An Alternative Critique of the Health Care Act

In light of the U.S. Supreme Court upholding the majority of the Affordable Care Act, I think it’s important to mention something that virtually no one is talking about when it comes to a critical analysis of this piece of legislation. Both the democrats and the republicans have a lot to say when it comes to their rationale about access to health care in general, government power, budget deficits, the constitutionality of this act, etc.  However, let’s focus for a moment on what they are not talking about.

I actually want to present a harsh critique about the consequences of this act (which, should be noted, is abruptly different from republican criticisms about it). But what the democrats and the republicans will not dare to mention is that this health care law essentially represents an overwhelming expansion of the medical-industrial complex. This act is not actually a form of “government intrusion” which “fundamentally changes the doctor-patient relationship” (ironically where 50 million Americans have no doctor-patient relationship to begin with), but rather, it represents the means to which the medical-industrial complex can grow even more complex and powerful.

The medical-industrial complex (MIC) “refers to the health industry, which is composed of the multibillion-dollar congeries of enterprises including doctors, hospitals, nursing homes, insurance companies, drug manufacturers, hospital supply equipment companies, real estate and construction businesses, health systems consulting and accounting firms, and banks.”1 The term medicalization refers to the encroachment or influence of the MIC upon the defining aspects of “health” and daily life. Essentially, since health care is primarily viewed as a business, we come to define aspects of health in terms of how it relates to the market relations of contemporary capitalism.2 Therefore, there is a great potential profit in the vulnerability of illness. In part, our health becomes a commodity that can be bought and sold.

One of the inextricable consequences of MIC operation has been to exclude large portions of the population from direct health care (those who are uninsured or denied access on the basis of race, class, gender, ability, health status, employment status, martial status, etc.), which is but one means (of many) to create the conditions necessary to make those people fall victim to sickness one way or another. (Since the MIC “owns the rights” to the access and definition of “health care,” it therefore controls the mechanisms to which illness can be alleviated. In other words, if you are not participating in “legitimate” MIC health care practices to make you healthy, then you will continue to be sick.) However, with the upholding of the Affordable Care Act, formerly excluded (uninsured), sick people will now have easier access to meet with doctors and ultimately “regulate” their health on the grounds that they consent to the subjection of their health as a biomedical business commodity.

Furthermore, once people have access to health insurance, they typically solidify their consent to view health as a biomedical business venture. So the real driving force behind the MIC is to:

1) make sure people get sick;
2) then have them visit doctors and hospitals where MIC defined diagnoses take place in exchange for a hefty fee;
3) then have them buy expensive pharmaceutical products to help alleviate medical conditions (which typically create adverse reactions that require more drugs to be taken); and,
4) only to have the cycle repeated over and over and over again until the person ceases to exist anymore.

So, in actuality, the Affordable Care Act does not promote health care; it promotes sick care. The MIC is designed to keep people in a state of perpetual illness.

While this law does indeed give more people access to health insurance and doctor visits, it more importantly gives the MIC better access to more people (which is one way to look at it). And just like any other American complex or institution, the MIC is based on the structural systems of capitalism, white supremacy, and patriarchy just to name a few. So this law also represents an expansion of capitalist, white supremacist, and patriarchal power (which is grounds for a much lengthier analysis).

Moreover, true health care reform would be based on people not getting sick in the first place! There would be very little need to acquiesce one’s health over to medical doctors, or to purchase expensive drugs if illness was not present. If everyone had the tools and the “borderless knowledge” to maintain their own personal health and well being, then there would be no profit to be made on illness and the MIC would no longer exist in its current capacity.3

This alone should serve to show us just how deep the matrix of social, structural, and physical control goes.

  1. Estes, Carroll L., Charlene Harrington, and David N. Pellow. 2000. “The Medical Industrial Complex.” The Encyclopedia of Sociology, ed. E. F. Borgatta and R.V. Montgomery, 1818-32. Farmington Hills, Michigan: Gale. []
  2. Shariati, Mehdi S. 2010. “Hegemony and the U.S. Health Care Crisis: Structural Determinants and Obstacles to a National Health Insurance Program.” Kansas City Kansas Community College e-journal 4 (1). []
  3. Also see: Giroux, Henry. 2012.Beyond the Politics of the Big Lie: The Education Deficit and the New Authoritarianism.” Truthout, June 19. []
Michael Ortiz holds an advanced degree in sociology. He works on equitable diversity initiatives and writes about issues that focus on consciousness raising and empowerment. Read other articles by Michael, or visit Michael's website.