In this article, I argue that the concentration of wealth and power in the United States and its accompanying ideals of corporate capitalism and globalization are destroying not only the economic security of US families, but also our health care system and the ideals of a participatory democracy. The article is composed of 2 parts. Part I is a portrayal of the US economic and health care system as it is, one that enacts an ideology of never-ending profit, inequality, and exclusion based on class, color, and ability to pay. Initially, I outline the wealth gap in our society and deconstruct the popular myth that most US families benefited from the stock market gains of the 80s and 90s; next I discuss the process of corporatization and globalization of business and the resultant attack on the ideals of participatory democracy. Finally, I briefly trace the history of the corporatization of US health care and outline its impact on costs, access, quality, and population health. Part II is a more philosophical discussion of ways out of the dilemmas portrayed in Part I. Among other things, I discuss how a deepening of our political commitment is needed, a process that entails a move away from the current politics of the Prince toward a politics of the people. This deeper way of living our politics makes every act a political act, enabling us to resist what we are told, denounce that which is unacceptable, unite around common ground, and enact previously unimagined alternatives.
It does not have to be this way–it could be otherwise. 1
In the United States, the huge concentration of wealth in the hands of a few, whereby 1% of the population has more household wealth than the entire bottom 95%, is a manifestation of a hegemonic discourse of corporate capitalism that respects the power of capital over human lives. 2(p5) In this article, I outline how this concentration of wealth and power with its accompanying ideals of corporate capitalism and globalization is destroying our economic security, our health care system, and the ideals of a participatory democracy. As nurses, we know intimately the effects of inequality in daily lives, for it is usually the work of nurses to enter people's homes and personally witness the devastation of poverty; to search endlessly for nonexistent “resources”; and increasingly, to turn sick people away from our clinics and emergency rooms, often on the basis of inability to pay. I believe the shocking inequalities we encounter in our daily work are but one manifestation of the tyranny of corporate capitalism, a tyranny which puts the preservation of profit above human lives and pits the most wealthy and powerful against most of the world's population.
The article is composed of 2 parts. Part I is a portrayal of the US economic and health care system as it is, one which enacts an ideology of never-ending profit, inequality, and exclusion based on class, color, and ability to pay. I first outline the wealth gap in our society, deconstructing the popular myth that most Americans have profited from the economic boom of the 80s and 90s. Next, I briefly discuss corporatization of business, and its dangerous twin, globalization; I then outline how global capitalism and the free trade policies destroy the democratic process. Next, I trace the corporatization of US health care and briefly outline its impact on costs, access, quality, and population health.
Part II is an attempt to begin thinking our way out of the dilemmas portrayed in Part I. Initially, I analyze why we as a society—and nursing as a profession—seem largely unable to denounce and change the worsening social and health inequities we encounter in our daily lives. I explore how a different engagement in politics, called a politics of contingency, could help us unite to destabilize hegemonic discourses that destroy democracy and health. In the process, I hope to open up space for us to begin to engage in politics in a deeper way, a way that is both critical and hopeful, an engagement that emerges from a deep love of ourselves, humanity, and the earth.
From the University of Washington School of Nursing, Seattle, Wash.
Corresponding author: Carole Schroeder, RN, PhD, 1129 N 81st St, Seattle, WA 98195 (e-mail: firstname.lastname@example.org).