librarypunk - 071 - Health Communism feat. Beatrice Adler-Bolton

Episode Date: November 5, 2022

We’re talking with Beatrice Adler-Bolton from Death Panel and the author of Health Communism. We talk about accommodations, surplus populations, extraction, and communism.  https://twitter.com/realLandsEnd  https://www.versobooks.com/books/4081-health-communism Readings Health Communism (10/20/22) by Death Panel podcast   Death Panel Podcast Reddit Question Man's Search for Meaning - Wikipedia  Capitalism and Disability - Marta Russell  Histories of the Transgender Child — University of Minnesota Press

I look so rough. Is this what happens when you get turn 30? You just like take a nap and look like you died when you take a nap. Oh, look who just got here to the old club. Well, technically in January, I'll be in the old club. But is this what happens? No. Oh, unless you got sleep apnea, in case, yes.

Well, I have a fucked up nose, but you might get it. No. Get to get the Spider-Man sleep apnea machine. I've done sleep tests before. I actually do have the weird spider-band sleep apnea machine, but it's not because I have apnea, and then I just don't use it. Yeah. All right, let's go. Hello, I'm Justin.

I'm a Skalkan. I'm a mom librarian. My pronouns are he and him. I'm Jay. I'm a music library director. My pronouns are he-him. And we have a guest. Would you like to introduce yourself?

I'm Beatrice Sadler Bolton. I'm the co-host of the Death Panel Podcast and co-author of the book Health Communism. Welcome. I'm so looking forward to this. I've been thinking about this episode all week. Thanks for having me. It's great to be here. Yeah, we've really been wanting to talk about like health care, well, like health and accommodations in general because people have come to us with questions and things like that. Jay's got some personal experience in the realm of accommodations. And I just went through a job interview and I said, I'm not going to do accommodations because I don't trust them. So you need to just tell me if I get remote work up front. They didn't like that. And then you were on PDA and Justin was like, damn it. I was like, God fucking damn it. We were just about to do one next week. I'll do a quick segment.

I've got some. Oh, no, I rebooted. I've got it. Let's do it. Let's do it. Ask Reddit. This one actually might be on topic. So I'm going to put it in the chat because it's kind of long, but I'll read it.

What nice URL, Reddit. out-of-state library accounts. I have been an out-of-state member of the Brooklyn Library for several years. I pay a fee and have access to e-materials. I went to renew this year and discovered they are no longer allowing out-of-state members. I would often use my Brooklyn card when my local library did not have a book. This was seven days ago, by the way, and they had that whole e-banned e-book thing. Whatever.

I'm aware of interstate borrowing, I think they mean an interlibrary loan. But I suffer from seizures, and it is not easy for me to get to the library. Having access to digital resources, audio and ebooks is amazing. Can anyone recommend other libraries with great digital resources that offer out-of-state cards? First thoughts. Interesting. Because, yeah, as long as you pay the fee, it's like, as far as I understand, most public libraries are just like, fine.

I don't know how the contracting on all that back-end works, but I've always seen, like, if you move, you can keep your... Yeah, and because, like, you know, the reason why your library is, quote, free is because you're paying, like, property taxes. And it's like your local taxes or it's paying for the library. And that includes electronic resources. And so if you just sort of pay that, but as a fee, when you move, there shouldn't be an issue. Maybe the contracts with the vendors changed and said you can't do that.

Maybe. I don't know. So I don't understand why Brooklyn would do that. But then, so there are responses. Okay. But actually, first off, Beatrice, what do you think about this first off as someone who talks about disability a lot more than we do? I mean, honestly, I'm not super. familiar with, I guess, what is on offer in terms of, like, being able to go from, like,

bigger or smaller library systems, because I'm used to living in an area that's got pretty decent coverage. I mean, I was in New York. Now I'm in Philly, and the free libraries got great resources. But, I mean, it's one of those, I think, issues where, in general, you know, library access is one of the things that has always been a kind of disability rights issue that's been, you know, I think whether it's like getting access to online or materials like e-books or audiobooks, these are things that are really important resources that are, I think, less accessible because they're also locked into a lot of these older UI interfaces as well. So it's kind of always a mixed bag. You're never going to find anything close to a perfect access point, I feel like.

Yeah, I was complaining about how bad our vendors are because basically when you contract with the government, you can just provide a shitty product most of the time. I always just think about military contracting and how much worse that is. It makes me feel a little better, but not by much. So I know from graduate school, because I did like an early online master's in history, and if you needed something from the academic library, they would send it via academic postage, or via library postage, which is something I'd never seen before and I've never seen since, but it's just a very plain-looking card that says library postage. And it means it's like prepaid both ways.

And actually when I was returning a book one time, like via mail, our postal carrier came down to our house and was like, are you sure this is going to go? Because they'd never seen it either. It's just like, it's just like a little postcard that says library mail or like, yeah, library postage. And I was like, that's what they gave me to send it back with. And she was like, okay, see if it works.

Apparently it did. But, you know, we don't send out. stuff by mail, physical items by mail. And I think with as much interlibrary loaning as we do between libraries, it shouldn't be that much harder to do mail services for disabled people. Yeah, I know when my master's program could be done either online or in person, and I did in person, but like if you were an online student and you needed a physical book, they could do the same thing that Justin's talking about where they could, the library would mail you the book. So I see no reason why that can't be done for like disabled patrons. But as far as electronic resources

go, like one, I don't know why this library is like ceasing that service that this person's been paying for. But that should be even like easier than providing like mailing physical materials. It seems silly that they, unless it's something with like a shitty vendor contract. I don't know of other, because I know the Boston Public Library, you can get an, e-card. If you can't get a like just a regular card, but it's only if you work or go to school in Boston

where it's like if you couldn't just get a, like if you don't live there and can't get a regular card, but you go to school or work there, you can get an e-card. So that's what most of the students and I do in my conservatory for certain things. But yeah, I'll just state things

I'm not sure about. I can't figure out why I found a statement from Brooklyn Public Library. As of July 15, 2022, Brooklyn Public Library is no longer offering its fee-based out-of-state library card. It doesn't explain why. Existing out-of-state accounts will remain until their expiration date and will not be renewable. But you can still have the book unbanned e-card. Teens and young adults age as 13 to 21 outside of the New York State can apply for it. Weird.

And none of the news stories are explaining why this is happening. It must be a vendor thing or like a tax thing. I don't know. That or maybe like New York State did something. and said like you can't serve patrons outside of the tax. Yeah, because even with Boston, it's like you can only get that e-card if you work there or go to school there if you don't want to live there. The Free Library of Philadelphia stopped offering fee cards in November 2019. Mirrors the reason serving their direct service area and assuring that local patrons have priority access. Yeah.

Yeah, it does not see why it's happened. So they're just putting it in the language of austerity, but they actually haven't explained, like, why? Because if you're paying for it, like, you could just change the rates. Anyway. Yeah. That was a weird one. But someone did give, like, a list of, like, places. So Houston Library, Queens Library, Library, Web.org, Chapel Hill Public Library, C.M. Library.

So I'll just put that in the notes. And if you need access to a good public library, God damn it, Reddit. Why is that URL so long? Then you can use that. And that was Ask Credit. Short and sweet. And F1 apparently opens up Brave Health Center. So I'm going to change that hot key.

Okay. So, Beatrice, we probably wanted to talk about health communism. Do you want to do your plugs up front? Tell us about Death Panel and Health Communism. Death Panel, you are wearing the merch. You can tell people where they can get the bomber jacket you're wearing. Oh, yeah. I mean, our merch is available on our website where we also have some limited transcripts,

and you can find our episodes there, and that's at deathpanel.net. but we're a twice weekly podcast about the political economy of health, and I do it with my co-author, Ardy Virkant, who I also wrote Health Communism with, as well as our collaborators, Phil Rocco, Jules Gil Peterson, and Abby Cardis. And in a lot of ways, the book is very much in keeping with the themes of what we cover on the show, but it takes a sort of angle of approaching health and the political economy of how we construct, health and commodify it from a kind of perspective of history and theory versus less sort of translated through current events, I guess, as we would do it on the show. Yeah, very succinct.

I was reading as much as I could before we started today, and you make a distinction about the term health communism and distinguish it from socialized medicine. Health communism is all care for all people. What's the point of making that distinction? Well, I think one thing that, is important to talk about is like when we talk about health justice movements or movements for single payer, we're often locked really into a national context. And there isn't, for example, you know, the NHS, while it's marginally better than the United States, it's not free of the logics that dictate why the, like the non-system we have here in the U.S. sucks. Just because it's sort of organized and socialized does not mean that it's not run under principles of austerity,

or under these kind of eugenic frameworks of trying to make sure that we're only, you know, allocating resources toward people who are considered productive members of society under these very narrow frameworks of sort of what productive means being, you know, that you're sort of normative, that you're non-disabled, that you're in any capacity, a good, quote-unquote, tax-paying citizen, a member of the body politic. And so there's this kind of fundamental relationship that we have to the idea of socialized medicine that's often really locked into a kind of nationalistic context that also reinforces the idea of borders and border security or of the nation itself. So health communism is communism with a small sea. And it kind of pushes past not only these frameworks that are really locked into the status context, but the idea is.

is also to really kind of push beyond what we've actually seen happen before in other countries. So we can, you know, say that we want Medicare for all in the United States because the U.S., quote, unquote, deserves a system just as good as Canada or just as good as the U.K. But what that's doing is that's not helping those movements to improve the systems there by putting them up on this sort of pedestal and saying that the U.K. movement or the, sorry, the U.K. National Health Service is, some sort of panacea that's free of problems. They're under, I think, united fights against austerity and privatization that we need to push beyond when we start thinking of health care reform within our own individual sort

of siloed fights or countries or even if you're sort of working on a state single-payer plan and it's not a national single-player plan, thinking of these as part of a larger hole that's working towards a kind of international health justice, I think, is really important. And that's what we were trying to write towards in the book. Yeah. And you were talking about sort of the austerity models. Oh, my gosh. I just had the whole thought.

And it's just the moment I opened my mouth, it just left me completely. Well, while you think about it, I had a quick, like, like, little point, if you want to think about it. Yeah, because, like, what this is discussion is also prompting in me is, like, with how we're using, like, language to describe our ideological. goals and our political goals and stuff. And like often what we call socialized medicine and socialized healthcare, like you said, is often like dog shit in some instances. It's not really in the spirit of socialism. It's often like very sort of, and again, what people think about the state's involvement in a socialist or communist state, but it's often like very heavily like state mandated, but the state as in like a liberal. Yeah, like Thatcher's state.

Yeah, yeah. And or even in other countries where they quote, like, do it better, it's still not what we are thinking of when we say words like socialism, right? Yeah. And so I like that, like, even if it is lowercase C communism, using the word communism is this very like in your face like, oh, you might be watering down what socialism means when you say like socialized health care. and socialize medicine, we're not going to do that. So I really like this like semiotic distinction you're making. It reminds me of, oh, I forget who it was who said this. But like this one director or someone who's like being interviewed and explicitly like called

herself a an anarchist or a communist or something instead of sort of talking around it. Because it's like, no, I'm putting myself as like an antagonist against these systems. So I want to be explicit about what I'm believing here. and where that positions me. Yeah. And so I really like that, like, language distinction you're making. Thank you. I appreciate that.

Yeah. Was she Kropotkin, who we read for last week, saying use the word anarchists? No, but I'm now imagining, like, a trans femme Krippokkin, and it's making me really happy. So, someone make me fan art of, like, trans femme Kropotkin, and I'll be your best friend. Yeah. Yeah. I mean, I feel like so often when you. see people talk about socialized medicine as a kind of political goal or as a kind of maybe on-ramp

to political organizing. You know, it's a kind of tantalizing proposal to a lot of people in the United States, especially of our generation, who most of the people that I went to college with have basically never known anything other than like multiple gig work freelancing on top of whatever, you know, advanced schooling. You're trying to pay down all of your loans. There's no, there's no like coming security, I think, for a lot of us. And when we start thinking about how healthcare is structured and allocated, not just like in terms of resources, but spatially, right? And the COVID pandemic and the way the vaccine rollout has gone, not just within the U.S., but globally is a great example. But before COVID, just simple things like the rates of untreated HIV AIDS in the south of the

United States where you have populations who are, you know, just completely abandoned by these kinds of myths that everybody has access to the affordable care that they need, right? When we talk about socialized medicine, people are always like, oh, it's okay. It's not going to lead to, like, communism. Like, socialized medicine, it's not so scary. Like, it's cuddly. It's fine. This is just making ethical capitalism.

And honestly, I think... Like the Nordic model of medicine. Right. You know, and I think, I think, you know, maybe there's a kind of frustration that I have there and that kind of, you know, capitulating to the kind of health capitalist model and saying, oh, no, no, we're just trying to, you know, make things a little bit better. Like, no, we're fundamentally trying to destroy abolish and redistribute resources. And this includes everything from spatial resources, resources in terms of pharmaceuticals, but also in terms of knowledge, gatekeeping knowledge, and access to training. in education, these are things that are like incredibly locked within the global north. And, you know, if we think about just like the Reddit question that came up of like this kind of situation of like, oh, I'm trying to like just access library materials, there's no reason that libraries need to be sharing resources only with the county that they're in, right?

Like we can start thinking of, I think, using these kinds of models of like open access to the means of survival, to the means of reproduction, social and in terms of like in the workplace and physical beyond these kinds of constraints of like the state and its control over health as a commodity, I think we can look towards, you know, all sorts of programs that might be much more destabilizing and much less cuddly than I think they sort of are sold as. And I don't think that we need to be sort of taking the time to pretend that we're not trying to do something that's quote unquote extreme because the kind of normal that we have been living in, not just the normal that we have now that the pandemic is on top of our

sort of reality has been extreme already. This is an extreme position of total extraction and commodification. And we, I think, need to be honest that some of the reforms that we're pushing towards are not just towards ethical capitalism, but they're towards a horizon that's fundamentally different. That, you know, is communism, that is beyond just a health capitalism that works for those who can get access to the affordable care they need, right? You know, that's not going to happen if we have these kind of socialist islands within a capitalist state. For the first time in American history, the young and dumb can no longer expect to be as

full of calm as their parents were. Where the fuck do you get these drops, Justin? I did thank Leslie for giving me the clean audio on that, because that was from David Twidey on Thanks for the Memories podcast. And I was like, I need a clean drop of that. Excellent. Because we're going to be talking about health care. Excellent.

Thank you, Leslie. Shout out, your real one. Yeah. When you talked about extraction, you talked, you brought up a point that I really want to get into real quick. Oh, gosh, this episode could go for hours, honestly. Surplus populations. There was an original context under Marx in which a surplus population is the population of workers that are not needed for labor, but are used to keep labor prices down. how do you use the term surplus population in health communism?

So, yeah, we're pushing it a little bit. We're pushing that sort of reserve army of labor a little bit broader than just, you know, people who are considered out of work or unemployed to include people who are non-workers and to include people who also are in conditions of precarious work. So I think in a way, the surplus population is a kind of construction that is necessarily larger than the working class because it also encompasses the working class because the sort of proximity to being made surplus to what happens to you when you can no longer work, when you can no longer sort of buy survival with your wage labor or with the maintenance of

your health through your wage labor, you face a sort of situation where you're not, it's not just like keeping workers in like specific jobs with bad conditions. It's a kind of total system of keeping you sort of in one position where you're in one social role where your labor is being extracted as surplus labor power. And then when you can no longer sort of meet the demands of those conditions of extraction, you're sort of cross this transom into the surplus class where your fundamental relationship to labor changes. And it doesn't mean that there isn't surplus profit that's sort of generated out of your body, but it's not necessarily coming from your labor power. Sometimes it's coming from the labor that's kind of necessary to help you survive. And so we could

think about this in a couple different ways. And the way that we chose to think about this under capitalism is that essentially that sort of citizenship and who's a member of the body politic is really predicated on being able to sell your surplus labor power. And that for people who are in the surplus, this is a kind of condition of non-life within society. You don't sort of have the full rights to social access to, like, space. And even during the very specific example of COVID, you know, people who are immunocompromised right now, they're maybe in the workforce, but the conditions of how workplaces are being managed right now with, you know, a lack of masking, with vaccines that provide protection in some capacity,

but are not stopping the spread of COVID and are not stopping immunocompromise people from having, even if it's just like a couple extra medical bills that month, that's like in a couple days of lost work, that can be incredibly precarious for all sorts of people. And so this kind of line that we think of is existing between surplus and worker is actually much more blurry than it actually is a binary. It's more that this is a kind of constant shifting matrix where many times we can sort of shift within and without the surplus population, whether we're workers or not. And so I think what we're hoping to do is kind of try and push people to think beyond, I guess, not just in terms of like that our goal should be thousands of unionized workplaces, right?

It's about finding ways to like come together and collectivity sort of beyond the workplace. Like how do we find ways for workers to be in solidarity with the patients that they care for and for the patients to be in solidarity with the care workers that they're interacting with. These are kind of contingent relationships that are often pitted against each other, and the only person that really benefits is whoever owns the company at the end of the day. No one in terms of the labor situation or in terms of the care situation is really getting any of what they need. And so I think the idea that we're trying to push and why we're trying to expand the surplus population is really to kind of, highlight the fact that this this firm barrier is actually not firm at all and basically doesn't exist fundamentally.

Yeah. I mean, it definitely made me think a lot about prisoners, people who are removed from society in a way and are still benefited off of, you know, whole towns are like, don't take our prison away from us. That's where all our jobs come from. That's federal money that comes in. That gives us an economy to build a town around when you have a prison like that. But when it intersects with the human body, body, my specialty is in early modern, unfree labor. Free labor and unfree labor hadn't become concepts until like the 19th century, but I was studying sort of like specific types of bond labor. And so in Maryland and Virginia in the 17th century, if you were in an indenture, which you could get into simply by showing up in the country, if you didn't have any kind of indenture, it was called custom of the country, you had seven years of labor, more or less, or four years, depending on whatever. And if you got pregnant, they could take you to the court and say, I had to deal with this

person while they were pregnant. You need to extend the indenture. So remember, this is a time really before, like, police. So everything was just your owner, more or less, being the person you had a contract with, could just drag you to the court and be like, you need to make them finish working for me. And that was more or less how labor contracts worked until, like, the mid-19th, century. And so it made me really think about like, that's property in the body of the person. And when you're talking about disabled people and people in prison, and there's a big overlap

there, of course, of constantly extracting when you're talking about value in the body of the person, this is why I wanted to really do research on, and I never got the chance to, of incarceration as state-sponsored human trafficking because it makes money for the state and for the interests that are in favor of incarceration. So it's in the state's interest to lock more people up. It's in those industry's interest to lock more people up. And there's value in the body of those people, especially when you talk about like jail rent and things like that.

And then you can also actually make them labor and get work out of them. I assume there's probably a very close parallel in terms of all the additional labor we make disabled people do in order to maintain their bio-certification. But that was just my little Justin's corner of history. I spent so many years studying this that I have to. Yeah, I mean, one of the things that we touch on in the chapter called Labor in the book is actually how you have, beginning with the English poor laws, some of the first attempts to create categories within the working and non-working poor along lines of essentially creating categories of people who are exempt from work that, comes at the same sort of time with the legal construction of the idea that work is a requirement for people who don't own property, right? And so this has always sort of been tied up in,

of course, like the idea of who's sort of legally exempt from having to quote unquote contribute to society as a kind of taxpayer, as a worker, as someone who's making their body as property sort of available to essentially sort of sell at a rate that's not just, sort of like the market rate, but a rate that's not a burden on bosses, most importantly. And that's really what the context of the poor laws is initially is that you sort of have this moment where because of the black death, you have a little bit of a power shakeup within the concentration of day laborers and skilled tradesmen that allows for people to sort of have a little bit more discretion over work that they're accepting or turning down.

And so part of the sort of framework of disability as a legal construction of a kind of identity as managed by the state actually comes out of this, you know, desire to sort of be able to discern between the kind of deserving and the undeserving poor in that moment. And this obviously sort of develops and you see this all over, you know, early colonial history in the United States, like under the kind of distinctions of like soundness, whether that's in slave markets in terms of, like, like valuing people based on these kind of race science perceptions of what they're, what like a kind of normal reaction to the stress and the negative social determinants of health of the kind of conditions that people are living in when they're enslaved and taking that and sort of pathologizing it. But ultimately, you know, the fact of the matter is is it's not just people who are already surplus who have their bodies commodified in this manner. Actually, everyone who, you know, is a worker now who may be living out in the free world, we're also sort of all subject to

this commodification. And it's one of those kinds of things where there are a couple like theorists who, you know, are people working, and particularly like 1870s to like the 1940s who are really talking about, you know, for so many workers, their only property is their body and their labor power. And I think ultimately that sort of has been what has been the fundamental logic that is driven both our systems of how we provisioned health resources and how we sort of pay for health care, but also what we define as disability and how we allocate resources for that as well. This is the best fucking conversation I've had in weeks.

I'm so excited when someone else knows this shit. I'm just so excited. I'm so a little hard emoji eyes whenever someone else is talking to me about 19th century labor history. This is amazing. I mean, yeah. There's lots of good deep cuts for that in this book, especially there's the whole section on the work Cure too, which was a big part of the rehabilitation movement. But my co-author and I,

he and I really like going back and reading, you know, the original sources and reading what the eugenicists had to say for themselves and how they were being covered in the New York Times. And, you know, if anything, health communism is pretty kind of quote heavy in a way because it's meant to be able to be used as a resource for sort of where to dig if this is something that you're interested in and it brushes up against your research interests, whether you're like in the ivory tower or you're an independent researcher like I am. You know, we all need ways to sort of like find those threads to pull. And so we tried to leave as many of those threads out for people throughout the text as we

could. And I feel like like, and sorry if this is like tangent throwing us off, but like with the world like with what you're talking about with like the politics of. the word cure and what it means and like in its relevance to like the body is property both of our property, private property, property of the state, all that. And like what cure is meant to do is like it's not meant to like quote fix anything. It's meant to just be able to get you back to work. Yeah. But under maintenance, right? And like thinking about how in the 19th century, granted not all of it was happening for this reason or I guess to be to phrase it differently,

it wasn't happening for just this reason. But all of the stuff. sexology that was happening during that time and coming up with taxonomies of human sexuality and human gender, where for the first time, it's like instead of someone doing a sodomy, you know, they were a type of, the co-gobling slut. Exactly. Oh, God, that episode is the dirtiest, filthiest thing we've ever done in our lives. But thinking about how like suddenly like homosexuality or urinism or being an invert. Like all of these things are suddenly like something you were, but in like a, it was like something you had. And therefore it was medicalized and that could be cured. It could be fixed. And that's how you start getting things like conversion therapy. And then like

DSM like homosexuality and like gender dysphoria and stuff being like mental disorders and whatnot is like where we're even like pathologizing. I don't love the word identity or the work that's doing here, but pathologizing, like, aspects of just, like, human experiences with our bodies and what we do with them and how we move them in the world, even outside of things like, like, having a cold or being, like, you know, needing prosthetics or something, you know. This is what I really enjoy about Victor Frankl's work. So if you're not aware of Victor Frankl, even if you were, like, a psychology student, you might not have known him because he's a little early. But Victor Frankel is a Holocaust.

survivor was a Holocaust survivor who was a Freudian psychotherapist and lost his wife in the Holocaust. And he came up with this idea called Logotherapy, which was like treating the soul more or less. And his whole thing was we pathologized too many things. His whole point was, you aren't ill if you are a cop and hate your job because it makes you treat people badly. You're a normal human being, have an enormous human human. reaction. There's no thing that we need to fix via therapy to get you back out in the world being a cop.

So I really love his work. I mean, as someone with like pretty severe mental illnesses, it was really a great thing to read at a certain time when I got to read it. So it's a man's search for meaning. Part of it is sort of like his autobiography and the rest is talking about dealing with patients. Highly recommend Victor Frankel. I mean, I've brought it up to like psych professors and they're like, who? I think maybe we cover him briefly. I brought up to my mom and she was like, oh, yeah, I think we covered him for like a day in my undergrad course. Yeah, I mean, there are a lot of people who are sort of engaging with these ideas partially in that generation and that post-war generation towards sort of a critique of, I think, how pathology has been leveraged by the state, not just by the T4 eugenics program, but also by the British Eugenics program and the American Eugenics program, which were, of course, like much more extensive. in terms of setting up a kind of research apparatus.

And there were studies that were going on, like they were sending people to Haiti, to study prisoners in Haiti, to sort of see if there was a way that they could genetically pick out why people were more rebellious, for example, in colonies in Haiti than other places. And that they were kind of looking for this, like, way to essentially sort of biologically verify

that there was some sort of thing other than the brutal political repression that was going on and colonialism that was driving this kind of revolt. It couldn't possibly be the political economy, right? It's got to be something wrong with people. And so you have a lot of people like the group SPK, who our book is dedicated to and who there's an extensive account of them in two chapters towards the end called care and cure. And SPK, like Frankel, was really inspired by existentialism and so you have people who are sort of talking about psychoanalysts and what's sort of in vogue at the time is sort of thinking about like, you know, these kind of figures of

people who are doing psychoanalysis is not just like doing psychoanalysis, but also is kind of engaging in like a type of political thought. And so you have this idea of sort of the identity of madness becoming more politicized as a kind of embodied identity during this movement. and there was a kind of rejection of biosec psychiatry that's also inherent to a lot of these movements and some of this work as well. But SBK was pretty unique in that they had an approach that, you know, was, and this is sort of happening in about a year and a half in early 1970s in Heidelberg. And this is in the hospital where, you know, some of the legends of biose psychiatry before World War II were sort of trying to discern, you know, the big day. between manic depression and dementia precocks, which like became schizophrenia. And so you have

kind of essentially all these moments where pathology is sort of iterated on and it becomes more complex than these taxonomies start to dictate access to care, but also life chances and survival outcomes as you start to hit the way that the state uses them. And so I think what's always important is to try and like go towards these critiques in a way that doesn't invalidate people's own, you know, pathologies that they might, like, form their identity around or they might use or need or, you know, in order to access accommodations or access their medication, but at the same time to sort of question, like, to what end are these things used? Like, is pathology right now used to get trans kids access to care? Like, absolutely not. Pathology is being used to, like, arrest access to

care in that situation. What you have, you know, in the context of, like, my disease, which is like a vascular autoimmune disease, right, is that pathology becomes like the reason that my insurance company pays for my medication, right? It's not, it's not this kind of like identity that I embody. It's more of like a billing code that I leverage in order to like get my maintenance medications. And so I think that there's a sort of fine line that typically on the left, we don't tend to walk of like finding a way to like have these critiques of how pathology is leveraged by the state and how it's leveraged in particular to sort of deny people access to all sorts of things if we're thinking about like the way that sort of mental illness as a frame

in the context of employment or in the context of sort of declaring that you've got access or accommodation needs like the kind of whole issue of like disclosure in the context of employment right is part of this as well but sort of finding ways to also like have that critique embrace people who do like, for example, like myself who like kind of require medication of all kinds. Like we can critique to what like end also the pharmaceuticals have been developed without saying that we can just like throw them all in the trash. And I think that that nuance is really, you know, something that like was really being developed in the 70s and was, you know, obviously like there are a lot of like spicy takes on either side. But this conversation kind of like in the 80s,

it kind of fell out and it kind of just became. this very new agey like mental illness isn't real and and sort of the social model of disability is all about physical disabilities and not chronic illnesses. And so I think we've just had this, you know, like essentially 50 years. We won't have ADHD under communism. Right. Yeah. I'm sort of like having to like unlearn kind of like all of the bullshit and pick back up where we were sort of in the early 70s, the left to sort of be thinking through pathology, not just in terms of a kind of individual framing of identity, but in terms of a critique of like state power as well. Yeah, and developing a model of when someone says, I need help actually giving it to them.

Yeah. Which would deal with all sorts of like mental issues, gender transition. I mean, things where it's like, we don't need to ration these things. You talk about like an austerity mindset that comes into it where we need to ration care under like socialized medicine and under health communism. It's, no, we'll get you help. We'll feel. figure out what it is you need, and we have this capacity to actually do that because of all the benefits of modernism. Yeah, it created the factories, yeah, it created the hellscape we live in now, but it's also created the capacity to actually provide help for people who need it. Yeah. I mean, to throw it back to the Reddit example again, as you all were saying, like,

I don't see any technical reason why this person should not have library access. The only reason I could think of is like a vendor being a shithead or they're being arbitrary rules. Yeah, it's like these are arbitrary rules of like intellectual property and, you know, this kind of like commodity structure and then not like resource constraint issues, but we talk about them as if they're sort of naturalized. Yeah, like they sprang out of the ground. I did want to talk, we're coming close on time. I don't want to keep you too long.

I do want to talk a little bit about the ADA because you said a few things about the ADA that really interesting to me and about the reactionary and reactive nature of the ADA and where you talked about Marta Russell and the symposium of essays coming out with the LPE project. You want to talk about that a little bit? Sure, yeah. They actually all came out already. So this was six essays on the work of Marta Russell and the anthology of her work

that Haymarket put out in 2019 called Capitalism and Disability. and she is a lesser known Marxist theorist of disability who was active kind of in the 80s, 90s, and early 2000s, but her writing was really sort of contextualized within the anti-war movement, like the sort of during the Bush era, right? Which is like a very kind of, it's a moment where you're kind of in this landscape where you're a couple years out from the victory of the Americans with Disabilities Act, which happened in 1990. and that was this kind of huge legislative battle that had been the culmination of like 40 years of policy lobbying, right? And so Marta Russell has a very, very early, very on point critique of the Americans with Disability Act that she's levying quite quite quickly after its passage because the problems with the kind of framework for access were evident, you know, throughout the process of sort of negotiating the bill. It's a fundamentally actually quite conservative law. And there are, you know, very mainstream legal scholars like Sam McEnstos who have written papers like the ADA's welfare reform.

Or you're sort of just looking at the bare legislative record, right, of like what was discussed on the floor of Congress in the context of passing this. You know, there was a lot of sort of framings that, you know, yes, in some sense, this was attractive as a law because it was being sold as a way to, get people off of welfare and get those disabled people working and into the workforce. And Marta's critique was not welcome. You know, this kind of moment in disability organizing was really centered around kind of realizing this promise of enfranchisement within capitalism. And so it's really idiosyncratic work for the time period. And I think for that reason, you know, it wasn't something that really became central in disability studies.

Like if you go and you're doing a disability. studies master, like you're never going to hear of Marta Russell probably. I hope that that's going to change. And I hope those citation practices change in the next 10 years. But, you know, essentially she died in 2013 and hadn't been working for a couple years when she died. And her critique is basically that, you know, this is a free market civil rights law. And that in one sense, it created a pathway for disabled people to work. But in another sense, it created simply a sort of layer of commodifying, you know, workplace accommodations and essentially saying that the only conditions upon which, like, disabled people should and could enter the workforce is when it

didn't present itself categorically a burden to the employer. And so you have this kind of fundamental relation that's set up within the sort of text of the law itself that really shapes, you know, how disability exists as a phenomenon within the United States, like culturally and legally and socially. And so what we were trying to do in this symposium with the Law and Political Economy Project is to bring people together who are thinking about political economy already,

who maybe hadn't worked with Marta Russell before, and to, you know, spend a year reading and discussing and thinking about her work and then working on these short little essays. So, for example, my collaborator on Death Panel, also amazing author, Jules Gil Peterson, who wrote the book, histories of the transgender child.

Highly recommend you read it. It's a great, great book. Jules' piece was taking Marta Russell's critique and working that into a kind of idea that she's been thinking about and writing on about the kind of way that the state is constructing itself as cis right now, this kind of idea of like a historical assertion of like a state gender being sort of official. And that this kind of gender binary, which hasn't like historically been a kind of function of how the state constructs itself is now being sort of levied as if it's like part of

textualism and it's been there since the constitution and this is kind of part of the idea of like trans kids being new somehow or this scary new viral phenomenon that's just you know quote unquote exploding all around us and you know jules's work is fucking awesome because it's basically like no that's all bullshit and trans kids have been around for a very long time and actually like you know, this kind of idea of it being like a kind of novel phenomenon is, you know, essentially like a construction that exists in order to reinforce the, the authority of medicine over trans people and an assertion that we don't sort of, we can have like state control over a quote unquote undesirable population.

And this is the same sort of like way that these eugenic frameworks are like applied to disability conceptually as well, this kind of eugenic framework. of like the state needs to have verification and control over these populations, less they, you know, explode in some sort of capacity. And these are like fundamentally sort of both austere, also hateful and like eugenic phenomenons that I think we're sort of seeing resurgent politically right now. So it's just like a reminder why like Marta's work is like really worth kind of engaging with and sort of why like we have to just kind of put.

beyond identity critiques towards like building a material politics. I'm obsessed with this idea of the state having a gender and like viewing like trans, like health and body politics vis-a-vis the state like in those, like, oh my God. Like when Justin was talking about him getting hard eyes, I was like, oh. I love giving things gender. Like force it on everything. It's fun. It's our new favorite game right now.

It's our favorite game. You have a gender. You have a gender. Yeah. Yeah. But. Well, you would like Jules' work. I highly recommend.

I should look into it. Yeah. I did listen to the episode. I think it was the first episode, Jules, was on your podcast as a permanent guest. And that was the taxonomy thing. Yes. That was Jules' first appearance as a full panelist, which was awesome. We did an episode on the recent decision in the Fourth Circuit Court to allow gender dysphoria.

as a qualifying impairment under the ADA. And the context for this was that this is a trans woman who had basically been tortured by the state prison intentionally both doing like an invasive exam that was absolutely unnecessary and humiliating, but that was done in service of like her health. And then she was denied access to care and her medications and put in a men's prison.

And so part of this sort of framework is a legal, strategy called like the disability frame extension where you sort of try and see if we can use laws like the ADA in order to, you know, seek remediation for moments where like the state sort of goes ahead and asserts itself in terms of like being the arbiter of like who is like a kind of truly verifiable trans person and who deserves to be in which prison and this kind of like process of state sorting and authority, which is obviously always sort of located in like the state's reliance on medical authority as well. And these are two things that go hand in hand. And I mean, that episode is awesome because it's like both a super nerdy dive into like what the ADA is. But also I

think one of those beautiful moments where, you know, it's just like the best, the best times on on death panel are like when we have awesome people on who we're thinking with in real time. And that's what's been like just so great having Jules as a as a full member. Because it's the kind of analysis that, like, you can only, like, build by, like, working with other people. None of these things are, like, anyone's ideas themselves. These are all things that we build together. Yeah. I think that's been a theme for us is building on concepts as they go.

And I'm sure we're going to reach out and try our best to charm Jules into coming on and talking about taxotomy of trans. Yeah, it's like you said, like, one of my, like, Manchurian candidate, like, sleeper terms. It's like, oh, taxonomy. Well, we just did the metadata anarchy thing. Yeah. So I think it'll, we need to,

we need to keep that as a theme for a little while and see where it goes with us. I feel special. I think it makes sense. I think it's a good new thing. This is like season, season two. Like, season one was like, why liberalism and libraries is bad.

Season two is going to be a metadata anarchy. Fuck yeah. I'm here for it. Reak havoc with your poetry. is the tagline. Yeah. That would be great. Do you have a moment to respond to a DM that we received?

I sent it to you earlier, and I don't know. I didn't get a response. Oh, this is the HIPAA one. Yeah. So what were your thoughts? We've been hanging on to this for a while because we haven't known what to do with it. Do you want to read it? I have like a couple thoughts on it.

I, unfortunately, I've got no good answers for this person, but I have some good bitching. I can't read it, word for word, but I can give a summary, so give me one second. So this is a person who wrote into us and said they're a disabled person, and they got an email that they sent to us that said, they'd obviously reached out to someone about teleworking and wanted to know about their state guidelines, and they wanted to talk about the family's first COVID leave. And the quote here is, having a medical condition is not a reason for teleworking so you can either continue to telework one week a month or you can apply for a COVID leave. And then they said, according to HIPAA rules,

you shouldn't be talking openly about your medical condition. And it's good practice to keep medical information, conversations private, and just among the staff person, HR, and the supervisor and the medical provider. And if you have any other HIPAA questions, ask HR. And that's basically where we left. I asked for a follow-up, because this was a while ago. Nothing, nothing in time. I mean, fuck. So what does HIPAA say about this? I mean, so, you know, HIPAA technically, it's in some capacity, it's meant to be able to be something that you can invoke to sort of not have your private medical information shared over the phone, for example, with people you haven't authorized. But, you know, it doesn't prevent providers from selling your medical records de-identified,

which can be very easily re-identified too. So, you know, it's, it's one of those laws where it's kind of like, it exists like the ADA in theory. Like, oh, there's HIPAA police who are just going to come and they're going to like give you a HIPAA violation for violating my HIPAA rights. Like, that's never going to fucking happen, right? There are HIPAA police. There are post office police, but if they show up, you are fucked. It's one of those police departments So like if they show up they are fucking getting you I mean abolish the cops especially the postal cops right

Yeah exactly I want to salute my post office worker every time they come by And I just feel bad that that's not a thing that we just do I mean sorry go ahead No it's all good This is the kind of idea of like Sorry your private health information that I've forced you to disclose in order to like request a comment during a fucking plague that's in the fucking air. I'm sorry, it's a viral respiratory disease that's all around us and all in our

workplaces and everywhere. And to say, okay, you've now voluntarily disclosed your illness or your medical condition or your diagnosis in order to basically beg me, like the representative of your employer, for the bare minimum amount of access, something that's like completely doable. but that, you know, we don't like to do because it could encourage things like malingering and, you know, gosh, how could we make sure that our workers are efficient if there's not someone there supervising them and keeping an eye on them all day and looking over their shoulder, of course. But this kind of idea of like, oh, and beyond that, because of HIPAA, like you shouldn't be even disclosing this to me is like adding fucking insult upon injury. It's one of those moments where it's like, so. evident how inconveniencing it is for people to sort of find out that you have a chronic illness

or you have a diagnosis. And it's an experience that I think anyone with any kind of label actually is probably had at least once or twice, you know, this kind of moment where you're like, yeah, you know, I'm really sorry, but I am X, Y, Z. I am fucking sick. And I am like someone who still deserves access to the same space. And no, like, HIPAA does not dictate that I should, like, be more polite to you and shut the fuck up about how I'm sick because it makes you uncomfortable. I mean, it's one of those terrible, terrible things where you kind of have this, like, right to privacy distorted as, like, a means of avoiding things that people would rather not talk about in the workplace because it's not appropriate or whatever. And, you know, that's what

they'll say. And then, like, six weeks later, they'll be like, oh, that job that you were applying for, actually, like, we got rid of that job. Like, we're, we're not hiring anymore. Or, oh, you know, it's not that we're firing you because we found out that you're sick. It's just like, could you, like, have, like, fewer emergency surgeries going forward? And then they fire you six months later. And it's, it's one of those things where, of course, the whole time, like, you know, you're making them uncomfortable. You're making the manager feel bad because you're the one that's sick and you're the one that's imposing on everyone else. And it's like these fundamental frameworks rest on the idea of one that like some kind of healthy

person exists, which is not true. And that's basically what our book is about, is the idea of health is bullshit. It's a kind of aspirational, unattainable thing because it's a commodity, right? It's not an intrinsic quality of like who you are as a human being. But, you know, it's part of fantasy where people are like, oh, I'm healthy. And that's the way of sort of separating themselves out. Like, oh, you know, us versus them. You're sick over there. Don't tell me that you're sick. I don't want to know that you're sick because it's going to change the way that I think about you. And it's like those kind of conversations that, you know, I don't know, people often call that kind of stuff like microaggression. It's like, no, these are like just fundamentally like just threats.

These are just verbal threats. It's not even aggression. It's just like, be quiet or else. Like stop talking about this. I'm like here in the background like going super say it. Yeah. Oh boy. Yep. All that happened to me. Exactly almost. I'm sorry. Yeah. No. Like it's like it's real. People don't these systems like, you know, especially like librarians already got enough shit to deal with about our labor being exploited. And then on top of that, you know, having our. our bodies and our minds exploited and worked. I mean, every laborer, this is, every worker, this is true. But, like, we had, we had an episode with Fabazi E.tar, who is the scholar who came up with

the concept of vocational law and, you know, talking about how, like, literally librarians are asked to die the profession, like, capital P. When librarians, like, were some of the first to go back into, like, public librarians, especially like into the workforce, like how soon after COVID started? Oh, right away. Yeah, right away. And like I think all of us have heard, you know, on library, Twitter, I've heard stories of like librarians like dying fairly early on like in those first waves.

And so like already we get asked like to do the stuff. And then behind the scenes like, you know, I'll say that like a lot of librarians, there's a high percentage of us that I would say are like neurodemeanor. divergent to some degree. I know a lot of technical services librarians who have autism or on that spectrum somehow, which I know that in and of itself, like I listen to Anders, like is its own complicated, like political diagnosis. But, you know, like I have like chronic pain issues. Say hi to, this is King Arthur. Arthur, you're going to help. A lot of us have like, you know, I mean everyone has health issues. That's, you mean everyone's had health issues the entire time? Yeah. I'm sorry. I'm just

friendly at this point. I was just like my like mind blanked out and like my eyes like rolled back in my head. And I'm like, oh, I have to smash something. Yeah. I mean, just being, being your friend while you were going through all of that made me realize that like I will never ask for accommodations at a library job because it can only be used to punish you. In what situation would a supervisor say, oh, these accommodations were great. They made Justin such a better worker. Like what supervisor would think to say that. But they could think to say Justin failed to send an email about how he can't do the thing that we already did the accommodation for, but it's extra work for disabled people. It's like you got a list, you got a new checklist of things you had to do in order for the accommodation. The university

already gave you. But then it was like, no, do more work to keep the accommodation. If you don't, those are all strikes against you in your annual evaluation. Like, I'm a shit. I'm a, I'm a like lazy as fuck. I like get drunk in the middle of the work day when I'm working at home. I mean, and nothing has ever been bad said about me on any of my work evaluations. But if I had like a list of other rules about every time I had to email my supervisor because like I couldn't drive to work that day because I have a severe panic disorder, no, that wouldn't work. It wouldn't happen at all. Yeah. Well, I mean, I think it's it's one of those sort of things where if we think about, you know, the kind of thing, like, really the problem is we need to raise awareness for mental health

diagnoses. Like, we just need more people to be aware, right? Like, that materially doesn't do anything to address the fact that fundamentally our entire political system and the entire legal structure with which we, like, manage disability and employment, is oriented around the idea that accommodations are a burden and that they can only be accommodated up until a point, and that there are things that are intrinsic to the individual. And so this is like one of those moments where it begins to tie into this kind of idea of like the proximity to surplus being a very blurry line, right? Because part of what, you know, separates me from you all is that I've been like certified that I'm like a valid non-worker. Like because I'm too sick and I can't see well enough.

I had to go through a process of vocational decertification where I sat with a judge and a vocational expert who had a big book with a bunch of codes in it has not been updated since the 70s, by the way, what types of jobs are in there. But that doesn't stop them from saying, well, it looks in my book, like it looks like you could be cashier number two. And I'm like, okay, well, what does that job entail? And they go, well, it's a seated cashier position. at like a grocery store, you know, where you'd only be handling cash. So like the credit card machine

wouldn't be a problem because, you know, you can't see well enough to use the credit card machine. And I said, well, would it be reasonable to assume that my employer would accommodate my blindness by having someone stand over my shoulder to make sure that I was counting the cash right? Because I can't tell the difference between a 10 and a 5 and a 5 and a 1. And they were like, oh, yeah, I guess you're permanently disabled. And it's not like, oh, you're finally, you know, we're sufficiently sure that you're sick enough to, you know, deserve Medicare. No, it's, no, we're sure based on these kinds of arbitrary rules that you're unemployable and therefore only then once you're certified a non-worker, or if you're under 65, are you entitled to, you know,

the only kind of socialized medicine that we have that is becoming increasingly privatized. in the United States. I mean, this year is going to be the first year that the majority of Medicare plans are private Medicare Advantage plans that are just bullshit, extractive plans. Under the Biden administration and under the Trump administration, I've been on SSDI under both. It was a shit show under both. But I am getting more mailers now about Medicare Advantage than I got under the Trump administration. And it's fucking, it's so aggravating. There's no, there's no benefit to Medicare Advantage. The networks are smaller. The coverage is worse. It's more expensive and it's designed to just, you know, make a lot of money on government subsidies. It is the

definition of waste, fraud, and abuse. But this is a concept that we don't apply to systems of extraction where it's appropriate to apply them to. We apply this to individuals saying, no, it's, you know, the problem is me. I'm waste fraud and abuse. You know, I'm a fucking drain. I'm a burden. And therefore, like, it's the right of a private company to try and extract as much, you know, capital for me as they can. And that's because I've been certified as deserving to, you know, be in that small sliver of people who are considered, you know, certifiably not workers. But, you know, it's one of those kind of moments where it's, it, of all the things that I did to my body over the years that resulted in me being so sick at the end of the day that I became decertified as a worker.

Like, would any of that have happened if I wasn't hustling to pay my insurance premiums and pay for my medications every month? You know what I mean? It's like, so yeah, in some sense, like, you know, we can't separate pathology and the ideas that we have about the identities of illness and disability from capitalism because fundamentally the systems of capitalism do define. like many of the ways that we arrive kind of at these identities of surplus, of sick, of disabled. But it doesn't mean that it like, you know, wholly makes them real.

But I think this is something that, you know, for a long time, we've kind of been tied up into this very romanticized ideal of the kind of perfect, healthy worker, right? Where you have the kind of sort of idea that like the union movement is going to sort of come out of like the blood, sweat, and tears of sort of working above and beyond. like the hours that you're working to unionize on top of everything you're already doing at your job. And these are like sort of some of those frameworks that I think the left is just like taken as common sense without taking a second to be like, well, wait, one, like, could we be building solidarity beyond just the workforce? You know, maybe this is kind of like a kind of thing where like, do we

really want to like be putting all of our eggs in one basket, which is a basket that essentially is sort of leaving out people who are not. non-workers, people who are outside of this workplace, right? And like, sort of how do we balance the kind of needs of like immediate term, you know, small collectivities with like the need to build these larger collectivities, right? And I think that's why if you kind of think about, for example, Medicare for all in terms of being able to support union movements in the same way that like IWW supports individual union movements that are happening in individual workplaces by being a kind of other organizing structure that's a little bit bigger and that's sort of

trying to tackle membership at a different level. I think these are the kinds of ways that moving forward as a left, we can start to sort of build like a need not for awareness, but for sort of more pointed critique that can begin to sort of slice some of this nuance and be able to sort of come into these like conversations around like workplace accommodations and union organizing that doesn't just sort of redound to these like, uh, these kind of ideas of like disabled people are burdens because of the need for accommodations because that's that's a fundamentally sort of capitalist ideology. You want to join our podcast?

I don't know. It's really good. That's a really, I'm going to have fun editing this. We have gone a little long. Well, it's been, it's been nice talking to you. Yeah. Is there anything you want to wrap up with in terms of like extra plugs, anything think you didn't mention at the beginning or any closing thoughts? Well, if you buy the book, please share it. You know, I'm a big believer in, you know, ideas not being property. So steal the book, read the book, however you can. We don't give a fuck.

You know what I mean? And we also have a great reading group in our Discord server for our show that is going to get started soon. And the reading group is going to be going through Health Communism, chapter by chapter led by one of our awesome admins, Lola, who's really great. And we're also going to do, I think we're going to do like a nice tribute to Aaron Schwartz in a January reading group because it'll be 10 years on the anniversary of his death in January of this year. So, yeah, I mean, if you get the book, make sure to share it also. Don't keep it to yourself.

Yeah. And have your library buy it. And yes, Oscar demand your library by it. Yeah. I was going to say, goby, let me buy the book. It's not letting me buy the book yet. Oh, yeah. It's not letting me buy the e-book. We did, I think, sell out our, we were in a second print run already, which is awesome and overwhelming.

But it might be hard to find the hard copy for a while in the United States. But I can send you a link to a tweet thread I did with like independent bookstores who have it. But also a lot of libraries have ordered it. So if you can't find it now, you should totally rent it. Check it out. Yeah. But also let me buy the ebook version, Kobe. Please let me buy it. It just says it's not published yet.

I don't know why. I think it has to do the platform, probably some delay, but I don't know how long the delays. Maybe there's like an embargo. It's not an embargo. It's just library vendors suck. That too. I mean, some, I maybe I guess there's multiple vendors because I know some people haven't had problems with it so far. And got it way early. Yeah, we could.

Well, the e-books, too, and some of the libraries gone them like a month ago. Library licensing is bullshit. It's a hell zone. I'm not talking about it. Good night.