Friday, October 15, 2010


I am trying to understand the political economy of the healthcare industrial complex, and the nursing home industrial complex. 

I am doing so to understand the broader dynamics that are currently determining my work life, and my relationships with the residents at the home I work in. 

I am constantly reminded of the temporality of my body's abilities, and really like how disabilities liberation framework talks about abled bodies as merely temporarily abled. Part of my resentment with my work is that the speed up forces me to contort my body in destructive ways, using my back muscles to substitute for safety and time. I see my coworkers exert themselves too and understand how we are all vulnerable like this. And how tragic it is that our exploited labor power will not even be able to be reproduced in this country since many of my coworkers will either not receive appropriate retirement and healthcare, or will return home, or will die because of these work-induced disabilities.This dimension of things makes me really interested in understanding Marxism, and reproductive labor, and labor power. 

I also am exploring and trying to understand disabilities liberation, and disableism, with an eye toward thinking about how my struggle for liberation as a healthcare worker, my desire to protect my body and the bodies of the residents, are all intertwined. 

I have felt that the language of safety for the residents/patients that is being used in nursing struggles is not enough, is not satisfactory. It talks about safety in a bland way -- not surprising given many of these struggles are led by the union bureuacracies in an ableist society. I hope to find models that integrate a healthier, more liberatory vision toward all bodies, with the struggles of the workplace. I think the healthcare workers' struggles present a concrete site for struggling around reclaiming liberatory aspects of technology and medicine, while discarding its harmful/capitalist dimensions.

I have been exploring a few articles and blogs that come at the issue from the perspective of the people receiving commodified care, people with disabilities (PWD) who are forced into nursing homes and undesirable/unwanted/damaging treatment.

Here's from Marta Russell: No Nursing Home on Wheels
She strikes me as some kind of social dem, sort of mainstream disabilities rights writer. I am learning alot from her writings and her references though:

On productivity, work and the displacement of non-productive bodies under capitalist standards: 

Not coincidently, the rise of the institution accompanied the rise of capitalism in Western societies. As work became more rationalized, requiring precise mechanical movements of the body repeated in quicker succession, impaired persons - deaf, blind, developmentally disabled, mentally impaired, those with mobility difficulties and others - were seen as less "fit" to do the tasks required of factory workers. They were increasingly excluded from paid employment on the grounds that they were unable to keep pace with the "disciplinary" power of the new mechanized, factory-based production system.   So it was that the operation of the labor market in the 19th century effectively depressed disabled people of all kinds to the bottom of the market.  As industrial capitalism demanded a standard worker body which would conform to the needs of production, disabled persons came to be regarded as a social problem and the justification emerged for segregating individuals with impairments out of mainstream life and into a variety of institutions including workhouses, asylums, prisons, colonies and special schools .

This reminds me of the prison industrial complex; Displaced, Surplus, Unusable Bodies = commodities

When a single impaired body generates $30,000-$82,000 in annual revenues, Wall Street brokers count that body as an asset which contributes to a nursing home chain's net worth. Though transfer to nursing homes and similar institutions is almost always involuntary, and though abuse and violation of rights within such facilities is a national scandal, it is a blunt economic fact that, from the point of view of the capitalist "care" industry, disabled people are worth more to the Gross Domestic Product when occupying institutional "beds" than they are in their own homes.

What happens to the disabled residents/patients, happens to the workers too

A rejection by both disability groups and workers of the corporate "care" paradigm means a rejection of the logic that human labor and disabled people's bodies must be reduced to commodities for sale - in order that someone can make a buck. 

Russell is arguing that nursing homes are remnants of this way of factory/institutionalizing PWD. That the better alternative is independent living with paid care work. I am thinking this through and trying to understand what this also means for workers who engage in that kind of care work. Women's labor/domestic labor/caring labor has historically been undervalued. In my work environment, the nursing home sweatshop I work in provides me with benefits and healthcare, which I wont get if I were to do home healthcare. More research!

1 comment:

  1. Hey Disparaged CNA, I have been reading a lot on slavery and the rise of capitalism in the US, and the prison industrial complex. It has been helping me think about disability too; that privitized nursing homes is a way for capitalism to make use of bodies that are no longer productive (like you and the readings you refer to lay out) but also that not all institutions under capitalism are productive or revenue...there are other functions necessary in a capitalist state. Speed-ups inevitable produce more disabled bodies, like you are experiencing and the authors describe, but I am thinking more that this is a problem for capitalism...just less of a problem than paying workers more, and caring for people outside of its system.

    Part of what has me thinking about this is reading about eugenics, and thinking about how after slavery new ways of enforcing racial heirarchy had to be established; a lot of the eugenics stuff on disability targets new industrial immigrants as well as people of color, to prove that disability was related to race. While eugenics has been largley debunked, those understandings of disability I think are still alive. I will share more on this when I have more available. For now I would reccomend Golden Gulag bu Ruth Wilson Gilmore and America's Johannesburg by Bobby Wilson.