The surplus population is often understood to be all non-working people, or those whose labour isn’t profitable to the ruling class. Extractive abandonment is the process by which these populations are made profitable to capital, such as charity fundraising aiming to “repair” disabled people to become workers and policies that support and grow for-profit private nursing homes. We then trace how these ideas are socially, intellectually, and structurally reproduced throughout our global systems, law, and governance.
“Health is capitalism’s vulnerability” – Briarpatch Magazine
This means that our politics must center the so-called surplus populations—a diverse range of bodies that are characterized as economically unproductive yet are paradoxically exploited for profit by the very system that deems them unproductive in a process that the authors call “extractive abandonment” (p. xvi). Adler-Bolton and Vierkant zero in on one segment of these surplus populations that illustrates capital’s parasitic relationship to health with particular lucidity: the disabled/chronically ill.
Lesley Thulin reviews Health Communism – Critical Inquiry
Many neurodivergent and generally disabled people overall are treated in a manner of extractive abandonment, rendering them in a term, which most people would already know from Charles Dickens, but which is which is Surplus, a surplus population, or in Marxist terms, a reserve Army of Labor.
The Rise of Anti-Capitalist Neurodiversity: Robert Chapman’s ‘Empire of Normality’ – YouTube
As Adler-Bolton and Vierkant show, capital’s sneaky solution is to cordon off this population while simultaneously turning a profit on it through rehabilitation—a process that aims to restore patients to health in order for them to return to the workforce—and medicalization. Institutions such as private nursing homes, hospitals, and prisons coconspire with the private insurance industry and the state in extractive abandonment—an idea that traces its genealogy to Marta Russell and Ruth Wilson Gilmore. This is Adler-Bolton and Vierkant’s main intervention in Marxist disability studies, a subfield that identifies capital as the primary social determinant of health. Their concept of extractive abandonment deftly synthesizes Russell’s “‘money model of disability’”—capital’s commodification of the disabled body and the privatization of welfare—with Gilmore’s theory of “‘organized abandonment,’” or the racial capitalist state’s deliberate neglect of marginalized communities (p. 13). As the authors point out, extractive abandonment names not only a relationship between a state and its own population but also its relationship to international populations; it is for this reason, they argue, that health communism requires an internationalist effort.
Lesley Thulin reviews Health Communism – Critical Inquiry
The surplus populations have become a source of capitalist profit generation through a process we define as “extractive abandonment.” The term extractive abandonment is a very obvious riff on Ruth Wilson Gilmore’s theory of organized abandonment, which is an idea that she talks about perhaps most famously in her book, Golden Gulag, which is about how the state makes itself through the expansion of carceral practices. Organized abandonment is the state’s capacity to enable the organization, disorganization, or “outright abandonment” of “various factors of production.”
State power, responsibility, and purpose become defined by the ways it counts, sorts, organizes, and disorganizes both its surplus labor power and its surplus populations—creating jobs, whole industries, and diversified revenue streams from these non-workers who capital putatively no longer wants.
All Are Not Well, All Are Not Safe
Extractive abandonment is the way in which we choose to reproduce our political economy through the optimization of the population at a demographic level. As we argue, “Profit lives in the interstitial spaces between bodies, in the counting of bodies, in the measuring of bodies, in the creation and destruction of bodies, in every locus where capitalism touches illness, disease, disability, and death…. This relation, in and of itself, is not intent to harm; instead, it is the capacity to levy harm at the population level…. In a political economy built on systems of extractive abandonment, the state exists to facilitate a capacity for profit, balanced always against the amount of extractable capital or health of the individual subject. We argue that, at the intersection of these forces, there exists a core relation of health to capitalism called extractive abandonment—that is, the means by which the state constructs ‘health’ culturally, politically, and institutionally. And in the process of constructing, destroying, and reconstructing health, the state itself is made.”
The problem is also that it is impossible for any person under capitalism to be “healthy”—not just those already sick, ill, mad, or disabled. None of us are well, none of us are safe.
All Are Not Well, All Are Not Safe
Thus, the existence of a surplus population is no less necessary for capitalism than is the existence of workers, since capitalism both creates an ever-expanding surplus population while also relying on them to act as a reserve army. Put another way, disabled people – who make up much of the surplus – need to exist for capitalism to exist, and are hence part of what is both produced by, and sustains, the system. So it is not just that the capitalist class also often finds ways to profit off the surplus class through a variety of industries built around the management and confinement of the surplus. It is also that the capitalist class both creates the surplus, and often needs them for the possibility of growth at all. For every time there is a possibility of growth, this suddenly requires more workers, and for them to be read a surplus population has to be maintained. On this view, then, it is not just the case that certain environments, especially when driven by capitalist logics, are disabling for people with impairments. It is also that capitalist logics both produce and require disablement, which is itself primarily determined in relation to the needs of capital at any given time.
The association between capitalism and health is complex, and has been further clarified by Adler-Bolton and Vierkant in their book Health Communism: A Surplus Manifesto. Here I have primarily focused on how capitalism led to a conflation of health with both normality and productivity. But there is more to say. Adler-Bolton and Vierkant emphasise how capitalism requires health, to some extent, for productivity. At the same time, it must pathologise surplus populations while mining them for productivity through industries of administration in order to extract profit from their ill health. And the central aim of this is not to improve the prospects of thriving for members of the surplus class, but rather for capitalists to profit from the ongoing maintenance of their unwellness alongside the exploitation of care workers.
The overall disposition of the capitalist political economy of health consists in what they call extractive abandonment. That is, capitalism both creates and extracts from the surplus class while simultaneously abandoning them. This allows Adler-Bolton and Vierkant to frame the surplus population as a class (rather than a subset of the working class). Importantly, this goes beyond a social model analysis, which frames disablement as oppression imposed by barriers. More than this, a political economy characterised by extractive abandonment of the surplus class must build industries to administer surplus populations in order to mine their oppressed status for profit while also extracting surplus value from workers at these institutions. We see this, for instance, in the multi-billion dollar Applied Behaviour Analysis industry, which does little to help most autistic individuals subjected to it, and harms many, but which continues to exist and grow because so much profit is made through it. Considering how the overall disposition of the political economy is one of extractive abandonment, this helps explain why this industry has been able to continue its expansion despite mass resistance from autistic activists.
Chapman, Robert. Empire of Normality: Neurodiversity and Capitalism (pp. 149-150).
Surplus Populations
Surplus populations are commonly understood to be non-working people. And if you’re working, it’s assumed that you’re not sick, ill, disabled, or otherwise. We push back on this false binary and assert that the surplus builds upon the working class. If health is the carrot (something workers are told they should aspire to), then the surplus class is the stick (something workers are threatened with becoming).
We are all surplus, even workers. While the surplus population does contain disabled, impaired, sick, Mad, and chronically ill people, it is not any illness, disability, or state of health that makes the surplus vulnerable. Our vulnerability is constructed by the capitalist state.
The false worker/surplus binary is the fundamental underlying dynamic of labour discipline. The imposed poverty of the surplus is always there as a looming threat leveraged against all worker demands. We are only entitled to the survival we can buy with our surplus labour.
Surplus populations are always assumed to be elsewhere, never assumed to be a worker or an organizer. Our movements need to stop thinking of the sick, the ill, the Mad, and the vulnerable as being elsewhere. We’re passing up a huge opportunity by devaluing the perspectives of those who live the day to day of the surplus population and their unique political thought that is lost when we say, “Oh, we’ll circle back and include those vulnerable people later.” Nothing good is going to come from fighting for only part of the working class.
“Health is capitalism’s vulnerability” – Briarpatch Magazine
“Since you ask me what I wish, gentlemen, that is my answer. I don’t make merry myself at Christmas and I can’t afford to make idle people merry. I help to support the establishments I have mentioned: they cost enough: and those who are badly off must go there.” “Many can’t go there; and many would rather die.” “If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”
That phrase–surplus population–is what first tipped me off to Dickens’ philosophical agenda. He’s taking aim at the father of the zero-growth philosophy, Thomas Malthus. Malthus’ ideas were still current in British intellectual life at the time A Christmas Carol was written. Malthus, himself, had joined the surplus generation only nine years before. But his ideas have proved more durable.
What was Dickens really doing when he wrote A Christmas Carol? Answer: He was weighing in on one of the central economic debates of his time, the one that raged between Thomas Malthus and one of the disciples of Adam Smith.
What Was Charles Dickens Really Doing When He Wrote ‘A Christmas Carol’?
“And the Union workhouses?” demanded Scrooge. “Are they still in operation? … If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”
Interesting, isn’t it? Later in the story, the Ghost of Christmas Present reminds Scrooge of his earlier words and then adds about Tiny Tim:
“What then? If he be like to die, he had better do it, and decrease the surplus population.” Scrooge hung his head to hear his own words quoted by the Spirit, and was overcome with penitence and grief.
“Man,” said the Ghost, “if man you be in heart, not adamant, forbear that wicked cant until you have discovered What the surplus is, and Where it is. Will you decide what men shall live, what men shall die? It may be, that in the sight of Heaven, you are more worthless and less fit to live than millions like this poor man’s child. Oh God! To hear the Insect on the leaf pronouncing on the too much life among his hungry brothers in the dust.”
What Was Charles Dickens Really Doing When He Wrote ‘A Christmas Carol’?
As they remind us in a riff on the old adage in the field that we will all eventually become disabled if we live long enough: “In the eyes of capital, we are all surplus”.
Lesley Thulin reviews Health Communism – Critical Inquiry
…our political projects must center the populations capital has marked as “surplus”: unwanted, discarded bodies viewed as waste that nevertheless have become the subject of capital accumulation. We are all surplus even if only via our proximity to state sanctioned vulnerability.
All Are Not Well, All Are Not Safe
