Some quick notes while reading Health Communism right after having read Søren Mau’s Mute Compulsion.
Going from memory, Mau makes a theoretical distinction between two kinds of social hierarchies, those inherent in capitalism, such that they’re ineliminable under any form of capitalism, and those arising historically and structurally reproduced by capitalism, such that some version of capitalism without them is logically possible. Mau takes pain to stress that making this distinction is not a matter of political or moral priority - something need not be inherent in capitalism to be an injustice, and all oppression should be opposed.
Furthermore, to say that a phenomenon’s origin was not inevitable within capitalism and to say that this phenomenon can no longer be eliminated without eliminating capitalism are mutually compatible. A form of oppression arising initially contingently can be made inevitable within capitalism and become so tightly interwoven within capitalism’s logic, so to speak, that to end that form of oppression requires a thoroughgoing opposition to capitalism and such an end to that form of oppression could be so socially disruptive that capitalism would be abolished in the process. I like the Mau book a great deal (I’ve just submitted a long review of it and a couple other books, with any luck the review will see daylight despite my verbosity; if nothing else I can always toss it up here at my little blog; anyway).
Anyway, I like the book and these are among the trickier passages, and passages dealign with issues that are sometimes fraught such that it’s hard to agree to disagree, I’m a little concerned I’m not doing the book justice (if anyone reads this at all of course, which isn’t *really* the point). As such I want to underline that this comes up in the book in the context of Mau laying out the manner in which Marx proceeds in setting up the categories involved in the critique of political economy. Marx starts with the most general conceptual categories and tries to derive other categories from them in effect by asking ‘for this to be the case, what else must be the case?’ In the context of that methodological argument Mau notes that there is disagreement over whether some forms of oppression like racism and sexism are logically inherent in capitalism or not, and as I said he stresses both the importance of anti-racist and feminist politics and argues, rightly, that these political positions do not stand on this kind of theoretical point. Hmm. I may be losing the thread of this thought, where was I?
The argument is more complex than this but part of the claims in the book is that forms of oppression that are historically contingent in origin can become taken up within capitalist social relations such that capitalism continues to reproduce them. A shorthand for this is the old saying that shit rolls down hill, and capitalism being pyramid-shaped means many people live at the bottom of the hill. Specific forms of oppression are ways of being kept at the bottom; capitalism’s characteristic forms of power (I won’t go into detail on what it is that makes those forms of power what they are, Mau’s great on it though, definitely read the book) form an obstacle to rectifying that condition.
It occurs to me right now that this means Mau provides an additional reason to oppose capitalism: it’s a system that selects for forms of hierarchy, oppression, inequality and preserves them, in addition to having some forms of such already inherent in the system. This also means that as chance events occur within capitalism’s history over time, if new forms of hierarchy develop somewhat contingently (as contingent responses to the negative outcomes capitalism predictably generates - in a loose, general sense of ‘predictable’), capitalism is more likely to give them greater longevity than it is to push against them, absent serious social unrest. To to put it another way: if we think of the set of forms of oppression logically inherent in capitalism and the set of forms oppression that existed just before capitalism, plus forms of oppression that have developed since, there’s no reason to believe that this exhausts the possible forms of oppression. Others could be coming. Capitalism makes it likely that others are coming because it’s an oppression-generating system. It’s not clear that all of those possible future forms of oppression are necessary outcomes of capitalism; some might be contingent responses to conditions in future societies, even so we can expect capitalism to structurally reproduce those.
With all of that in mind, as I read Health Communism - I’m somewhere between half and two thirds of the way through - I keep thinking about the status of disability in capitalism. I’m getting ahead of myself though; I’ll come back to that.
Health Communism spends a great deal of time on what the authors, Artie Vierkant and Beatrice Adler-Bolton, call the worker/surplus binary. This is a core concept of the book and I’m writing this more for my own thought process than for others’ use so I’m not going to try to present the concept fully. If anyone reads this I hope it suffices to say that workers are people who can find buyers for their labor power (and hence get a wage) while surplus populations can’t. I want to underline two things here. First, this “can/can’t find a buyer for labor power” is defined by, is an artifact of social conditions, not the capacities of the individual person. There’s nothing inherent about a person who suffers employment discrimination that renders them unemployed, rather they’re subject to judgments that consign them to that status. Second, I want to underline that this is a continuum, not a hard and fast line. To put it simply, the further along into the surplus end of the continuum a person or population is consigned, the more likely they are to be consigned to various kinds of hardship and death by exposure. As Adler-Bolton has put it elsewhere, in capitalism people are only entitled to the survival they can buy (to say nothing of actual thriving), and access to money isn’t guaranteed.
Vierkant and Adler-Bolton emphasize as well that surplus populations often wind up being themselves commodified and incarcerated as objects of administration often called care. A paradigm case is a disabled person warehoused (the authors build on writing by the disability activist and theorist Marta Russell), though there are other cases as well.
From what I’ve read so far in the book and from what else I know of their views based on some of their other writings and things they’ve said on their show Death Panel my sense is that disability figures here as an especially important way in which the worker/surplus distinction is organized over time - generally speaking the tendency is that to be surplus is to be disabled and vice versa. I want to stress here that these are assigned social conditions.
There are periods where people can be pulled back across the line of dis/qualification from surplus into worker (or, pulled further from the surplus end of the continuum and more toward the worker end). Audra Jennings’s book Out of the Horrors of War has some examples, where World War Two created both new demands for industrial production plus labor shortages, as well as some ideological/rhetorical openings (the economic end of the war effort was framed along the lines of ‘this is a war of democracy against tyranny, producing war materials is patriotic’, which created some space for disabled people to demand inclusion in war production based on claims to citizenship). There are also periods, and this is more in keeping with the emphasis in Health Communism, when people previously included as workers suddenly get shifted to being surplus. My book has bits on this regarding employment discrimination; Health Communism has a more capacious framework and set of examples.
Okay, coming back to the status of disability in capitalism now, more explicitly and in the way I wanted to get to and above temporarily shelved, and which connect to Mau’s book... it seems to me that there’s at least three strands of disability, so to speak. One is historical stigma against disabled people that pre-dates capitalism - capitalism is an inherently ablist form of society, but it doesn’t seem to be the case that ablism never existed prior to capitalism. Here Mau’s argument about capitalism reproducing oppression is on point. I’m inclined to say there may be an element of ablism that’s historically contingent in original origins but structurally reproduced (hence made in some respects no longer contingent) in capitalism.
Second, insofar as/when disability is at least in part a condition of need or vulnerability denied (for instance, I’m super nearsighted, without corrective lenses I’d be in big trouble) and insofar as in capitalism needs are generally met via commodities, capitalism promotes disabling and harms against the disabled. (This varies: I’m very nearisghted but for someone in the time, place, and socio-economic status I live in, I can get the needs that arise from this met and this isn’t stigmatized, so under these particular conditions, this isn’t an impairment that’s disabling. It would be - has been, is - disabling in other circumstances.) Further, insofar as some of these conditions, and their compounded status when needs are denied, are stigmatized, capitalism tends to reinforce the resulting harms as per what I said above in relation to Mau.
Third, insofar as capitalism denies lots of people of what they need and subjects people to instrumental use by others for the sake of the imperatives of profit, capitalism tends to produce harms such that people acquire new needs and vulnerabilities. (Engels talked illuminatingly about this in terms of social murder, I think Marx’s writings on the working day, machinery, and so-called relative surplus populations are illuminating here as well.) This affliction applies across the continuum from worker to surplus though in situationally specific ways, and it creates a kind of low level gravitational pull toward the surplus end. (I say ‘low level’ insofar as the number of people pulled toward surplus tends to be regulated by various mechanisms insofar as capitalism tends to make sure there’s roughly enough available labor power over the long term. Three qualifications on that point. One, it doesn’t protect any actually existing individuals or groups, it just means that in general over the long term capitalists tend to get enough workers one way or another. Two, closely related, this compatible with tremendous violence, suffering, and death among workers. Three, these patterns tend to play out over time jaggedly rather than smoothly, so to speak, meaning that a lot of unexpected events happen, generally for the worse. Back to the point I was trying to make.) This means that over time people not currently marked as surplus tend to teeter closer to the edge - people age into disability - and moreso the further they call in the class structure.
Here too it occurs to me just now that Mau’s book is illuminating. He distinguishes between horizontal relationships among capitalists, vertical relationships between capitalists and ‘their’ employees as well between the capitalist class and the proletariat, and the general condition of everyone in capitalist society being market dependent. As Mau explains, capitalists’ relationships with each other drive social crises. They also shape prices for goods, like the various kinds of care and health-promoting/preserving/creating things that people need, the lack of access to which is harmful and often disabling. Plus under conditions of market dependency access to these goods is contingent on ability to pay. The vertical relations (and the interaction of those vertical relations - such as employer power over employees in a context of intense competition) in turn partially get at why workplace accidents, repetitive stress injuries, and exposure to disease tend to happen.
I’m losing the thread a bit again but this all to try to sketch out some more of why it seems to me that capitalism includes in its concept that it is disabling. (I’ve got an essay forthcoming on some of this, written prior to my reading either of these books and which I’m frankly nervous about the quality of, but at the least it helped me to start thinking more about this stuff so that I read these books more attuned to these particular issues.) This means that that any capitalist society will exclude some people as disabled (in Marx-nerd terms this means that disabling is already built in to Marx’s starting point when he begins with the commodity as the capitalist form of wealth), as part of capitalism’s tendency to produce a so-called surplus population (Mau’s good on this as well, it’s the area, I think, where there’s the most explicit overlap between these two books), which is not to say that disability and surplus reduce to each other. This has two facets: capitalism has an inevitable tendency to generate a social position of disabled-as-surplus to lean on Health Communism’s terms, and also to cause people to be treated in a variety of ways such that they are more likely over time to come to inhabit that status. And all of this is uneven in the short term, which is to say jagged and unpredictable within individuals’ lives: that there are wolves, so to speak, and that some get bit is predictable, who and when specifically is somewhat unpredictable such that there is tremendous insecurity in people’s lives.
As I said I think in addition capitalism may *also* have a tendency to generate patterns of disabling which may be contingent within the system yet which once generated become structurally reproduced (Health Communism’s account of warehousing the disabled - and the forms of institutionalization which seemed to but did not really replace warehousing - as a form of extractive abandonment is extremely on point here; I won’t lay out the details here but it’s really important. For now, I’ll just say that part of what happens, as Adler-Bolton and Vierkant show, is that as it becomes profitable to take people assignment to status as surplus and treat them as raw material/objects to act upon within a capitalist production process, there develop powerful capitalist enterprises who can lobby to lock-in the status as assigned to surplus and the consequences of that assignment. Doug Crandell’s recent Twenty Two Cents An Hour is relevant here btw, it’s a pretty detailed empirical study that’s less capacious and far less theorized, which isn’t meant as a criticism. Here too Mau’s book is on point, in the argument that economic power tends to be self-reinforcing and a cause of itself: to be on the receiving end of the economic power of capital tends to have effects that keep one on the receiving end thereof.) And finally, again, capitalism seems to in addition have a tendency to reproduce forms of oppression that pre-existed it, which would include any pre-capitalist pattens of disabling/ablism. I bope it’s obvious as well that whatever the conceptual status of these distinctions, in any given situation in the actual world it’s not at all clear that these are distinction in practice - in situation to some extent anyway power is power regardless of its origins.
Alright well I’ve had some thoughts hence serving the purpose of ye olde writinge toe thinke blogge, I’ll leave it at that. I just wanted to get down the inklings I had today while reading because I’d likely forget them otherwise.
A thought to remember to think about another time at more length: disability as also an ideological category for defending structural patterns/depoliticizing systemically generated harms: in brief, nobody important ever gets harmed because to get harmed is to be unimportant. Generally speaking anyone who thinks they currently live far enough up the hill to be above the flood waters will, regardless of their objective social position will nevertheless find that once in the water they’re down at the base of the hill among the nobodies - so being a somebody isn’t protective against waking up a nobody. That it feels so is irrelevant in terms of life outcomes and very relevant in terms of ideology and whatnot.
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