adler-bolton and vierkant, 2022, health communism

written 20240121.

explores how capital wields the concept of health, primarily as a means of demarcating the healthy (fit for work) population from the surplus, “those who fall outside of the normative principles for which state policies are designed, as well as those who are excluded from the attendant entitlements of capital.” adler-bolton and vierkant highlight that it is not any characteristic of the population that makes them inherently vulnerable to becoming surplus (e.g., being disabled, sick, or mentally ill). instead, their vulnerability is constructed through the deliberate diversion of resources away from these communities.

the surplus population then exists for capital as both a threat to the healthy population (of being certified surplus), that is, a means of buttressing capitalist hegemony, and as a source of profit generation. adler-bolton and vierkant call this second function “extractive abandonment” and spend a considerable portion of health communism working through its manifestations in , for example, for-profit prisons and nursing homes, and in the history of the asylum.

the book is remarkably clearsighted in how it unpicks these processes. it provides a vocabulary to account for the way capitalism constructs, extracts from, depends on its surplus populations. beyond the healthy/unhealthy demarcation in this book, it reminded me of gregory sholette’s description of the art world’s vast accumulation of redundant works, and of sofi thanhauser’s description of an export processing zone as an island of stability dependent on the instability of its host country - to name two at random.

there is, in short, so much in this book, on the mechanics of extractive abandonment, its man ifestations throughout the nineteenth and twentieth centuries, and the radical movements that opposed them, whose fates were more often than not recuperation and repression.

with capitalism so tightly coupled to health, health communism argues that health is then a c ritically overlooked vulnerability for capitalism. it is necessary to sever health and capital, for which it is necessary to “both center the surplus populations and also to categorically refute the political, biostatistical, and sociological stratifications that lie at the center of the very construction of the surplus.” adler-bolton and vierkant emphasise this is not to sim ply “celebrate the surplus,” it is recognising that all of us, healthy or ill, are subject to extraction under capitalism. the book asserts, we are all surplus.

adler-bolton, beatrice, and artie vierkant, 2022, health communism, verso books