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Health Communism: A Surplus Manifesto

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Written by co-hosts of the hit “Death Panel” podcast and longtime disability justice and healthcare activists Adler-Bolton and Vierkant, 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. No one talks like Adler-Bolton and Vierkant do – those in public health and medicine are too deeply embedded in the status quo to even acknowledge the searing logic of their words. Linking this rapine economic system to democracy, too many people have yet to accept they are not merely on a "hamster wheel of depreciation" (my term) they are actually being ground down, a la Soylent Green, by the system they are so enamored to espouse. Overall, Health Communism is an interesting if at times flawed read that presents some fascinating insights into the links between capitalism, health and control. It’s an interesting history, but after the broad, internationalist lens of the first two-thirds, it feels out of place.This book is brilliant and awful, for it clearly shows the true roots of Capitalism's need for workers/labor to exist and thrive. it isn’t enough to separate out the deserving from the undeserving, those who can rehabilitate vs those who will “never contribute”, we of course have to make mONEY off the abandoned. I definitely found some of the ideas in this book valuable and interesting, and the SPK history was particularly of interest, albeit a bit lacking in analysis, but I think the book was ultimately muddled by its scope, and its liberal use of jargon.

This book shares the impressive truth that we are all surplus in the political economy of health, whether we are presently ‘healthy’ or ‘sick.I think my main criticism though is that there were a lot of parts that could use more explanation and parts where they present a cool idea or part of an argument but don’t explain further. I was frustrated by the one chapter where they use Palestine as a case study but it’s tacked on at the end in a way that seemed rushed. Heath Communism is not "well-behaved": It is not interested in sober consideration, dry pontifications. Arbitrary divisions between ‘well’ and ‘unwell’ mirror earlier attitudes towards the ‘deserving’ and ‘undeserving’ poor to determine which sections of the population receive any form of relief from the conditions under which capitalism forces people to live. Rooted in the contemporary reality of mass death and disability, it reworks our familiar, commonsense concepts of sickness and health, care and cure, labor and waste to show how capitalist biomedicine wrings every last drop of productive labor from us before discarding us into the trash heap of 'surplus population' to carelessly be picked over and plundered until our death.

In Health Communism, [Adler-Bolton and Vierkant] show how members of the ‘unproductive’ surplus class are cast as burdens even as health capitalism sets up entire cottage industries (e. The political economy demands that we maintain our health to make our labor power fully available, lest we be marked and doomed as surplus.Ultimately, Adler-Bolton and Vierkant argue, we will not succeed in defeating capitalism until we sever health from capital. 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. The language used throughout is fairly dense and directed towards a particular audience, indeed some of the glowing reviews are provided by people quoted in the text. The ways that definitions of health and illness are used to ‘other’ people and widen divisions is examined extensively throughout the text and do provide some useful points for discussion. Nor can I imagine a more needful book for the pandemic we are still in, let alone the pandemics yet to come.

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