Profiting From Deviance
From Private Prisoners to Cancer Patients
In the West we began institutionalizing deviants in Bedlam. It was not much for an institution—no rehabilitation, no “patients.” Prior to that landlocked, padlocked ward, we had the Ship of Fools—a sort of Pied Piper in reverse—where the captain would arrive in town and let the “fools” loose, demanding payment to corral them back onto the ship and sail off.
Foucault described the Panopticon as a disciplinary architecture, allowing the “guards” to constantly observe the “inmates,” while remaining unseen. Police today use exactly the same method when approaching people in the dark—shine a bright light directly into their eyes—for the same purposes.
The prison is a modern institution, using the term “modern” in the academic sense that it is of that era. Qualities of modernity are seen in the transition from predominately feudalist economic relations to proto-capitalist ones—the rise of private property and ownership of means of production with the concomitant purchase of labor-power. Religious monarchies give way to secular nation-states as determinant political bodies, entirely new legal codes are constructed around concepts of “rights” and “equality,” and we see social class orders start to challenge social caste orders.
Science becomes more significant, its methodologies and ontology improving modes of production, making socialized production possible on previously-unimaginable scales. Modernity was a centuries-long process of globally socializing production. We no longer produce for ourselves. We instead produce for others. Not simply on the shop floor where labor-power is being sold, but in the activities that labor-power is directed to be doing. Goods or services, it matters not—the raison d’etre of capitalist production is social.
The legal claim to any value created, however, is privatized. Through the dynamic of capitalist production, the productive force of the entirety of the global working class is fully captured and held by the very few who can claim legal ownership; twenty-four hours a day, seven days a week, for as long as the game lasts. It adds up to a tremendous amount of real value. But the kicker is, there can never be enough.
The modern nation-state became the tool by which deviance in society would be dealt with. A legal system that would guarantee the accused of due process under law, and a carceral system where the convicted would be put on a schedule, labor for public works on chain gangs or farms (or making the proverbial license plates), and perhaps be provided with opportunities for vocational training or other education.
Science not only proved valuable for producing increasing amounts of capital, it also developed new approaches to disease and physical disorders that proved (scientifically) to be more effective at curing ailments. Later, scientific medicine would show how to prevent diseases through sanitation and vaccination.
We know that when an industry develops it is fulfilling a demand, and under capitalism it is the goal of all businesses to increase demand for their goods or services, to increase their scale and efficiency of production, and to increase profitability.
In the wave of privatization that was ushered in by Reagan, we see private capital stepping in to provide deviance-treatment services, sometimes to the state itself. When we allowed a private prison industry to develop, we were inviting the owners to promote criminal deviance—and indeed, private industry has always lobbied for mandatory minimum prison sentences because to them, those are labor contracts.
Make crimes of things that were not crimes before, increase surveillance, and increase demand for institutionalization—these are keys to ongoing profitability. Reduce spending per “client” whenever possible, and force them to labor at unbeatable wages. All value is produced through labor and the only way to make a profit is to exploit labor. Every penny paid to employees is profit lost, and no one in the United States—not even undocumented laborers—are paid less per hour than prisoners.
The only way to make disease profitable is to charge patients more than the costs of their treatments. This has gotten so far out of hand in the U.S. that no one is expected to be able to meet the costs of annual, routine medical care out-of-pocket—insurance is mandatory, literally with the ACA. The Affordable Care Act was created because the costs of disease are greater when then are untreated, and it was necessary to force health care rationing corporations to take on losses. Not that these losses would make them unprofitable but that they would cut into profitability. The corporations would profit less.
Left to their own devices, health care rationing corporations would offer no services to the most costly clients, or would just dump costly clients at the end of the annual contract. Unlike prisoners, patients are not valuable laborers, what with their contagion, their symptoms, and low productivity. Plus you have to pay them non-prisoner wages.
There is only one way for a health care rationing corporation to make increasing profits: Ration health care more efficiently. Deny claims, in other words.
Those are “market forces” at work when it comes to deviance—sick people needing hospitalization are net-negatives, so we want less of them (but more drugs—commodities that become most profitable when used for chronic conditions). Criminals needing imprisonment are net-positives, so we want more of them.
We can see through the past forty years a reduction in deviance leading to hospitalization and an increase in deviance related to imprisonment.