A lot of people seem to think the problems in healthcare are rooted in how large pharmacology companies distribute medications, and leads to a lot of conspiracies regarding how medication can be trusted. While there are serious issues with distribution and profitability of pharmasutical drugs, I think that these issues and misconceptions surrounding them obsfucate much more serious issues in healthcare right now.
One especially that worries me is wellness. Now, I’m not saying that you should not take care of yourself. But that’s not really what wellness is. It’s also not preventative healthcare, which is actually a very important part of medical treatment. Instead, wellness is more about making a healthy person become “better” or “more efficient”, an entire market dedicated to a new idea of what health should be.
Think about how wellness is focused not around eating a nutritious diet or exercise, but about improving various aspects of yourself, like as if you have RPG statistics - superfoods supposedly “increase” your mood stat, special teas “boost” your concentration stat, and cleaning up clutter around your house “boosts” your emotional wellbeing stat.
But who does wellness really exclude in its campaign? The disabled - the original concern for healthcare in the first place. For many, concentration, mobility and mood stability are physically difficult to achieve and require socially expensive means to achieve - something that wellness never considers.
Lets look at an example. Think about how in the last two years, we have heard a lot about “mental wellness” during covid. This is obviously a campaign to attempt to improve mental health, but who is most excluded by the concept of “mental wellness”? The most vulnerable, the mentally ill. Mental wellness doesn’t apply do them, since they were never very well to begin with during covid. How can they maintain wellness when everyday living is already a struggle? But Covid isn’t just making people mentally ill because of the social impact of the disease, but the disease itself has a high chance of triggering mental illness in vulnerable people. This means that pleas for mental wellness exclude the people directly harmed by Covid!
Wellness also appropriates heavily from the alternative health movement to try to legitimize itself within healthcare spaces. Think about how things like yoga, herbal teas, and excess vitamins are pushed heavily in wellness spaces. Not only are these practices appropriated, but they are actively being recontextualized within a nearly medical context where, instead of the alternative health movement which has moved largely in opposition to medicine. In some cases, like with hallucinagen microdosing, it even encourages practices that are poorly researched and potentially very dangerous in the long run - all for just promoting a “stat boost”.
Now, taking care of yourself can make serious health conditions easier to manage, and can improve prognosis. But wellness isn’t really about making these conditions easier to manage. It was never designed with the ill in mind. It was designed with how to make the average person think that they are somehow sick and capable of getting even “better” with small changes in their lives. Indeed, this is the strategy of the alternative medicine as well - but the difference is, that because wellness advertises itself as a form of preventative healthcare, it has heavily penetrated the medical system. Everywhere you turn there is a new movement towards wellness. Wellness is an extremely profitable industry, projected to earn over 6 trillion dollars in value by 2025 - 6 trillion dollars not going towards helping people who are actually sick.
Why is wellness so popular with people? Well, for one thing, it gives the appearance of less alienated care. Every aspect of the wellness interface appears much more friendly than their medical counterpart - instead of going to see a doctor for 30 minutes to get a refill on a prescription for a life changing disease, many interactions of wellness involve groups online discussing how to treat themselves, encouraging active participation of patients. The market then injects itself into this discourse, providing treatments, tools, exercise equipment - you name it - so that it can profit at nearly every margin of this movement. Not only this, but everyday life in a capitalist world where you work in an alienated job, where for 8 or more hours every weekday, your time and work is ripped from your hands to sell to a consumer who only cares about the end product, wears down on people’s bodies. It might not make most people extremely ill, but it does make them feel tired, unhappy and frustrated - something that can be mitigated by making them believe they are sick and pressuring them into trying to optimize their bodies.
While alternative health has profited off of these margins for years, Wellness is very different in one key respect: The fact that healthcare providers, hospitals, health insurance companies and other medical institutions are picking up on the trend is genuinely worrying, because it means the difference between alternative health and general healthcare is dissolving. Medicine had no choice but to submit to the pressures of the market, putting the lives of the very ill in extreme danger in the future by replacing itself with the consumer’s healthcare. Wellness, after all, is much cheaper to implement, and far more profitable, than actually treating severe illnesses, which are complex, involve many vectors of bodily functions and requires a serious background in medical research to even begin to try to treat. And anyone can be convinced that their mild malaise or everyday awkward pains are something that needs to be fixed instead of something that needs to be accomidated for.
So how do we get to a point where medicine is not about treating the ill and instead is about making the well think they are sick? It boils down to how disabled identity is produced by society.
Recall that disabled people emerge through our interactions with labor. Disabled people are people who cannot work. Medicine then emerges as a process to try to correct identified disabilities, disabilities that are noticed after many similar people can’t work. Medicine describes the body through anatomy, physiology, pharmacology and other complex fields, which constructs an image of a healthy human body, in contrast to the many disabilities that were used to describe each aspect. This way, a doctor can understand how a body “should” operate in comparison to the disability, and help a disabled person become capable of labor once again.
However, as this process continues, we can use this healthy body template as a way to make more people appear healthy. We can take aspects of that healthy body and improve them, optimize them. But recall that - our image of a healthy body directly comes from the disabled subject! And the disabled subject is rooted in our relationship with labor! So what this means is that the healthy body that we are trying to optimize actually comes from a process of trying to optimize bodies for labor. And what this means is that wellness is really an attempt to take people who are otherwise not disabled and make them work harder.
This is obvious when we consider what most wellness tries to address - issues like concentration, focus, pains, posture, and mild depression - all things that interfere with work. Issues like blindness, mobility issues, metabolism problems, mental illness or injuries are already excluded from labor, as a result of already being disabilities, so there is almost next to no wellness on these issues. Even accessibility, a means of trying to improve the lives of the disabled, is being transformed into a process to make people work harder and more efficiently rather than improving people’s lives. And thus, wellness is a subtle apparatus to exclude the disabled from participation in society.
If we do not question our relationship with labor in society, if we assume that it is our bodies that are failing rather than our society failing us, we will inevitably produce a system that seeks to pressure us into their production until our bodies inevitably fall apart, to which we are abandoned and reduced. We turn into a society of open eugenics - a eugenics that exists to fit a cog into a wheel.
Sources: https://www.cuimc.columbia.edu/news/how-does-covid-affect-mental-health https://www.statista.com/statistics/491362/health-wellness-market-value/