism, health becomes intertwined with concepts of productivity and worthiness. The struggle for universal healthcare is important, but equally vital is challenging the capitalist framework that impacts how health and sickness are conceptualized. This framework shapes how individuals are valued and how they are either utilized or abandoned by the system. It extends beyond the fight for universal healthcare to encompass the broader ways in which health intersects with capitalism, affecting societal norms and individual well-being.
The Historical Treatment of Surplus Populations
The categorization of surplus populations, those who fall outside normative principles and are excluded from capital's entitlements, has a long history tied to the poor laws and other policies. People deemed surplus have historically been seen as non-contributing, non-working, and a drain on the economy. This perception has led to their marginalization, institutionalization, and systemic exclusion. The poor laws, in particular, played a role in establishing a categorical distinction between the idle poor and unemployed workers, contributing to labor control and social division. Understanding this history sheds light on the treatment of surplus populations today.
The Role of Pharmaceutical Companies in Health Capitalism
Pharmaceutical companies play a significant role in health capitalism as international actors that influence global public health. They participate in constructing a global rationing system for therapeutics and care, shaping the distribution of healthcare resources based on profit and economic value. These companies operate extra-state, leveraging international trade policies to further their interests. The control over patents and the marketization of medicine are key components of their power. Health communism calls for dismantling the influence of pharmaceutical companies and ensuring equitable access to care globally.
The History of SPK and Health Commnism
The podcast episode explores the history of the socialist patients collective (SPK) and its relevance to the concept of health communism. SPK was a patient group formed in Heidelberg, West Germany in 1970. They advocated for patient autonomy and participation in treatment and research, challenging the traditional doctor-patient power dynamic. SPK's work was criminalized and misrepresented as left-wing terrorism, but their critique of the medical-industrial complex remains important. The episode highlights the need to understand health issues through a political and economic lens, and challenges the notion of the working class by incorporating the perspectives of the surplus and sick proletariat.
Language, Politics, and Solidarity
The episode discusses the importance of language in political discourse and building solidarity within the left movement. It emphasizes the need to expand our understanding of health and the economy of care to expose the power dynamics embedded in our political economy. The concept of health communism is presented as a tool to challenge the oppressive nature of capitalist systems and promote collective liberation. The episode encourages a reimagining of healthcare systems that prioritize autonomy, solidarity, and care for all people, transcending the limitations of traditional left justice movements.
When we think of health under capitalism, it's easy to go straight to the fight for universal healthcare, and understandably — that battle is one of the most contentious and important in the ongoing class war between the mass of people and those who rule us, the capitalist class.
But it would be a mistake to think that that’s where our battle ends, that there isn't an expanded struggle over the ways that health and sickness are even conceptualized under the capitalist ideological framework which shapes how we value ourselves and how we are either utilized or abandoned by this system.
This conversation glides from Marxist economic analysis to healthcare policy to history and to some of the most foundational philosophical underpinnings of the political economy of health. Beatrice directs a striking blow against any perceived possibility of true health ever existing under capitalism, arguing that we must fight for our lives, literally, to bring forth the fall of capitalism and to build a new system that works for everyone — what she calls health communism.
Thank you to Carolyn Raider for this episode’s cover art and to Fugazi for the intermission music. Upstream theme music was composed by Robert Raymond/Lanterns.
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