The NHS is often wielded uncritically on the left, reproducing a fetishised, nostalgic notion of its existence. Further, the NHS is intertwined with the left’s nostalgic fetishisation of the Labour tradition and post-war social democracy; Bevan standing over us as a great statue of socialism’s past, as someone we hope to emulate again one day. All of this is understood from an ahistorical, immaterial perspective that erases the way the NHS was birthed through the bloody exploits of the empire. Welfare and warfare coming together. El-Enany highlights how welfare ‘embodied the assertion of white entitlement to the spoils of colonial conquest.’ [20] Alfie Hancox provides a devastatingly lucid account of this in his essay, Lieutenants of imperialism: social democracy’s imperialist soul . Reforming the NHS within the confines of methodological nationalism would leave ongoing imperialist exploitation intact. Just as Bevan ignored this when he proclaimed that Attlees’s Britain had ‘ assumed the moral leadership of the world’, despite how his government spent several years violently repressing communist and anti-colonial uprisings in some of the bloodiest years of British imperialism. We must, as Shafi and Nagdee demand, ‘refuse the British left’s historical dereliction of duty: its compromise with imperialism and its rejection of radical internationalism.’ [21] Anti-Imperialist Health Communism

In Health Communism, Beatrice Adler-Bolton and Artie Vierkant first identify and provide an overview of the methods and ideology that have solidified into modern Health Capitalism.

Ethno-Nagleism is the Idpol of fools

S.G.: You’ve talked particularly about how nursing homes extract value from the people they are supposed to take care of. You argue that surplus populations are used to stave off broad reforms that would otherwise be destabilizing to capitalism. Usually, however, “common sense” argues that that the surplus population constitutes a twofold burden to society—that is, a eugenic burden and a debt burden. Historically, how has this rhetoric shaped arguments for and against socialized medicine in the US?

Huber was critical of the American model of psychiatry, especially the way it failed the lower classes. He saw capitalism itself as a hurdle to patient care, with the class system dividing patients and doctors, but also precluding access for those who could not afford it. The model of treatment he developed with his patients was called “therapeutic political education” a blend of anti-psychiatry and anti-capitalist politics (140). With the term “extractive abandonment,” we’re trying to give people a way of naming how health is constructed through logics that are carceral and extractive, not towards making your quality of life better or relieving your pain or curing you. Rather, there is simply an agreement that this economic relationship is going to pass through you, which is the result of discrete decisions at the structural level—not your personal choices. We’re arguing for a new theory of health and class that pushes beyond this disciplinary relationship in which the subjection of people who are not workers acts as a way of enforcing terrible labor conditions: so-called “health” is actually the primary form of labor discipline.We set the productive forces free and control the destructive ones. We exterminate what is inferior and increase what is useful....anyone who makes the slightest effort can see what’s waiting in the future. It’s like a serpent’s egg. Through the thin membranes you can clearly discern the already perfect reptile.” Beatrice Adler-Bolton and Artie Vierkant, Health Communism (London: Verso, 2022), 184. Emphasis original. This growth was mirrored and fed by pharmaceutical monopolies. State subsidization of pharmaceutical rights instituted the present role of capital “as defender of a global intellectual property regime”, enforcing the trade dependence of developing countries. The authors provide a densely-researched history of the pathologization of illicit drug use as a foreign social contagion and the privatization of licit drug production from the Cold War to the present day. They make a forceful case that resistance to this internationalist privatization requires an internationalist platform. “…[I]nternationalism must be an essential part of health communism if we are to achieve the end of capitalism,” the write.