Health Communism: A Surplus Manifesto

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A.V.: We do want that, actually. But we don’t want to just carbon copy what exists in the U.K. because the NHS actually is a perfect example of why doing universal health care but making it operate still under principles of austerity only accomplishes so much. This seamless book fills an urgent void in leftist theori Health Communism is itself a blueprint, in the (roughly translated) words of SPK, for turning illness into a weapon. Jess McAllen, The Baffler A searing analysis of health and illness under capitalism from hosts of the hit podcast Death Panel

Another example of resistance is the campaigning to close Manston detention camp where people seeking asylum were detained in the most horrendous conditions and subjected to violence. In response to pressure people were moved on, however there are reports of it still being used and the camp hasn’t yet been closed. In December 2022, an Iraqi man died of diphtheria whilst being detained. The struggle to close detention centres and stop deportations is paramount to health justice. 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. Some people may be surprised to find that, in Health Communism, there’s not a gigantic chapter on COVID-19. But that omission is really intentional: we’re trying to make a hard point. A lot of people like to say that we’ve learned some very tough lessons with COVID, but that’s absolutely not the case. These are not new lessons. These are not new horrors. We’re looking at an acceleration of an existing political economic phenomenon that was already marking people for a slow death. What we’ve seen is the pandemic applying additional pressure to a system that was already unsustainable and in no way conducive to “good health.” Health Communism offers an analysis of capitalism and health that provides insights, but neglects the need for solidarity, argues Caitlin Southern

Ethno-Nagleism is the Idpol of fools

In this way they went beyond most of the contemporary anti-psychiatry movement that tended to be reformist, with left and right wing political iterations. On the right, US libertarian Thomas Szasz promoted the idea that psychotherapy was mostly fake, but that it’s value was subjective and should be determined by the free market, meaning those who could not afford it were not a major concern to him (134). Azfar Shafi and Ilyas Nagdee, Race To The Bottom: Reclaiming Antiracism, (London: Pluto, 2022), 172. Even so, the pharmaceutical industry had a big hand in shaping US colonialism via the creation of capitalist global trade regimes and laws that ensured corporate control over who could produce and profit from vital medicines as well as ensuring scarcity as needed to guarantee higher profits for pharmaceutical companies. Today this regime, known as Trade Related Intellectual Property Rights (TRIPS), means that “in effect, twelve corporations made public law for the world” (90). Those countries not willing to play by the rules of TRIPS may be excluded from trade in and access to life saving drugs and treatments. This “global rationing regime” marks “entire nations as surplus” (78). Hoffman was an early professional voice against socialized healthcare, but that resistance became entrenched in one of the most powerful medical institutions in the US, the American Medical Association (AMA). Wikipedia currently lists the AMA as having “one of the largest political lobbying budgets of any organization in the United States.” The AMA led the efforts to defend the capitalist mode of healthcare in class solidarity with other industry groups (33). They lobbied strongly against President Truman’s 1948 health insurance plans. Various physicians groups set about associating socialized medicine with communism, the Civil Rights Movement, and the Soviet Union as scare tactics to discredit any reforms that would threaten their professional hegemony in running a privatized, for profit healthcare system. That coalition of private organizations wanted to guide the state to carry out their own interests (34). One method of extracting value from surplus populations is putting them to work. The “rehabilitation movement” swept America in the nineteenth century with the goal of making impaired workers “normal,” meaning productive to the capitalist class. The authors note this made the medical profession “a kind of industrial maintenance” arm of the ruling class (50).

Michael Richmond and Alex Charnley, Fractured: Race, Class, Gender and the Hatred of Identity Politics (London: Pluto, 2022), 110. BEATRICE ADLER-BOLTON: One of the things that we were working on before the pandemic was developing a lens of looking at how policy affects people’s lives in material ways. How do we economically and materially feel the impact of laws that dictate what care is and how care is supposed to be paid for? What are we entitled to in terms of housing or clean air or clean water? As soon as COVID began, it was obvious that these kinds of questions were indicative of the direction the pandemic was going to take. You didn’t need to be clairvoyant to see how bad this was going to be.The authors claim that they offer one of the most comprehensive accounts of the SPK in the English language. Indeed, their historical account of the SPK, and their revival of the group’s relevance and political concepts, is one of the book’s greatest strengths. Though the SPK originated as a collective of psychiatric patients and doctor collaborators, the authors emphasise their unitary theory of health, making no differentiation between the physical and mental, rather seeing all illness as the result of social and political determinants. The ‘communism’ of the book’s title speaks to its manifesto-like character, with the urgency stemming from its clear aim as a political intervention. The short text covers a dizzying amount of ground, switching from case studies to broadly sweeping socio-political analysis with vertigo-inducing speed. The current pandemic, during which Health Communism was written, is wholly and deliberately excluded. None of the Covid pandemic’s “lessons” were unknown, and none of its effects (save for the most menial) were unforeseen. They have only affirmed the authors’ socially determined view of health: housing is healthcare, working conditions are healthcare, food is healthcare, and clean air is healthcare. To attain it is to center on our demands of the current system and the surplus population that it creates and extracts. Beatrice Adler-Bolton and Artie Vierkant, Health Communism (London: Verso, 2022), 184. Emphasis original.