Beatrice Adler-Bolton is co-author of Health Communism and co-host of the Death Panel podcast. She is a health and disabilities advocate. The conversation centers on the intersection of capitalism, health care, and disability rights. Below are notes from the video.
Capitalism’s Weakness in Health Care
Labor power as health: Adler-Bolton explains that labor power—one's capacity to work—relies fundamentally on health. Capitalism exploits health by commodifying labor power. Health is treated as a resource to be managed for the sake of productivity rather than a human right.
Environmental determinants: Health is influenced by broader social factors, such as clean air and safe working conditions, which capitalism often ignores. For example, a worker exposed to poor air quality cannot maintain health or labor capacity.
COVID-19 Example: Workers faced impossible choices during the pandemic: continue working while sick and risk spreading the disease or stay home and risk financial ruin. Capitalism disregards worker health unless it directly impacts productivity.
Commodification of Health
Insurance Industry: The health system, especially in capitalist societies, is shaped around what is billable by the insurance industry. Health care is reduced to codes, diagnoses, and treatments that fit the insurance model but doesn’t necessarily address broader health needs. Insurance also dictates what is considered medically necessary and what practices are considered evidence-based.
Commodifying Workers’ Bodies: Historically, labor power has been commodified in extreme ways. For example, in the past, workers' limbs were "actuarialized" and given a value when lost or injured on the job.
Pharmaceutical Industry’s Role in Health
Intellectual Property Cartels: The pharmaceutical industry, controlled largely by U.S. and European companies, limits access to life-saving drugs globally. Pharmaceutical companies prioritize profits and markets over health, which is evident in their control over drug patents and pricing. Despite the existence of lifesaving drugs, they are often inaccessible due to trade laws and corporate profits.
India’s Cancer Drug Incident: In 2013, India sought to produce an affordable version of a cancer drug, but the U.S. intervened with threats of sanctions, illustrating the global power of pharmaceutical companies and the U.S.'s role in maintaining the intellectual property regime.
Surplus Populations and Expendability
Disposability of Vulnerable Groups: Both the U.S. and Canada have treated certain populations—older adults, people with disabilities, the immunocompromised—as expendable, particularly during the pandemic. In Sweden, early COVID-19 responses led to older adults being denied care without family consent, reflecting how surplus populations are managed.
Eugenics Legacy: The idea of surplus populations is tied to the historical belief that certain lives are less valuable. Socialized medicine systems that ration care based on perceived worth, such as in Canada’s handling of rare cancers, exemplifies the commodification of human life under capitalist systems. Michel Foucault’s analysis of biopolitics in Society Must Be Defended describes how modern states exert power by deciding who gets to live and who must die.
Mental Health and Psychiatry
Pathologizing Dissent: Psychiatry has a history of being used as a tool to pathologize dissent and remove people from society under the guise of treatment. Psychiatry, like other forms of health care, has been shaped by capitalist imperatives to return people to the labor market. An inability to produce is considered immoral and something that must be corrected.
Carceral Sanism: Mental illness is often viewed through a carceral lens, where people deemed "mad" are seen as unsafe and dangerous. Many U.S. cities, especially in poorer states, rely on carceral institutions—prisons, psychiatric hospitals, etc.—for economic stability. This creates a system where marginalized bodies are economically valuable not as workers but as inmates or patients.