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)!