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Health Communism: A Surplus Manifesto

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The state thereby underpins the creation of “capacities for profit,” to the detriment of individual health, which is quantified for these purposes. Counterfire is a revolutionary socialist organisation working to build the movements of resistance and socialist ideas. And yet, still so many people, and not even just those best-caparisoned by the system, continue to act as if it is the only system that could possibly work to provide what humans need to survive and thrive.

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They see the export of American-style private health provision and insurance through forced trade deals as a form of imperialism that undermines social-welfare systems globally. In a society where the rule of capital has ended, despite the real scarcity imposed on the country by the US blockade, the Cuban people have prioritized a system that provides care to all, in their homes, in dialogue rather than direction, and with a truly internationalist orientation. Where it really shines is when it is dismantling the various accepted “truths” of health and, later, going through the history of SPK.

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This may be in part due to the somewhat niche nature of the academic community to which it is aimed. It establishes that the supposed divide between workers and those deemed unable to work, and thereby contribute to the economy, is a false one due to capitalism’s need to extract some form of worth from every body. It’s an interesting history, but after the broad, internationalist lens of the first two-thirds, it feels out of place. Health communism" (the title of a planned Verso book) cannot mean anything else but the dictatorship of the medical doctors' class. This exploitation does not stop in those countries, and the immorality of its existence should be at the forefront of discussion.

But your brain gets used to it, and the lengthy, fascinating historical anecdotes provide some relief amidst all the scholarly theory. Importantly, the reliance on a worker/surplus binary as a means of sorting the deserving from the undeserving establishes a concrete historical record offering de jury justification for organized state abandonment. And that have a more nuanced analysis of what has constituted this surplus in settler colonial capitalist nation states? Some other concepts and historical items I was introduced to through this book include the underrated story of the radical left Socialist Patients Collective in West Germany (legendary as heck); the eugenicist history of psychiatry (and how it's pretty much an extension of the police state (see: carceral sanism, eugenics)); the necessity to think about health communism, as a theoretical framework, from an internationalist perspective (no, "nationalized" healthcare is not "one weird trick" to fixing the dumpster fire that is U. Heath Communism is not "well-behaved": It is not interested in sober consideration, dry pontifications.

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. 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. 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. The history of ACT UP exposed me to a new critical perspective on the org and its methods (which I can attest from personal experience in disease advocacy are championed as wholly aspirational and uncomplicatedly good. My optimism was confirmed and then some, and rarely do I come across a book that has something new to teach every single person who picks it up, regardless of academic level or familiarity with the content.

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