Health Communism: A Surplus Manifesto

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CHARLIE MARKBREITER: Some readers of Health Communism might be familiar with the ideas you discuss on the podcast Death Panel, which you cohost together. How would you describe that project? Health capitalism is a system where health is an impossibility: a state one cannot get to, but to which one must always strive. It refers to the way capitalism has intertwined itself so completely with health to make the two seemingly inseparable; its definition of health as ‘able to work’ seemingly unquestionable. The call to revolutionise the political economy of health, is a call to revolutionise the left. To move from imperialist social democracy to a decolonial communism. Breaking with the hegemony of the Labour Party allows the opportunity to rethink the NHS, to rethink health, just as engaging critically with the NHS, from the perspective of health communism, provides an opportunity to weaken the hegemony of Labour and its workerist, racist politics. The myth of the Labour Party is at least in-part entangled with the history of the NHS. The invocation to save the NHS is not dissimilar to the rallying cry to save the Labour Party – but whilst the latter should be left to rot, the former shouldn’t be abandoned as a ground of struggle. Indeed, health communism is an expansive project that can coalesce multifarious struggles to come together and build a new society out of the ruins of this one. Whilst defensive measures to resist state violence are needed, health communism can link struggles together and provide a positive vision that we can fight for. This seamless book fills an urgent void in leftist theories of illness...the achievement of such a concise yet cogent framework (aided by the fact that the past years have only confirmed its conclusion) is a marvel. Selen Ozturk, PopMatters

Ultimately, Adler-Bolton and Vierkant argue, we will not succeed in defeating capitalism until we sever health from capital. To do this will require a radical new politics of solidarity that centers the surplus, built on an understanding that we must not base the value of human life on one’s willingness or ability to be productive within the current political economy. Azfar Shafi and Ilyas Nagdee, Race To The Bottom: Reclaiming Antiracism, (London: Pluto, 2022), 172. Health Communism and other recent abolitionist writings show the massively negative impact of capitalist and eugenic ideology and methodology on our ability to have nice things. The ubiquitous caving to the assumption that there is simply not enough for everyone still mars efforts to defend education, health care, etc. The idea that providing more to all will only hurt the deserving and worthy core of society is always just a defense of the capitalist class’ presumed right to maximum extraction of value and profits from every aspect of society. Artie Vierkant points out that “this could have been the new normal for medicaid or the beginning of something much bigger or better...” While he sees the necessity of fighting against these massive cuts, he reminds the listeners that “Just like everything else with Covid, this is a signal for the importance of a movement to totally sever health from capital.”He was an anti-socialist race-scientist and a representative of the Prudential Insurance Company at the turn of the twentieth century, very much an “industry stakeholder.” His approach to healthcare focussed on defending the capitalist system. Delegates of pharmaceutical companies visiting the Soviet Union found they had more physicians and medical staff than was expected and that in fact they were exporting their medical workers to less developed countries (39). Some suggested the US engage in a medical arms race against the Soviets as a form of colonial strategy. The authors rightly point to the fact that socialized medicine usually produces better outcomes than capitalist ones. I had slight reservations on some of their descriptions of Bolshevik Russia as “communist” but in the context of the book, this is perhaps a minor quibble, and I have no idea of what critiques of Bolshevism or Leninism they might have.

A searing analysis of health and illness under capitalism from hosts of the hit podcast “Death Panel”Written by cohosts of the hit Death Panel podcast and longtime disability justice and healthcare activists Beatrice Adler-Bolton and Artie, Health Communism first examines how capital has instrumentalized health, disability, madness, and illness to create a class seen as "surplus," regarded as a fiscal and social burden. Demarcating the healthy from the surplus, the worker from the "unfit" to work, the authors argue, serves not only to undermine solidarity but to mark whole populations for extraction by the industries that have emerged to manage and contain this "surplus" population. Health Communism then looks to the grave threat capital poses to global public health, and at the rare movements around the world that have successfully challenged the extractive economy of health. Asylums are a paradigm of this intersection of care and carcerality. As institutions grew, they harnessed the labor-power of patients, from launderers to farmers to research subjects (this is the most harrowingly researched part of the book). Deinstitutionalization did not end these profit mechanisms but distributed them to the present American network of consumer-driven, “publically private” long-term care homes. Death Panel has an amazing aesthetic, from the show images to the merch to the ending music. These component parts are great in and of themselves, but they really come together to create a very coherent, intentional, and effective aesthetic. Before we go: How was this aesthetic developed, and how would you describe it? Vicente Navarro, Class Struggle, The State and Medicine: An Historical and Contemporary Analysis of the Medical Sector in Great Britain (Oxford: Martin Robinson, 1981), 10. We articulate how health is wielded by capital to cleave apart populations, separating the deserving from the undeserving, the redeemable from the irredeemable, those who would consider themselves “workers” from the vast, spoiled “surplus” classes. We assert that only through shattering these deeply sociologically ingrained binaries is the abolition of capitalism possible. The contours of capitalism have formed around health, to the point that they have come to appear inextricable from each other (xii).