Separating out the well and worthy workers from the sick and unproductive surplus class is one of capitalism’s more insidious divide-and-conquer tactics. We all know the person who brags about not taking one sick day in 20 years. But if capital separates the workers from the unwell, capitalists still manage to profit from both. The state, which could sustain the sickened surplus, instead neglects them, and the private health care sector steps in to profit. Adler-Bolton and Vierkant coin the term “extractive abandonment,” (a variation on Ruth Wilson Gilmore’s description of the carceral system as “organized abandonment”) to describe how public subsidies flow to privatized facilities offering substandard care, from for-profit nursing homes to prisons. As a result, those in need of care are less likely to receive it where they could thrive, let alone exercise their self-determination.
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