Above image: Kazimir Iskander.
In their 2022 book, Beatrice Adler-Bolton and Artie Vierkant argue that under capitalism, the sick and elderly are treated like surplus populations.
And that a better system is possible.
health com•mu•nism
noun
a framework that separates healthcare from profit, productivity and judgments of worthiness
What makes it communist”?
Advocates Beatrice Adler-Bolton and Artie Vierkant say health communism isn’t about tweaking the current healthcare system but ending a system in which only those deemed “productive” or “deserving” are allowed to live well. Instead, care should be guaranteed to all — because we exist, not because we work.
Under capitalism, care is often tied to productivity. But as Adler-Bolton and Vierkant argue in their book, Health Communism, that logic is the problem. Sickness, disability and aging aren’t anomalies; they’re part of being human. A truly humane health system, then, would not treat nonproductivity as a defect.
Under the current system, many people — especially the chronically ill, disabled, elderly and institutionalized — are treated as “surplus populations,” expensive burdens to be managed. Health communism sees their liberation as central to the fight for justice.
What about proposals for universal healthcare?
Medicare for All, as it’s typically proposed, would be a huge step forward, but health communism argues “the task at hand is much greater than one program.” Even those on Medicaid and Social Security Disability Insurance first have to prove they’re sick enough, poor enough or disabled enough — and even then, they’re often left with inadequate care, surveillance and bureaucratic cruelty. And recently, Medicaid got a strict new work requirement, thanks to President Donald Trump’s so-called Big Beautiful Bill.
“Health under capitalism is an impossibility,” argue Adler-Bolton and Vierkant. “Under capitalism, to attain health you must work, you must be productive and normative, and only then are you entitled to the health you can buy.”
Health communism says: scrap the means testing and the moral judgment. Build systems to make care unconditional and expansive.
Where has this idea shown up in practice?
In 1970s West Germany, the Sozialistisches Patientenkollektiv (SPK) organized patients and psychiatrists around the belief that illness is not an individual failure but a product of capitalist alienation. Their rallying cry, “Turn illness into a weapon,” challenged the very foundations of psychiatry and medicine. They saw the sick not as a burden but as a revolutionary class.
In the United States, similar principles animated the Black Panther Party’s free health clinics, the 1970 Young Lords’ Lincoln Hospital takeover in the South Bronx, and disability justice movements that have long fought for care systems respecting body-mind difference rather than pathologizing it.
Health communism demands a world where care isn’t rationed, sickness isn’t punished and no one has to prove their worth to live.
