I covered a lot of my thoughts about the way in which capitalism structures the health care industry, both materially and ideologically (see my health series). This discussion follows fairly directly from those ideas.
Partly this is spurred by a recent experience I had, in which someone I knew was being kept alive on a ventilator, although it was against both their own wishes as expressed in the advance directive and the wishes of their spouse. I was reminded of the fact that more than a quarter of the total health care costs in the U.S. are spent on people in the last stage of their lives.
Indeed, the U.S. has one of the most expensive (especially in comparison to quality) health care systems in the world. The unjustified costs stem largely from the attitudes I discussed in my previous posts: 1) the assumption that the causes of ill health are material/individual and always require material interventions; 2) the obsession with "normality" and the treatment of variable states as "deviance"; 3) and the aversion/inability to cope with death and irrational belief that prolonging life is desirable.
1. When people feel a little different than usual, they go right to the doctor. Even colds are not considered as things that occur from time to time (like bad weather) and pass with time and rest. Some intervention must take place.
2. At the doctor, people only feel satisfied with the visit if they have a diagnosis and a prescription. Compounding the problem, doctors often are paid according to the number of people they can see everyday, thus encouraging them to breeze through each visit, barely listening, slapping together a diagnosis, and writing off a prescription. [I already discussed my frustration with the over-prescription of antibiotics - not only is it costly, but it weakens immune systems and promotes the rise of antibiotic resistant bacteria.]
3. People believe that health care providers are capable of solving every problem and should theoretically be infallible. Doctors and hospitals are always under threat of law suits. This, of course, directly raises the costs of health care; it also indirectly increases costs because doctors feel compelled to order millions of tests - many of them costly and unnecessary - to cover their butts, and may also be induced to expend resources wastefully to comply with families' demands (like keeping someone on a ventilator when they are going to die in a few days anyway). This point, in particular, is attributed responsibility for a lot of the cost inefficiencies in the U.S. health care system compared to other health care systems.
The upshot of all of this can be characterized by a libertarian maxim: people want a lot more than what they are willing to pay for. They want all of the medical interventions possible, but have constructed a system that is not able to absorb all of the costs. What happens, of course, is that all the people with insurance and means to afford out-of-pocket costs who demand unnecessary tests and treatments, and thereby drive up the costs of care, make it that more difficult for people in poverty to afford the care that IS necessary for them. Once again, it is the poor who are subsidizing the extravagance and irresponsible behavior of the well-to-do.
Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts
Thursday, November 22, 2012
Tuesday, March 6, 2012
Catholics and Contraception
I have been lagging with my posts lately, due to other commitments, so I am kind of forcing myself to write something. It seems like the contraception debate has been the biggest hot button issue lately, and while I have already written a bit about this, I may as well address it again.
I have argued that religious institutions can be a force for great good as well as harm. The Catholic Church has its share of blemishes, but in parts of the Third World, particularly in Latin America, it has been a significant champion of the poor and oppressed. Its anti-birth control stance has actually allowed the Church to fight against eugenicist projects (see discussion here about eugenics and contraception), among other things. So I think it is unfair to unequivocally condemn the Catholic Church for this stance.
In the case at hand (requiring coverage of contraception), however, I don’t know if contraception is really the issue. At first blush, it seems like the Catholic Church is being kind of silly. Hormonal birth control has medical uses entirely independent of contraception, to the extent that the name “birth control pills” is a misnomer. [On a side note, I don’t entirely understand the Catholic Church’s position on birth control. If the reasoning is that sex should only be for reproduction and not for recreation, then why is the “rhythm method” acceptable? It is a (fairly ineffective) means of having sex without conceiving. It seems there is some inconsistency there. But I digress.]
I came across an article, which I am too lazy to find again and link to, written by a Catholic who argued that what is at stake is the nature of liberal society itself. This gets to the heart of the issue. The legislation requiring coverage of contraceptives, and the maelstrom surrounding it, demonstrates once again the tenuousness of boundaries created between “politics” and “religion.” (See my previous discussion here.) It is liberal/secular doctrine that religion should be confined to the private life of the individual, leaving the public sphere free for a non-religious civil society. Of course, this set-up was historically buttressed by defining religion as a set of beliefs, and therefore a matter of individual conscious rather than public morality.
The creation of categories and boundaries is always strategic, and never conforms exactly to reality. Thus “religion” and “politics” as we know them do not exist in reality. What we actually have are competing systems of morality/interpretation/practice. Catholics and other religious voices are correct when they insist that legally confining religion to the individual conscious is, in fact, a victory for liberal/secular society. When they say that their religion is more than a set of beliefs – also a code of morality, a set of real practices, and a mode of organizing society – they are being truthful.
For this reason, when I watch the debates, I don’t really “feel” anything at all or “choose sides” (aside from noting the nonsensicalness of the Catholic Church’s outrage in this particular case). I just sit back and watch another instance of the inherent conflict built into the modern social structure.
**I want to add an addendum to this post that I actually wrote a number of days ago. I don't know if the terrain has shifted or I am kind of out of touch with the national conversation, but it has recently come to my attention that the terms of debate now include the claim, advanced by conservative pundits of all Christian stripes, that this bill would, in effect, be forcing citizens to pay for women to have sex. Once again, side-stepping the urge for an immediate emotional reaction and outrage at the lack of logic employed, one must question why they are reacting in this way. I propose it arises from the capitalist framework for understanding health, in which health is always seen as an individual problem and a matter of personal responsibility. People should not be spared the consequences of their decision to have sex.
I have argued that religious institutions can be a force for great good as well as harm. The Catholic Church has its share of blemishes, but in parts of the Third World, particularly in Latin America, it has been a significant champion of the poor and oppressed. Its anti-birth control stance has actually allowed the Church to fight against eugenicist projects (see discussion here about eugenics and contraception), among other things. So I think it is unfair to unequivocally condemn the Catholic Church for this stance.
In the case at hand (requiring coverage of contraception), however, I don’t know if contraception is really the issue. At first blush, it seems like the Catholic Church is being kind of silly. Hormonal birth control has medical uses entirely independent of contraception, to the extent that the name “birth control pills” is a misnomer. [On a side note, I don’t entirely understand the Catholic Church’s position on birth control. If the reasoning is that sex should only be for reproduction and not for recreation, then why is the “rhythm method” acceptable? It is a (fairly ineffective) means of having sex without conceiving. It seems there is some inconsistency there. But I digress.]
I came across an article, which I am too lazy to find again and link to, written by a Catholic who argued that what is at stake is the nature of liberal society itself. This gets to the heart of the issue. The legislation requiring coverage of contraceptives, and the maelstrom surrounding it, demonstrates once again the tenuousness of boundaries created between “politics” and “religion.” (See my previous discussion here.) It is liberal/secular doctrine that religion should be confined to the private life of the individual, leaving the public sphere free for a non-religious civil society. Of course, this set-up was historically buttressed by defining religion as a set of beliefs, and therefore a matter of individual conscious rather than public morality.
The creation of categories and boundaries is always strategic, and never conforms exactly to reality. Thus “religion” and “politics” as we know them do not exist in reality. What we actually have are competing systems of morality/interpretation/practice. Catholics and other religious voices are correct when they insist that legally confining religion to the individual conscious is, in fact, a victory for liberal/secular society. When they say that their religion is more than a set of beliefs – also a code of morality, a set of real practices, and a mode of organizing society – they are being truthful.
For this reason, when I watch the debates, I don’t really “feel” anything at all or “choose sides” (aside from noting the nonsensicalness of the Catholic Church’s outrage in this particular case). I just sit back and watch another instance of the inherent conflict built into the modern social structure.
**I want to add an addendum to this post that I actually wrote a number of days ago. I don't know if the terrain has shifted or I am kind of out of touch with the national conversation, but it has recently come to my attention that the terms of debate now include the claim, advanced by conservative pundits of all Christian stripes, that this bill would, in effect, be forcing citizens to pay for women to have sex. Once again, side-stepping the urge for an immediate emotional reaction and outrage at the lack of logic employed, one must question why they are reacting in this way. I propose it arises from the capitalist framework for understanding health, in which health is always seen as an individual problem and a matter of personal responsibility. People should not be spared the consequences of their decision to have sex.
Wednesday, October 26, 2011
Breast Cancer Awareness Month
Being the skeptic that I am, I have never gotten too into the breast cancer awareness stuff. This month, I have gotten just downright annoyed. It was during a plane ride, when my beverage service was infringed upon by a breast cancer donation collection, that I decided that things have gone too far. Consequently, I felt quite vindicated by this recent On Point episode.
Not only have I argued that foundations (and this includes cancer research foundations) are essentially tax shelters for corporations/businessmen who want to build a positive reputation for themselves, and certainly the pink ribbon gimmick benefits corporations more than anybody, but I am also troubled by the way that these breast cancer awareness campaigns shape notions of gender and femininity.
Why is it that women's health has come to be represented by a disease that affects the breasts? Breast cancer is not the biggest health threat for women. Is it because we reduce our concern for women's bodies to their reproductive organs/capacities... is the idea of a woman losing her breasts (as opposed, say, to a liver or a kidney) that much more disturbing because it is transgressive of our image of womanhood?
And why the pink? To enforce the perception that breast cancer is inherently "feminine"?
That brings me to another point of contention, which is the whole concept of "women's health" and "women's issues." Yes, there are certain ways in which most females' bodies differ from most males'. (But even here the difference is not actually discrete. When it comes to biological sex, the reality is more complicated than our binary categories of male-female would lead us to believe.) Perhaps, even, the organs that one does or does not have can determine the types of afflictions to which one is susceptible. (On this account, it is important to note that men can and do get breast cancer; it is not only a women's disease.) All this means, though, is that you won't get prostate cancer if you don't have a prostate gland. It does not mean that the general conditions - social, economic, political, biological - that predispose certain people to certain types disease - are actually gender specific.
In other words, the focus on "women's health" locates the cause of specific forms of female suffering within the female body itself. It is women's own bodies - specifically the parts that are marked as feminine - that bear the responsibility for affliction.
Women suffer because they have breasts.
Nowhere in these "women's health" and breast cancer awareness campaigns is any attention paid to whether or not women have equal access to healthcare; whether they receive the same treatment/respect by health professionals (in terms of their personal ability to act and make decisions; the assignment of moral culpability; the risks that are taken; and the expectations as to their ability to cope and recover); or how social norms and gender stereotypes may affect women's attitudes toward their own bodies and health. Just examples.
When I see pink ribbons on products, I see coporations yet again exploiting women for profit.
Not only have I argued that foundations (and this includes cancer research foundations) are essentially tax shelters for corporations/businessmen who want to build a positive reputation for themselves, and certainly the pink ribbon gimmick benefits corporations more than anybody, but I am also troubled by the way that these breast cancer awareness campaigns shape notions of gender and femininity.
Why is it that women's health has come to be represented by a disease that affects the breasts? Breast cancer is not the biggest health threat for women. Is it because we reduce our concern for women's bodies to their reproductive organs/capacities... is the idea of a woman losing her breasts (as opposed, say, to a liver or a kidney) that much more disturbing because it is transgressive of our image of womanhood?
And why the pink? To enforce the perception that breast cancer is inherently "feminine"?
That brings me to another point of contention, which is the whole concept of "women's health" and "women's issues." Yes, there are certain ways in which most females' bodies differ from most males'. (But even here the difference is not actually discrete. When it comes to biological sex, the reality is more complicated than our binary categories of male-female would lead us to believe.) Perhaps, even, the organs that one does or does not have can determine the types of afflictions to which one is susceptible. (On this account, it is important to note that men can and do get breast cancer; it is not only a women's disease.) All this means, though, is that you won't get prostate cancer if you don't have a prostate gland. It does not mean that the general conditions - social, economic, political, biological - that predispose certain people to certain types disease - are actually gender specific.
In other words, the focus on "women's health" locates the cause of specific forms of female suffering within the female body itself. It is women's own bodies - specifically the parts that are marked as feminine - that bear the responsibility for affliction.
Women suffer because they have breasts.
Nowhere in these "women's health" and breast cancer awareness campaigns is any attention paid to whether or not women have equal access to healthcare; whether they receive the same treatment/respect by health professionals (in terms of their personal ability to act and make decisions; the assignment of moral culpability; the risks that are taken; and the expectations as to their ability to cope and recover); or how social norms and gender stereotypes may affect women's attitudes toward their own bodies and health. Just examples.
When I see pink ribbons on products, I see coporations yet again exploiting women for profit.
Tuesday, June 28, 2011
The Pharmaceutical Industry and Intellectual Property
Going along with the HIV/AIDS theme, I read an article in the New York Post* that discussed, in part, how HIV drug costs remain high despite (that is the tone of the article; I would say in order to sustain) an enormous amount of profit from their sale:
"HIV drug profits are exceptionally high, as indicated by the 37 percent earned on sales in 2010 Gilead, the leading HIV drugmaker. This is twice the general profit level in the pharmaceutical industry, which is itself substantially higher than in most industries."
One sentence, in particular, contained one nail-on-the-head truth, and one falllatious myth of neoliberalism:
"Federal and state governments can no longer afford to subsidize the lofty profits that were useful when new HIV drugs needed robust incentives for quick development."
First, it is absolutely true that by sponsoring programs to make HIV treatments more affordable for low income individuals, the government is essentially subsidizing the massive profits of the pharmaceutical companies. That is why this "charity" approach is far inferior to a more systemic challenge of the legitimacy of intellectual property laws.
But that brings me to the myth. The idea that large monetary incentives are necessary to promote innovation has reached the level of taken-for-granted, common-sense hegemony.
Of course creativity requires guaranteed monetary incentives. That is why human beings created nothing at all until the concept of intellectual property was developed a century or so ago.
The problem is, the notion of "intellectual property" rests on premises that are not compatable with the actual nature of cultural production. The best way to illustrate this nature is through a linguistic metaphor. Literary theorist Mikhail Bakhtin famously described the way in which every linguistic utterance mimics a pre-existing pattern of speech (associated with a particular group of people and related to the group's other socio-cultural attributes). Although each individual in theory possesses infinite creative capacity in terms of what she or he can say (language is infinite), in practice people almost always repeat bits of speech (sentences, phrases, grammatical stylings etc.) that they have already heard in their particular social milieu. The true nature of innovation and change lies in the way in which people take the words of others and (in the words of Bakhtin) populate them with their own intentions, as well as bring them into new combinations with the words of others.
Following Bakhtin, other cultural theorists have argued that innovation of any kind occurs through novel melding of material from other individuals. Thus, creativity is not an individual endeavor. In fact, creativity requires "plagiarism." I am reminded of an excellent quote by Chris Martin, the frontman of the band Coldplay:
"Well, you know, I think as we go further and further from just being influenced by Radiohead to being influenced by lots more people... It's just blatant plagiarism. I mean, all that we've done, really, is expanded our plagiaristic palate."
If creativity requires a free flow of ideas, then the existence of intellectual property actually inhibits, rather than promotes, creativity.
Where did this concept come from then? Very simply, it is a quite effective way of legitimizing monopolies. That is the only purpose the concept of "intellectual property" has ever served, and the pharmaceutical industry is an exemplar, not an aberration.
Furthermore, pharmaceutical companies patent genetic material (obviously something they can't "create"!); often they solicit indigenous communities around the world to share information regarding local plants and herbs. Once the genetic material is patented, these groups no longer have the free access they enjoyed before! There is no way to argue that this practice encourages innovation. The pharmaceutical companies employed no intellectual effort of their own to obtain this knowledge (except, perhaps, for preparing the necessary legal conditions that allow them to do this). It is much more akin to "stealing" than innovation.
Intellectual property does not protect artists, writers, or inventors. It protects the corporate oligarchy. If we want to fight this oligarchy, we must challenge the notion of intellectual property.
*"We can change the reality of AIDS" by James Driscoll
"HIV drug profits are exceptionally high, as indicated by the 37 percent earned on sales in 2010 Gilead, the leading HIV drugmaker. This is twice the general profit level in the pharmaceutical industry, which is itself substantially higher than in most industries."
One sentence, in particular, contained one nail-on-the-head truth, and one falllatious myth of neoliberalism:
"Federal and state governments can no longer afford to subsidize the lofty profits that were useful when new HIV drugs needed robust incentives for quick development."
First, it is absolutely true that by sponsoring programs to make HIV treatments more affordable for low income individuals, the government is essentially subsidizing the massive profits of the pharmaceutical companies. That is why this "charity" approach is far inferior to a more systemic challenge of the legitimacy of intellectual property laws.
But that brings me to the myth. The idea that large monetary incentives are necessary to promote innovation has reached the level of taken-for-granted, common-sense hegemony.
Of course creativity requires guaranteed monetary incentives. That is why human beings created nothing at all until the concept of intellectual property was developed a century or so ago.
The problem is, the notion of "intellectual property" rests on premises that are not compatable with the actual nature of cultural production. The best way to illustrate this nature is through a linguistic metaphor. Literary theorist Mikhail Bakhtin famously described the way in which every linguistic utterance mimics a pre-existing pattern of speech (associated with a particular group of people and related to the group's other socio-cultural attributes). Although each individual in theory possesses infinite creative capacity in terms of what she or he can say (language is infinite), in practice people almost always repeat bits of speech (sentences, phrases, grammatical stylings etc.) that they have already heard in their particular social milieu. The true nature of innovation and change lies in the way in which people take the words of others and (in the words of Bakhtin) populate them with their own intentions, as well as bring them into new combinations with the words of others.
Following Bakhtin, other cultural theorists have argued that innovation of any kind occurs through novel melding of material from other individuals. Thus, creativity is not an individual endeavor. In fact, creativity requires "plagiarism." I am reminded of an excellent quote by Chris Martin, the frontman of the band Coldplay:
"Well, you know, I think as we go further and further from just being influenced by Radiohead to being influenced by lots more people... It's just blatant plagiarism. I mean, all that we've done, really, is expanded our plagiaristic palate."
If creativity requires a free flow of ideas, then the existence of intellectual property actually inhibits, rather than promotes, creativity.
Where did this concept come from then? Very simply, it is a quite effective way of legitimizing monopolies. That is the only purpose the concept of "intellectual property" has ever served, and the pharmaceutical industry is an exemplar, not an aberration.
Furthermore, pharmaceutical companies patent genetic material (obviously something they can't "create"!); often they solicit indigenous communities around the world to share information regarding local plants and herbs. Once the genetic material is patented, these groups no longer have the free access they enjoyed before! There is no way to argue that this practice encourages innovation. The pharmaceutical companies employed no intellectual effort of their own to obtain this knowledge (except, perhaps, for preparing the necessary legal conditions that allow them to do this). It is much more akin to "stealing" than innovation.
Intellectual property does not protect artists, writers, or inventors. It protects the corporate oligarchy. If we want to fight this oligarchy, we must challenge the notion of intellectual property.
*"We can change the reality of AIDS" by James Driscoll
Saturday, June 25, 2011
Corporations and Individual Rights
The recent court ruling to give pharmaceutical companies the same rights to free speech that pertain to individual citizens makes me feel like it might be time for another series of discussions on health. For now, however, I will just make a few comments in response to this case.
Before getting to my first real point, I will start off by saying that, of course, I think pharmaceutical companies have sacrificed the general welfare for personal profit. The privileges that they retain (with support of the federal government), including monopolies and price-fixing, have rendered drugs unaffordable for many people in the world. In underdeveloped nations, in particular, populations are subject to epidemics of diseases like AIDS, while life-saving drugs remain out of reach solely due to prohibitive costs.
I think that it is also true that, in circumstances where people can afford to pay, pharmaceutical companies promote the use of drugs far beyond what is necessary. The rise of antiobiotic resistant bacteria stands as a good example of how detrimental this practice can be.
However, all those considerations aside, does it stand to reason that, as is argued in this particular case against the pharmaceutical companies, they are solely responsible for the promotion and use of unnecessary drugs? Certainly pharmaceutical companies bear a lot of the responsibility. But what about the doctors? I can think of multiple cases from personal experience alone (and I am a generally "healthy" person who stays away from doctors) in which doctors have encouraged me to take an expensive name-brand drug even when much cheaper generics were available. I do not believe any of these doctors were directly persuaded to do so by pharmaceutical advertising (explaining what seems to be the more plausible reasons, however, would require divulging too much unnecessary information about my health). One doctor even tried to set my mind at ease by telling me there was a good discount and the insurance company would be bearing most of the cost anyway. I also bet there are also people out there who would choose to get name-brand over generic even without doctor/pharmaceutical encouragement just because part of them still believes that a more expensive name brand must be better.
This whole situation kind of reminds me of the controversy over cigarette ads put out by the tobacco industry. True, advertising and marketing may exacerbate the ills of late capitalism and certainly promote gratuitous consumption of products. However, these practices are not the root cause of the problem; they are mere symptoms (to use a popular metaphor). Attacking corporations for advertising is like treating pneumonia with aspirin. Overproduction and overconsumption (which drives advertising/marketing) are fundamental characteristics of the development of capitalism and the contradictions which this development tries to overcome.
The other and perhaps more important issue, then, is the granting of individual rights to corporations. This, too, does not concern me. Corporations already enjoy "rights" and privileges far exceding that which is granted to ordinary citizens. To enshrine this state of affairs in the law is to simply be transparent. If anything, this is beneficial, because blindness leads to complacency.
The concept of individual rights is nothing more than rhetoric. True, it has social implications and it is useful but in and of itself, it has no social referent. It is empty. The concept of rights was born in the realm of the hypothetical/philosophical and migrated into the domain of the political, where its primary use is to fabricate the illusion of democracy (an issue I have already discussed at length). Thus, "rights" is a word used to make arguments, but not a social reality. Occasionally the "rights" concept is used to challenge structures of domination by those who are oppressed; however, the challenge could easily be made without any such concept of "rights." Furthermore, the very concept of "rights" used to challenge the oppressors may be also used by the oppressors in return to coopt resistance movements, calm hostilities, and divert actions toward activities that maintain the status quo. Therefore, while the concept of "rights" may be used in power strugges, the concept itself is merely incidental to these struggles - the material with which these wars are waged, but not their driving force.
In the end, it does not matter what sorts of symbolic "rights" are granted to corporations. The fact of the matter is that corporate interests (not necessarily unified) are the state, are the legislator, are the justice system. Since the framework of "human rights" holds these very institutions responsible for the enforcement of rights (in fact, the only rights that can exist are those that can be protected by state and trans-statal legal apparatus), then "rights" can only exist in so far as they are guaranteed by dominant corporate interests - the very forces that exploit, alienate, and de-humanize a broad swath of humanity.
So that is why I say "who cares?" to the issue of corporations being granted individual rights: because they are the guarantors of individual rights, and in that sense, already above individual rights, at a systemic level.
Before getting to my first real point, I will start off by saying that, of course, I think pharmaceutical companies have sacrificed the general welfare for personal profit. The privileges that they retain (with support of the federal government), including monopolies and price-fixing, have rendered drugs unaffordable for many people in the world. In underdeveloped nations, in particular, populations are subject to epidemics of diseases like AIDS, while life-saving drugs remain out of reach solely due to prohibitive costs.
I think that it is also true that, in circumstances where people can afford to pay, pharmaceutical companies promote the use of drugs far beyond what is necessary. The rise of antiobiotic resistant bacteria stands as a good example of how detrimental this practice can be.
However, all those considerations aside, does it stand to reason that, as is argued in this particular case against the pharmaceutical companies, they are solely responsible for the promotion and use of unnecessary drugs? Certainly pharmaceutical companies bear a lot of the responsibility. But what about the doctors? I can think of multiple cases from personal experience alone (and I am a generally "healthy" person who stays away from doctors) in which doctors have encouraged me to take an expensive name-brand drug even when much cheaper generics were available. I do not believe any of these doctors were directly persuaded to do so by pharmaceutical advertising (explaining what seems to be the more plausible reasons, however, would require divulging too much unnecessary information about my health). One doctor even tried to set my mind at ease by telling me there was a good discount and the insurance company would be bearing most of the cost anyway. I also bet there are also people out there who would choose to get name-brand over generic even without doctor/pharmaceutical encouragement just because part of them still believes that a more expensive name brand must be better.
This whole situation kind of reminds me of the controversy over cigarette ads put out by the tobacco industry. True, advertising and marketing may exacerbate the ills of late capitalism and certainly promote gratuitous consumption of products. However, these practices are not the root cause of the problem; they are mere symptoms (to use a popular metaphor). Attacking corporations for advertising is like treating pneumonia with aspirin. Overproduction and overconsumption (which drives advertising/marketing) are fundamental characteristics of the development of capitalism and the contradictions which this development tries to overcome.
The other and perhaps more important issue, then, is the granting of individual rights to corporations. This, too, does not concern me. Corporations already enjoy "rights" and privileges far exceding that which is granted to ordinary citizens. To enshrine this state of affairs in the law is to simply be transparent. If anything, this is beneficial, because blindness leads to complacency.
The concept of individual rights is nothing more than rhetoric. True, it has social implications and it is useful but in and of itself, it has no social referent. It is empty. The concept of rights was born in the realm of the hypothetical/philosophical and migrated into the domain of the political, where its primary use is to fabricate the illusion of democracy (an issue I have already discussed at length). Thus, "rights" is a word used to make arguments, but not a social reality. Occasionally the "rights" concept is used to challenge structures of domination by those who are oppressed; however, the challenge could easily be made without any such concept of "rights." Furthermore, the very concept of "rights" used to challenge the oppressors may be also used by the oppressors in return to coopt resistance movements, calm hostilities, and divert actions toward activities that maintain the status quo. Therefore, while the concept of "rights" may be used in power strugges, the concept itself is merely incidental to these struggles - the material with which these wars are waged, but not their driving force.
In the end, it does not matter what sorts of symbolic "rights" are granted to corporations. The fact of the matter is that corporate interests (not necessarily unified) are the state, are the legislator, are the justice system. Since the framework of "human rights" holds these very institutions responsible for the enforcement of rights (in fact, the only rights that can exist are those that can be protected by state and trans-statal legal apparatus), then "rights" can only exist in so far as they are guaranteed by dominant corporate interests - the very forces that exploit, alienate, and de-humanize a broad swath of humanity.
So that is why I say "who cares?" to the issue of corporations being granted individual rights: because they are the guarantors of individual rights, and in that sense, already above individual rights, at a systemic level.
Monday, April 11, 2011
Capitalism and Health
I decided that I wanted to devote a number of posts to the subject of health. The way we view and act upon the human body is a concern of central political, economic, and social importance, as well as instrumental to the way in which we perceive ourselves as individuals. To start, I will provide an overview of the capitalist approach to health that has become so pervasive and naturalized.
This approach entails the following assumptions:
1. It is the "normal" state of affairs to be "healthy." Thus, ill health and other physical maladies are a form of deviance.
2. Deviance comes in discrete packages: "disease," "infection," "syndrome," and "disability" are the most common. Each form of deviance, in turn, has a discrete and identifiable cause. Some causes represent inherent abnormality (genetic defects); some represent outside threats (bateria, viruses, fungi) which can be managed and prevented; and some derive from behavior. Furthermore, to the extent to which susceptibility to "outside threats" is determined by "inherent abnormality" and behavioral causes, its role is more that of a secondary cause.
3. Health is managed at the level of the individual, in terms of individual defects and behaviors. In this way, each individual often becomes directly culpible for his or her own health, and public health strategies focus on "education" and the management of behavior (encourage kids to exercise, regulate salt content, tax cigarettes, etc.). An ideology of "personal responsibility" and the employment of governmental power relations (two non-contradictory components of capitalism: both seeking to effect change at the level of the individual) are the name of the game.
4. Understanding of causation is extremely linear and material. A one-to-one correspondance is often sought between illness and personal hygiene, eating habits, level of physical activity, and engagement in "risky" (i.e. non-socially sanctioned) behaviors.
5. With discrete, material causes of health-related deviance, the restoration of "normality" may be pursued by equally discrete, material means: thus, the domain of health care is easily penetrated and transformed by capitalism and its tendency toward commodification of every possible aspect of life.
The following are some examples of the "simple math" that has characterized our approach to health:
-People with heart disease are often fat. Therefore, being fat must cause heart disease. Furthermore, you must be fat because you eat fat. Consequently, a low-fat diet will prevent heart disease. Oh, how convenient, now we have created a market for I Can't Believe It's Not Butter!
-If you have chest congestion and fatigue, you probably have a respiratory infection. Infections are caused by outside agents. Outside agents must be killed by antibiotics (because the human body is not designed to deal with bacteria and viruses on its own). Oh, how nice for the pharmaceutical companies, people are willing to pay lots of money for drugs! (Oh, too bad for the poor people who actually need them but can't afford them...)
-Syphillis is a sexually-transmitted infection. Since syphillis is a "deviant" condition, it must result from deviant sexual behavior. Therefore, only people who deserve to get syphillis get syphillis. Hey, why not use poor black people with syphillis for the unnecessary medical research that supports our gainful employment? If we treated them, we would only be shielding them from the consequences of their actions anyway.
-Everyone's body is, ideally, exactly the same. If someone's body deviates from this ideal, it must be their fault. They should live in constant guilt and shame. They also should spend an inordinate amount of time, energy and money trying to become closer to the ideal. Since practically nobody is "normal," what a large market that creates for diet products, exercise equipment, fancy scales, and magazines with helpful tips on how to "get the abs of your dreams" (or, just for Schadenfreude, investigations into which celebrities have gained 2 pounds)!
This approach entails the following assumptions:
1. It is the "normal" state of affairs to be "healthy." Thus, ill health and other physical maladies are a form of deviance.
2. Deviance comes in discrete packages: "disease," "infection," "syndrome," and "disability" are the most common. Each form of deviance, in turn, has a discrete and identifiable cause. Some causes represent inherent abnormality (genetic defects); some represent outside threats (bateria, viruses, fungi) which can be managed and prevented; and some derive from behavior. Furthermore, to the extent to which susceptibility to "outside threats" is determined by "inherent abnormality" and behavioral causes, its role is more that of a secondary cause.
3. Health is managed at the level of the individual, in terms of individual defects and behaviors. In this way, each individual often becomes directly culpible for his or her own health, and public health strategies focus on "education" and the management of behavior (encourage kids to exercise, regulate salt content, tax cigarettes, etc.). An ideology of "personal responsibility" and the employment of governmental power relations (two non-contradictory components of capitalism: both seeking to effect change at the level of the individual) are the name of the game.
4. Understanding of causation is extremely linear and material. A one-to-one correspondance is often sought between illness and personal hygiene, eating habits, level of physical activity, and engagement in "risky" (i.e. non-socially sanctioned) behaviors.
5. With discrete, material causes of health-related deviance, the restoration of "normality" may be pursued by equally discrete, material means: thus, the domain of health care is easily penetrated and transformed by capitalism and its tendency toward commodification of every possible aspect of life.
The following are some examples of the "simple math" that has characterized our approach to health:
-People with heart disease are often fat. Therefore, being fat must cause heart disease. Furthermore, you must be fat because you eat fat. Consequently, a low-fat diet will prevent heart disease. Oh, how convenient, now we have created a market for I Can't Believe It's Not Butter!
-If you have chest congestion and fatigue, you probably have a respiratory infection. Infections are caused by outside agents. Outside agents must be killed by antibiotics (because the human body is not designed to deal with bacteria and viruses on its own). Oh, how nice for the pharmaceutical companies, people are willing to pay lots of money for drugs! (Oh, too bad for the poor people who actually need them but can't afford them...)
-Syphillis is a sexually-transmitted infection. Since syphillis is a "deviant" condition, it must result from deviant sexual behavior. Therefore, only people who deserve to get syphillis get syphillis. Hey, why not use poor black people with syphillis for the unnecessary medical research that supports our gainful employment? If we treated them, we would only be shielding them from the consequences of their actions anyway.
-Everyone's body is, ideally, exactly the same. If someone's body deviates from this ideal, it must be their fault. They should live in constant guilt and shame. They also should spend an inordinate amount of time, energy and money trying to become closer to the ideal. Since practically nobody is "normal," what a large market that creates for diet products, exercise equipment, fancy scales, and magazines with helpful tips on how to "get the abs of your dreams" (or, just for Schadenfreude, investigations into which celebrities have gained 2 pounds)!
Tuesday, March 8, 2011
Obama Is A Marxist/Anti-Colonial/Socialist/Racist/Muslim
Although these types of statements have been fairly habitual the past couple of years, a couple of recent ones have prompted me to devote a few posts to debunking these claims.
Now, for the purposes of this blog, I neither support nor oppose Obama (and honestly, that comes pretty close to my personal feelings as well). I am not writing about this because I am an ardent follower of Obama. I think it is relevant to my blog because the unspoken premises on which these claims are based form an important part of the ideological fabric which cloaks the forces of domination in this world.
I will start, in this post, with "Obama is a Marxist."
I wish.
Seriously, I wish.
On what grounds is this claim made?
-Actual policies? Obama has continued, without hesitation, the economic strategies of his predecessors. If Obama is a Marxist, then so is Ronald Reagan.
-Government take-over of healthcare? Healthcare is probably the one area where Obama has appeared to do something different. Appearances can be deceiving. I will definitely devote a post to healthcare. But, assuming Obama did make significant changes to the relationship between the state and the healthcare industry, considering that state subsidization and regulation of industry is endemic to capitalism, and considering that Marx envisioned a stateless society, this would still not make Obama a Marxist.
-Stated beliefs? I never heard one thing come out of Obama's mouth that sounded the slightest bit Marxist.
-What about redistribution of wealth? Obama may have made statements that directly or indirectly referenced this principle (though the accuracy of these quotes I cannot verify), but it certainly has not been a component of his platform. Furthermore, redistribution of wealth is NOT A MARXIST PRINCIPLE! Marxists are not so concerned with distribution of wealth per se as they are relations of production. On the other hand, under the aegis of capitalism, a significant redistribution of wealth occurs every day - from the poor to the rich. The excesses of millionaires are financed by the Third World.
-I am afraid of black people, especially when they attain positions of power? Now we're getting somewhere...
So I say to all of you, as a proud Marxist, Obama is not one of us!! Please don't call him a Marxist!
Now, for the purposes of this blog, I neither support nor oppose Obama (and honestly, that comes pretty close to my personal feelings as well). I am not writing about this because I am an ardent follower of Obama. I think it is relevant to my blog because the unspoken premises on which these claims are based form an important part of the ideological fabric which cloaks the forces of domination in this world.
I will start, in this post, with "Obama is a Marxist."
I wish.
Seriously, I wish.
On what grounds is this claim made?
-Actual policies? Obama has continued, without hesitation, the economic strategies of his predecessors. If Obama is a Marxist, then so is Ronald Reagan.
-Government take-over of healthcare? Healthcare is probably the one area where Obama has appeared to do something different. Appearances can be deceiving. I will definitely devote a post to healthcare. But, assuming Obama did make significant changes to the relationship between the state and the healthcare industry, considering that state subsidization and regulation of industry is endemic to capitalism, and considering that Marx envisioned a stateless society, this would still not make Obama a Marxist.
-Stated beliefs? I never heard one thing come out of Obama's mouth that sounded the slightest bit Marxist.
-What about redistribution of wealth? Obama may have made statements that directly or indirectly referenced this principle (though the accuracy of these quotes I cannot verify), but it certainly has not been a component of his platform. Furthermore, redistribution of wealth is NOT A MARXIST PRINCIPLE! Marxists are not so concerned with distribution of wealth per se as they are relations of production. On the other hand, under the aegis of capitalism, a significant redistribution of wealth occurs every day - from the poor to the rich. The excesses of millionaires are financed by the Third World.
-I am afraid of black people, especially when they attain positions of power? Now we're getting somewhere...
So I say to all of you, as a proud Marxist, Obama is not one of us!! Please don't call him a Marxist!
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