We're Not All Sick but None of Us is Well Nate Holdren (bio) Beatrice Adler-Bolton and Artie Vierkant. Health Communism: A Surplus Manifesto. New York: Verso, 2022. 240 pp $24.95. ISBN: 9781839765162. Health Communism examines the destructive effects of capitalism on human well-being through two theoretical concepts, the worker/surplus distinction and extractive abandonment. The worker/surplus distinction focuses on the role of money in regulating the health and well-being of individuals, households, and populations in capitalism. Workers are conceptualized here as people supplied enough money—via labor markets, as wages received for the sale of labor power—to maintain their and their households' lives and current [End Page 400] social condition. The so-called surplus population are conceptualized as people who do not get an adequate amount of money to so maintain themselves, a condition which leads to a cascade of negative effects. It's important to stress here that any position on the continuum from worker to surplus is relatively unstable, with more workers being pushed into surplus status over time through a host of forms of insecurity. As the authors write: "It is not necessarily the case that we are all sick. But none of us is well." Over the course of our lives, "each of us ripped and maimed, strangled and buried by capital, in one way or another" and "entire industries exist to eke out slivers of profit from our eventual deaths." (183.) It's a stark portrait, appropriately polemical given the violence the book analyzes and opposes. All the ways people can be minoritized and stigmatized—including categories like race, gender identity, sexuality, drug use, and migration status—provide methods of being pushed into the surplus population as well as the ideological justification for poor treatment. That said, disablement is an especially helpful category for understanding the treatment of so-called surplus populations. Disabled people's treatment encapsulates the general subordination of surplus populations. Being rendered surplus tends to mean exposure to conditions that further impair one's health, leading to further disability. Finally, people seeking to defend the treatment of surplus populations tend to ideologically draw on disability and ablism for additional ways to stigmatize specific groups and to defend the treatment to which they are subjected. Health Communism points out that surplus populations are often treated as a kind of threat or burden, simultaneously authorizing appallingly unjust and often violent treatment while depoliticizing these actions. Surplus populations aren't treated as enemies of the social order so much as defects in need of an ostensibly apolitical correction: they are framed as being a "debt/eugenic burden." (xiii.) The term refers to two rationales that often work in tandem, one monetary and one biological. Once marked as abnormal, people get treated as expensive to have around and/or as having additional harmful effects on society. This ideological frame manifests in pressures to reduce costs of care and welfare provision, thus worsening lives for the recipients whose conditions of life are rendered mere costs, through practices of segregation and incarceration. While often ideologically framed as burdens, there are profits to be made off of surplus populations, insofar as their care and/or incarceration is supplied by for-profit companies or state agencies for whom surplus populations provide an existential legitimation. Here Health Communism builds on the work of disability justice activist and writer Marta Russell, who developed what she called the money model of disability.1 People barred from labor markets on the pretext of disability become fed back into the market as raw material, because caring for or warehousing disabled people can be profitable. The authors link Russell's money model of disability to geographer Ruth Wilson Gilmore's work on mass incarceration through the concept of extractive abandonment. People abandoned to deprivation aren't simply cut loose in the wild, but rather are to a significant degree pushed out of legitimate membership in the polity, and so become objects of institutional control. Therefore, people marked as surplus are often treated like commodities, via institutional statuses like patients, wards, trainees, prisoners, inmates, etc., within markets gilded [End Page 401] with rhetorics of service and care. Organizations in those...
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May 26, 2023
Wojciech Guz 
Open Access