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“Just Don’t Get Sick:” Neoliberal Health Care in the Pandemic

Banner image featuring a graffiti painted mask and the title of the series.

Jane Shulman

June 26, 2020

Image of a person holding a bottle of sanitzing wipes, bleach, and hand sanitizer.On March 17, 2020, my second day of indefinite isolation (as I am one of the immuno-compromised people at higher risk of dying if I contract COVID-19), I wrote the following observation on Facebook:

"COVID-19 will be a fantastically tragic model to explain to students the neoliberal agenda of putting the onus on the individual to obfuscate the reality that most of the horrors of our time are neoliberal-made disasters. There is no viable reason in Canada in 2020 that there are not enough ventilators or health care providers to weather this. Yet we swallow the absurd dominant discourse because we have to, i.e., ‘it's your responsibility to not catch a highly contagious virus,’ the subtext of which is: ‘We have annihilated the systems that were designed to care for you; we're going to have to choose who lives and who dies if you ‘eff’ this up, and we are focusing the entire power of our governments and infrastructures on reinforcing that.’"

Ever the student of culture, my attention has been focused on the ways that governments are using the pandemic to advance neoliberal agendas to defund and privatize health care, and how that is playing out for the rest of us. For the purposes of this reflection, I am constructing my definition of neoliberalism from the work of cultural studies researcher Jackie Stacey. In her 1997 monograph Teratologies, Stacey meticulously traces her cancer experience in Margaret Thatcher’s England of the 1980s. Stacey argues that the neoliberalizing of health care was part of the Thatcherite legacy of the “cult of the individual” (3) when health began to be treated as a personal, rather than a state, responsibility.

During and after the eras of Thatcher in the UK, Reagan in the US and Mulroney in Canada, lifestyle choices (eating healthy foods, not smoking, getting enough sleep) became the focus of public health strategies. Social determinants of health (poverty, homophobia, racism, sexism, etc.) were minimized because neoliberal governments were not concerned with measures to reduce social disparities and environmental factors that might be making people sick. Decades of austerity meant endless cuts to health care spending, reduced staffing, and commodification of services through privatization (Viens 152). The staff and equipment shortages we are seeing now are the result of this coordinated effort to cut costs by whatever means necessary.

Early in the pandemic, Canadians were inundated with terrifying, graphic media reports of doctors in Italy forced to decide who would be treated with ventilators and who would be condemned to death by suffocation, alone in quarantine wards, separated from their loved ones. These stories served as grim public service announcements to underscore our individual duty to “stay home, and save lives.” We were told, before the virus even reached Canada in great numbers, that hospitals were not equipped to manage the pandemic with the resources available, and people might die as a result. Now we know that Black and Indigenous people, people of colour, and people with low incomes are more severely affected by COVID-19 and unattainable public health care directives.

As a person with chronic health issues and a professional background researching and advocating for more equitable health care access, I am worried about individualistic framings of the virus. It was a shrewd political move, disguised as public health policy, to shift responsibility for COVID-19 from governments to individuals. By framing COVID-19 as a sort of choose-your-own-adventure tragedy, where each of us could follow public health regulations or be culpable for even more carnage if we did not (or could not), governments and public health officials were leaning into a well-established deterioration of collective responsibility for health in favour of a model where the onus is on the individual to stay healthy.

In the absence of adequately funded and staffed health care systems, and with the ongoing rhetoric about our individual responsibility to stop the spread, I believe we are headed for trouble. The individual-focused approach to communication and prevention is having serious unintended consequences. There are media features with doctors and journalists answering hundreds of questions from frightened readers, more than double the number of people are poisoning themselves with household cleaners compared to last year at this time, and people are waiting too long to visit ERs and risking their lives because they are afraid of catching COVID-19.

To be clear, I support telling people to wash their hands, wear masks, and stay a good distance from others for the time being. What is concerning to me, from a Cultural Studies perspective, is the acceptance of the inevitability of workforce and supply shortages and the resulting deaths, and the pressure exerted on people to protect themselves. Governments have even resorted to pandemic policing and citizen-snitching in their fervour to shift responsibility for managing the virus. This hyper-individualism is the crux of neoliberal health care ideology. Many of us are so scared, confused and/or distracted that we have not called out this absurdity. The neoliberal strategy is working.

Stacey, Jackie. Teratologies: A Cultural Study of Cancer. Routledge, 1997.

Viens, A.M. "Neo-Liberalism, Austerity and the Political Determinants of Health." Health Care Analysis 27, 147–152 (2019).

Jane Shulman completed a Master’s degree in Cultural Studies at the University of Winnipeg, studying queer people’s health narratives, and queer content in nursing pedagogy. She currently works for the RISE Research Program on 2SLGBTQ+ inclusive Education.

Essay image credit: Photo by Kelly Sikkema on Unsplash.

The banner image was designed by Lauren Bosc, adapted from an image by Adam Nieścioruk on Unsplash.

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