Trading on Health: The Problem of Marketising the Body

**Possible Spoiler Warning

Last night, a friend and I went to see the new Neill Blomkamp film, District 9, a sci-fi thriller ostensibly about the interaction of humans and aliens in near-future Johannesburg. The film opens by giving a brief background of how the extra-terrestrials that become the focus of the film's two-hour running time found themselves in the slummy shanty town of "District 9" in the middle of the South African city. Twenty eight years before the film begins, an alien spacecraft arrives above Johannesburg. Following the expectations created by decades of invasion movies and fantasies, the humans on the ground formulate two possible outcomes of this strange floating residency. First, the aliens are here to declare war, and will soon annihilate the city below them. Secondly, they are here on friendly terms and our interaction with them will herald a new dawn in technological advancement as we gain access to their weapons and advanced computer systems. Neither of these scenarios materializes. The aliens do not attack, or make any gesture as to their demands. Their weapons cannot be operated by humans, as they require a genetic match with their user. Only aliens can operate alien machinery. The aliens, pejoratively referred to by the citizens of South Africa as "Prawns," become refugees. They are given shelter in a tent city below their hovering mothership, and quickly settle into a long residency as the tents rapidly give way to clusters of clap-board shacks and improvised economies built on theft, murder and exploitation.

The film, outside of being remarkable and very fun, clearly treads on some very thin ice and allegorically addresses a number of social issues, perhaps most notably, the legacy of apartheid and segregation that haunts South African political and racial relations. However, the theme that kept rearing its head most clearly to me, was that of the marketised body- the transformation of health, blood, flesh, and bone into commodified business objects. Wikus van der Merwe, the film's unlikely and highly conflicted protagonist, is an agent with Multi-National United, a private company established to monitor and administer the many complex operations that take place in District 9, including handing out eviction notices to the Prawns, and organizing the efforts of mercenary troops and personnel during such eviction episodes. On one such occasion, Wikus accidentally comes to be a carrier of certain alien genetic sequences, and thus becomes capable of operating all the weapons and machinery that the international arms market is desperate to obtain for its own use (including MNU, itself- it's one of the world's largest arms manufacturers and distributors). As one of the characters in the film notes, Wikus instantly becomes the most "sought-after business object" on the planet.

Perhaps it's simply my own busy mind churning too hard, or perhaps its the furor developing in the United States currently over the issue of healthcare reform, but this issue of health and physical state as potential capital struck the deepest nerve with our current reality. Being Canadian, I struggle to comprehend the debate raging in the United States at the moment over President Obama's attempts to reform and nationalize certain elements of healthcare. Millions of Americans struggle daily with meeting their basic medical needs. A close friend recently moved to California, and still travels back to Canada for medical procedures. The travel expenses are less than simply being treated in the United States. And yet, any attempt that the White House makes at reforming the health care system is immediately lashed and struck down by moronic complaints of communism, socialism, totalitarianism, and occasionally, Canadianism. And so the status quo is maintained: Private insurance companies extending tenuous coverage to those who are most healthy, and denying care to those who need it most because they are liabilities in a system that demands maximization of profits, low-risk investing, and cutting your losses before they materialize. Charging citizens "market price" for medical services, giving monetary, discrete value to abstract, amorphous concepts such as the body, health, well-being, and survival.

There is a violence in marketised health care. It's not a literal, visceral, bodily violence (although in some cases, it may well be), but it is a symbolic violence. Unregulated capitalist industries place value on certain practices and behaviours. The tend to 'rationalize' their actions and duties. That is, they break whole entities or concepts down into manageable and quantifiable stages, then arrange those stages in such a way as to maximize production, minimize inefficiencies, save money, and make everything understandable and manageable at the most micro-level. This is what the car industry does. This is what the consumer goods industry does. This is what the garment and clothing industry does. And unfortunately, this is what the health care industry does. It extends the rationalize-quantify-maximize logic of the market (a decidedly violent, dissociative logic) to those spaces and concepts which are not easily quantifiable, things like the body and health. The body becomes systematically dismembered by the market forces that run American health care. Insurance companies put a price on your immune system by refusing to pay for certain prescription drugs. Hospitals put a price on your organs, on the help you need to stay healthy. Ultimately, your body becomes priced, and traded as a commodity. Your kidneys have a certain price and risk. Your eyes. Your skin. Your heart. All things that can be evaluated, understood, and risk-managed by an economy based not on well-being, but on the exchange and accumulation of capital. Those who represent the lowest risk to insurance companies and care-givers (that is, the healthiest and wealthiest of all citizens) are most likely to receive insurance plans, and most likely to be able to obtain care, should they ever need it. Those who are most sick, those who need the help of prescriptions and hospitals, though, are too much of a liability. They are a bad investment, and are left to fend for themselves.

Wikus van der Merwe in District 9 is this marketised body incarnate. MNU pays no attention to the physiological, emotional, social, or psychological trauma that Wikus becomes burdened with upon being exposed to the alien genetic material. He begins (literally, in some cases) to fall to pieces as he is pursued by war-lords, underground arms dealers, government agents and private mercenary soldiers. His suffering body, and the suffering mind that accompanies it, represent capital, and nothing more. The film is gory and at times very unpleasant to watch, and I can't help but feel this is something more than Peter Jackson (producer) having a real penchant for making viewers squirm in their seats. The violence carried out by marketised and private health care systems in the West is highly symbolic- it exists in the realm of rhetoric, economic jargon and the sly actions taken by those behind desks. It is, nonetheless, tangible. However, when we hear stories of things like underground organ trades in other (mostly third-world) countries, we cringe. We simply can't stomach the fact that something as sacred as the body can be literally carved up, doled out, and sold for passports, work visas, and the like. We judge the people who commit such acts as less-than-human, as violent, as criminals of the worst kind, all the while ignoring the fact that these organ traders are simply making physical the symbolic crimes and injustices that our insurance and health companies commit every day. Wikus' failing body, and the attempts to harvest its secrets for monetary gain, represent both the symbolic violence of marketised health and the physical violence of the commodified body. He is at once a representative of the private sector impinging upon abstractions such as "home" and "self," and a victim of this very system- a manifestation of the body disrupted by a relentless drive for capital and competitive advantage.

It may seem silly to discuss such important issues through something as apparently menial as a sci-fi thriller, but District 9 is a remarkable film, and one that pushes the boundaries of its own genre, and could not have been released at a more timely juncture. It makes visible the problems of bodily valuation and disrobes the problematic and disturbing truth of the violence of the marketised body