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National Health Insurance must be a comprehensive and universal health insurance
Meilton 79, Sandra L.- JD "Cost Containment in the Health Care Industry: An Analysis of Physician
Reimbursement Under Medicare and the Implication for Future Regulation in the Health Care Field."
Dick. L. Rev. 84 (1979): 51.
National Health Insurance is defined as a comprehensive national plan for the provision of and
payment for health care. The primary goals include insuring that all persons have access to medical
care, eliminating the financial hardship of medical bills, and limiting the rise in health care costs.

Comprehensive plans are clearly defined – excludes single-service policies like the aff
Maeda and Beyer 16 – Jared Maeda, Susan Yeh Beyer, analysts in CBO’s Health, Retirement, and Long-
Term Analysis Division (“How Does CBO Define and Estimate Health Insurance Coverage for People
Under Age 65?” Congressional Budget Office, December 20th,
Health insurance policies vary widely, ranging from some that offer substantial coverage for a variety of
health care services to some with a limited scope or amount of coverage. Therefore, in preparing any
estimate of the number of people covered by health insurance, it is useful and important to identify
where to draw the line to distinguish policies that provide some type of comprehensive coverage
from those that do not.
An important function of insurance is to provide financial protection against high-cost, low-probability
events. Consistent with that notion, CBO broadly defines private health insurance coverage as a
comprehensive major medical policy that, at a minimum , covers high-cost medical events and
various services, including those provided by physicians and hospitals. The agency grounds its
coverage estimates on that widely accepted definition , which encompasses most private health
insurance plans offered in the group and nongroup markets. The definition excludes policies with
limited insurance benefits (known as “mini-med” plans); “dread disease” policies that cover only
specific diseases ; supplemental plans that pay for medical expenses that another policy does not
cover; fixed-dollar indemnity plans that pay a certain amount per day for illness or hospitalization;
and single-service plans, such as dental-only or vision-only policies.

Un-comprehensive coverage explodes limits – opens the door to tons of AFFs covering
single diseases and specific demographics and single services. Preparing against those
is impossible without generics, so letting their AFF in unbalances the playing field and
decreases the quality of all debates, including ones about the heart of the topic
because research time is finite.
The affirmative’s endorsement of fixing the ACA, using private health insurance
companies, and maintaining the private provision of care reinforces the ontological
protocols and economic presumptions of neoliberalism
Xavier 17 (Steve Xavier, blogger, activist, and writer, “ Is Obamacare Worth Defending ?” Resistance: A
Journal of Marxist Politics, February 26, 2017,
GOP members of the House seem in a state of disarray over the lack of a concrete proposal for a replacement for the ACA, with some vowing to
vote against any repeal without a replacement plan in place. Some
of the proposals being discussed by rightwing think
tanks would shift significant out-of-pocket expenses onto the backs of working class people while
giving more breaks to the rich. During the 2016 Presidential campaign, the Republican field of candidates all
promised to “repeal and replace” the so-called Obamacare health insurance plan. In December, Paul Ryan
assured the public that there ”will be a transition and a bridge so that no one is left out in the cold, so
that no one is worse off” As recently as a couple of weeks before the inauguration (1/3/17), Trump
spokesperson Kellyanne Conway promised that there would be a replacement plan, saying, “We don’t
want anyone who currently has insurance to not have insurance…” Mixed signals about the health care law have led
to confusion among the ranks of Republicans and have led to speculation about what will replace the ACA. In his Inaugural speech, the new
President failed to include to any mention of health care in his “America First” rhetoric. After a month of the Trump regime, no “alternative”
seems to be on the horizon and activists are mobilizing against individual members of Congress to defend the ACA. Members of Congress have
faced angry constituents at town halls and many legislators have refused to have public meetings with voters in order to avoid confrontations
with protestors. Trumphas decried the town hall protests as the work of “professional” protesters. Some
commentators have drawn parallels between the protests against members of Congress with the Tea
Party protests in the early stages of the Obama administration. People in the US often brag that the
US healthcare system is the best in the world. This claim may well be true, but the truth is that quality
medical care is rationed according to income, with the richest getting the best care and the rest of us
facing a confusing and unnecessarily expensive system . Despite the Affordable Care Act (ACA)
reform, which was supposed to address the question of the uninsured, some 29 million people in the
US remain without health insurance. During the Bush years, sentiment was building for a solution to
the crisis in health care costs. Advocates for a Single Payer system felt that the incoming Obama
administration would enact some form of single payer, but hopes were dashed when the final
product of Obama’s efforts emerged from the Washington meat grinder . Obama, formerly a
supporter of single payer, received more than $20 million in contributions to his 2008 campaign. From
Romneycare to Obamacare The ACA is similar to the plan originally proposed by Hillary Clinton during the

reign of Bill Clinton . It bears a resemblance to the privatized healthcare schemes passed under neo-
liberal regimes in Columbia and elsewhere and is very similar to the statewide reform passed under
Governor Mitt Romney in Massachusetts . When Obama was elected, his promise to reform health
care and make sure that everyone in the US was covered quickly evolved into something else . The
pressure of the private medical insurance companies made sure that there would be no “public
option” included in the final product . While the public option was included in the bill that passed the
House, by the time the Senate had completed its work, this notion had been stripped from the law.
Some progressive aspects of the law survived, like protection for people with pre-existing conditions and the extension of the time an adult
The ACA, or Obamacare, as the right wing quickly labeled it, has
child can remain on their parents’ insurance plan.

become an expensive failure . Despite the mythology among its defenders, the ACA is not an
improvement for all working families . The reform had the effect of cutting off the movement for
Single Payer, while acting as a bailout of private insurers . The reality of neo-liberal health care means
that some get decent coverage while others scramble to survive. The ACA keeps for-profit insurance
companies at the center of the medical care system . The ACA system is based on a sliding scale of
cost tiers referred to as the metal plans – bronze, silver, gold and platinum — in which the costs are
managed through differing plans based on varying premiums and out-of-pocket expenses . For example,
the “bronze” plan has lower premiums and higher co-pays while the “gold” plan has higher premiums
but offers more coverage options and lower out-of-pocket expenses . Lower income workers are
more likely to choose a plan with a lower premium, but their out-of-pocket expenses can be
prohibitive if a health crisis occurs . Premiums continue to rise, with a projected 24% increase in 2017
and health care costs continuing to rise across the board. The massive overhead due to administrative
costs of private, for-profit, insurance companies continues to contribute to the high cost of health
care. We should continue to defend the progressive aspects of the ACA. As socialists, our support must be in terms of
how we see the health care debate . First , we support health care as a basic human right . Everyone
should have the same access to quality health care. Second , we want to remove the profit motive
from medical care . The toxic role of private insurers, healthcare corporations, and pharmaceutical
manufacturers serves to keep vital treatment from the vast majority. We should be fighting for a
single payer system to replace the current system . Of course, the progressive aspects of the ACA, like coverage of pre-
existing conditions and protections for women’s reproductive health, must be preserved. That said, the preservation of profit-

centered healthcare will only continue to undermine any advances made by working people . Pro-
capitalist politicians, both liberal and conservative, will argue that taking the profit out of healthcare
would stifle innovation . The staggering number of vaccines, cancer treatments and other medical
breakthroughs made by the Cuban healthcare system stands as a sharp repudiation of the assertion
that a profit-driven is best for patients and providers. Working under conditions of scarcity, and under
siege by US imperialism, the Cubans have managed to build a system of medical care unlike any
other . The Cuban people don’t have to worry if they will be able to afford a doctor or vital medicines .
The Cuban government has famously sent medical aid, including doctors, to war torn regions and to the care for the victims of natural disasters.
The only real
Under the Sixth CCP Congress reforms the Cuban health care and educational systems have been undermined.

beneficiaries of a for-profit healthcare system are the rich. We must fight for an alternative that sees
health care as a basic human right . The increasing proletarianization of health professionals crea tes
the potential for an alliance of healthcare workers with a mass movement aimed at winning a system
based on human needs . Working conditions of nurses and other personnel, including doctors, have
eroded, with longer hours and patient loads in excess of what is considered safe for either the
workers or patients. Doctors are much more likely to be employees of corporations than self-employed practitioners. Saddled
with debt from student loans and working under increasingly poor conditions, doctors and nurses
should be natural allies of a movement for free universal health care. Health care for all will be won
through the mass struggles of working people . Depending on politicians of either ruling class party or
on an NGO-style method of passive mobilization and lobbying won’t win the fight. Winning single
payer is only a first step. A national health insurance system would still leave private, for-profit,
healthcare corporations in the mix . The goal of socialists should be to bring the entire healthcare
system under public ownership — neighborhood clinics, hospitals, and the pharmaceutical industry
— and build a system based on human needs, not profits .

The alternative is to reject the neoliberalization of healthcare—comparing NHI

proposals against the metric of anti-capitalist health provision is crucial to effective
CPUSA 5 (Communist Party USA Healthcare Commission, “A United States Socialist Vision of Health,”
Current State Of the Struggle for Healthy Families in the USA; And What to do About It The outright greed of the health care
industry in the United States generates huge corporate profits on the one hand, and at the same time increasingly
excludes access to quality health care for millions of working families across the nation. Untold misery and
uncounted premature deaths are left in its wake. These two processes have become inseparable in the United States.
They have resulted in the highest health care costs in the worldboth in terms of the cost of health care relative to the
rest of the nations economy, and in terms of the per-person cost of health care. A significant portion of these costs are in
actuality profits. At the same time, the health of American families, compared to the health of the people of all nations, has been steadily
falling behind for decades. The World Health Organization continually lists the United States at 37th of all nations in the world. The class

and race aspects of the U.S. system are dramatic . If you have the money, you can afford to pay the excessive out-of-pocket
costs for expensive health services like chemotherapy, MRI tests and related diagnostic and treatments. The fancy technology that health
industry power brokers proclaim is often reserved for those with financial resources. The racist edge has been proven over and over again. A
few simple statistics prove the point: African American males life expectancy is just 61 years old, well below the normal retirement age; and
Monopoly is the
infant mortality in African American inner cities is two to three times greater than in more affluent parts of U.S. cities.
central feature of the U.S. health care industry. During the last several decades control over vast health
resources have been concentrated in the hands of fewer and fewer corporate entities. Hospitals and nursing
homes are owned by the hundreds by these entities. The old health insurance companies have grown to become diversified international
corporations that both sell health insurance on the one hand, and provide health care through vast holdings of hospitals, clinics, and health
maintenance organizations (HMOs), on the other. They are working both sides of the street, so to speak, in a way that has no precedent in the
industry. These health industry giants have come to dominate entire communities, and increasingly entire regions as monopolies. The
invasion of communities by these corporate health care giants has resulted in a series of destructive,
sometimes deadly, changes in the capacities of communities to care for families. Where there used to be a large number of health
facilities, expanding hospital chains often buy up both public and private nonprofit hospitals in communities. Sometimes they convert them to
for-profit hospitals as an acquisition to their holdings, and sometimes they simply close them down. In New York, investor owned
hospitals are not allowed, so the massive voluntary, not for profit hospitals are being combined as if they were for profit. These hospitals act is
if they are profit generating. The guiding principle is todestroy the health services competition. Typically public and private non-
profit hospitals provide a higher proportion of charity care, so when these facilities are gone, it is tremendously destructive to
low-income and racial minority families . Corporate hospital chains also have a long history of eliminating less profitable medical services such as emergency rooms, labor and delivery and burn unitsan unequivocal act of profit maximization and the destruction of critical community health needs in one blatant action. In rural areas, this regional economic monopolization is leaving tens of

thousands of people with no hospital and physician access. After all, these companies feel that if a hospital or physician is located with a few hours, this is good access. Monopoly power has never been greater, In fact, for the first time in our nations history, these financial and political power elites have one of their own guiding the United States Senate. U.S. Senator Bill Frist, MD, may be a medical doctor, but more importantly, he is the heir, and financially linked to the Hospital Corporation of America [HCA]. HCA is the largest for-profit hospital chain in the United States.
There is desperate and despicable self-interest in HCAs leaders seeking political power. Their executives have been found guilty of Federal Medicare fraud, with a number of them doing federal prison time. They are in league with corporate scofflaws like the federally indicted Richard Scrushy, the former CEO HealthSouth. HealthSouth is the largest U.S. chain of outpatient surgery, diagnostic imaging and rehabilitation centers. It was founded by Scrushy in 1984 and has some 50,000 employees and about 1,700 sites in all 50 states and overseas. He was indicted for falsifying
the books to enrich him by $2.7 billion. HCA and HealthSouth are the poster children of Profits in Health Care, a system which the Republican Party and too many Democrats are committed to preserving. The White Houses obsession with trial lawyers and eagerness to dump what Bush refers to as frivolous law suits including medical malpractice suits are directly linked to these fraud cases. This is the only country in the industrial world that has a medical malpractice problem because we are only country without a national health program that takes care of peoples medical
needs. The Institute of Medicines report that over 100,000 patients die each year in hospitals has these corporate scofflaws shaking in their boots in fear of legitimate negligence suits which are needed to help victims of medical errors and neglect to put their families back together after massive hospital bills. [The other leg of this anti-law suit attack is the asbestos suits facing corporate scofflaws like Halliburton, Vice President Cheneys company. Bushs recent attack on asbestos law suits is gruesomely anti-victim and a direct payoff to his contributors] Profits Dictate Health
Care The invasion of profit-maximizing health maintenance organizations has forced entire families to abandon their health providers of choice for someone on the list. The health care of families is fragmented when different members of a family fall under different plans, and are forced to use different providers. Too often patients with complicated treatment regimens, such as chemotherapy, are forced to change physicians because of a change in the list. In Medicare, the sudden collapse of large numbers of entrepreneurial HMOs, spurred on by the privatization of the
federal Medicare system, has left untold hundreds of thousands of families in debt or bankrupt from unpaid medical bills that were supposed to have been be paid by the HMO. Moreover, even when bills are paid, elders, among our most frail, suffer discontinuity of, and lapses in, care, as they are shuffled from plan to plan, and doctor-to-doctor. There is little profit in low-income communities, which are disproportionately minority and/or rural communities. These communities are often entirely abandoned by the health care industry. Families in these communities are
forced to use abusive and ineffective Medicaid mills, or the vastly overcrowded and poorly equipped offices of sliding-fee community clinics. Often they simply do without care at all, relying on ineffective over-the-counter drugs, or tailgate venders of fraudulent or outdated drugs. The soaring costs of health care have pushed it to become in recent years the single most frequent cause of personal bankruptcies in the United States. This has been reflected in decades of health insurance cost increases that have consistently outstripped the annual inflation rate. Employers,
who have to use insurance carriers, respond to this dent in their profits by shifting more and more health related costs to workers, while forcing workers to accept increasingly inferior plans. Workers are also forced to choose between much needed wage increases and health benefits. Every year growing numbers of employers have simply abandoned health benefits altogether, often with disastrous consequences for the workers and their families. There are approximately 45 million people in the United States with no health insurance at all. Tens of millions of additional

tens of millions of family members who do have health insurance cannot afford the co-
people spend some part of the year uninsured. Finally, additional

payments and deductibles, and are therefore effectively barred from adequate health care. The
safety net is seriously shredded . Millions of Americans have Medicare health insurance coverage, but physicians are not required
to honor it. Medicare and Medicaid are increasingly becoming unredeemable vouchers. As a result, while a community may have an adequate
supply of health care providers, few if any may be willing to see a patient with Medicare insurance, because the provider could see a patient
with private health insurance and make much more money. Furthermore, Medicare does not cover the cost of drugs. Recent federal
prescription drug legislation purports to address this serious omission, but the legislation does not take effect for several years even then it
is so plagued with giveaways to corporations , and inferior coverage , and incredible cost overruns ,
that its effectiveness is seriously in question. Attacks on Medicare and Medicaid, as weak as these insurance systems have
become, are very real cynical efforts to abolish altogether meaningful health care for seniors, dependent children, the working poor, and
disabled. In addition, hundreds of thousands, perhaps millions, of additional workers and their families are losing health care coverage in the
economic crisis. Meanwhile, hospital and public clinic closings continue unabated. These are life and death struggles that must be met with
militant mass action. Medicare and Medicaid Since their inception in the mid-1060s, Medicare and Medicaid have been increasingly privatized,
with grave consequences for cost containment, equity, efficiency, quality and continuity of care. The CPUSA supports the demand
to refederalize the Medicare and Medicaid systems, a demand which engages broad sectors of the nation in the struggle. It adds an anti-
monopoly and anti-corporate element that every public poll indicates would be very popular among the electorate. In addition, the logical
trajectory of this reform leads directly toward the goal of
a completely public sector n ational h ealth s ervice. The
popular rallying cry for the struggle could be, Medicare & Medicaid Funds for Health Care, Not Profits. Or, Healthcare
for People, Not Profits. National Health Service The Party has continually supported popular struggles and
legislation that pave the way for, or would establish, a national health service (NHS). The uniqueness
of a national health service strategic direction is that this form of socialism can and does take place
within the capitalist system. The NHS in the United Kingdom remains the jewel of health services despite its underfunding problems.
Raising the banner of socialized medicine sends the kind of message that a Party of Socialism needs to communicate.
Also, this demand with its logic and realism is the kind of anti-monopoly program that can combine with other peoples struggles such as
increased public housing, jobs, etc. Key elements of a national health service include, but are not limited to: 1. the
elimination of profit from all aspects of health care and public health measures; 2. payment for all health care
including true public health measures from steeply progressive taxes ; 3. the delivery of all health care and public

health services from publicly owned hospitals and community health facilities federally financed via global
budgeting; 4. the delivery of all health care and public health services by salaried public health care providers
and workers, who earn a living wage, have job security and full benefits and who have the right to organize; 5. the
elimination of all financial barriers to access to health care; 6. a tiered and publicly system of governance relying on local,
regional, and national elected boards; 7. a national system of quality assurance and guaranteed services; 8. a regionally based system of
publicly owned health care worker education and research facilities which have no financial barriers to access and no ties to corporations.

is against these anti-monopoly, pro-people principles that all n ational h ealth i nsurance and service proposals
must be judged . Insurance Based Systems: Single Payer/National Health Insurance National health systems based on
reimbursement are insurance systems and will inevitably have major gaps in services . These gaps are usually

filled easily by people with money, but not by working class people. The racist edge will be apparent ,
as it is in the Medicaid and to some extent the Medicare systems. The Party cannot fully support n ational h ealth

i nsurance schemes that funnel public funds into the for-profit health care industry or a so-called not-
for-profit system that behaves the same as profiteers. Such schemes are the health care equivalent of vouchers in
education. This is obvious when the high sounding proposals are made by the American Medical Association, the American Hospital Association
and even the Insurance Association. But, there
is also no guarantee that a single payer system proposed for
individual city and states or the
federal government would be comprehensive. Most single payer system that
have been proposed in the past would result in an ongoing, giant financial payoff to the health care industry.

Costs would rise precipitously , as the government and politicians with feed their industry buddies and
single payer would evolve into an ‘unfunded mandate.’ This would result in the uninsured suffering
the same problems as faced by Medicare and Medicaid participants . Our Party activists, while playing a role in
these movements, should also put forward a more advanced position that actually solves the problems. That is
the Communist plus that our Party stands for. However, we believe it is important to work with single payer advocates in broader coalitions
around positions that are open to the advocacy of National
Health Service or key elements of NHSfor example, bills that directs
Congress to enact legislation that provides real access to comprehensive health care for all Americans.
Some proposed single payer bills are far better than other proposed similarly labeled legislation. Some such
proposals, for example, seem to exclude any role for insurance carriers, for example as third party administrators.
However, even the most advanced single payer proposal , at this time, preserves the antiquated fee-for-
service physician payment system at the exclusion of salaried physician emphasis. Single payer
insurance-based systems also do not guarantee the delivery of services since hospitals and community
clinics would remain in private hands . There are important physician groups working on one such a proposal, HR 676 [see
below], with whom we work. The efforts to gain labor support for HR 676 are very useful for future struggles for national health legislation.
Health Care Policy And Trade Union Work But, while labor support for HR 676 is increasing there are objective reasons that organized labor has
not been at the front of the struggle for national health legislation, i.e., any health legislation. This is a key issue for labor and therefore for our
Party. The key issue for labor is: What happens to our negotiated health benefits in any national health
bill? There are major objective reasons that labor union leaders and members worry about any national health program. For example, the
year 2003/4 enactment of the Bush Medicare Prescription Drug program could allow employers to cut back on negotiated prescription drug
plans. This will further put the worry sign up for labor leaders and members. In addition for organizing purposes and identification purposes,
labor has become wedded to their negotiated health benefit programs. The is a fact that must be taken into consideration by all health care
activists. Solving this series of issues is not easy, but it is achievable. Labor
unions must be allowed to continue their
current health benefits programs regardless of any national health program. This will help to unite all elements
of labor to endorse progressive national health legislation including the building trades, manufacturing, services and public sector unions. The
Party has a special role in making sure that workers are protected from any detrimental actions of
their national government. This is also integral to an anti-monopoly strategy . How can this be accomplished? Our answer would be to ‘grandfather-in’ all labor-negotiated health benefit programs, and fashion a national

health insurance program around them. We would also ‘grandfather-in’ the current and refederalized Medicare & Medicaid programs. Individual labor unions could then voluntarily fold their health benefit programs into the federal program, at their own discretion. The Canadian health system was started with this kind of approach. And, the French, German and other European health systems still maintain a special role for organized labor. This could then be called: ‘Labor Programs Plus Medicare for All’ or ‘Labor/Medicare for All.’ But, first the Medicare agenda must
include the demand to fully federalize Medicare and Medicaid. The ‘Medicare for All’ slogan is shorthand for a national health insurance program that would resonate with policy makers, workers, retirees, and many others. Since the failure to enact national health legislation in 1994, the Democratic Party and the AFL-CIO had agreed to keep health policy issues ‘Off Agenda.’ This approach resulted from a misreading of conditions, since health care was, and is, high on the agenda of all people in the USA. Recent movement by the AFL-CIO on health policy is part of the
prescription to throw out the Republicans from Congress and the White House and make health care a right, not a privilege, in our country. It didnt succeed in 2004, but the seeds for future victories have been sown. If organized labor were to adopt this approach then it could protect their own legitimate interests and once again be at the head of the peoples movement for health. We believe organized labor and the Medicare movement should work together to write their own bill and then cover everyone else. After all, who has more direct, on-the-ground experience in
the organization, delivery and financing of health services. This is a good starting point. Our job is to work with organized labor to support a progressive health bill. The Partys Health Commission members are working with leaders of the labor movement to encourage organized labor to develop, write, and propose labors own national health legislation. This new approach is being well received by health policy people and labor leaders/activists who are trying various ways to get labor to drop its opposition to national health legislation. The issue of protecting currently
negotiated health benefits is crucial to continued labor support. Once this stage of struggle is attained, then the next stage of a National Health Service is within reach. State Actions There is a groundswell of activity by various city state labor councils seeking to find solutions to the crisis in health care. Wisconsin and California are two examples of state labor councils seeking state action to get health care for everyone in that state, and others are contemplating similar action. The issue is becoming, Should labor expend its political strength and energy on state governments,
or should the focus be on Congress? The AFL-CIO Executive Council made it clear that many actions will be necessary to get health care to be a focus of the year 2004, 20 06 and the presidential and congressional elections of 2008. The key issue remains here as with national health legislation: What happens to our negotiated health benefits? That is the key issue that even the most progressive national legislation reform, HR 676, has failed to address. Labor unions must be allowed to continue their current health benefits programs regardless of any national health
program. The legislative Struggle for National Health Legislation The details of proposed legislation changes from revision to revision, and certainly from year to year. This is to be expected given the vagaries of Congress and politicians. Nevertheless, we can use recent examples to clarify important health care issues. Three pieces of progressive legislation for national health care that were introduced in the 107th Congress show the levels of action that will probably continue through the next period of time. Congressman John Conyers was the primary sponsor of two of
them, and a secondary on the third. Congresswoman Barbara Lee from California is a supporter of all three and lead sponsor of the National Health Service proposal: ‘House Concurrent Resolution 99’ ‘HR 676 Single Payer National Health Bill’ ‘HR 3080 National Health Service Bill’ The tactic of The Health Care Access Resolution (HCAR), embodied in House Concurrent Resolution 99 (H. Con Res. 99), and Senate Concurrent Resolution 41 (S. Con. Res. 41), directed Congress to enact legislation by October 2005 that would provide access to comprehensive health care for all

The most
Americans. While not an actual piece of legislation, it was meant to gain broader support for a national health bill. The struggle for national health legislation began taking the form of a House Concurrent Resolution 99 for Universal Health sponsored by Congressman John Conyers. This was seen as an effort to allow all progressive organizations and professionals to unite behind a set of principles. It is the precursor to an actual bill; and, still is. The principles looked very similar to those embodied i n HR 676 and HR 3080

recent version of a federal Single Payer National Health Insurance system [HR 676] has responded to the demands
that previous single payer proposals were deficient. It is vastly superior to the single payer proposal of the late US Senator from Minnesota,
Paul Wellstone, since the Conyers proposal is federal and not state-based; and, it the federal government is the administrator, not private
insurance companies which mimicked the Medicare mistake. These factors make the current version far more supportable and anti-
monopoly in character since there is no role for insurance carriers in the financing aspects. It is a reform that is certainly and short be
supportable. But, the delivery of services under this system is still in private hands and fee-for-service
physicians take precedent over salaried physicians. HR 676 sponsors have been unwilling to offer labor the option of
maintaining their own health benefit programs. On the sate and local level, most of the single payer proposals are not on the same level as HR
676. As we tactically and strategically consider, support and organize for insurance-based national
health legislation, we must continue to treat the proposed legislation of Barbara Lee, ‘United States Universal Health
Service Act [US UHSA]’ with complete respect. Congresswoman Lee is carrying the torch of Ronald V Dellums in keeping alive the
only piece of national health legislation that systematically addresses the major contradictions in our
current health system. Its principles are public health and hospital services; salaried doctors to make sure
they are available in the urban and rural settings; health planning; educational program for professional positions with maximum
affirmative action; etc. It recently had ten sponsors, and it provides a guide to measure other proposals by. In reality it stands as much a chance
of passage as bills similar to the two Conyers bills. Conyers has been a sponsor of the Lee bill. HR 3080 is a direct attack on all the monopolies in
the health industry. We strongly encourage organizing delegations to meet with their U.S. Senators and members of the House of
Representatives to get them to co-sponsor all proposed progressive health legislation. We encourage local, national and international labor
union leaders and members to join in support. Grassroots movements like these can galvanize a movement to put
people before profits in health care, and smash the root cause of the health care crisis . As a Party,
we must be careful about what is called comprehensive, single-payer, full access; and uses all the hot
button terms to gain support for a piece of legislation. Measure what is being said against the
principles outlined earlier. Many political candidates put forward their idea for national health care.
Most of these ideas are calculated to sound like a universal, fully accessible health care proposal.
Some are totally unsupportable. Others proposed by some liberal members of Congress scale back
their financing and benefit proposals to withstand the assault from the Republican Party, the Medical-
Industrial Complex, and their politicians and media wizards. Candidates fear to be too advanced since
the price tag would appear to be too expensive. Typically these proposals are not completely supportable.
Nonetheless, it is a good sign that the candidates are at least joining the debate. Critical thinking and critical actions have
never been more important for movements to see the unique contribution of Party members working
with them. Big Tent HCAR 99/S41 came as a response to health activists seeking to bring the broadest number of politicians to begin to pay attention to the issue of national health care. The American Public Health Association, The Universal Health Care Action Network and many other groups have signed on to the proposals. Labor has also joined in. According to the Universal Healthcare Action Network (UHCAN) there were over 450 national, state, and local organizations on board. For the first time since the collapse of

health care reform in the early 1990s, the U.S. Senate showed some positive movement. Key liberal Senators signed on to this HCAR movement. They are: Senators Edward Kennedy of Mass; Russell Feingold of Wisconsin; and Jon Corzine of New Jersey. These are the Senators who will have to be in the leadership of the Senate if the Health struggle is to succeed. The formal title of this proposal is Senate Concurrent Resolution 41. Given the apparent fear by members of Congress–fear of powerful corporate and political enemies–to put forward a serious major piece of
comprehensive health legislation, the following statement by UHCAN is important: HCAR is part of a broad effort to educate the American public about the need for affordable access to comprehensive health care for all, and to mobilize them to take action toward that goal. HCAR is seen an essential first step to enacting heath care reform that provides health coverage for everyone. Popular Actions; Uniting with Social Security Struggle It is clear that there are many grassroots health care action coalitions developing around the country, from prescription drug campaigns to
state and local referendums and legislation demanding comprehensive, universal health care. In Philadelphia a citywide referendum demanding city wide universal health care and in Ohio a statewide effort for reduced prescription drug benefits are good examples of building broad local coalitions. In many areas we are already deeply involved in others we need to join and become active. The new national retiree organization, Association of Retired Americans, is a great way for comrades to become active in the health care fight. Also union retiree organizations, like SOAR

the unique feature of a National Health Service is that it

are important avenues of struggle. All health struggles must unite with the struggle to preserve and expand social security against the Bush Agenda of privatization, greed and profit. Party of Socialism Must Promote Socialist Ideas and Ideals As stated earlier,

is socialized medicine and it is at work in the United Kingdom and is very similar to systems in other European countries. It is an
advanced demand that challenges monopoly and greed with practical, within capitalist economic
systems. The Cuban system is a beacon for developing countries. The World Health Organization
regularly commends the Cuban health system as the best for developing countries. Health systems in
the former Soviet Union and its Socialist country partners worked and worked well. The health status
declines and horrendous mortality increases in the decade since 1991 has shown that to be true. This
simple fact is critical in exposing the lies about the Soviet Union and its amazing victories and
advances during its 75-year history. Our Party as a Party of Socialism must continue to propose socialist
solutions within capitalism that make sense. Socialized Medicine makes sense. And, with the
international mobility of our working class, they are seeing, first hand, this fact for themselves.
Progressive insurance-based systems, conjoined with the strategy for labor to write their own national health proposal, that pull
the peoples movement toward socialized medicine must be supported and pushed in that direction.
These movements will rise and fall and will offer different legislative proposals . They need to be
weighed against our socialist alternative , the N ational H ealth S ervice. That is our rudder of action.
Party activists are encouraged to use the big tent approach to health struggles. A united health care movement is our goal .

There must be a movement that unites behind clearly stated, broad goals ; and, that maximizes the
role of labor and its members as the only force, along with Medicare and Medicaid activists, that can
have the political weight to gain health care for all and make a constitutional demand of Health Care
for the People, Not Profit a reality.
The affirmative operationalizes a fantasmatic logistics of health insurance which roots
and constitutes the subject and the nation against risk, creating the conditions of
possibility for existential violence
Patel ‘7 (Geeta, Associate Professor, Middle Eastern & South Asian Languages & Cultures and Women,
Gender & Sexuality @ UVA, “Imagining risk, care and security: Insurance and fantasy,” Anthropological
Theory, Vol. 7.1, pp. 110-111)
INCORPORATING PERSONS The kind of personhood promised through insurance fantasies relies on imagining
an ideal state of things, an idealized corporate nation-state, an idealized nation, and an idealized
financial institution in how we imagine an idealized person (Rajchman, 1995). Closely bound to these idealizations is
the ardent belief that institutions that support a good future will not fail. If these institutions fail, the person
whose life care and hopes (success, security, safety, life beyond death) are so closely involved with the schemes that this person hedges on or
banks on to promise their future is in trouble. This kind of personhood demands an infinite life for the entities that
underwrite their life. 19 Let us consider a familiar story from the USA: the failure of Enron and of its pension funds – that assured employees a life (hope, care, protection against risk) after the end of a lifetime of a certain kind of labor. S hares in

Enron had bought certainty for employees who bought themselves (as a part of a wage relation) a piece of their employer. Employees also simultaneously and necessarily bought into the idea of the company’s life, the company’s future, as forever. The form of the company had to have a
visible life beyond the vanishing point on the other side of a worker’s retirement, understood as their horizon. Their future could not be assured otherwise. The pay given in their future for the labor extracted from employees required their employer to live in a temporary form of forever,
as surety in a present that was as uncertain as the future they envisioned, and fantasized as certain. This particular folding over of time, embodied in the probability of success, was the hedge employees had against uncertainty. Enron employees bought into the corporation’s life and
invested in the idea of the infinite life of the corporation (and in the case of instruments like social security, in the idea of the state). The assurance vested in the life of the corporation/state was the collateral that employees of Enron and employees who expect their social security or
state pensions to come through had to ensure that they would have a life worth living after retirement, after they stopped work. The life of the corporation or the state was the hedge against the end of a life of labor. In its 1886 decision, in the case of Santa Clara County v. Southern
Pacific Railroad, the United States Supreme Court constitutionalized corporate personhood, giving corporations complete access to the legal status then awarded to all ‘natural persons’. Corporations ‘had basic common law rights (to own property, sign contracts and so on)’ augmented
by the full legal protection extended to persons under the 14th Amendment of the United States constitution. Corporations were affirmed, yet again, as legally fictionalized persons.20 Over time people have commonly come to accede to that convention, even when they dispute it and its
ramifications. What are the ways in which corporations actually become people for people in a quotidian fashion, so that the idea that the corporation is a person does not jar? Financial advertisements of various sorts use the ruse of personhood in describing their corporation – people
who are corporations have become a familiar advertising convention. Bank of America advertisements regularly show viewers the ‘Portrait of a Bank’ by showcasing specifically named employees and people who bank with them. Another set of financial planning advertisements set up a
viewer to be confused. The series orchestrated conventional family scenes culled from albums that narrate summary biographies of various families – a man looking at newly born babies, a man at a soccer game, a man sitting by a woman at the beach.21 In each case, the advertisement
opens with the protagonist speaking about his family’s future in a familiar, caring way. In each case a subsequent voiceover unmasks the man even as the camera pans back to reveal the truth. The man talking with such authority (as a member of a family) is in fact the family’s financial
planner – he is the person they hired to take care of them. What the advertisement portrays is his closeness to the family. He is so intimately involved with that particular family that an outsider and perhaps even a family member could get confused. The corporation is not just as any
person but a thoughtfully nurturing member of a family. UBS has been running a series of advertisements that feature the slogan – ‘you and us’; they, the corporate person, promise to know you, the investor, so well that there is no one in your world but the two of you. The State Farm
insurance agency has a series of advertisements in which a local agent takes care of a disaster for a young person. In the process the agent provides compensation, replacement and care in the form of advice that the teenager was afraid to seek from parents. The advertisements promise
people who obtain their insurance or planning skills or banking services that a person who embodies their corporation will be ‘there for you’ (a consumer) perhaps in ways that even your family cannot envision. They, the members of a firm, are more than your family; your family can
never quite live up to them. These people are all faces of the corporation; the corporation as person is insinuated into the life of the consumer who purchases financial help, insurance and bank policies. These company advertisements are supposed to entice a viewer into feeling that the
corporation is a care-provider whose face, through the people who work for it, will give you, the consumer, what you need; they share your world. When people buy into the life of a company, they also procure a share in the belief that the company is a company, and that it takes on a life

The kind of personhood promised through insurance

as a being. The fiction of personhood allows the company to be fetishized as a company by being fetishized as a person – a caregiver.

fantasies is one in which the care each person needs, the risks each person encounters in the daily business of living, and
the seductive pull towards ‘prevention of those risks’ as a hope for a changed future seem to assure
the fantasy of that person’s social completeness.22 Care , as prevention of risks, installed in hopes for a
shared future appears to promise social completeness. When a company or a state, fetishized as itself
by being fetishized as a caregiver, holds that promise, it can also hold out the future mitigation of risk
as a resolution of the promise. And when a person’s life hopes are entailed in an organization’s bid to
live forever (‘defend itself to the death’ in Aretxaga’s words [2005: 172]), that person appears to buy without notice the
belief that their future care will be emboldened by preventing risks to themselves through averting
risks to the organization. The possibility of terrorism as a future risk to the organization’s wellbeing
and completeness, and so also to the person’s, becomes quotidian ; the exception seems so ordinary it escapes

interrogation (Aretxaga, 2005: 135) – and therein lies the genesis of a security state, which will secure care
and hope as it installs juridical measures to forestall the possibility of a likelihood (which is not even the
possible actuality) of the risk of spectralized terrorism (Aretxaga, 2005: 172). This dance between organization and person
echoes Aretxaga’s mirroring dynamic between the state and the terrorist, except here terror is held at bay as the hopes featured in the self of
the state – its life, its promise of care as benevolence (Aretxaga, 2005: 135) – mirror future care as hope for a risk-free future for a person
(Aretxaga, 2005: 236–9). In seemingly sharp contrast to the fiction of the corporation as a person who is fully ensconced in a consumer’s life is
the production of the consumer by the corporation.23 People
collated into forms of self who are engaged in doing the
work of similar risk mitigation (risk pools) are related to each other in parallel lines, through capital as
a collective production (Ericson et al., 2003). A person as a subject is a compendium of factors, broken down
and recalculated, drawn up again in a series of statistical particularities tallied up: likelihood of death
by heart attack, death in a plane crash, death by ‘bioterrorism’. Sciences of the population are the
sciences of surveillance and security: statistical data, tabulation of information, graphs, charts, the
mean, the modulated, produced as transparent (Appadurai, 1997; Aretxaga, 2003; Ewald, 1991; Hacking, 2002; Mitchell,
2002). ‘ Good’ is webbed into the true; truth becomes data , a kind of mathematical calculus. Truth becomes a
transparent generation of pure information through which a future is given as a hypothetical
possibility to a select few. Each person who gets insurance and envisions themselves through insurance
fantasies is produced by the firm as an independent monad, coupled with other such people through the
foregoing series of abstractions.24 Insurance technologies link each client individually and serially (in a vertical series)
to a spectralized central management. Their juridical framework is the contract between client-consumer and company
manager. If one envisions a client as a citizen and the links produced between clients as constituting an
imaginary community (Aretxaga, 2005: 78–80), technologies (not print ones) play into drawing assumed
connections between people who may not know each other.25 Communities, affiliations and configurations become
collectivities related through a series of abstractions. People inhabiting risk communities – risk pools – can be produced in
some of the following ways. Groups of people can either be pulled away from other kinds of
collectivities such as trade, family, neighborhood, or reinforced in and returned to these collectivities
26 to form series of risk pools established through ‘the sciences of risk’. Consider the current search
procedures at US airports where new risk factors are generated through new information – shoes in the
case of the shoe bomber, and all shoes are checked. A terrorist can be told through her or his (usually his) suspect shoes. Shoes carry risk.
They are a risk factor that can identify a person as risky, and the person in turn, recognized through the risk factor they
carry on their person, turns into a terror- ist. People traveling with this ‘terrorist’ are ‘at risk’ of being in a terrorist
episode – they form a collective. Though this kind of almost farcical use of risk factors may make us cringe, risk factors as the theatricalized
farcical episteme, giving knowledge, especially in global, national, multiply ‘scalar’ engagements, have been necessary to how information is
gathered and assessed in much less obvious ways. ‘The boundaries between fiction and reality become
indistinguishable – endowing encounters between the state and terrorism with a phantom quality’ (Aretxaga, 2003: 402). Through
this episteme knowledge is generated about nations, populations, and the likelihood of paying off IMF loans. This is
salient information that enables governments to supposedly know what to do: for example, risk of famine is assessed
through the collection of data on past ‘events’ – food production, birth rates and so on (Mitchell, 2002; Moss, 1996, 2002). Epistemic

certainty is guaranteed by a belief in the efficacy of collecting data and in the power assigned
mathematical modeling to produce a future in which risk is given good value. Consider a case of habitation.
People compose social, economic and political intimacies as spectral solidities in, by and through risk. A person might organize a community or
join one that offers them a share in similar losses and similar risk factors – loss of a child, risk of HIV, risk of cancer. Survivors of drought,
smokers who share a room, survivors of war, Alcoholics Anonymous, breast cancer survivors, can be political entities as support groups that cut
across other notions of community belonging that are reconditioned through risk. Police and terrorists, resisters and armies – ‘a mirroring
dynamic often takes the form of powerful identifications and obsessive
attachments’ (Aretxaga, 2003: 402). These
identifications and attachments become a way to envision a changed future, a care for oneself as care of
the self, shaped through insurance fantasies. Risk: each person is produced as a member-subject in a
community. Each person is considered a citizen of communities that cut across other lines, through intimacies that travel in the wake of
capital (perhaps along with capital as debt and credit), intimacies that travel through notions of risk. Risk can be regarded as a paradox, ‘a
phantomic mode of production’ (Derrida, 1994: 97) at the heart of practices of intimacy fashioned through desire. Risk
offers forms of
alienated intimacy or empathy when a person who is at risk is brought together or comes together
with others with whom she shares that risk and with it partakes of an insurance fantasy. Alienated intimacy
offers the following: When do familiar intimacies turn against you? When does a person close to you, your neighbor, your friend, your lover,
your confidante turn risky, mutate into the terrorist you must turn away from, so that you can turn towards those who share your risk?27 ‘The
“terrorist” is, then, a next-door neighbor, your high-school friend’s brother, an acquaintance with whom you’ve had a drink on several
occasions, or that guy from your college class’ (Aretxaga, 2005: 167). Your intimates are alienated from you even as your desires coagulate
around others who share your risk. ‘Being at risk’: a phrase that is familiar to people who live in the USA and who engage with issues around
race, disability or sexuality. Being at risk: for losing one’s life if one is a young black or Native American man, for losing one’s rights to healthcare
if one works for a corporation that is downsizing. Women of color become bonded to each other, stand surety for each other perhaps, because
they are at risk for not getting access to the kind of life that is made through the labor of producing a good life – whether that is via education
or a job or access to a breast examination or welfare or to medi- cation for HIV. In this way, the
process through which people
find each other in political alliance dovetails with the process instituted by and through insurance
companies who use actuarial tables to bring people (initially fragmented into pieces and cut apart) who carry the
same risk profile together so that the companies can spread their risk. Insur- ance fantasies produce
collaborative intimacies of tensile power because they bring together fear of loss with the hope of
change and care. Can we reissue political and affiliative intimacies, political and affiliative empathies
as forms of alienation? What are the ‘risks’ of alienated bonding through risk? We are familiar with alienated labor,
have heard about the alienation of property, think about selves as alienated, and talk about new
forms of social intimacy as the breakdown of earlier practices. Perhaps it is also salient to talk about civil/civic-public
intimacies as partially composed out of these forms of alienation. Political collectivities that round themselves out
through risk instantiate the violence of the insurance fantasy: alienation of person from person, each
person secured in their social fullness as a cohort through risk mitigation. Care of oneself is threaded through
alienated intimacies and the law of the camp becomes social reason (Aretxaga, 2005; Davis, 2001; Lyon, 2001; Mbembe, 2003; O’Harrow, 2005;
Staples, 2000). Risk, rebirthed through insurance fantasies, allows us to rethink privatized culpability – the
monetized privatization of culpability. Community culpability is so necessary to the politics of communities formed around desire. And
communities need to acknowledge their responsibility in legacies of racism, homophobia, which come from this kind of language
of risk and fault as shared responsibility. I think it is politically salutary to share responsibility across community, but it is also essential, as
one contemplates responsibility, to understand the legacy of insurance and risk in their neo-liberal imagined
accountings, and the after-effects of these legacies and their aftermath. CLOSING WITH LOSS Insurance, and here I include pensions,
embeds and collates and entrances us in ways that exceed the financial exchanges embodied in the
acts of buying any one policy. There is nothing necessary in insurance , nothing that ought to make insurance
intrinsic to life. But insurance has a kind of enchantment. Insurance is shaped through mystifications that
attend the acts of buying insurance, which allow alienation (the separation of self from self through giving pieces of self
monetary value) to be completely absorbed into the daily business of living as desire for care, hope for
change and intimacy through loss. These mystifications travel unevenly, erratically and incompletely with forms of global
capital that are manifested in the various technae that make up insurance, and I have retheorized them as insurance
fantasies. Insurance fantasies permit feeling and forms of being that are made up of something other

than merely technical and mathematical to be brought to questions of finance. Where does loss figure in
these fantasies? I take insurance fantasies produced in neoliberal engagements as a kind of envisioning, a
kind of promise of life’s fullness that in an impossible way assures that plenitude against loss. Here loss or the risks of future loss
(of an object, of life, person, work, health, property) seem intrinsic to an ideos of life as it has been
constituted in time – between birth and death, as well as beyond death. Losses I consider here are neo-liberal notions of
the loss of capital invested in life, life’s capital. Losses are produced as life hazards. The temporalities of loss in the
temporality of life lived to death and beyond it generate a kind of visual shaping of time where visibility is a future of something you can never
pay for. Assurance is marketed as visualizations of a future beyond value (Miller, 1996). Insurance companies get a ‘client’ to
buy insurance as an assurance against losses, as a hedge against the risks of life. These risks are sold
as both quotidian and extraordinary events necessary to the course of any citizen’s life. To collect on
the money you, the client-consumer, have paid out you must show the company evidence of your loss. If you
keep up your payments you get money back, if you cannot afford to keep up, you count the payments you had made as a loss. Through

insurance fantasies, you , the consumer, strike a contract with time that your future of care provision will
go according to plan. You envision a future beyond value – your assurance is the visual shaping of a future beyond
value. You captivate or capture time, and with it you marry yourself to an idea of cultivating a self
(Rajchman, 1995). You will be cared for. What you get in the event of a loss is not merely money for a lost object. You materialize
a future that is planned as well as one beyond something that is planned and managed. You work to mitigate uncertainty – you
have worked so hard that you begin to feel that it is not right to lose provisioning, that it is unfair to lose something you worked for. This is a
form of idealization that projects certainty. You do not have to feel absolutely certain, but your life’s hopes are woven through with it.

paradox of hope is that the vision of a future is both certain and liable not to be. Most new literature
on insurance looks at the relationship between morality and money but in this article I have looked at
lives through the material idealities of economies. This small piece of a much larger project ends with the questions I have
to answer in a provisional fashion: How does one give substance to salutary possibilities envisioned through political work? What happens to
these possibilities if one speaks them into being through risk where so much of the political is lodged? What is the imbrication of care with loss?
Death and terror and trauma are at the heart of a politics
How does one recuperate loss? How does one finance risk?

where the quotidian materials of the political make it possible to kill with impunity (Agamben, 1998;
Baucom, 2005; Davis, 2001; Mbembe, 2003), where the law is not reason. This is the place that Begoña Aretxaga sought to
interrogate through the last book she wrote. My journey over the course of this piece dovetails with the questions Begoña asked at the close of
her life: What feelings permit one to stand by, or on the other hand, believe with every piece of oneself that
only through another’s death can one recuperate one’s own trauma? How does care of oneself permit
a person to do this? How do traumatic losses , conceived of as the unexpected givens over the course of life rather than as
accidental surprises, which many thinkers believe to be endemic to modernity (Cvetkovich, 2003), transform political possibility?
Fantasies grow out of traumas understood in this way, and enliven the alienated intimate conjoining
of people in such a way as to make the death of someone else possible. Politics negotiated through
language, such as that of rights, which relies on trauma and loss, forms itself around the kind of
contract also struck by insurance companies. This contract is spectralized through the paradox
invested in insurance fantasies – you buy insurance against loss and you have to show evidence of
the loss to collect on it. I am not nullifying communities that form themselves around shared loss; I am not invalidating attempts to
recuperate fullness. I am just asking us to consider for a moment loss not as primordial, but implicated in the

seductions of economies of the risky self that have become the unmarked projects of daily living.
Where then lies the possibility of politics ?

The affirmative actualizes a mode of imperial affectivity which operates on bodies and
spaces through the expansion of its own logistics at the level of life and the
phenomenon of abnormality, causing violent intervention and extinction
Ahuja 16 (Neel, Associate Prof of Feminist Studies and Core Faculty in Critical Race and Ethnic Studies @
UC Santa Cruz, Bioinsecurities: Disease Interventions, Empire, and the Government of Species, 195-205)
Despite German American physician Hans Zinsser’s depiction of infectious disease as a sign of nature’s timeless and intractable “nationalism of
species against species,” replete with tragic but inevitable consequences of death and debility, I have argued in this book that

interventions are political pro- cesses, ones that link media, bodies, institutions, and medical technologies
in order to securitize privileged forms of circulation against the queer poten- tials of interspecies contact.
Such containment has been a consistent preroga- tive of the US security state throughout its twentieth-century
experiments in trade, military, and territorial expansion, crossing a variety of institutional projects to control space, engineer

immunity, and enhance the scale of inter- vention against infectious disease. Species are not, then, simply in
protracted, ancient struggles for survival. If— in today’s era of mass extinction and eco- logical crisis—critical social and political
theories are beginning to imagine the intensification of species war coincident with current forms of empire, this would not simply be a war
between independent species struggling for evolu- tionary advantage. The government of species has a history, one that suggests that power
takes shape in part through the organization of bodily forms and relations. Contemporary modes of
violence and extermination may indeed, then, be intimately linked to Jacques Derrida’s vision of an “infernal,
virtually inter- minable survival.”l Derrida’s words relate to the specific context of industrial animal agriculture, where the grand
scales of mass killing at the slaughter- house occur not in the service of simple extermination, but in the persistent rendering of life into
capital.2 This idea has bearing not only upon the prac- tices of the government of species described in this book, but also on the more general
understanding of contemporary
neoliberalism and its futures. Aus- terity, inequality, unemployment, and
chaotic biological and economic risk— the symptoms of systems conducting greater masses of bodies and
species through the processes of slow death —signal the exhaustion of populations under the
combined banners of free markets and security ; the ever-narrowing securitized zone of human life
regenerates against the backdrop of a collapse of environmental and social systems , producing a kind of
“infernal, virtually interminable survival.” Yet one difficulty of describing these connections through an anthropo- morphic account of the
political—one that focuses on human society to the exclusion of its embeddedness in ecological systems crossing species—is that we may miss
how trends toward austerity and a shrinking state coincide with the neoconservative expansion of security interventions across the
domains of life and planet. Thus it
is necessary to explore the potential for empire’s sup- planting of an earlier phase
of neoliberalism with emergent forms of securi- tization. The concept of the government of species as outlined in this
book offers a genealogy of the shift toward the securitization and remaking of bio- logical life coincident with
privatization, the dismantling of state investments in social welfare, and imperialist efforts to contain
the transnational effects of decolonization. In the pages that follow, I offer some concluding thoughts on how this book’s
analysis of the conjunction of biopower and necropower con- tributes to understanding these political trends. This is
especially important as today free-market trade imperialism opens into full-spectrum military- industrial
defense, an attempt to securitize posthuman environmental, social, biological, and technological
assemblages. Noting that the early neoliberal “Washington Consensus” advocating free trade, austerity, and privatization seems to have
collapsed internationally de- spite those cases —like Greece—where it can be forcibly imposed, I reflect in this epilogue on some central
questions concerning the futures of neoliber- alism and security. In particular, I explore how Left critiques within the aca- demic fields of
postcolonial studies and American studies can respond to (1) the difliculty in capturing the persistent materiality of race and other forms of
difference as they relate to debates over neoliberal forms of economic and ecological crisis; (2) the question of whether emerging
posthumanist concep- tions of risk reflect neoliberal logics or their transformation into a new post- neoliberal phase of security; and ( 3)
confusion over how securitizing logics af- fect the political form and representation of US empire given the mainstream political adoption of the
language of imperialism. These questions bear filr- ther on how to think about the interspecies history of US empire in relation to changes in
the global economy and the rise of environmental politics and powerful “semiperipheral” or “first-third-world” states. I have argued throughout
this book thatrace has long played a central role in the US security state , particularly as it works to map
and aggregate bio- logical risk. From the depiction of native Hawaiians as vanishing victims of Hansen’s disease in the late 1800s to
the imagined extermination of North American populations by epidemic smallpox in the 2003 Iraq invasion, many public visions of
infectious disease outbreaks figure particular social groups as conduits for the aggression of microbial
species, the incessant processes of viral and bacterial emergence that always threaten to disrupt the
fabric of life itself. Dread life processes the living potentials and fears of contact into spe- cific
architectures of power, exercised in the medical incorporation of racial- ized groups, the expansion of
markets and institutions, and the configurations of species and distribution of technologies across
dimensions of time, space, and scale. Dread life’s aesthetic and ontological linkage of race and species continues
to play a persistent role in the work of the security state precisely because it offers road maps for
navigating the uncertainty of contact internal and external to the body. Race is a structured element of the
government of species, not because racialized groups bear unchanging relations to the state, but
because racial form generates national sentiments and strategies of insti- tutional incorporation—
ways to flexibly aggregate vital potentials into forms of intervention when there is otherwise only a generic sense of
vulnerability or uncertainty. I am describing race as a set of technologies connecting feeling to representation and giving form to insecurity
rather than only a content- driven set of policed phenotypes. Race
is fluid, emergent in the crises of interspecies contact
that generate politics. Despite the late twentieth- century myth of a postracial United States, the security state and the private
institutions upon which it relies continue to depend on various forms of racial knowledge and profiling to justify
funding and legal authority. While in this sense neoliberal and neoconservative logics converge in the nexus of state and corporate
efforts to control life, the question remains as to whether this nexus represents an emergent order in which human security supplants
The racialization of uncertainty and risk in disease con- trol offers some broad lessons about

US and international health delivery, ones that scramble certain accounts of neoliberalism’s
homogenizing logic . Today life can be regulated intricately against a specter of insecurity that
increasingly recedes into a vision of aleatory risk: an emergent “environmentality.”4 The layering of space, time, scale, and
species is furthermore geared toward en- vironmentally targeted ideals of human security increasingly adopted in the state’s forms of risk
the Affordable Care Act might seem to contradict this potential
assessment.5 The passage in the United States of
turn from a laissez-faire neoliberalism to an inter- ventionist human security, as it depends on
privatized insurance markets. Yet even if it follows logics of privatization, it is also suffused with
emergent logics of human securitization against a specter of environmental risk; these logics allow for different types of
actors, ideologies, moral claims, and epistemolo- gies of risk to come together in processes of securitization. Witness a key mo- ment in the oral
arguments over the bill, where Supreme Court justice Stephen Breyer compares the universal insurance mandate to the vaccination authority
highlighted over a century earlier in Iacobson v. Massachusetts. Breyer explains the new US mandate for individuals to purchase private care
with reference to the necessity of enforced vaccination during an epidemic, echoing the exact language that the World Health Organization and
US biosecurity officials used to depict the “sweeping” threat of epidemic smallpox in the lead-up to the Iraq invasion: “A disease is sweeping the
United States, and 40 million people are susceptible, of whom 10 million will die; can’t the Federal Government say all 40 million get
inoculation? So here we have a group of 40 million, and 57 per- cent of those people visit emergency care or other care, which we are paying
for. And 22 percent of those pay more than $100,000 for that. And Congress says they are in the midst of this big thing. We just want to
rationalize this system they are already in.”6 Although Breyer may simply have wanted to de- fend the state’s
authority to create a universal health program, the legislation offered him a logic of risk preparedness
through insurance pooling . Combin- ing a long-standing rhetoric of species war with the statistical
aggregation of population risks, Breyer’s numbers turn toward mass catastrophe to justify
intervention. The statistical sublime of this sweeping epidemic underwrites both a turn toward the
privatization of risk and an attempt to incorporate futurity and unpredictability into the sphere of
human security. This logic articulates the connection of neoliberal austerity with neoconservative pre- paredness, couched in the
language of species war innovated by Justice Harlan in the Iacobson case a century earlier. This form of preparedness has a connection to the
problem of race that I have explored throughout the book. Liberals
in the United States have logi- cally responded to
the situation of deepening inequality domestically and internationally through an embrace of the
social welfare state , imagined as the real defense against various forms of proliferating precarity
intensified by neoliberalism. But what if this response erroneously characterizes the form of power
emerging in the nexus of austerity and security? The emergent logics of human security reflect how
today even social reform policies are worked through a fear of racialized dependency . It is important to
remember that the strengths of social welfare were challenged early on in the United States and Britain precisely at the moment when
immigration reforms led to a racial backlash aimed at the supposed parasitic dependency of diasporic popula- tions and the integrationist state
itself. As I explained in chapter 4, neocon- servatives turned the idea of the hubris of government’s attempts to contain a complicated world of
race relations (domestically) and communism and de- colonization (internationally) into twin attempts to dismantle the welfare state and to
militarize foreign policy. Thus the turn from a social welfare state to both austerity and security could be interpreted as a response to the
apparent loss of racial privileges coeval with the mass arrival of third-world immigrants. Even
as protecting and expanding
social policies represents an important and necessary response, such agendas will face at least two
difficulties. First, they will be increasingly vulnerable to austerity and to panics over migration that have
grown stronger since the recent interventions in West Asia have created mass refugee crises. Second, as securitizing logics do
expand rationales for human security, the emphasis in social programs is more likely to be oriented
toward crisis thinking, transforming the logics of welfare from within . Social programs are more likely
to be governed by logics of systemic risk and pre- emption rather than social provision or
socioeconomic equality . They may furthermore be captured by discourses of civilizational or cultural
difference that distribute social goods according to a different set of criteria than in the past. The
racial and colonial legacies of medicine and public health compound these uncertainties over the
future of social democracy in the international context, particularly as it relates to global public health. The intensifying prob- lem of
antibiotic resistance has been accelerated by a pharmaceutical empire that has unequally distributed antibiotics across the international
division of labor and has improperly allowed industrial agricultural use of the drugs. At the same time, many publics openly reject or question
medical and sanitary authority backed by Western nongovernmental organizations and interna- tional organizations. In the introduction, I
explained that a technique like vac- cination had become deeply politicized, with Donald Rumsfeld using it to ad- vertise the nation’s shared
vulnerability to Saddam Hussein, and the CIA using it as a clandestine weapon in the hunt for Osama bin Laden. In the twenty-first century, such
nefarious uses of health internationalism for strategic military or political obj ectives— combined with many failed international medical
and sanitary projects in the Global South—continue to threaten the advertised neutrality of health and
medical interventions . This is a problem that end- lessly frustrates global health experts who hope to battle “superstitious” dis- trust
of modern medical knowledge and practice across poor countries and, increasingly, in the United States and Europe as well. As I explained in
the discussion of paranormal discourse in Puerto Rico in chapter 3, it is necessary to understand such political logics of suspicion. Resistance to
the racialized differences in health and medical outcomes is political, not simply cultural. It is alive and well today, apparent in the Taliban’s
execution of health workers in Pakistan; the mistrust over sexual education programs in southern Africa and Ebola screening in West Africa; and
the rising antivaccination campaigns in the United States and Britain, to name a few examples. As I have argued throughout the book,
disease interventions are constantly confronted by the challenges of patient activists, related social and political
movements, and the unruliness of bodies and media assemblages. The results are uneven . For ex- ample, in
attempts by patients to gain access to experimental Hansen’s disease treatments in chapter 1, the state was criticized as the barrier to
obtaining more expansive care. This dynamic was reversed in chapter 5, where racialized HIV quarantine involved a violence that completely
broke down trust in doctors and their diagnoses. My point in this book has not been to denigrate medical sciences and pub- lic health as
inherently violent or exploitative, nor to idealize patient activists, writers, or research animals as sites of resistance to the imperial order. Al-
though Frantz Fanon once emphasized the Manichean resistance of the colo- nized body to dissection by the disciplines of medical surveillance,
the vari- ous cases of disease intervention I have reviewed demonstrate more complex biopolitical relations, especially once patients actively
take part in treatments and when medicine links human and animal research subjects across circu- itous geographies of pharmaceutical
intervention. Healthand medicine are embedded in logics of intervention that are not internal to their
own practice. One lesson of this book, then, is that such disease interventions have never followed a strictly
scientific logic guiding which diseases to target and how to produce therapies and policies to
maximize public good for humans writ large or even for specific national communities. They are
embedded in domi- nant forms of state vision and media assemblages that take planetary space and
interspecies relation as proper sites of intervention and expansion, even as they also proliferate
racialized visions of freedom and precarity, debility and independence. Thus more equally
distributing health care is undoubtedly one important political strategy, but it may also open new
forms of imperial securitization that layer power across an expanded range of bodies and envi-
ronments. Foucault suggests that at the very moment that security apparatuses ani- mate the state and the
human as the privileged domains of sovereignty, they simultaneously unveil the state as unable to
control life itself, as being depen- dent on circulatory processes that move laterally beyond its explicit
exercises of power. This is one reason that it is necessary to carefully review the spec- tacular visions of environmental crisis that guide
some current trends in the environmental humanities, which have been especially popular in postcolo- nial studies. These studies have at times
turned to the environment and planet in ways that shore up a concept of universal human sovereignty, a trend that may be more a reflection of
empire’s logics than a critique of them. One promi- nent critic has argued for a universalist species thinking given his assessment that the fossil
fuel economy makes the human itself into the planet’s primary historical-geophysical agent? Yet in the last decade, these forms of planetary
feeling—which universalize the sense of being out of joint with the evolu- tionary and geological time scales of the planet— converged with
imperial at- tempts to more broadly technologize inner and outer spaces, to engineer em- pire’s forms of human security against intensifying
precarities. Mary Louise Pratt helpfully attempts to situate this public sense of the uncanny separation of human time from planetary time as
an outgrth of capitalist generation of risk sociality and slow death . Pratt, explaining the rise of millenarian visions of mass
destruction, quotes anthropologist Iames Ferguson to explain the emer- gence of vast zones of exclusion inhabited by

millions of socially organized people who are and know themselves to be utterly dispensable to the
global order of production and consumption. All over the planet, then, large sectors of organized
humanity live conscious of their redundancy to a global eco- nomic order which is able to make them
aware of its existence, and their superfluity. People recognize themselves as expelled from the
narratives of futurity the order offers, with little hope of entering or re-entering. This expulsion from
history has been accompanied by rapid pauperization , eco- logical devastation , and a destruction of
lifeways unprecedented in human history. . . . More and more people across the globe speak of the place where they live as a
place where there is nothing, where nothing happens, where you would never want to live. Everything of value is elsewhere.8 As the
idealism of the global is transcended by figurations of planetary crises of human security in the form
of extinctions, resource depletion, climate change, and epidemic disease, postcolonial critique is confronted with
new holisms (the human as species, the Anthropocene, planetarity) that risk mask- ing the precarious grip of empire’s
reproduction of contained forms of life. The fact that empire’s risks intensify preexisting forms of
inequality and mi- grate outside of the spectacular time of crisis does indeed suggest the need for new
forms of representation and critique ; however, this means more intricate accounts of bio -necro collaboration rather than new universals that misguid- edly assert a generic human domination of the planet. This turn to
planet relates furthermore to some broader shifts in post- colonial studies, particularly its attempt to transcend its traditional divisions of metropole and periphery, and to acc ount for a US empire that appears to present a more diversified geography of political forms, not least in its
current misadventures in West Asia. It has now been nearly twenty years since editors Amy Kaplan and Donald Pease published a postnationalist reappraisal of the US empire in The Cultures of United States Imperialism, signaling the rise of a new internationalism in a field that had
historically celebrated US exception- alism. Then, it was imperative for Kaplan to chart the politics of the “absence of empire in the study of American culture.” Today, the emphatic, axiomatic presence of US empire in a new American studies is matched by overt recog- nition by state
functionaries who debate and idealize the idea of American empire. “We are now an empire,” says Bush advisor Karl Rove of the Iraq War, against the protest of Supreme Court justice Antonin Scalia, who nonethe- less upheld the imperialist policy denying petitioners legal standing at
Guan- tanamo Bay. In a move evoking Rudyard Kipling’s 1899 poem “White Man’s Burden,” which passed the torch of empire from Kipling’s Britain to the United States during its conquest of the Philippines, British historian and Harvard professor Niall Ferguson interprets the United
States as taking on the British empire’s avowed interest in globally spreading democratic liberties.lo Such congratulatory invocations of empire portend more complex realities: to what extent does the acknowledgment of US empire work to confirm the exception- alist logic of US
hegemony? Can the neoconservatives’ late embrace of empire itself be seen as a form of force projection, rather than a sober assessment of a disavowed historical truth? There is furthermore talk of the rise of China, of the ascendance of the first-third-world states of India, Brazil, and
South Africa, and the rising economic and political muscle of fossil fuel-producing states such as Russia, the Gulf states, and Venezuela. Is the will to represent US empire a sign of its very demise? On Left and Right, answers to these questions have persistently psycholo- gized the imperial
project, turning away from analyses that would situate empire in vital and capital processes, in materialisms new and old. For Niall Ferguson, quoting Freud, there is the irrational “denial” of US empire by the American public, as well as the “attention deficit disorder” of politicians (with
the exception of the neoconservatives). It is only in the continued and ex- plicit commitment to an evangelism of liberal democracy— including wars in its name—that the United States will maintain its proper global role.11 In an otherwise sharp critique of the imperial politics of

incarceration in the war on terror, one critic has characterized the United States as a “paranoid empire,” an empire constituted by a “doubleness with respect to power,” moving “precari- ously between deliriums
of grandeur and nightmares of perpetual threat.”12 This assessment helps to capture the doubleness of power I have
described as central to dread life, which channels inflationary fears of contact into the force of intervention . However, the
psychological metaphor of paranoia constructs an empire constituted by a lack, an “enemy deficit” that must insistently be produced as structural effect of what essentially appears as a psychodynamic process. Failure to recognize and illuminate such disavowals constitutes, for another
critic, a practice of history that is “disabled.”13 Given the central role of historicist studies in the post- 9/11 work on US empire, it is not uncommon to hear of the public’s amnesia concerning the long history of US intervention- ism; indeed, a Google Scholar search for “historical amnesia
US empire” re- veals dozens of relevant scholarly studies. Yet rather than psychopathologizing the imperial subject or the US nationalist historian, in the process invoking the moral taint of disability to convey empire’s failure of self-recognition, could we not instead track how debates
over empire intersect with emergent projects of securitization? How can we disentangle the important work of critical his- torians of empire who have widely detailed the violence of empire from the agendas of neoconservatives who attempt to use such descriptions of power as
weapons of force projection within informational warfare? A limited understanding of empire as the exercise of sovereignty beyond territoriality would overlook security’s mutually reinforcing dynamic between territoriality and circulation, a process that has been explored in Marxist ac-
counts of the relation between US empire and the development of global capi- talism. Giovanni Arrighi sees this relation between territoriality and circula- tion as reaching its apogee in the unity of settler colonialism, racial slavery, and the rise of the “free enterprise system” in the
formation of the United States.14 Yet Arrighi nonetheless distinguishes this concentration of power from em- pire, arguing that successful US “hegemony” within the world capitalist sys- tem is based on delimiting this territoriality to the continent rather than pur- suing a planetary

the delimitation of sovereignty is at times the very basis of territorial expansionism and the
empire. As I have argued,

tenacity of the accumulation of power and wealth. More recently, Radhika Desai’s impor- tant account of the growing
constraints on US power in a world of “uneven and combined development” argues that multipolarity is displacing the last gasps of empire
expressed in the Bush war in Iraq and constrained by the 2008 financial crisis.15 Desai gives a compelling account of the limits on US power
over the international system. Nonetheless, I see neoconservative logics (such as those of biodefense, environmental government, and human
security) as more deeply embedded in institutions than Desai’s account allows. Also, in
a world of aleatory risk the object of
power is no longer humanist containment but posthumanist proliferation: constant intervention and
adjustment. It may be that the form of empire no longer depends solely on exercises of sovereign
domination but rather on the flexible capacity to intervene. In the nexus of contemporary security, environment, and
health, there is continuing evidence of unequal abilities for the United States to intervene and to channel profit through health markets,
military technologies, and state formation in various parts of the world. This holds true even if the emergent economic nexus of Gulf oil
extraction, US military exports, and Chinese manufacturing link security capacities to decentralizing political economic structures. Thus more
work needs to be done in postcolonial studies and American studies to account for the changing articulations of empire as US depen- dencies
on West Asian oil and South/East Asian manufacturing (as well as a variety of export markets) coincide with shifts in the governing logics of US
power. This book has argued that empire persists not only through its accu- mulation of military force and
capital, but also because it can retreat into the apparently neutral domain of life to flexibly
regenerate forms of expansion . The disavowal of empire is also in part an effect of the fact of
empire’s lateral imbrication in vital processes of regeneration and slow death that escape the
spectacular temporality of the dramas of sovereignty and resistance. Thus it is especially important
to track imperial form, to recognize the effects of ma- terial circulation in the emerging constitution of
security. As I explained in the preface, life gives form to the political, including forms of imperial domi- nation
that transfer affective and institutional energies into the reproductive disciplines of the body. When
empire loses its sole character as the sovereign and takes on a circulatory form , it produces complex
geographies of contact that embed the regenerative powers of bodies in intricate and intimate forms
of warfare .

The alternative is to collapse utopia into dystopia, inaugurating a spectral sociology

which flees from the ontological and epistemological armature of contemporary
Featherstone 17 (Mark, Senior Lecturer in Sociology @ Keele U, Planet Utopia: Utopia, Dystopia, and
This is, of course, the point made by those who struggled against capitalism in the late 1960s. While Deleuze and Guattari (1983) fought the
Oedipal structures of the patriarchal system, Marcuse (1987) argued against the performance principle which reduces every aspect of human
life to economic value. Although capitalism shifted to a new form in the wake of 1968, becoming high-tech
creative capitalism in order to absorb the imaginative potential of its opposition, it appears that this
recent Californian transformation has now run its course. The terminal nature of the system , what we might call its lateness,
was already evident before 2001 with the rise of the new anticapitalist left in 1999, which expressed significant discontent with the
capitalist idea of the good. However, even today, the problem of attachment remains a significant one. Although the capitalist
machine may seem devoid of meaning and spirit, the dual technologies of bio- and psycho-power mean
that the neoliberal subject , homo economicus, remains the hegemonic psychological type, even though this

way of being currently resembles a zombie mode of subjectivity without life, meaning, or significance .
How, then, is it possible to fight this state of being that is already dead ? Perhaps the only way to resist
this type, which seems to live on after its own death, is to create the conditions for the kind of dialectical reversal
from base materialism to a new kind of imaginative idealism by insisting upon the dystopian state of
the contemporary world system . In order to provide an example of what this dystopia of method might look like, consider Walter
Benjamin’s (2009) work on German tragedy, and imagine that the contemporary global system resembles a kind of baroque catastrophe. In
Benjamin’s (2009) work on the trauerspiel, early modern German tragedy captures the image of tyranny in a state of collapse. The tyrant
seeks to exert control, but continually fails, because fate dictates that his efforts to shore up his empire must
always miss their mark. Realising his terminal situation, the tyrant falls into an abyss of melancholia ,
characterised by a sense of paralysis and a perception of the end: the end of his reign, the end of his meaning, the end of
his-tory. Surveying his world, the sovereign sees nothing but failure, ruination, and decay everywhere.
It is in this dystopian vision of collapse that Benjamin finds utopian possibility and the space of the
new. In a world devoid of meaning and significance, he explains that the exposed thing, or what he calls the creaturely, offers hope for the
future, because it affords the opportunity to begin again. As Susan Buck-Morss (1991) shows, Benjamin saw the same situation played out in
the Paris arcades of the late 19th century, where the ruined objects of early consumer capitalism shone with utopian possibility. Perhaps this
perspective is still appropriate, or even more appropriate, for the contemporary world, where
consumer capitalism has become
a global form, what Benjamin might call a global ur-landscape, a kind of natural background or fate which seems
absolutely inescapable. Frozen in this natural system, there is nowhere to go, and we collapse into repetition,
compulsion, and routine in order to dull the pain caused by our lack of future. However, descent into
the dark underworld of the contemporary addictogenic society offers no real escape, because immersion in the
compulsion to repeat simply emphasises our profane objectivity—unless, of course, it produces reflexive recognition and the
determination to engineer change. There is, therefore, value in ruins . There is ruin value in the debased worker
who is simply a meaningless cog in a machine, ruin value in the prostitute who is little more than a piece of meat bought and
sold like any other commodity, ruin value in the addict who is a slave to junk, ruin value in the slum dweller who must
struggle to survive on a daily basis. In these ruined bodies living in dystopia we confront Benjamin’s (2009)
creaturely life, the blank people Catherine Malabou (2012) calls the new wounded, the waste products of late capitalism who
open up the possibility of the kind of catastrophic and post-catastrophic subjectivity Wilfred Bion explored through his
work. For Bion (1993) these subjects come face to face with bare life, or the thing in itself he captured through his use of the
symbol O, and must find some way forward into the future. In other words, O represents the lived experience of dystopia, a
world catastrophe for a destroyed subject which is also a blank canvas, an island of hope that points towards an infinite number of possible
futures. Although Bion was centrally concerned with catastrophic subjectivity, Benjamin’s (1999) utopians were not only destroyed subjects-
cum-objects—the prostitutes, the beggars, and scum of the capitalist system—but also children, who always exist on the edge of the world,
because they are in the process of being socialised into normal ways of living. Benjamin (2006) found utopian hope in kids,
whose naïve questions—Where did I come from? What is this, that, and the other? Why is the world
the way it is? and so on—suggest distance from orthodoxy and the accepted order of things, because
their way of being suggests a model of imaginative, ludic thought and practice which might enable
everybody else to escape the closure of modern, capitalist society. Against the hard pragmatism of the
capitalist, who is only interested in costs and benefits, Benjamin wanted to wake the capitalist subject up to the dream-world
of the child who invents the future through everyday play. For Benjamin, the human future is hidden within these small

utopias (Stewart, 2010). Even in the contemporary situation, where the child has become a key source of value production for capitalists,
Benjamin would resist despair on the basis that children will always find the new in their play with even the most profane objects. In his work,
capitalism evolves through different conceptions of value, where use value becomes exchange value
becomes symbolic value becomes ruin value becomes utopian value, which results in the transition of
the object from a useful object to a commodity to be bought and sold to a symbol to be exchanged and finally a
ruined piece of waste that signals the closure of one way of thinking and the possibility of some other
path into the future (Featherstone, 2005). This is how Benjamin finds utopia in dystopia, infinity in the finite
and the profane, and suggests we might escape the nihilism of the always the same of capitalism . Ž ižek (2008,
2010) makes a similar point in his recent works on catastrophe and utopia. In his In Defence of Lost Causes (2008), he argues that we must
exploit the current global situation in the name of the lost cause of the eternal idea. However, whereas Ž ižek’s eternal idea
reflects a Platonic notion of justice, I would argue that this concept has little value today, simply because of its inherent
authoritarianism, and must instead be taken to represent a kind of empty signifier, which we need to
fill out through creative practice. Thus, my view is that what the pursuit of the eternal idea of justice calls for is
less some transcendental imperative around division of resources imposed from above and more the
creation of a space of immanence to enable experimentation about what it is people value in life.
Although this call may appear to be based in utopian idealism, I would argue that such activity is absolutely practical and
rooted in the immanent idealism of the child at play. Absorbed in play, this utopian child exemplifies the idea of fixation,
which reflects deep immersion in the objective world, where profane things become magical signs of the future to come. Utopian play is
purposeful, and characterised by practice organised around an imagined goal, but centrally a goal which is open to adaptation
on the basis of creative interaction with changing circumstance. Thus it becomes clear why culture is so important
politically—culture is the space of interaction between the subject and the objective world, where the subject simultaneously
makes meaning in the world and in doing so creates his own identity. In my view, this is what utopian
practice means today, and how we can develop a mode of concrete utopianism to oppose the global
capitalist system that seems devoid of spirit, significance, and human meaning. As Žižek points out in his
apocalyptic Living in the End Times (2010), the generalised crisis of late capitalism, which takes in looming
ecological catastrophe and intractable social division , means that we must find a way to move beyond
the neoliberal utopia-cum-dystopia in the creation of a human world. In my view, culture must play a central role in
this task, because culture is communication, and the basis upon which humans form worlds. Culture is also the medium of human imagination,
creativity, and fantasy, what Winnicott called our little madnesses (Kuhn, 2013). I would argue that we
need more little madnesses
in the contemporary world, simply because neoliberal capitalism has created a worldless world where
meaning is reduced to economic equations around value. There is no humanity in this mode of
thinking. Thus, my objective in this book is to consider the concepts of dystopia and utopia from the vantage
point of the seashore where children play and imagine possible worlds very different from our own . Following this introductory chapter, where I

have sought to read global politics through the lens of the psychoanalysis of D. W. Winnicott, in the next chapter I move on to focus on the situation of contemporary Greece. Wrecked by EU austerity measures caused by fantastical attempts to build a new neoliberal utopia on the back of unsustainable debt and credit, I compare and contrast the Greece of the early 21st century with the Greece of the original utopians, the ancient Greek philosophers Plato (1991) and Socrates, in order to try to articulate a vision of a more socially just, economically sustainable society. In
Chapters 2, 3, and 4 of the book, which comprise the centre of the first part of the work, I move on from this exploration of Greece, which re-reads Plato’s Republic (1991) through the lens of Alain Badiou’s philosophy, in order to try to understand how the contemporary global capitalist model emerged and whether it is possible to read this history through concepts of utopia and dystopia. On the basis that there is no sustained study of the utopian vision of capitalism, which is supposed to be the realist mode of social and economic organisation par excellence, in these
three chapters I track the evolution of capitalism and capitalist thought back through the work of Adam Smith (1982, 1999), John Locke (1988), and Thomas Hobbes (2008) before leaping forward into the works of Milton Friedman (2002) and finally the key theories of contemporary financialisation. In order to kick-start this history, I begin with a discussion of the difference between the capitalist vision of economy and the archaic, primitive view of economy found in Plato (1991), but also anthropologists such as Marshall Sahlins (1974) and Marcel Mauss (2000). Where the
latter primitivists regard economy in terms of the need to sustain life, the capitalists, perhaps starting with Bernard Mandeville (1989) and John Locke, take economy as a means of ever-increasing productivity and profitability. Tracing the development of this history, in Chapter 3 of the book I explore the development of capitalism in America, and particularly across the post-World War II period when Milton Friedman (2002) and the neoliberal thinkers read economics through the cold war cybernetic theory of early computational thinkers such as Norbert Wiener and John

economy evolved from a system for the distribution of scarce goods

Von Neumann, who, with John Nash, was instrumental in the development of game theory (Mirowski, 2002). In order to extend this work, which shows how

necessary to sustain life to a technoscientific cybernetic model concerned with the production of
profit removed from any concern with human or environmental sustainability, I move on to look at the ultimate
form of capitalist, economic abstraction, financialisation, where money makes money without the need for human production. Against this
theory of the non- or post-human dimensions of contemporary economy, where human and world are
subordinate to the needs of the financial system that abolishes the future in the name of debt repayment, in
Chapter 5 of the book I take up an alternative vision of economy, organised around the irreducible sociality
of people and the necessary relationship between human and world explored in the philosophy of Merleau-Ponty
(1969) and Deleuze and Guattari (1994). The aim of this chapter, then, is to suggest a leftist, red-green model of what I call the
minor utopia, where work and productivity are understood in terms of natural productivity and the
satisfaction of need, rather than abstract profit making that harms humanity both in itself and
through the destruction of its biospheric life support system. In this chapter I connect Merleau-Ponty (1969) to Marx
(1988), and recall my earlier reference to Winnicott (2005) on infant creativity, in order to argue that humans are infinitely creative
and imaginative and defined by the need to express themselves and that the capitalist model of
economy has progressively subjugated this potential and reduced humans to profit-making machines.
Inspired by Marcuse’s (1987) work, I suggest that under this utilitarian model there is no room for life or human
imagination that transgresses the current order of things, which is by definition beyond utility . In Chapter 6, I return to the issue of utopian

potential through an exploration of the dystopian dimensions of the ur-space of sociality, the city, in the cinema of the Danish director Nicolas Winding Refn, and particularly the ways in which he situates his characters within an autistic space where social relations never hold and continually break apart. The space of the city is, of course, key here because the history of the ideas of utopia, dystopia, identity, society, economy, politics, and culture can be traced back to the invention of the urban form that creates a space for the articulation of everything human. Akin to a
variety of contemporary utopias, which envision the city in terms of dystopian collapse, Winding Refn’s films, but particularly his most recent works Drive (2011) and Only God Forgives (2013), imagine the globalised city (his cities span the globe, from LA in the West to Bangkok in the East, to create a nightmarish vision of the global city) saturated with asociality, suspicion, mistrust, and ultra-violence. At the heart of both films I consider, the main character is explained in terms of destroyed masculinity rooted in lost childhood and the kind of abandonment one might
imagine Winnicott’s children suffer in the mechanised world where alienated work in the name of profitability is more important than human development. It is on the basis of this work on cultural expressions of global dystopia linked to ideas of the collapse of social and particularly familial relations that I turn, in Chapter 7, to a consideration of the situation of youth in contemporary Britain. In this chapter, entitled Dis-United Kingdom, I move back into straight sociological critique and take up a discussion of the riots of 2011. Building upon the recent work of Bernard

Stiegler (2012), who writes of uncontrollable societies and destroyed subjectivity, I seek to understand the riots in
terms of the explosive frustrations of a blank generation, or what we might call a de-generation, whose future, and thus
utopian hope, has been taken away by the condition of intergenerational abandonment that is implicit
in neoliberal economics, politics, and society. In this dystopia, which I explore through the idea of hoodie horror, the real
horror is not the horror of violent youth (a kind of feral, criminal underclass), but the horror of youth abandoned by a mechanised
economic system that puts profit before intergenerational debt, social responsibility, and a
sustainable, liveable human future. Finally, and in order to conclude the book, I think about possible responses to this hopeless,
dystopian situation and seek to argue for the critical value of what I call the spectre of sociology. Here, in the concluding chapter, I seek to
articulate a new ethico-political role for sociology that transcends a concern with the production of
‘useful facts’ and revolves around the need to oppose the violence of neoliberal capitalism in the
name of a liveable future. Since neoliberalism must ignore an ethical sociology, which consequently
becomes a spectral way of thinking concerned with invisible social relations and abandoned
responsibilities, and instead seeks to transform the discipline of Marx, Durkheim, and Weber into an
instrumental servant of the state that produces fact and never asks questions , I close the book by
suggesting that sociology, sociological thought, and the sociological imagination are ghosts, ghouls, and spectral
manifestations of the future that haunt the neoliberal utopia/dystopia of the present. In the
contemporary critical period, where there appear to be no alternatives but also no way to carry on
with the current order of things , the future is literally unimaginable. Any imagined future is
ridiculous, science fiction, and thus utopian in the worst sense of the word, simply because
instrumental rationality cannot imagine change outside of its fixed vision of the world . This is a truly
dystopian state of affairs that demands utopian thinking. In this respect I argue for a utopian, spectral
form of sociology—a ghostly, value-based way of thinking from the past that we must paradoxically
keep alive in the name of future possibility to come. In this respect I seek to imagine a new version of
sociology, a utopian sociology able to imagine the unimaginable, a critical sci-fi sociology on the seashore.

The semiotic and economic constitution of the system is terminally unsustainable

Featherstone 17 (Mark, Senior Lecturer in Sociology @ Keele U, Planet Utopia: Utopia, Dystopia, and
In his recent high-profile work, Past-Capitalism (2015), Paul Mason paints a picture of global capitalism on its last legs. Following
Piketty’s recent Capital (2014), which presents a similarly grim vision of the future of capitalism, Mason explains that
capitalism has run out of space for development. In his view, the utopian principle of growth , which has
sustained capitalism from its origins in modern Europe up to the present day, is over. As Piketty’s (2014) work
shows, the problem with the principle of growth is that it was always a utopian ideal. Growth was assumed to be infinite, but
what became abun- dantly clear in the early 19705 and has become ever more apparent since is that capitalism has been pushing
up against its technological and environmental limits since the late 19th century (Meadows, Meadows,
Randers, and Behrens, 1972). While the early modern limits of national economic space were escap- able
through imperial adventure, which enabled capitalists to drive down costs and increase profitability in the name of further
development, the devastation of two world wars created a space for growth through reconstruction. At the same time, the American century
took off and new technology opened up a new frontier for further modernisation. Although the turn to
postmodernism challenged the modern conceit that development necessarily equalled progress , and to
some extent imagined the end of capitalist modernisation, the post- modern turn to signification, and the related transformation
of the real into a kind of excremental remainder, created the conditions for the financial inno- vation that
would eventually form the basis of the final modern/postmodern utopia—the global financial system. The
rest is, of course, history. While the happy ’90s saw the articulation of a new form of cyber-utopianism, which was not only good for the
elites who could now play the stock market with wild abandon, but also everybody else who could create and recreate their
identities free from the miserable limits of their bodies, what the collapse of empire Zizek (2009) writes about really entailed
was the realisation that this virtual, informational utopia was no longer sustainable . After the destruction of the Twin
Towers in September 2001, which represented the power of global capitalism, the financial system itself crumbled in 2008
under the weight of excessive debt , which should be understood in terms of the return of repressed materiality
of the world. The problem of the massive debts racked up in order to sustain development under
conditions of neoliberalism was essentially that they relied upon growth to remain serviceable, and this is precisely
what had become problematic in the period since the 1970s. Although the Chinese and Indians have become engines of growth
since the 1980s because they are playing catch-up on Western modernity, the West appears to have become
senile through a lack of long-term prospects for increased productivity and a related failure of
innovation capable of making a real difference in the material economy. This is precisely what financialisa- tion was able to achieve from
the 1980s through the early 2000s, but the problem of this innovation is that the financial elites forgot that ultimately their
empire of signs was premised on real productivity to service debts to enable further debt creation,
ever more innovation, and ultimately growth in the real economy. While there is a case to be made that collapse was
produced by the greed of elites, who pushed debt creation to extremes that meant that it became unsustainable, there is also a sense in which
the problem of the
final utopia of financialisation was that it was fated to collapse from the very beginning
because its commitment to endless virtual growth was produced by and based in a system that had
ultimately run up against its limits in the materiality of the world. It is precisely these limits that came
back in the form of the materiality of debt in the crash and continue to haunt the global eco- nomic
system today. In terms of possible futures, Mason (2015) explains three possibilities. He says that the elites might seek to keep
the current global capitalist system on the rails and continue to extract profit from a low-growth
situation by driving wages down and pushing the masses further into poverty . While this is possible, and
precisely what we see happening across the world simply because there is no sense of a workable alternative to modern/post- modern
capitalism based in the endless expansion of production/consumption, Mason points out that eventually the masses will start to
revolt in response to their increasing immiseration. At this point, the masses will start to vote for either extreme left or
extreme right political parties, and the neoliberal con- sensus that has held since the 1980s will break down. Mason (2015) worries that this
will result in the end of processes of globalisation—which is exactly what we see in the cases of Trump ,
who wants to build a wall around America; separatist nationalist challenges , such as a movement to take the UK
out of the EU; and ISIS , who think it is possible to turn back the clock to the medieval period of history and refound the caliphate based in

sharia law—and that this will create conditions for endless warfare . In many respects this thesis was developed by thinkers such as Zygmunt Bauman (2002) and Paul Virilio (2008) long before Mason saw the collapse of the global consensus into a neo-medievalism, but what

interests me about his work is his exploration of a potential way out of the nightmare that threatens a rerun of a long 20th century made up of 1914-1918, 1939—1945, and 1949—1989. Mason (2015) calls this alternative post-capitalism and starts his account of this new form by explaining that what has destroyed contem- porary capitalism is new technology and specifically information technology. From this point of view, capitalism made use of new technology, and the postmodern turn to signification over materiality, to enable financial innova- tion and maintain
growth in the face of falling rates of productivity, but also—and herein lay Mason’s key idea—-created a new form of value, informa- tion, that is essentially impossible to effectively privatise. Of course, the capitalist system sought to make use of technology to further discipline the worker, through the creation of the techno-proletariat chained to their workplace wherever they happen to be at whatever time of day or night, but Mason’s (2015) point is that even these strategies are unable to completely enclose information and suppress the potential of the commons
inherent in the new network society. While these disciplinary tactics represented, and continue to represent, an attempt to squeeze as much productivity as possible out of the worker in the name of profitability and growth, Mason (2015) points out that it is no coincidence that social media, and platforms such as Facebook and Twitter, took off in the wake of Lehman Brothers’ collapse in 2008. Even though these platforms have also sought to develop ways to monetise infor— mation, and essentially transform communication into data useful for corpora- tions looking to
sell to consumers, Mason does not think it is possible to completely contain or capitalise the ideal economic figure Drucker (2007) talks about in terms of the totally networked person. The reason Mason (2015) believes that the totally networked person will always exceed capitalism and capitalist attempts to monetise communicative labour is because it is ultimately impossible to absolutely privatise digital information that does not degrade with use, but rather remains absolutely reproducible. In Mason’s view, it is precisely this feature, which we might talk about in terms
of the excessive quality of information that means it can never be made scarce, that opens up a space for a new economy based on sharing, common innovation, and social forms of production. Although Mason (2015) would not dispute the late capitalist truth that society is a factory, his question is about what kind of factory we occupy. In his view the late capitalist infor- mational factory is no longer a factory where it is easy for capitalists to extract profit from productivity, because privatisation is extremely difficult to achieve in a world where everybody and everything is
online. As a result Mason thinks that the basis of struggle in contemporary society revolves around the potential of capitalists to privatise and monetise information in the face of its inherent reproducibility and tendency towards commonality. In this respect Mason (2015) rehearses the kind of techno-Spinozan theory of the potential of the multitude developed by Hardt and Negri (2000, 2004, 2009) in their Empire trilogy, where the workers are effectively able to opt out of capitalist processes and form their own circuits of production on the basis of the reproducibility of
information, but it would strike me that what this thesis lacks is an explo- ration of power, and particularly the power of information—rather than knowledge, which I would suggest is information incorporated or incar- nated—to destroy subjectivity and render individuals unable to orientate themselves in their world. It would seem to me then that the problem with Mason’s (2015) account, and also the work of Hardt and Negri (2000, 2004, 2009), is that it underestimates the destructive power of information, particu- . larly when this confronts the individual who is

emphasise the
unable to translate this new data into embodied knowledge. What Mason (2015) lacks, therefore, is a phenomenology of what Negri’s Italian colleagues call semio-capitalism, which in a sense refers to the kind of network economy he thinks will produce a post-capitalist society. Unfortu- nately, the theorists of semio—capitalism are not nearly so optimistic, precisely because of the phenomenological roots of their work, which leads them to

catastrophic consequences of the late capitalist reduction of the material, embodied, and natural to a
kind of excremental remainder of the economic ideal— abstract symbolic, semiotic value without the
material remain- der of quality to obstruct the exchange of pure commensurable quantity. This is the
dark other side of Mason’s (2015) positive take on the infinite reproduc- ibility of information that he thinks will
eventually ensure its democratic commonality. In other words, it is precisely the infinity of digital information, the fact
that it never wears out and can be reproduced without end, that reveals the horror of the capitalist
machine, particularly in its neoliberal form, that takes materiality for something that needs to be
destroyed in the name of creation of monetary value. It is this vision that means that late capitalism will never
stop searching for ways to increase productivity and squeeze profit out of the beleaguered worker
and shows that opposition to this monstrous system should come less from the side of infinite
information which, in my view, is representative of the space of neoliberalism itself, and more from
the exhausted, excremental other of materiality that insists upon the quality, fragil- ity, vulnerability,
and humility of life itself. This is precisely the view that, I think, it is possible to find in the works of the Italian autonomist thinkers,
Marazzi (2008), Lazzarato (2014), Berardi (2015a), and their German colleague Raunig (2016). The key point, it seems to me, in their work
concerns the way in which capitalism
has developed into an ideal, symbolic form that ignores the reality of
materiality that remains the essence of production, and it is for this reason that reference to their work is essential today.
The reason for this is simple—the current crisis is first and foremost a crisis opened up by the
realisation of the chasm between symbolic value (abstract, deregulated, money) and its material
equivalent in the world (labour, productivity). In a sense Mason (2015) picks up on this problem in his book on post-capitalism when he points to the difference between Marx’s (1990) labour theory of value and Walras’ (2010) marginal utility theory, where the contrast is between a form of value concerned with the productive body and one that

pushes the arbiter of worth towards the market. In the latter view there is no inherent value, but only what the market will pay, which is a price that can be arrived at on the basis of calculat ions around supply and demand. However, while this contrast shows how economics was able to start to decouple value from materiality, since the input of the worker is no longer a guarantee of worth, Mason (2015) never really runs with this point in order to illustrate the problem of the late capitalist form Berardi (2015a) and the autonomists talk about in terms of

semio-capitalism, which is' precisely the way in which it ignores materiality for a kind of abstract, ideal
conceptualisa- tion of value that holds its worth essentially because it lacks reality. Here, unreality is
valuable because of its emptiness, its elegance, its beauty, and its lack of weight. By contrast, this is precisely
the reason Berardi (2015a) writes of the monstrosity of the post-human semio-capitalist economy that has no
body and is allergic to the thickness of the thing. For Christian Marazzi (2008, 2011) it is this allergy to thickness,
thingness, and the slowness of materiality that underpins the violence of financial capitalism. He points out
that even though money was always symbolic, ever- increasing abstraction has meant that money and
the value that inheres in the form of money has now vanished into an entirely ideal mode of
expression that is set up against material worth which was, in traditional economy, the real guarantee of value. The reason for this is that
material worth is in a sense always contextual, since it is valuable somewhere to somebody, and this is essentially an obstacle to
absolute commensurability in a global marketplace where any contextual limitations block access to
the smooth spaces of the wide open spaces of what Guattari (2009) wrote about in terms of integrated world capitalism.
From this point of view, what is most valuable under condi— tions of semio-capitalism is what is absolutely shorn of all material, contextual,
worldly value and can be exchanged in totally abstract capitalist space without impediment. Semio-capitalist
code is, therefore, not a thing itself, but rather the reduction of thingness to the state of colourless,
tasteless, meaningless nothingness that paradoxically carries maximum value on the basis of its blank,
bleak mediocrity. The problem for Marazzi (2008, 2011) with the absolute semiological destruction of quality
in blank quantity is that the material world starts to become meaningless because humans live in
semiotic webs that they use to describe and make sense of their world. What happens, then, when these webs are reduced
to code, a series of zeros and ones, in the name of the absolute communicability of value ? Marazzi’s (2008, 2011) answer is to return to Marx (1988) but extend his

man becomes poor in world, unable to

original problem of estrangement. It is now not only that the worker is estranged from the means of production, with the consequence that he becomes a beast, but that the speaking, cultural human is cast out of language, which transforms into a means of economic calcula- tion, where he becomes a stupid animal. In Heideggerian (2001) terms,

properly think about his environment or conceive of a future beyond the present he currently
occupies. The irony of the situation Marazzi (2008, 2011) explains is, therefore, that the contemporary semio-capitalist
society is simultaneously marked by a crisis of significance and an absolute proliferation of
communication . In Berardi’s (2015a) view, these two movements, which seem to pull in opposite directions, are not unconnected, since
the lack of significance contained within language is directly related to the proliferation of the quantity of
signification which overturns the old relationship between language and world in the name of
abstraction and commensurability. Under these conditions where language seems to lose its purchase on the material, and fails
to describe our situation in the world, Berardi (2015a) argues that signification proliferates. Words, signs, symbols,
concepts become meaningless, so they proliferate in a desperate attempt to capture the
meaningfulness of the world , which was, of course, lost in the turn to semio-capitalist abstraction
where signification is about the commu- nication of empty value. Berardi (2015a) writes of this paradoxical
process that opposes lack to excess and degradation to exorbitance in terms of the semiotic inflation of
the postmodern neo-Baroque. Here, he compares the pres- ent to the Baroque, which saw the failure of the old world and the
opening up of the new, in order to explain why more words , more signs , more symbols appear in order to capture
the significance of experience in the world that appears meaningless. Of course, the difference between the two
historical moments, the Baroque and neo-Baroque, is clear. While the Baroque was concerned with the attempt to make sense of the new
modern world, the semiotic inflation of the neo-Baroque emerges from the degradation of lan- guage under
conditions of abstract capitalism. It is this process, that is to say the translation of all signification into
markers of monetary value, that creates the conditions for the neo-Baroque and semiotic inflation related to the
desperate attempt to impose significance upon the world. In this way the problem of complexity in
contemporary global capital- ism is not simply about our inability to think through and understand the
speeds and connectedness of the world, but also about the way that the rise of semio-capitalism has
transformed language into a worldless carrier of abstract value. Given this new, degraded form of language, is it any
surprise that com- plexity seems incomprehensible? For Berardi (2015a) it is possible to trace this problem back to Nixon’s floatation

of the dollar in the early 1970s. In Berardi’s view what this achieved was the deregulation of money, its decoupling
from material referent, and its translation into pure sign. The knock—on effect of this was twofold. On the one hand
money became worldless and able to effectively colonise the entire planet by virtue of its ability to
invade every sphere of life. On the other hand the monetisation of every sphere of life started to undermine
the meaningfulness of the world, with the result that the new global situation began to confront
people like a monstrosity—a nightmarish abstraction they could not understand, but which seemed to
control their lives from afar. The fatal response to this condition has been to generate ever more
signification in an attempt to effectively understand the world, even though the means of cultural
representation and reflection have already been degraded by the imperialism of the abstract money
form . For Berardi (2015a), then, it is no coincidence that Nixon’s deregulation of money and the rise of financial capitalism—where money is simply a sign with no reference to cash or other material symbol of value—emerged in the same period that saw the computerisation of the world. Following Lyotard (1984), who first identified the importance of computation to contemporary capitalism in his The Postmodern Condition, Berardi (2015a) writes of the com- puter in terms of a calculating machine. Where the abstraction of money derealises

significance, deterritorialises value, and essentially un-worlds, the computer seeks to calculate, evaluate, and produce programmatic responses to the new un-world of late capitalism. However, this process of abstract un- worlding and computational calculation is fatal because there is no possibility of the emergence of sensuous meaningfulness. Everything takes place at the level of abstraction, which is why, even when the computer appears to sys- tematise the world—in the case of, for example, the great moderation—there is no sense in which the world feels any less
alien. This is, in a way, the fundamental problem of Mason’s (2015) vision of post-capitalism; That is to say that the problem with his utopia is that it seems absolutely premised on the emergence of a kind of techno-Spinozan multitude formed through the Internet or social media that would not address the problem of the unworldli- ness of contemporary capitalism. Instead of setting about the re-creation of real worlds, it would seem to me that what the techno-Spinozan multitude would achieve would be a kind of degraded, alienated community of people who share

the essential violence of semio-capitalism, which is precisely

likes on Facebook but never reconnect to each other or their world in a more meaningful, phenomenological sense. In this respect, the problem of Mason’s (2015) account is less concerned with economics, and more about the way he misses

about its allergy to materiality, quality, and life that cannot be commodified, quantified, or rendered
absolutely commensurable. What Mason (2015) misses, therefore, is the violence of semio-capitalism that attacks
singularity and trans- lates real life into the meaningless shit of a system that has no time for the
world beyond numbers. In his recent works on indebtedness, Maurizio Lazzarato (2014) refers to Deleuze’s (1997) short paper on the
control society in order to argue that the violence of finance is founded upon the way it subjects quality to
quantity and destroys life in the name of the obligation to balance the books. Follow- ing Deleuze, Lazzarato
explains that the indebted subject—which includes more or less everybody in financialised capitalism—is
enslaved to their obligation to repayment. Under these conditions, the freedom the subject might have had
in democratic society to decide upon alternative futures disappears and they become part of a
cybernetic machine concerned with the service of endless debts. For Lazzarato (2014), Berardi (2015a), and the other autono- mists, this situation of enslavement to numbers stands in stark contrast to the situation in the child prior to processes of Oedipalisation. Before

induction into the nightmarish society of control, the child possesses what Deleuze and Guattari (1987) write about in terms of machinic subjectivity, which sees alternatives everywhere and wants to explore the world. It is the passing of this utopian form of subjectivity into the maturity and enslavement of Guattari’s (2009) integrated world capitalism that, I would suggest, forms the centrepiece of the autonomists’ critique. Of course, late capitalism valorises creativity, imagination, and thinking otherwise, and it is easy to identify this ideology in the Californianism of, for
example, Apple and Google. But for Berardi (2015a) there is a qualitative difference between the form of mock creativity we experi- ence when we pick up the latest Apple product and the imaginative production Deleuze and Guattari (1983, 1987, 1994) prioritise in their works. , In his recent book, And: Phenomenology of the End (2015a), Berardi captures , this difference through reference to notions of conjunction and connection. While the former idea, conjunction, represents true creativity, in that the subject changes through his interactions with others and world,
Berardi thinks connection is a debased, ultimately defensive, mode of conjunction, where the individual reaches out but never really engages with otherness. Where conjunction is an open process, which is essentially decentred, for Berardi connection, and connectivity, is closed and based upon a programmatic centre that dictates the terms of contact. In Berardi’s (2015a) view this is how we relate today, and this is how we should understand the Californianism of Apple, Google, and the other techno-utopians who promise to transform people into creatives who open out
onto the world. Reading Berardi (2015a), it becomes clear that this cannot be the case, because real openness to the world would take place through the (un)mediation of our corporeality which is already in the world. This is, of course, precisely what Dcleuze and Guattari (1987, 1994) mean when they refer to the plane of immanence. By contrast, what computational technology achieves, when it places a media device between self, other, and world, is the disruption of the consistency of the world and the alienation of the machinic subject in the Californian individual

there is no ontological or ecological depth to their work, but instead the

who thinks he is creative because he connects to others programmatically. Although Apple and Google imagine that they connect the world,

(dis)integration of lonely indi- viduals into a cold unity that promises some relief from alienation
through desperate connectivity. That is to say that the lonely individual, cut off from others and world by
semio-capitalism, reaches for the alienation of program- matic connectivity in order to survive. It is
this desperate, defensive strategy that accounts for in turn what Berardi (2015a) refers to through the idea of the swarm
effect, where the simulation of integration appears on the basis of mass programmatic dis-individualism and the fascistic
brand loyalty tech cor- porations, such as Apple, are able to command, simply because they offer some sense of consistency in a world
that seems alien and meaningless. This is, however, a terminal strategy in light of the way
connectivity defends against unworldliness through a denial of the incalculability of materiality, what
Deleuze and Guattari (1983, 1987) variously call the schizophrenic and the machinic, and further disassociates self from other and world.
Although the disorientation of the self is endless, Berardi (2015a) explains that semio-
capitalism is in the process of seeking
to rewire human hardware so that there is no gap between the technological system and human
responses to the environment. Writing of what he calls neuro-totalitarianism , he points out that humans are currently
unable to cope with the complexity of their world and the abstract code given to them to make sense of their environment. Humanity’s
organic neural networks are out of line with the technological networks which have evolved through
processes of globalisation. Although our brains are plastic, and can evolve within reason, for Berardi (2015a) we have reached the
limit of organic humanity in contemporary cyber—time. In the face of the lightning speeds of semio-capitalism, he
explains that a range of psychological/neurological problems have emerged : dyslexia, dyspraxia, attention deficit disorder, and a range of addictions concerned with a desperate need for stimulation. Consider the example of

sex addiction. In Berardi’s (2015a) view, sex addiction is the result of the loss of the other brought about by late capitalism. In the face of endless work, which saps energy, and instru— mental rationality, which destroys the possibility of eroticism, sex transforms from an affective relation in the world to an objective encounter fetishised by the misery of loneliness and fantasies about the pleasure of the other. However, the sex addict, who occupies the space of drive and is only really concerned With his own trauma, takes the other for an object. The other is a commodity,
an object, a despised thing, which is precisely why the other can never really solve the addict’s problem—the loss of human orientation towards the other and beyond this, the world itself. Unfortunately, Berardi (2015a) cannot even find potential salvation from this horror show in the figure of a mother who might provide children with a more sensuous, affective, and essentially human introduction into the world, because he notes that contemporary kids tend to learn their first words from machines. The problem here is that words learnt from machines fail to establish a
relation between language, touch, and the sensuous world, but instead induct kids into a monstrous world of abstraction where words have no real connec- tion to things and thus never provide them with the machinery to reflect back upon their own experience. While Merleau-Ponty (2011), the philosopher who casts a long shadow over this theory, finds the roots of the alienation of self from world in the modernity of Descartes, Berardi (2015a) looks to the origins of America and the Puritans who were already out of place and ended up despising life itself in the name
of abstract perfection. In his view we can, therefore, find the roots of semio-capitalism in the original American settlers who, he explains, invented the cybernetic figure of the more than human neo-human. From this perspective, the history of modernity through post- modernity, and the history of capitalist economics from Smith (1982, 1999) through Friedman (2002), might be re-read in terms of the evolution of the neo-human who finally finds his un-home in the neoliberal society. As such, Berardi (2015b) thinks the 1970s realised what started in early modern America,
and captures this through reference to Bowie’s enigmatic Heroes. Here, Bowie’s line ‘We could be heroes . . .’ is simultaneously a recognition that there will be no more heroes in the new programmatic society where everybody is a pseudo-individual, and a desperate call for heroism in a world marked by depression, despair, and the end of utopian hope. Despite the rise of the neo-human, represented by the fantasy of the always- on worker who spends his days and nights searching for new ways of making money, and the collapse of real heroism into the fantastical
celebrity, the media star Adorno and Horkheimer (1997) explored in their Dialectic qf Enlightenment, humans are not machines and cannot live without others and world. In this respect perhaps the best representative of the horror of the neo—human in semio-capitalism is the Japanese hikikomon' who cuts himsey (because the shut- ins are usually young men) off from material interaction with others, but then reaches them through machines—the various computers and new media technologies that form the monstrous architecture of his semio-capitalist womb.

the hyper-connective environment is

Although the hikikomon‘ retreats towards this techno womb in order to escape the horror of the world, which seems frightening and threatening, the problem with his strategy is that it offers no escape. As Berardi (2015a) notes through reference to South Korea, the most connected society in the world, which also has the highest suicide rate,

unlive- able. Under these conditions, where the connected are cast into a living death by technology
that transforms them into tech-no-bodies, suicide seems like the only way out. The real alternative,
disconnection from the machine, seems impossible and largely unimaginable. However, for Berardi (2015a), this is
precisely what must happen through, first, the poetic reclamation of language able to express the sensuous, affective materiality and depth of
life beyond measure, and second, the reconstruction of the real world through this new language which is itself founded upon the perceptive
interactions of self and other in the environment. When Berardi (2012) writes of the
uprising, then, what he means is opposi- tion
to the deregulation of reality in semio-capitalism. We could say that what Berardi proposes here is the schizophrenic
deregulation of late capitalist deregulation, which has led to the post-human territoriality of abstract
economics and neo-human nobodies, and the reconfiguration of new ecologies based upon the
ontological relation between self, other, and world that are irreducible and real beyond the dire
constructed, symbolic order of capitalism that imposes a false order of scarcity and excess upon
humanity . While Mason (2015) founds struggle upon enclosure, the problem of private property, and capitalism’s need to gener- ate surplus value, Berardi (2015a) shifts the terrain of battle towards ecology, environment, and the human life world that semio-capitalism seeks to destroy in the name of abstraction. This is why Mason’s (2015) utopia of open source connectivity is not enough from Berardi’s point of view. From this perspective the Californian utopia of Apple, Google, and info tech is in reality a dystopia of absolute

capitalism that transforms the embodied human into the abstract neo-human and then sells the desperate, disassociated self a fantasy of interaction, interconnectivity, and creativity, which it invariably consumes in order to try to ease the pain of mutilation and loneliness. Against the fantasy world of Steve Jobs and the other virtual utopians, Berardi (2015a) finds the truth of the semio- capitalist utopia in the paranoid dystopias of the other Californian, Philip K. Dick, where technology is never a route to some happy, creative dreamworld, but instead the gateway to the
kind of neuro-totalitarianism he identifies with Google’s latest attempts to translate reality itself into a live data set. However, the situation is far from hopeless because, in Berardi’s (2015a) view, paranoia, which derealises the normal utopia of semio-capitalism into a sinister dystopia, and depression, when the future looks bleak and we cannot see a way forward, create the conditions for the new on the basis of their destruction of the constructions of the present. Through reference to Guattari’s own winter years, Berardi (2008) argues that

depression has the potential to produce political change . Although depres- sion and despair are more
normally associated with exhaustion and an inability to act, Berardi suggests that the desperation of
depression, the very lack of future , may produce the will to change , precisely because no external
possibility of change seems present. In this way Berardi (2008) connects depression and despair to voluntarism and the
revolutionary will and argues that alterna- tive worlds might be born in the darkness of misery . Akin to Philip K.
Dick, and perhaps the 20th century’s most famous paranoiac, Daniel Paul Schreber, Berardi suggests that other worlds grow out of
disassociation from the now and a refusal to accept reality in its present configuration . In his own dark
fantasy, semio-capitalism is really a kind of thanato-economics, which destroys the individual who cannot sleep for
electronic images flashing before his eyes, that pushes towards the critical point Guattari (1995) called the chaosmic spasm
suggestive of a new kind of reality. Although Berardi (2008) never really spells out what this new reality would look like, my sense
is that where his critique of semio-capitalism leads is Deleuze and Guattari’s (1987, 1994) plane of immanence or the body without organs
where the self is immersed in the other and world and reality is based upon anonymous flows of perception that meet in the formation of
subjectivities comfortable with openness. In his book After the Future (2011), Berardi tells us that the future expired sometime in the 1970s,
around the time the Sex Pistols closed their Anarchy in the UK with the refrain ‘No Future’, because this is when language started to collapse
into abstract signification. Shorn
of the ability to write the present, or effec- tively remember the past, the
future began to disappear, especially for the young, because there was no way to construct temporal
trajectories out of the now. In this respect Berardi’s (2011) vision of the horror of neoliberalism is very close to Bernard Stieglcr’s
(2009, 2010, 2013) account of the problem of disorientation. Similarly, Berardi and Stiegler are also more or less in agreement about how to
respond to this situation. Where Stiegler (2013) suggests political struggle over the status of knowledge, which in his view mustbe
wrestled away from technocrats who are only interested in instrumental rationality so that it can
enable people to better understand their world, Berardi’s (2012) turn to poetry and sensuous thought is about the
reclamation of language in the name of the reconnection of speech, writing, and the body that perceives. Only when this happens,
and there is a relationship between embodiment, perception, suffering, thought, and articulation in
language and culture, will we be able to escape the horror of the permanent present of semio-capitalism
where humans have been reduced to the status of soft machines and language is little more than a
tool for keeping accounts. In a sense, then, it is clear that Berardi is, like Stiegler, keen to protect the human, and the humanist
tradition, from the post-humanism of techno-semio-capitalism. However, it is also clear that he has little time for the possessive individualism
that conspires with the nihilism of capitalism and prefers instead the kind of eco or geo-philosophy Deleuze and Guattari (1994) wrote about in
their final work, What Is Philoso- phy? I think the reason for this is clear. Deleuze and Guattari’s concepts of the
plane of immanence
and the body without organs have the potential to translate the destroyed capitalist self, who is
defined by lack, despair, and indebtedness, into an ecological subject founded upon its relation to
others rooted in the environment. With regard to the way in which the shift from semio-capitalism to a more
ecological, material world might take place, there is once more common ground between Berardi (2011, 2015a) and Stiegler
(2014). For the latter, late capitalism has exhausted itself in instrumental rationality to the extent that the
very spirit that supported its progress into the future has vanished. The critical moment this loss of spirit
produces is, for Stiegler, a moment of cata- strophic possibility. The same is the case with Berardi who, in works such as
After the Future (2011) and And (2015a), presents the collapse of the future and the destruction of the self in
depression and despair in terms of a schizo- phrenic strategy where the autistic semio-capitalist individual might open out
onto the complicity with everybody and everything that surrounds them. Unlike Stiegler (2013), who takes his lead from Derrida, Berardi’s
(2015a) theory is straight out of Deleuze and Guattari, who imagined a similar schizo- phrenic cartography. More specifically, Berardi (2008)
draws on Guattari’s theory of transversality, which he developed in his work at La Borde, in order to think through the possibility of a new
flat ontology. Here, human psychol- ogy is no longer premised on Freudian Ocdipal relations between Mom, Dad, and me, but rather self, other,
and a new third object capable of opening up schizophrenic possibility. Given Deleuze and Guattari’s (1994) geo-philosophy, Guattari’s (2014)
late concern with ecology, and Berardi’s (2015a) own focus on the importance of materiality, my view would be that this third object must be
world, or perhaps more properly earth, since earth is where humans find their ontological roots. It
is impossible for humans to
survive without earth , and it is on the basis of their perception of earth that they develop culture and
create life worlds. The problem with the current, semio-capitalist, world is, however, that earth and
human perception have been abandoned for abstraction and this has led humanity into crisis , where
the global social, political, economic, and perhaps centrally cultural system no longer works . According to
the German thinker Gerald Raunig (2016), the problem of the present is precisely the militarised neo-human, the
individual, who resists the truth that he is born and lives in others, worlds, and earth . Reading Raunig’s recent work, it is clear that the late capitalist individual—who evolved out of a

long history of attempts to theorise the self-identical self stretching back to Descartes (1984)—is essentially a paranoiac, living in a delusional universe where there is a very clear line between self, others, and world. In this respect we confront the solipsistic dimension of paranoia, which seems to throw Berardi’s (2015a) view of the use value of paranoid thought into sharp relief, where the traumatised self cuts himself off from the world in his own fantasti- cal private space. However, in much the same way that Berardi (2008) seeks out the possibility of depression,

the militarised, neo-human individual is representative of the final

despair, and withdrawal from trauma, which is, of course, a key strategy of Italian workerism where the central idea was to refuse labour, Raunig (2016) thinks that

moments of the self-enclosed, solipsistic self and that breakdown will ultimately result in the
emergence of a new form of ecological subjectivity he writes about through the anthropological idea of dividualism. While Deleuze and Guattari (1983, 1987), and following them Berardi (2015a), rely on the figure of madness, the schizophrenic, to capture subjectivity beyond individualism, Raunig (2016) refers to anthropology, and shows

how non-Western primitive society is defined by dividualisnL Here, where the gift economy prevails, there is no sense that there is an individual who can balance his books and somehow extract himself from society, but rather a recognition of dividualism, where the self is naturally divided in origins, reliance, and future potential in others and the environment. While this form of interdependence and reliance has become a symbol of weakness under conditions of Western modernity because of its associations with vul- nerability and fiagility, Raunig’s (2016) suggestion is

the armoured self, the Freudian ego, that confronts the environment through military
that dividualism is the truth of the world and that

operations is an unsustainable fantasy .

1NC Implementation Fails
The aff builds on a broken foundation- the process of initial ACA passage means the
aff will be implemented poorly and constantly challenged
Adler 16 Jonathan H. - Johan Verheij Memorial Professor of Law and Director, Center for Business Law
Regulation, Case Western Reserve University School of Law, Of Kings to Come: The Future of Care
Reform Still Remains in Federal Court, 20 Emp. & Emp. Pol'y J. 133, 146 (2016) Provided by: Harvard Law
School Library
These factors are all important contributors to ACA litigation, but they are not particularly unique to the
ACA. As already noted, there are many other federal statutes that are costly and complex and require
substantial amounts of administrative implementation, and there are many other federal statutes that
have spawned substantial amounts of litigation. There are other things about the ACA , however, that
magnify the incentives and opportunities for litigation. Start with how the ACA was enacted." Drafting
large, complex regulatory statutes is hard. Making sure all the pieces fit together and work as planned is
difficult stuff. The ACA, however, did not go through the usual processes that help ensure that laws
enacted achieve their stated purposes. 16
The law that was enacted was not a finished product. It was, for all intents and purposes, a negotiating
draft, and was not the bill that anyone had initially intended to enact.17 Health care reform legislation
initially passed in both the House and Senate. Supporters of reform planned to reconcile the competing
bills in a House-Senate conference, as is the usual congressional practice. Yet this was not to be. Scott
Brown's victory in the Massachusetts special election to fill Senator Ted Kennedy's Senate seat deprived
Senate Democrats of a filibuster-proof majority. This meant that the product of a HouseSenate
conference could not be enacted, as there were not enough votes. The only way that health care reform
could become law would be for the House to enact the Senate bill. Some modifications to what would
become the ACA were made through the reconciliation process, but not every desired modification
could be made."
One consequence of enacting the Senate drafted bill without the benefit of a House-Senate
conference was that the bill did not go through the traditional editing and revision process that helps
to ensure that legislation accomplishes its stated aims.19 During a HouseSenate conference, legislators
from each chamber negotiate over the fine points of the bill. More importantly, legislative staff review
and revise the technical language of the legislation to ensure greater consistency and clarity and fix
potential drafting errors. With the ACA, however, none of this occurred.20 Another benefit of a
HouseSenate conference is the production of a conference report that reviews the final bill and details
the purpose and effect of each provision. Such a report can help clarify the meaning of complex or
ambiguous statutory text. Yet without a House-Senate conference, there was no conference report to
serve as a guide to interpreting the ACA.21
The way the ACA was enacted encourages the persistence of litigation in another way. Rightly or
wrongly, Republican critics of the ACA view it as a partisan enactment. Unlike previously enacted social
welfare legislation of equivalent scope or scale, the ACA was enacted along party lines.22 Further, the
law was enacted - critics would say forced through - using an unorthodox procedure. ACA proponents
used the reconciliation process to enact the ACA because there were not enough votes to prevent a
filibuster. Under reconciliation, a simple majority would suffice. To bill opponents, this represented a
willingness to write the rules and force the bill through - and if extreme measures could be taken to
enact the ACA, extreme measures (such as persistent litigation) would be justified to undo it.2 3
Whether such perspectives are justified is not the point here. Whether justifiably or not, ACA
opponents see the law as less legitimate than legislation enacted on a bipartisan basis and through
more traditional means . Feeling this way, some ACA opponents have looked frantically for ways to
undo or undermine the law. Litigation, in this perspective, is a means to an end - a way to fight back
against legislation that (some critics believe) should not have been enacted in the first place.24

ACA has no chance of success- implementation tainted the pot and mean it can never
be effectively pursued
Adler 16 Jonathan H. - Johan Verheij Memorial Professor of Law and Director, Center for Business Law
Regulation, Case Western Reserve University School of Law, Of Kings to Come: The Future of Care
Reform Still Remains in Federal Court, 20 Emp. & Emp. Pol'y J. 133, 146 (2016) Provided by: Harvard Law
School Library
The ACA creates a perfect storm for litigation, unlike any we have seen before.o Litigation over large,
complex, and costly legislation is inevitable. Yet there are reasons to suspect that ACA litigation will be
greater, as the ACA, its enactment, and its implementation all provide more than the usual amount of
fuel for the litigation fire.
It is common for the enactment of major regulatory legislation to be followed by years of litigation. In
simple terms, the larger and more complex a piece of legislation is, the more there may be to sue over.
The 1990 Clean Air Act Amendments and ERISA are but two examples of large statutes that spawned
extensive amounts of litigation - litigation that continues to this day." Spanning hundreds of pages, the
ACA certainly belongs in this company.1
The greater the economic costs and consequences of a piece of legislation, the more likely it is to be
litigated as well. Thus the cost of the ACA, and its effect on private investment decisions, also feed
litigation. Health care spending accounts for approximately one seventh of the U.S. economy.13 In
remaking this sector of the economy, the ACA creates lots of winners and losers. Some companies and
sectors gain substantially from the ACA's provisions, while others stand to lose. Given the amounts at
stake, litigation is inevitable as winners seek to protect and preserve their gains, losers seek to
minimize their losses, and other interests spy rent-seeking opportunities.
The ACA is also particularly complex. Such complexity - and the resulting uncertainty - further
encourages litigation. If the ACA were simple, clear, and straight-forward, there would be less legal
uncertainty and less to litigate over. The specific structure of the ACA further expands the
opportunity and incentive for litigation. For starters, much of the ACA does not go into force
automatically. Rather, as is common for complex statutory schemes, the ACA delegates the
responsibility for implementing key provisions to various federal agencies, primarily within the
Department of Health and Human Services and the Department of the Treasury, and this will require an
extensive amount of rulemaking.14
That so much of the ACA must be implemented by federal agencies - and remains to be implemented
even five years after passage - magnifies the opportunities for litigation. Each rulemaking and binding
administrative decision represents a final agency action that may be challenged in court. With each
administrative decision, implementing agencies are choosing interpretations and policies that will
inevitably please some interested parties and disappoint others. Those that are disappointed then have
the opportunity to take their objections to court.
They lead to rationing for scarce resources.
Williamson 17 director of the National Review Institute’s William F. Buckley Jr Fellowship Program in Political Journalism (Kevin D., “The
‘Right’ to Health Care,” National Review, May 7, 2017,
The ‘Right’ to Healthcare
There isn’t one.
With the American Health Care Act dominating the week’s news, one conversation has been unavoidable: Someone — someone who pays
attention to public policy — will suggest that we pursue policy x, y, or z, and someone else — someone who pays a little less careful attention,
who probably watches a lot of cable-television entertainment masquerading as news — responds: “The first thing we have to do is
acknowledge that health care is a human right!” What follows is a moment during which the second speaker visibly luxuriates in his display of
empathy and virtue, which is, of course, the point of the exercise.
It’s kind of gross, but that’s where we are, politically, as a country.
Here is a thought experiment: You have four children and three apples. You would like for everyone to
have his own apple. You go to Congress, and you successfully persuade the House and the Senate to endorse
a joint resolution declaring that everyone has a right to an apple of his own. A ticker-tape parade is held
in your honor, and you share your story with Oprah, after which you are invited to address the United Nations, which
passes the International Convention on the Rights of These Four Kids in Particular to an Individual Apple Each. You are visited by the
souls of Mohandas Gandhi and Mother Teresa, who beam down approvingly from a joint Hindu-Catholic
cloud in Heaven.
Question: How many apples do you have?
You have three apples, dummy. Three. You have four children. Each of those children has a congressionally endorsed, U.N.-
approved, saint-ratified right to an apple of his own. But here’s the thing: You have three apples and four children. Nothing has

Declaring a right in a scarce good is meaningless . It is a rhetorical gesture without any application to
the events and conundrums of the real world. If the Dalai Lama were to lead 10,000 bodhisattvas in meditation, and the
subject of that meditation was the human right to health care, it would do less good for the cause of actually providing people with health care
than the lowliest temp at Merck does before his second cup of coffee on any given Tuesday morning.
Health care is physical, not metaphysical. It consists of goods, such as penicillin and heart stents, and services, such as
oncological attention and radiological expertise. Even if we entirely eliminated money from the equation,
conscripting doctors into service and nationalizing the pharmaceutical factories, the basic economic
question would remain.
We tend to retreat into cheap moralizing when the economic realities become uncomfortable for us.
No matter the health-care model you choose — British-style public monopoly, Swiss-style subsidized
insurance, pure market capitalism — you end up with rationing: Markets ration through prices,
bureaucracies ration through politics. Price rationing is pretty straightforward: Think of Jesse James and his “Pay
Up, Sucker!” tattoo on his palm. Political rationing is a little different: Sometimes it happens through waiting lists and the
like, and sometimes it is just a question of money and clout. American progressives love the Western European medical
model, but when Italian prime minister Silvio Berlusconi needed a pacemaker, he came to the United States to have it implanted.
Rich people always get better stuff. That’s what it means to be rich. And money is only one resource: Political connections matter enormously
in some places, as might a good family name or employment in a powerful firm. If you live in one of the poorer corners of the world, you may
have “free” health care, meaning that if you should become infected with HIV, you will get a free aspirin. On the other hand, the Coca-Cola
Company distributes antiretroviral drugs, free of charge, to employees around the world being treated for HIV. That may seem unfair to us.
That may be unfair. It
may be unfair that you have four kids and three apples. After we are done lamenting
the unfairness of it all, what do we do?
Ideally, we’d plant some apple trees. We would find ways to invest in medical care with an eye toward
making it more effective and less expensive. There is no substitute for abundance. And the great enemy
of abundance is the bias against profit. There is something deeply rooted in us that instinctively thinks we are being abused if
someone else makes a profit on a deal. That is a dumb and primitive way of thinking — our world is full of wonders because
it is profitable to invent them, build them, and sell them — but the ang
1AC provides reproductive health services for undocumented

Trump says he’ll act against immigrants on welfare soon but hasn’t yet
US News 17 (6/21/17, US News “Trump Calls for Stricter Limits on Welfare for Immigrants”
CEDAR RAPIDS, Iowa (AP) — President Donald Trump said Wednesday he'll pursue legislation that
would bar immigrants from being eligible for welfare for at least five years — though most already are.
Trump said at a rally in Cedar Rapids, Iowa, that "the time has come" for "new immigration rules" that
would require those seeking admission to the country to be able to support themselves financially and
would bar the use of welfare for a period of at least five years.
He said his administration would be "putting in legislation to that effect very shortly."
It is unclear, however, how Trump's proposal would change the current situation.

Losing on health care causes Trump to look for an easy win on immigration
Racke 17 (Will, 6/28/17, Reporter at Chicago Business Journal “Trump Looks For Easy Win On
Immigration After Health Care Delay”
President Donald Trump will pivot to a pair of immigration bills Wednesday, following a major setback
to Republican efforts to move forward on a health care reform law.
Trump is backing two proposals working their way through the House of Representatives: A measure
that would pull funding from sanctuary cities and another that would stiffen penalties for illegal aliens
caught entering the U.S. after being deported. The bills are expected to pass a Republican-controlled
House before lawmakers adjourn for the July 4 holiday recess. (RELATED: WH: Signing Anti-Illegal
Immigration Bills Is A Priority)
In advance of a House vote scheduled for Thursday, the president will host a meeting with the victims
of crimes committed by illegal aliens at the White House, reports the Washington Examiner. The
move draws attention to one of Trump’s legislative priorities, tougher
immigration enforcement, and away from the GOP’s stalled plans to repeal and
replace Obamacare.
The effort to craft a repeal bill fell into disarray Tuesday, when Senate Majority Leader Mitch
McConnell was forced to table a vote due to defections by a dozen Republican senators. It was an
embarrassing blow to the White House, which has struggled to get Republicans to follow through on
Obamacare repeal, one of the president’s signature campaign promises. (RELATED: Trump Tells GOP
Senators ‘We Aren’t Going To Like’ It If They Don’t Pass Health Care Bill)
Trump finds his party more unified on the immigration question than on health care reform. Though
many GOP legislators have pushed back against the administration’s proposal to build a wall along the
U.S.-Mexico border, the House immigration enforcement bills enjoy widespread support among
Congressional Republicans.
That turns case – it results in a deportation of all immigrants who have used public
welfare and enroll in health insurance
Thompson 17 (Derek, 2/1/17, Senior Editor for The Atlantic “Trump Has a Message for Poor Immigrants:
Get Out”
After less than two weeks in office, President Donald Trump has issued executive orders that have the
potential to rewrite American immigration policy and undermine its global reputation as a destination
for the world’s brightest—and its most needy.
Indeed, that is the plan. As Steve Bannon, the president’s chief strategist, has said of America’s weak
economic growth: “Twenty percent of this country is immigrants. Is that not the beating heart of this
problem?” (The actual number is closer to 13 percent.)
Last Friday’s executive order temporarily banned refugees along with immigrants from seven Muslim-
majority countries. This week, The Washington Post has received drafts of two additional executive
orders that the president is reportedly considering signing. Among other things, they call for the
deportation of poor legal immigrants who take any government welfare, an
extraordinarily broad group that could include middle-income families who get tax credits for their
young children. They would also make it much harder for low-income immigrants to move to the United
The government already blocks many immigrants who may become a "public charge.” Under current
law, the U.S. can deny entry to individuals who are likely to rely on cash assistance. The new executive
order would broaden the rule to also deny immigrants who are likely to enroll in Medicaid, or require
child-care or housing subsidies.
But the order goes even further, saying “the United States does not welcome individuals who are likely
to become, or have become, a burden on taxpayers." The language is vague, but immigration law
experts I spoke with on background said it might mean that millions of legal immigrants who have ever
received public assistance—as half of native-born Americans currently do—would be targeted for
deportation. What’s more, the executive order would force these immigrants’ employers to pay the U.S.
government back for any public health care or tax welfare incurred before deportation. As Vox’s Dara
Lind writes, it would build a wall around public welfare and hang a sign on it: For Native-Born, Only.
Finally, the Trump administration is also reportedly mulling severe restrictions to the availability of H-1B
visas, a type of work visa that is commonly used to hire foreign-born workers at technology companies
and other white-collar firms. The order’s language is broad, but it seems to restrict H-1B visas to high-
wage earners.
Even if you discount the idea that the United States is big and rich enough to share its bounty with a
handful of foreign-born individuals from war-stricken countries, the economic case for immigration is
strong. Immigrants are more likely to start companies than native-born citizens and less likely to use
welfare; when on welfare, they use fewer benefits. Despite what Trump’s supporters might think,
existing U.S. immigration policy is not exactly a confetti canon of food stamps for the foreign-born.
Undocumented workers are barred from public benefits, and most immigrants cannot receive federal
benefits like SNAP for their first five years in the U.S. unless they have refugee status.
The lesson here is not subtle. The administration’s top priority, above health care or tax policy, is to
send an unambiguous message to immigrants—particularly those who are non-white and Muslim: We
are closed for business; go home, or stay home. This is how a country builds a wall without laying a
1NC Corruption
Corruption turns the case
Klein 14 (January 16th, 2014, Ezra Klein is an American journalist, blogger, and political commentator
who currently serves as editor-in-chief of Vox, “Is the U.S. too corrupt for single-payer health care?”
You often hear people say that the reason the United States doesn't have a single-payer health-care system is that special interests have a hammerlock on Congress. But in the course of
The reason
reporting out my article on what liberals miss about single payer, Princeton's Uwe Reinhardt, a single-payer supporter, made an interesting variant of this argument:

the United States shouldn't have a single-payer system, he said, is that it's too captured by special
interests to manage one well. "I have not advocated the single payer model here," he said, "because our
government is too corrupt. Medicare is a large insurance company whose board of directors (Ways
and Means and Senate Finance) accept payments from vendors to the company . In the private market, that would get
you into trouble." The key to a single-payer system is that the government sets prices. Usually, it empowers boards of independent experts who set those prices low.

Reinhardt's argument is that in the United States, health industry interests have so much sway over Congress that

the prices would end up being set by health-care interests. "When you go to Taiwan or Canada," Reinhardt said, "the
kind of lobbying we have here is illegal there. You can’t pay money to influence the party the same way. Therefore the bureaucrats
who run these systems are pretty much insulated from these pressures. Here you have basically a
board of directors in the House Ways and Means Committee that gets money from lobbyists both at the
regulatory writing stage and during normal operations. And they can call an administrator and demand they stop something from happening." The question in any argument like this is the
counterfactual. Outside of Medicare, Medicaid and some other government-run health systems, prices are set by health-care interests now. But they're much lower in Medicare and Medicaid
than they are for private insurers. So it's simultaneously possible for the U.S. government to be much worse at setting prices than, say, France's government, but still be able to negotiate much
lower prices than private insurers can manage. Still, Reinhardt's argument is a reminder that the simple fact that a policy worked in another country does not mean it will work in this country.
One of the most interesting pricing experiments in the United
His point about the importance of independence is particularly crucial.

States is all-payer rate setting, where public and private insurers band together to negotiate with
providers. There was a time when all-payer rate setting was common. Now it's only used in Maryland (see Sarah Kliff's report on Maryland's unique system). Why? Because
Maryland based its plan around a genuinely independent board , argues health-care expert Paul
Ginsburg: In the 1970s, a number of northeastern and mid-Atlantic states set hospital rates for private payers and Medicaid, and some received waivers to include Medicare in their
systems. When the shift away from regulation took hold in the 1980s and Medicare inpatient prospective payment was thought by many to be adequate to control hospital costs, each of the

I believe that Maryland’s staying power is a direct result of its

systems was abandoned except for Maryland, which continues to this day.

structure as an independent regulatory agency . The Maryland Health Services Cost Review
Commission resembles what some are discussing today as the “Federal Reserve Board” model of governance for
health care. The governor appoints volunteer commissioners to long terms, and commission decisions are

not reviewable by the legislature or executive branches.

1NC Underlying Inequality
Increasing access doesn’t reduce health disparities – it just drives disparities in the
quality of care.
Schpero et al 17 (William L. Schpero, PhD student in the Department of Health Policy and
Management, Yale School of Public Health, Nancy E. Morden, associate professor of community
and family medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Geisel
School of Medicine at Dartmouth, Thomas D. Sequist, associate professor of medicine and
health care policy at Harvard Medical School, Meredith B. Rosenthal, professor of health
economics and policy in the Department of Health Policy and Management, Harvard T. H. Chan
School of Public Health, Daniel J. Gottlieb, research associate at The Dartmouth Institute for
Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, and Carrie H. Colla,
associate professor at the Dartmouth Institute for Health Policy and Clinical Practice, Geisel
School of Medicine at Dartmouth (“For Selected Services, Blacks And Hispanics More Likely To
Receive Low-Value Care Than Whites,” Health Affairs, Vol. 36, No. 6, pgs. 1065-1069, June
2017, Available to Subscribing Institutions, Tables omitted)
Study Results The black, white, and Hispanic Medicare populations that we studied were qualitatively
similar in terms of age, percentage female, risk score, number of outpatient visits, and proportion of
outpatient visits to primary care providers (Exhibit 2). Black and Hispanic beneficiaries tended to live in
ZIP codes with lower median household incomes and were more likely to be disabled and enrolled in
Medicaid, compared to white beneficiaries. We found that receipt of low-value care among black and
Hispanic beneficiaries was often demonstrably higher, compared to white beneficiaries. For example,
fewer than 5 percent of white Medicare patients with dementia received a feeding tube, compared to
more than 17 percent of black and nearly 13 percent of Hispanic patients with dementia (Exhibit 3).
Similarly, more than one-third of black beneficiaries received opioid or butalbital prescriptions for the
treatment of a migraine, compared to fewer than one-fourth of white beneficiaries. And more than 16
percent of Hispanic beneficiaries inappropriately received bone density testing, compared to fewer than
10 percent of white beneficiaries. Before adjustment for covariates, we found that receipt of low-value
care among black and Hispanic beneficiaries was significantly higher than receipt among white
beneficiaries for seven of the eleven services measured (Exhibit 1). After adjustment for covariates, we
found that receipt of low-value care was significantly higher for five of the eleven services among black
beneficiaries and for six of the eleven services among Hispanic beneficiaries (Exhibit 4). Adjusted relative
odds of receipt were highest for feeding tube placement in both black and Hispanic beneficiaries with
dementia. Adjusted relative receipt for black beneficiaries was lowest for inappropriate use of
antipsychotics with dementia and for Hispanic beneficiaries was lowest for inappropriate use of opioid
prescriptions for the treatment of migraines. Greater use of the health care system, defined as the log
of the number of outpatient clinician visits, was associated with significantly higher rates of low-value
care for five measures among black beneficiaries and for six measures among Hispanic beneficiaries,
relative to white beneficiaries (Exhibit 5 and Appendix Exhibit 2).9 These included the administration of
antipsychotics to patients with dementia, cervical cancer screening, bone density testing, and vitamin D
screening. Discussion For a selected set of services, we found that black and Hispanic Medicare
beneficiaries often receive more low-value care than white beneficiaries do. Despite ample evidence
that minority patients generally receive fewer effective services (such as cancer screening and
diabetes monitoring), we did not discover a corresponding protective effect against the receipt of low-
value, potentially harmful, care. For nine of the eleven measures, we found that the adjusted odds of
receiving low-value care were directionally similar for black and Hispanic beneficiaries relative to
whites ; this suggests differential care irrespective of specific minority race or ethnicity .
Race/ethnicity differences varied considerably across the low-value services studied, which suggests
that a singular corrective intervention is unlikely to be universally effective. The mechanisms underlying
the apparent receipt of more ineffective care among minority beneficiaries for some services remains
unclear, but they warrant rigorous exploration and explicit targeting by quality improvement efforts.
Underuse of effective care among black and Hispanic patients in the United States has commonly
been attributed to obstacles in accessing the health care system .1 In our study, the relationship
between the use of health care and the receipt of low-value care was positive for some measures.
Suggestions that greater health care utilization through improved access would reduce disparities in
the receipt of effective care might be tempered by our findings that greater utilization may similarly
increase receipt of some forms of low-value care, thus actually widening disparities in care quality .
The findings from this study of a selected set of low-value services suggest a complex relationship
between minority status and the US health care system. Importantly, greater receipt of certain low-
value services among black and Hispanic patients may crowd out the receipt of effective care , thus
compounding broader disparities in health care and health outcomes. As the health care community
wrestles with new ways to incentivize improving the quality of care, these findings highlight the fact
that efforts aimed at improving quality should ideally assess the experience of minority patients and
address both the underuse and overuse of health care. Health care performance metrics are now
beginning to specifically target disparities.15 Experimentation with such metrics tied to incentive
regimes may accelerate the correction of the long-understood racial and ethnic differences in care that
our study reveals to be multidimensional. Conclusion Black and Hispanic Medicare beneficiaries are
often more likely to receive low-value care than white beneficiaries. Understanding racial and ethnic
differences in the receipt of low-value care should inform the design of policies and payment models
aimed at addressing health care disparities, highlight the importance of improving quality relative to
access, and call attention to the complex interplay between underuse and overuse of care.
Cloistering ourselves in truth games makes debate valueless—voting aff constitutes a
psychotropic attention economy that makes the plan net less likely to happen
Harsin ‘15 (Jayson, Department of Communication Studies, Baruch College, “Regimes of Posttruth,
Postpolitics, and Attention Economies” Communication, Culture & Critique, early release) ** ROPT =
Regime of Posttruth
Key to regimes of posttruth is the proliferation of truth games, within big data-, predictive analytics-
driven strategic communication (corporate-political) markets. Importantly, there is no authoritative Debunker,
although the desire to debunk remains; there is a market/desire for it. As truth claims proliferate
across fragmented networks, so, too, do upright citizen debunkers and entire organizations, which can
never suture fragmentation through a judgment for an entire society, and certainly cannot endure
temporally. Also key here is that these truth games seek only partly to appeal to conviction within
ideological filter bubbles . The goals of various actors also appear to be about occupying the field of
perception, the attention economy, to induce and manage participation in a way that collapses
politics into Rancière's (2001) figure of “the police”—the point being to avoid contingency/politics by
predictive analytics and controlling/patrolling what appears and is heard. Truth remains welded to
power, but the domination of truth regimes now demands popular attention to/participation in its
discursive games (instead of just adherence to its products). Postpolitical, posttruth regimes While some documenters of
truth-change blame new technologies and information overload, and others blame changing news
values and journalism practices, few connect these phenomena to the (20th) century-long development
of professional political communication, which has figured masses of citizens, in democratic and
totalitarian regimes, as risks to be managed (Harsin, 2006). Deleuze presaged new forms of power based on surveillance
in a society saturated with marketing techniques and predictive analytics (algorithmically driven), but he (like Foucault) had little to say
about political marketing, its research and development with cognitive sciences to work not just on
the body but on the brain, on attention and affect, which Bernard Stiegler has dubbed psychopower (Stiegler, 2010). Thus
regimes of posttruth also emerge out of postpolitical or postdemocratic strategies (Crouch, 2004) common
to control societies where especially resource-rich political actors attempt to use data analytics to
manage the field of appearance and participation (even if it is important to watch closely what resource-poor political
actors are doing with coding, algorithmic, and data analytic knowledge—Foucault did speak after all of a “political economy of truth”). This
political apparatus depends on “ participatory ” social media politics. Resource-rich elites have
analyzed and attempted to manage the breakdown of mass audiences and markets, opting to exploit
and encourage the recognition of skepticism toward cultural authorities in journalism, politics, and
the academic disciplines, each with their experts. They multiply truth claims (often entertainingly
tabloidesque) whose meaning, if not veracity, is not easily or quickly confirmed. The proliferating truth
games extend biopower into psychopower—managing not simply ideologies, discourses, and bodies in
institutional enclosures but attention itself. From telescope to zoom, in particular instances, we find the clash and
historical resolution of truth games where subjects attempt to play strategically to their advantage
and, somewht differently, in which they demonstrate their truth claims are part of games in a regime (of
posttruth) whose rules they have misrecognized as relative or universal, instead of historical—parrhesia and regimes of
(post)truth. This phenomenon is about multiple marketed ROT (an overall ROPT) designed to manage citizen-
consumers by having them (a) accept that there is no way ultimately to verify truth, (b) believe their
own truth arbiters in their markets, and subsequently (c) engage in vigorous counterclaiming and
debunking. The rush to debunk and counterclaim is usually to no avail , since there is no main venue
in which a trusted authority can definitively debunk truths by suturing multiple
audience/market/network segments, and since reaching most of them (associated with virality) in a short
amount of time is very difficult. Above all, ROPT capture attention to de-mobilize political subjects by
forging a realist acceptance of the status quo; or to mobilize them to create a managed spectacle of
claiming , sharing, liking, debunking, and refuting “issues” that are ultimately designed to block the
emergence of more inclusive social justice agendas or even the reorganization of the plane of
political agency itself.
AT: Perm
The perm links—only a radical being-without-prescription can fracture the
metaphysics of hope and inaugurate dystopic possibility.
Cadava and Cohen 12 (Eduardo and Tom, Prof of English @ Princeton and Prof of English/Director of the
Institute for Critical Climate Change, “Health: No Prescription, Not Now,” in Telemorphosis: Theory in the
Era of Climate Change, Vol. 1, ed. Tom Cohen, p. 293-306)
We cut short this quick symptomatology to return to the real patient, America itself, and to the
allegorical real that traverses this shadow play that pretends to address the patient’s ill by restoring
the country’s de- pendency on the insurance lobby and corporations. As we already have noted, the latter represents a
different sort of body, a non-subjective “le- gal” citizen, but one that, as the United States Supreme Court now has declared, has the rights of a
subject to make unlimited political contribu- tions, and brings the Wizard from behind the screen. If tempophagy is what one might call the
active consumption of “time” in an accelerated turning back that feeds on itself, we conclude with a series of three
symp- toms that
begin to enterlegibility in spectral fashion, as the confusing life-support of a post-Imperium zombie
“democracy” made even more legible by the recent health care debate: 1) What is most legible in the current
debate—and especially in the ongoing diminishment of health reform in general—is that America her- self is
increasingly entering the zone of the uninsured, self-curtailed by its “pre-existing condition” in the
still-expanding implications of what we telegraphically can name the “Bush catastrophe” and of being “America” in
a palpably post-democratic era. America finds itself entirely unprovid- ed for in a world that it has
both helped shape and destroy. 2) Without any remedy, the import of the zombie trope returns (zom- bie banks, zombie
politics, and a host of zombie films that make light of the question: vampire or zombie?, the two “public options” we have left for us today). For
what “Obama” (as the name of a network of medi- ated relations) performs across the boards is a naming of the
“dilemma” and then a recoil, a refold, a reinscription into the same order we were to have left
behind—a reflex to restitute the facade of the familiar, to re- store the discredited institution in order
to simulate minimal functional- ity. Even if this script was handed to Obama by the Bush Administration, it doesn’t matter, since
he remains unable to break its spell in the medi- acracy that has supplanted the pretense of “democracy.” As with Bush, this tactic
appears less a defense against catastrophic logics than a con- trived deferral and acceleration of them,
a Ponzi scheme in re-animation mode. Increasingly losing his credibility, Obama mimes the evacuation of credit from within
an accelerated system anticipating intervention from without (whether this intervention is to arrive in the form of
technologi- cal solutions, rapture, or the debt and deprivations of the unborn on a dying earth). Whether
what we still call Capital has, as some imagine, an illimitable capacity to manufacture such relapses is hard to discern. If the current
system accelerates in relative inertia, this would mean, according to cal- culations, not just the usual
litany of climate catastrophics and their re- lated consequences, but a virtual splitting of populations-
to-come into the gated communities of the hyper-wealthy and everyone else—a vir- tual species split, which
links the “survivor” of tomorrow to the eugen- ics of the “Nazi” phantom, albeit in accordance with wealth rather
than with race, at least officially. From this perspective, which always has been that of the corporate right in
America, there simply is no point in juggling health care to include everyone. Such a pretense would have to
disappear at some point regardless. 3) The health care debate plays to the current symptomatology of an
“America” paralyzed internally by a sort of numb panic and tempophagy. What the gods would
destroy, they first drug and stupefy (lead-poisoning in Rome would not in any way compare to what is in today’s acquifers, e.g.
cocaine, anti-depressants, hypertoxins). It may be that Obama knows this and is merely managing things to an honorable
appearing sleep, dif- ferently than “Bush,” who had stuck all the needles and NS in the patient to keep her ignorant and distracted, using
“9/11” as a narcotic and plot- ting resource acquisitions for the elite decades hence (we might recall here the innovation of the film 2012,
where the moneyed elite keep the information of a megadisaster to themselves as they plot their exclusive escape). Beneath
reflecting surfaces in this labyrinth are the meta- physics and econometrics of pharmaceuticals and
drugs. So pervasive is this in “America” today that it links wars and global politics, failing neigh- bor
states with new shadow narco-states, deals cut with the pharmaceu- ticals that also accept the
toxification of current generations en masse (of which traces abound, now, in the river systems) and mediacratic
spells that reinforce this intoxication in a way that, as we have tried to suggest, hopes to make true and lasting
health reform in the United States a thing of hope rather than of reality. This is why, if “there is hope,
infinite hope,” it is increasingly “not for us.” In an environment in which “hope” has wrought so much
peril—co- opted as it has been by the telecracy as a meme of delay and a facade for re-inscription—would it
not be best to retire “hope” in its current forms? Is it possible to inaugurate a politics finally without
hope? This is perhaps an impossible hope, but the one that seems most commensurate to what the
recent health care debates have exposed and left for us to read. In the end, perhaps we can only hope
that our being without prescription or remedy may reap us a benefit that we cannot yet see.
The reproductive rights framework is limited and ultimately supports neoliberal
politics, despite their claims to a transformative reproductive justice framework
Wondergem ‘10 (Tyler, MA Candidate @ San Diego State University, “WESTERN FEMINIST IMPERIALISM
Although the reproductive rights framework has dominated political activism around reproductive
oppression, it is a limited approach (Price, 2010; Silliman, Fried, Ross, & Gutiérrez, 2004). This framework emphasizes
individual rights and focuses primarily on legal issues (Asian Communities for Reproductive Justice [ACRJ], 2005).
Specifically, the reproductive rights model prioritizes the legal right to safe abortion, reproductive

healthcare, and family planning services (ACRJ, 2005). Specifically, the reproductive rights movement relies
on neoliberal ideologies of “free” choice (Duggan, 2003; Silliman et al., 2004). The basic concept of the pro-choice framework
is that women have the right to choose abortion, choose their reproductive healthcare provider and services, as well as choose their
contraceptive method (Price, 2010; Silliman et al., 2004). According to Silliman et al. (2004), “‘choice’ implies a marketplace of
options in which women’s right to determine what happens to their bodies is legally protected,
ignoring the fact that for women of color, economic and institutional constraints restrict their
‘choices’”(p. 5). Despite feminist scholars and reproductive justice activists’ critiques of the “prochoice paradigm” for ignoring the contexts
in which women must make “choices,” mainstream approaches to reproductive and sexual health continue to be informed by individualistic,
neoliberal ideologies of “free” choice (Duggan, 2003; Silliman et al., 2004; Smith, 2005a; Smyth, 2002). The
problems with the
emphasis on “choice” are readily apparent in the mainstream reproductive rights movement’s
approach to laws regulating sterilization (Silliman et al., 2004; Smith, 2005a). For instance, in 2004, Gloria Feldt, then president
of Planned Parenthood Federation of America, wrote a book entitled, The War on Choice: The Right Wing Attack on Women’s Rights and How
to Fight Back (Feldt, 2004; Smith, 2006). Although the reproductive justice movement had been protesting the use
of dangerous longacting hormonal contraceptives to colonize and control indigenous women and women of
color in the US, Feldt (2004) argues that those objecting to Depo and Norplant are also objecting to choice
(Smith, 2005b). Utilizing the rhetoric of “war on choice,” Feldt (2004) ignores the ways in which oppression

based on race, class, sexuality, nation, age, ability as well as other markers of difference, work
together in restricting women’s reproductive freedom (ACRJ, 2005; Smith, 2005b). Moreover, this understanding
of “the war on choice” reflects Mahmood’s (2008) argument that underlying assumptions of liberal and
Western feminist ideologies facilitate US imperialism. Specifically, Feldt (2004) relies on tropes of freedom,
democracy, and gender inequality in order to discuss both efforts to control women’s reproductive
rights as well as in developing strategies to “fight back.” While Mahmood (2008) considers the ways in which these underlying assumptions
of feminism encourage US imperialism abroad, for Feldt (2004) these tropes contribute to her marginalization of women of color within the US.
In particular, Feldt’s
preoccupation with “freedom of choice” facilitates racist, colonialist practices within
the US. Despite the use of dangerous long-acting hormonal contraceptives to colonize and control indigenous women and women of color in
the US, Feldt argues that those objecting to Depo and Norplant are also objecting to choice (Smith, 2005b). Given Feldt’s (2004) discussion of
the “war on choice,” it is likely that the
“war on women” rhetoric also rose out of a reproductive rights
framework. It seems that the rhetorical implications of the “War on Women” marginalize the experiences
of women currently facing US imperialist wars. By rhetorically equating domestic patriarchal
regulation of women’s reproduction with US imperialist aggression, this discourse obscures the reality
of war, particularly the reality of wars waged on the pretext of liberating women. Not only does this discourse
obscure the reality of current neocolonialist wars in Afghanistan and Iraq, but it also ignores the ongoing colonization of

indigenous women’s bodies through coerced and forced sterilization in the US (Smith, 2005b). Because
the current discourse of the “war on women” reflects underlying assumptions of the choice paradigm,
it neglects to consider the ways that reproductive technologies have been used in forced and coerced
sterilization of women of color and poor women (Ross, 2006; Silliman et al., 2004; Smith, 2005b).
This model of sanitized Western feminism forms the crucial backbone of global
intervention – feminism becomes imperial all too easily
Wondergem ‘10 (Tyler, MA Candidate @ San Diego State University, “WESTERN FEMINIST IMPERIALISM
Because FM largely propagates a narrative of oppressed Muslim women through which Western
women, especially white, wealthy feminist women, recognize themselves as liberated, FM readily supports,
encourages and even helps construct the Bush Administration’s justification of the “war on terror” as
“liberating Afghan women.” While never challenging the notion that US military intervention in Afghanistan offers a way to
“liberate” women, FM does assert that the US is not upholding its “moral obligation” to Afghanistan. Rather than recognize the ways in which
this narrative exists only to perpetuate war and justify US empire building projects, FM instead attempts to hold the Bush Administration
accountable in fulfilling this narrative. For instance, FM began offering “Global Women’s Issues Scorecards on the Bush Administration” specific
to women in Afghanistan in August 2003. The initial scorecard included measures based on reconstruction funding, support for Afghan women-
led NGOs, expansion of international peacekeeping troops, support for women in the drafting of a new Afghan constitution and support for
women’s rights in education, health care, employment and politics (FM, 2003b). While these “scorecards” draw attention to sexism in the Bush
Administration, they construct women’s issues as universal and uphold the US as a potential “savior.” In the press release, “Reality Remains
Dire for Women in Afghanistan and Iraq,” the Global Issues Scorecard is discussed to hold the Bush Administration accountable. For example
FM (2003c) seeks to hold the Bush Administration accountable in writing: Since August, the Bush Administration has made new commitments
to improve U.S. policy towards Afghanistan and to secure Afghan women’s political rights. Almost two years after the U.N., the Afghan
government, and women’s rights and human rights organizations first called for an expansion of international security forces, the
Administration pledged its support for women’s rights in Afghan constitution. Rather than challenge the Administration’s
motives or suggest that the Administration is using women to justify US empire building, FM instead
applauds the Bush Administration for its “commitments to Afghan women.” Moreover, Eleanor Smeal is
subsequently quoted as saying that “words are not enough” reaffirming the US as the rightful savior of Afghan women. FM calls for
increased “humanitarian aid” and an expansion of US “peace troops” in Afghanistan. Here, there is a
clear blurring of humanitarianism and violence which renders US violence as humanitarian, or rather,
humanitarian militarism (Atanasoski, 2013). This call for increased troops and humanitarian aid packages ignores that these will also
be accompanied by increased violence waged by and against the US. Moreover, FM never opposes the violence propagated by the US in
Afghanistan, and instead only offers support of US humanitarian military intervention. In the upholding of the US “war on terror” as
humanitarian, FM draws on an Orientalist logic of the “Muslim World” as inherently violent and barbaric. In a Press Release from May of 2001
“Taliban Retaliates After U.S. Humanitarian Aid Package,” Eleanor Smeal is quoted saying: How long is the civilized world going to stand by and
watch this barbaric regime destroy the lives of millions of Afghan women and children?...We energized with last week’s $43 million
humanitarian aid package, but clearly more help is needed from the international community. (FM, 2001g) This is a clear articulation of
Orientalist logic in FM’s call for the “civilized world” to save Afghan women from the violence of their men. While the “West is civilized,” the
East is barbaric and devoid of humanity. The
West is constructed as superior and the rightful saviors of Muslim
women from inherently violent Islamic men. Moreover, the US is positioned as a model to the rest of
the world and an exceptional Western nation. In this way, FM ties its allegiances to the nation-state and
speaks for “Afghan women and children” in advocating for further US humanitarian military
intervention in Afghanistan.

The external impact is a feminization of labor which causes violence

Corsani ‘7 (Antonella, economist who has participated, with Maurizio Lazzarato and Antonio Negri, in
sociological research on forms of “immaterial labor” in contemporary Paris, translated by Timothy S.
Murphy, Associate Professor of English at the University of Oklahoma, “Beyond the Myth of Woman:
The Becoming-Transfeminist of (Post-)Marxism” SubStance, Issue 112, Volume 36.1)
Since the crisis of Fordism, unemployment and precarious employment have been established as
norms of wage labor, but far from being strictly economic phenomena, unemployment and precariousness are the results of a
societal upheaval, as Margaret Maruani and Emmanuèle Reynaud convincingly argue.24 Thus, for example, during the period 1965-1996
in France, the percentage of women employed has risen from 43 to 78 percent. In the US during the same period, this percentage grew
similarly: from 45 to 76 percent. The near-explosive growth of women's presence on the labor market has spawned studies and research from
several directions. A first approach seeks to denounce the wage and career discrimination women face on the labor market. A second
approach, not too distant from the work of Hardt and Negri, involves grasping the new nature of labor by means of some sort of feminine
model of labor that would become a common matrix for everyone. The
feminization of labor is often mentioned in order
to account for the confusion between production and reproduction that is scrambling the categories
of political economy, and making the borders between the time and space of life and those of so-called "productive" labor seem to
disappear, in order to account for the phenomenon of "setting affect to work" or "setting life to work."25 Does the fact that the borders
between labor and non-labor are being effaced mean that everything is becoming labor? The question I am raising is not new, and elsewhere,
while inscribing my work within the kind of Marxism of which I spoke earlier, I have tried to point out the erasure of the border between labor
time and life time. All
of life has become productive for (and within) capital, which leads to the justification
of the legitimacy of a guaranteed income for all, unconditionally, as a monetary recognition of the
wealth produced, even though it is outside of the realm of business.26 If the concept of "guaranteed income" can act as a factor that
destabilizes the category of labor, one that brings about a displacement of the hegemonic discourse on employment and unemployment, can it
translate the multiplicity of groups that are rising against the capitalization of the living? Can it express a heteroglossia without claiming to be a
common language? These [End Page 124] are the questions I am posing today, along with the question of what perspective one should adopt in
order to think about guaranteed income. V. Some Hypotheses Without claiming to provide definitive and perfectly coherent answers, and as
part of a critical and self-critical process, I want to risk advancing several contradictory hypotheses that will open up some rather different
perspectives. My point of departure will be an analysis that bears not so much on the structure of the labor market as on the metamorphoses
of capitalism, the nature of labor, and the modes of valorization of the various capitals. According to these analyses, the
entry of
women into the so-called sphere of production would have contributed significantly to the cultural
modification of the nature of labor by introducing into it the characteristics proper to the social
reproduction of life: interrelationality, flexibility as an intelligent response to the unforeseen,
creativity, subjectivity, and the heterogeneity of tasks as so many characteristics that could not be left
trapped within the standardization of time and the objective measurement of value. Sara Ongaro has
analyzed these ongoing transformations over the course of thirty years in terms of a process of integrating reproductive activities into
production, a process that she defines as "productive reproduction" (145-53). In other words, the sphere of reproductive
activities is integrated into that of production, so these activities no longer function to reproduce
labor-power but instead are activities that directly produce surplus-value. In the fusion/confusion between production and
reproduction, political economy's categories of "production" and "reproduction" go into crisis. What is reproductive activity? It is
the set of activities that create life, the cognitive, cultural and affective universe, a set of activities
that runs from biological generation to domestic labor and activities of social, emotional,
communicational and relational reproduction. What is happening with these activities today? Biological generation
is becoming a new market, a field of valorization in itself, through the sale of "organs without bodies"
and the renting of the uterus. As for domestic labor, a new division of labor between women arises here.
Women are externalizing this activity of low "social value." We are thus witnessing the development of personal
services, clusters of jobs that reproduce the life of others. Ultimately, the labor of reproduction as a set of activities that
create life, the cognitive, cultural and affective universe, enters into production by modifying the
nature of labor. [End Page 125] From this perspective it should then be possible to speak in terms of a "becoming-woman of labor."27
The becoming-woman of labor would concern the very nature of labor, its being as an activity that
produces economic value, goods and services on the basis of extra-economic human qualities such as
language, relational ability, and affectivity. Corresponding to this setting to work of feminine competences is a generalization
of specifically feminine conditions to a growing fraction of the active male population: precariousness, instability and atypical contractual forms
will no longer be exclusively the feminine condition, but will encompass all of human activity. Byentering the labor market,
women will have exported what had been their condition to the rest of the world. This is the sense in
which one could agree to analyze the feminization of labor as a situation that extends "the
mechanisms of subjection applied above all and historically to women , " 28 a situation consisting of
forms that are worth investigating and resistances, obstacles, and modes of flight that are worth
grasping. This will involve grasping the relations of domination in the field of the production of knowledges, images and information not
merely from the angle of exploitation, but also from that of subjection and oppression.
This uncertainty means that the ACA is tainted beyond recovery
Adler 16 Jonathan H. - Johan Verheij Memorial Professor of Law and Director, Center for Business Law
Regulation, Case Western Reserve University School of Law, Of Kings to Come: The Future of Care
Reform Still Remains in Federal Court, 20 Emp. & Emp. Pol'y J. 133, 146 (2016) Provided by: Harvard Law
School Library
ACA litigation will continue so long as the ACA is on the books. For some of the same reasons, ad hoc
implementation of the ACA is likely to continue as well. A consequence of these phenomena is that
the ACA, as it is implemented and experienced, will be uncertain and at variance with the statutory
language Congress enacted.
Future elections may alter the ACA's prospects, either by producing political majorities that seek to
expand and fulfill the ACA's purposes or those that seek to undo the ACA's architecture and replace it
with something else. Such efforts are unlikely to end the phenomena discussed in this article. Indeed,
it is possible they could provide even more fuel for the litigation flames. Efforts to undo health care
reform, much like the efforts to enact it, could encourage resort to litigation. In short, even post-King
there is every reason to believe that the future of health care reform remains in federal court.

That means ACA reform flames litigation efforts that undermine effectiveness
Adler 16 Jonathan H. - Johan Verheij Memorial Professor of Law and Director, Center for Business Law
Regulation, Case Western Reserve University School of Law, Of Kings to Come: The Future of Care
Reform Still Remains in Federal Court, 20 Emp. & Emp. Pol'y J. 133, 146 (2016) Provided by: Harvard Law
School Library
The structure of the ACA also facilitates and encourages litigation and conflict in a way that some
other types of social welfare legislation might not. Lacking the votes for a single-payer system that,
whatever its merits, would be relatively immune from legal challenge, health care reformers opted for a
system that relies more heavily on non-federal actors to achieve its goal of expanded health insurance
coverage. As a consequence, the ACA relies upon pervasive commandeering and cooperation .25 The
law imposes mandates on private employers, individuals, and insurance companies. At the same time, it
encourages (in some cases coerces) cooperation from state governments. Some are willing participants
in the ACA regime. Others, however, resist, and one form of resistance is litigation to challenge the
mandates, the inducements, and the terms of cooperation. For good or ill, this structure creates both
the opportunity and incentive for resistance to the ACA that a singlepayer system would not .26

Courts have specifically rejected the notion that specific services must be provided in
accordance with the right to health.
Kinney 08 J.D., Professor at ndiana University Robert H. McKinney School of Law (Eleanor D.,
“Recognition of the International Human Right to Health and Health Care in the United States,” Rutgers
Law Review, Vol. 60, No. 2, 2008.
With regard to public health insurance programs, the Supreme Court has ruled that the government
does not have to provide specific benefits in its public health insurance program, even though it has recognized
that women may have the right to obtain these services as a matter of constitutional law. Specifically, in Maher v. Roe, n162 the Court stated
that "the Constitution imposes no obligation on the States to pay ... any of the medical expenses of [*359] indigents." n163 In
so doing,
the Supreme Court rejected the idea that the Federal Constitution has recognized a right to health
care that the state has a duty to fulfill as a matter of constitutional law. n164
Indeed, the Supreme Court has historically been resistant to ruling that either the states or the federal
government have an affirmative obligation to enhance the economic and social human rights of Americans as a
matter of constitutional law. In DeShaney v. Winnebago County Department of Social Services, n165 which involved serious injury to
a child by his father while under the supervision of social services for child abuse, the Supreme Court stated: "Consistent with these principles,
our cases have recognized that the Due Process Clauses generally confer no affirmative right to governmental aid, even where such aid may be
necessary to secure life, liberty, or property interests of which the government itself may not deprive the individual." n166
Nevertheless, once the government decides to provide a health care benefit through a public program, it must comply with constitutional
guarantees of procedural due process. In Goldberg v. Kelly, n167 the Supreme Court recognized that beneficiaries of government programs,
which include health insurance programs, had an entitlement interest in benefits that was eligible for protection as property under the
procedural Due Process Clauses of the Fifth and Fourteenth Amendments of the Federal Constitution. n168 As such, before benefits can be
terminated, government agencies must provide notice and an opportunity to be heard in a meaningful time and manner. n169
In recent years, both
Congress and the courts have limited due process protections for beneficiaries of
public entitlement [*360] programs. n170 One threat to procedural due process is the attack on the
concept of entitlement programs and the judicial sanction of the diminished status of benefits in government entitlement
programs due to their statutory definition. n171 Courts have upheld legislation specifically stating that a benefit is not an entitlement and is
exhausted at the end of fiscal appropriations. n172 In
legislation reforming welfare programs and establishing the
children's health insurance program, Congress affirmatively stated that program benefits were not
entitlements in order to eliminate open-ended obligations to actual and potential program clients. n173

Health delayed is health denied

Roy 15 founder of Roy Healthcare Research, a healthcare policy and investment research firm, President
of a non-partisan think tank, the Foundation for Research on Equal Opportunity (Avik, “No, Donald
Trump, Single-Payer Health Care Doesn't 'Work Incredibly Well' In Canada & Scotland,” Forbes, August 7,
Canadian health care model: Send tough cases to America
Canadian health care is popular with healthy Canadians who never really have to use it. But if you’re
sick, look out. A 2014 study by the Fraser Institute found that wait times for medically necessary
treatment in Canada have increased from 9.3 weeks in 1993—not great—to 18.2 weeks. Wait times
were especially bad if you needed hip, knee or back surgery (42.2 weeks) or neurosurgery (31.2
As we know from the scandal involving the U.S. Veterans Health Administration, health care delayed is
health care denied. The people who suffer the most under the Canadian system are those who can’t
afford to hop on a plane or pull strings to get treated in the United States.
Martin Samuels, the founder of the neurology department at Harvard’s Brigham and Women’s
Hospital, found this out when he worked as a visiting professor in Canada. “The reason the Canadian
health care system works as well as it does (and that is not by any means optimal) is because 90% of
the population is within driving distance of the United States where the privately insured can be
Seattled, Minneapolised, Mayoed, Detroited, Chicagoed, Clevelanded and Buffaloed,” Samuels wrote
recently in Forbes. “ In the United States, there is no analogous safety valve.”

Scotland: Nearly the worst health outcomes in Europe

The sick in Scotland, unfortunately, have no such safety valve. They are forced to wait, and wait, and
wait. In 2008, a group of investigators conducted a worldwide study of cancer survival rates, called
CONCORD. The investigators asked the question: if you get diagnosed in your country with breast
cancer, or colon cancer, or prostate cancer, how long are you likely to live?
In that study, the U.S. performed better than every country in western Europe. The United Kingdom
came out second-to-last. The researchers broke out the data for Scotland, and the results are revealing.
If you’re diagnosed with breast cancer in the U.S., you have an 84 percent chance of living for five years.
In Scotland, it’s 71 percent. If you have colon cancer in the U.S., you have about a 60 percent chance of
surviving five years. In Scotland, it’s 46 percent. If you have prostate cancer in the U.S., you have a 92
percent chance of living five years; in Scotland, it’s 48 percent.
This is the system that, according to Donald Trump, “works incredibly well.”