W/Health: Constructions of delusional perceptions

The recent release of Deadly Spin by Wendell Potter, former head of corporate communications for CIGNA, has triggered media interest in trying to explain why there is no sound universal health care system in the United States nor does one appear on the horizon.

In fact, this book could be re-titled “The Confessions of a Public Relations Hit-man.” Potter was, as he writes, a “spinmeister” for the health insurance industry, in particular Humana and CIGNA.

He reveals some of the methods that are commonly used by corporations to “create perceptions without any public disclosure of who is doing the persuading or for what purposes.” He discloses the fundamental tools of the spin-business utilized by industries (health insurance, oil, tobacco, etc.) to manipulate so-called “public opinion” with faulty information, statistics and worse. Words and phrases like “propaganda”, “fear mongering tactics”, and “consumer” appear regularly. This spin-business has found support and sustenance in the absence of political examination of the current US society.  Potter is critical of the process but rarely, if ever, critical of the neoliberal thinking that vindicates it. In The Birth of Biopolitics: Lectures at the College de France, 1978 – 1979, Michel Foucault argued “liberalism in America is a whole way of being and thinking.” Potter’s book confirms this critique of `liberalism in America.”

In my attempts to summarize what Deadly Spin exposes, I realized that what it does not expose is equally important. Potter exposes in great detail the technique and the technology of crafting messages made to diminish actual stories of mistreated people to a mere discussion of their economic viability. He also exposes the collusion between corporate power and political power in the United States, showing how corporations get involved in writing bills aimed at controlling their own power.

Potter exposes PR groups, such as APCO, that specialize in “influencing decision-makers and shaping public opinion by crafting compelling messages and recruiting effective allies”. For instance, Michael Moore produced a truthful documentary, Sicko, on the suffering of American citizens who were denied financial coverage of their medical needs. Moore focused on American citizens who had health insurance and how they were vulnerable to the health market emphasizing that access to care was a financial privilege. APCO worked strenously with Potter’s PR team to produce propaganda against Sicko and succeeded in reducing the impact of the film.

A turning point in Potter’s professional life occurred when he came across a RAM (Remote Area Medical) clinic and saw with his own eyes the ways in which people seek care were packed and packaged. Tellingly, the clinic was installed in animal stalls. Nothing prepared him for what he saw.

What the book does not reveal is the link between neoliberal dogma as religion and the reduction of people to consumers of health care. What if Potter had the same revelation in Philadelphia, where he lives, where there is massive poverty, where life expectancy, in some areas and especially in African American communities, is lower than in Bangladesh? What if Potter hadn’t had to travel to the distant rural zones to see the health care situation?

Potter reviews the history of health care reform without revealing the profound effect of racial and social discriminations. His framework remains free enterprise, service, such as there is, remains service to the consumer. He fails to reveal that the neoliberal Public Relations industry has also worked in the worldwide promotion of the same market based health care. Cigna was among the health insurance companies that invested in countries where Structural Adjustment Programs imposed the destruction of public social services, including health care. CIGNA was one of the health insurance companies that grossly benefitted from those deregulations.

Potter also does not address reproductive health and rights, except to note that women’s policies cost more because of pregnancies. In this, he mirrors the decision of the Obama administration to bargain away coverage for abortion and reproductive health as well as immigrants’ health in the passing of an ill conceived and inadequate health care plan.

Nonetheless I appreciate and respect his personal and emotional inquiry. He is right when he says that journalism has become corporately infused. Corporate, and I would add nationalist as well. He gives many examples of PR constructions and distortions of realities meant to keep people in the dark with regard to their health care system, “selling the illusion of coverage,” constructions and distortions that were never denounced or investigated properly by journalists. Those distortions have formed the faith in the power of the neoliberal economy. In the United States, opposition to that faith is subtly silenced. Wendell Potter comes short of acknowledging this relationship. Instead he remains focused on the manipulation of news media, maybe because he started his career in journalism and has now returned to it as a senior fellow on health care at the Center for Media and Democracy.

 

(Photo Credit: PR Watch)

 

Nascent Collectivities: Transnational Abandonment, I

On November 20th 2008, as reported by George Washington University’s student newspaper, the Hatchet, a Latino worker installing windows in a GW residence hall was killed after a fall from the 7th floor. The worker, Rosaulino Montano, worked for Engineered Construction Products, a window subcontractor for primary contractor Clark Construction. His death was featured in one article in the Hatchet, which also reported that the Occupational Safety and Health Association (OSHA) was investigating the incident. The coverage of Montano’s life and his relationship to the university was brief. The Hatchet reported that he lived in Virginia and had several children. The conditions of his work, the events of the accident, and the relationship of the university to Clark Construction or Engineered Construction Products were not examined although the article did note that he was subcontracted to work at GW. There have been no follow up articles.

OSHA reported that sanctions had been imposed on the firm that had hired Montano. The firm “…received one serious violation for violating OSHA’s fall protection standard (1926.501(b)(1)) and a monetary penalty of $2,500.  This was the only citation and penalty issued in relation to Mr. Rosaulino Montano, 46, fatal injury.   No other employer …was deemed responsible for ensuring safety at the site.”

A brief Hatchet article dutifully marks Montano’s death: “A man fell to his death while installing a window on the seventh floor of the new GW residence hall.” It is reported that he “lost his balance” and “died instantly after he fell out of the window and hit the concrete below.” The article gives a few details about his life. Through a statement by a university spokeswoman, his family is mentioned. After this brief enunciation of concern and regret for loss of life, there is no further curiosity about his life or the manner of his death.

The language of the Hatchet article evokes personal feeling and sympathy or charity (he lived in Woodbridge and had several children) yet the structural contexts of his death aren’t explored. There is little investigation of his employment status, no investigation of what it means to be subcontracted, and no investigation of the routes, economic or otherwise, through which he came to work at the university.

The relationship between Montano and the university community is thin. His life and his death have little content or detail, and no noteworthy or substantial legal, social, economic, or emotional connection to the university community. While there are a few modes of identification, his ties to the university community are tenuous. University business continues, there is no memorial service, there are no statements of regret by university officials, and there is little coverage or desire for information about his life. The conditions of his employment, the conditions of his work, the details of the accident which killed him, and the routes through which he came to work at the university are not visible in accounts of his death.

Short lived regret and sympathy doesn’t pursue what happened to Montano’s family; they are abandoned to depoliticized charitable discourse. It doesn’t pursue the role of the state, the economic arrangement between subcontracted company and the university, the citizen status of the worker, or the relationship between his labor and the life and well-being of the university community.

Giorgio Agamben has something to say about the biopolitics of life and the institutional role of universities in neoliberalism that might help us understand `what happened to Rosaulino Montano”:

If the exception is the structure of sovereignty, the sovereignty is not an exclusively political concept, an exclusively juridical category, a power external to law … or the supreme rule of the juridical order …: it is the originary structure in which law refers to life and includes it in itself by suspending it. . . . (W)e shall give the name ban … to this potentiality … of the law to maintain itself in its own privation, to apply in no longer applying. The relation of exception is a relation of ban. He who has been banned is not, in fact, simply set outside the law and made indifferent to it but rather abandoned by it, that is, exposed and threatened on the threshold in which life and law, outside and inside, become indistinguished. It is literally not possible to say whether the one who has been banned is outside or inside the juridical order. . . . It is in this sense that that paradox of sovereignty can take the form `There is nothing outside the law.’ The originary relation of law to life is not application but Abandonment” (Agamben’s italics).

In a world of abandonment, bodies who do not fit into regimes of life are written out of discourses of mourning, structure of feelings, knowledge systems, and world view of the university. In the rhetoric of abandonment, subcontracted means outside of a collective narrative, recognition of name, traditions, and care of a community, the feelings of community belonging, and the protections of institutions of the state. A public discourse demarcates among kin and those who are not kin, differentiating and marking out, a political space between those who are directly and deeply involved in community and the university (through a relationship to an employer, a relationship to intellectual labor, or a relationship of in loco parentis) from those who are not seen as deeply or directly involved in the work of the university. Public mourning tells us who is valuable and who is not valuable, who is intelligible and not intelligible, which subjects, which bodies, which labor, and which behaviors contribute to domains of value and utility that neoliberal universities produce. Exceptional subjects are included in relationships of ethical responsibility and are mourned. Unexceptional subjects are abandoned to discourse of charity.

The single public text of Mr. Montano’s death reveals a structure of American modernity and liberalism that makes Latino workers disappear.  The domesticated immigrant worker in the neoliberal center is identified through markers as father and family man. Work and heterosexuality has the effect of briefly making Montano’s life visible so he can be recognized, his death can be regretted, and responsibility can be directed to the subcontracted company. The events of his life and death are then quickly folded from view. Montano’s death does not become a presence which resonates after a fleeting moment when the events of his death are duly recorded and regret is expressed. He becomes in the structures of feeling of the university a ghostly presence, there but not there, a palimpsest of whom unactualized traces exist.

 

(Image Credit: Union Safety)