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ABSTRACT
Healthcare has traditionally been structured by biopolitical processes of indexing. The rhetorical practice of indexing stratifies bodies into risk categories and determines who has access to services and at what cost. Indexing generalizes features of identity, artificially classifying them into risk categories to maximize corporate profits. This dubious process accounts for traditional matters of health such as disease and illness, but also assesses broad demographic markers such as gender, race, and disability. This essay engages an attempt by disability activists to resist such practices through a 2005 sit-in at the Tennessee State Capitol.
Disclosure statement
No potential conflict of interest was reported by the author.
Notes
1 Anita Wadhwani, “Few Losing TennCare can Afford Insurance,” Tennessean, July, 24, 2005: A1.
2 Pictures from that morning show the nameplate of the aide who turned them away, “Andrew Jackson.”
3 See Equal Access and Disability Rights Commission, “Disability Rights History,” www.equalaccesscommission.org.
4 Anita Wadhwani, TennCare Timeline, Tennessean, October 5, 2014.
5 Bob Herbert, “Curing Health Costs: Let the Sick Suffer,” New York Times, September 1, 2005: A23.
6 David Mitchell and Sharon Snyder, The Biopolitics of Disability (Ann Arbor: University of Michigan Press, 2015).
7 Merri Lisa Johnson and Robert McRuer, “Cripistemologies: An Introduction,” Journal of Literary and Cultural Disability Studies 8 (2014): 127–147.
8 Lisa Duggan, The Twilight of Equality? Neoliberalism, Cultural Politics, and the Attack on Democracy (Boston: Beacon Press, 2003).
9 Nikolas Rose, The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century (Princeton: Princeton University Press, 2007), 132.
10 Kelly Happe, Jenell Johnson, and Marina Levina, “Introduction,” Biocitizenship: The Politics of Bodies, Governance, and Power (New York: New York University Press, 2018), 1.
11 I tend to use identity-first language (“disabled person”) in this essay because that is the widely preferred choice of contemporary disability advocates.
12 James Cherney, Ableist Rhetoric: How We Know, Value, and See Disability (College Park: Penn State University Press, 2019).
13 Rose, The Politics of Life Itself, 137.
14 Cathy Cohen, “Punks, Bulldaggers, and Welfare Queens: The Radical Potential of Queer Politics?,” GLQ 3 (1997): 437–465; Iris Marion Young, Intersecting Voices: Dilemmas of Gender, Political Philosophy, and Policy (Princeton: Princeton University Press, 1997); Isaac West, “PISSAR's Critically Queer and Disabled Politics,” Communication and Critical/Cultural Studies 7 (2010): 156–175.
15 J. Blake Scott, Risky Rhetoric: AIDS and the Cultural Practices of HIV Testing (Carbondale: Southern Illinois University Press, 2003), 116.
16 Jonathan Levy, Freaks of Fortune: The Emerging World of Capitalism and Risk in America (Cambridge: Harvard University Press, 2012), 3.
17 François Ewald, “Insurance and Risk,” The Foucault Effect: Studies in Governmentality, eds. Graham Burchell, Colin Gordon, and Peter Miller (Chicago: University of Chicago Press, 1991), 198.
18 Ewald, “Insurance and Risk,” 199.
19 Jay Dolmage, Disability Rhetoric (Syracuse: Syracuse University Press, 2014), 29.
20 Catherine Chaput and Joshua Hanan, “Economic Rhetoric as Taxis: Neoliberal Governmentality and the Dispositif of Freakonomics,” Journal of Cultural Economy 8 (2015): 46.
21 Jonathan Cohen, Sick: The Untold Story of America's Heath Care Crisis (New York: Harper, 2007), 34.
22 Jessie Wright-Mendoza, “How Insurance Companies Used Bad Science to Discriminate,” JStore Daily, September 17, 2018.
23 Dan Bouk, How Our Days Became Numbered: Risk and the Rise of the Statistical Individual (Chicago: University of Chicago Press, 2015), 185.
24 Bouk, How Our Days Became Numbered, 185.
25 Joi Ito, “Supposedly ‘Fair’ Algorithms can Perpetuate Discrimination,” Wired, February 5, 2019.
26 Ito, “Supposedly ‘Fair’ Algorithms.”
27 Mel Chen, Animacies: Biopolitics, Racial Mattering, and Queer Affect (Durham: Duke University Press, 2012), 43.
28 Lauren Berlant, “Slow Death (Sovereignty, Obesity, Lateral Agency),” Critical Inquiry 33 (2007).
29 Jasbir Puar, The Right to Maim: Debility, Capacity, Disability (Durham: Duke University Press, 2017), 65.
30 Puar, Right to Maim, xvi.
31 Puar, Right to Maim, xviii.
32 Puar, Right to Maim, 73.
33 Vanessa Beasley, “The Trouble with Marching: Ableism, Visibility, and Exclusion of People with Disabilities,” Rhetoric Society Quarterly 50 (2020): 171.
34 Dolmage, Disability Rhetoric, 152.
35 Dolmage, Disability Rhetoric, 95.
36 Michel Foucault, The History of Sexuality: An Introduction (New York: Vintage Books, 1978/1990), 138.
37 Robert Hariman, Political Style: The Artistry of Power (Chicago, University of Chicago Press, 1995), 148–49.
38 Hariman, Political Style, 168.
39 Johanna Hartelius, “‘Undocumented and Unafraid’? Challenging the Bureaucratic Paradigm,” Communication and Critical/Cultural Studies 13 (2016): 7.
40 Chaïm Perelman, The Realm of Rhetoric (Notre Dame: Notre Dame University Press, 1982), 49.
41 Emphasis mine.
42 Robert McDonald, “Metastasis and Retroactive Causality in Incentive Rhetoric,” Quarterly Journal of Speech 104 (2018): 400–421.
43 Peter Conrad, The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders (Baltimore: Johns Hopkins University Press, 2007).
44 “Governor Bredesen Delivers National Democratic Address,” U.S. Federal News Service, June 11, 2005.
45 Josh Levin, “The Welfare Queen,” Slate, December 19, 2013. See also Natalie Fixmer-Oraiz, “(In)Conceivable: Risky Reproduction and the Rhetorical Labors of ‘Octomom,’” Communication and Critical/Cultural Studies 11 (2014): 231–249.
46 Eric King Watts, “Postracial Fantasies, Blackness, and Zombies,” Communication and Critical/Cultural Studies 14 (2017): 317–333.
47 Sheila Wissner, “TennCare Enrollees Say Bredesen Broke Pledge,” Tennesseean, September 9, 2005: B1.
48 Sheila Wissner, “Not Everyone Critical of Cuts to TennCare,” Tennessean, August 7, 2005: A1.
49 Wissner, “Not Everyone Critical of Cuts to TennCare,” A1.
50 Jim Shmerling, “Bredesen Has Done the Right Thing for TennCare Survival,” Tennessean, August 3, 2005: A15.
51 Kelly Happe, “Parrhēsia, Biopolitics, and Occupy,” Philosophy and Rhetoric 48 (2015): 211–223.
52 Sean O’Rourke, “Circulation and Noncirculation of Photographic Texts in the Civil Rights Movement: A Case Study of the Rhetoric of Control,” Rhetoric and Public Affairs 15 (2012): 685–694.
53 See, for example: Christopher Schmidt, The Sit-Ins: Protest and Legal Change in the Civil Rights Era (Chicago: University of Chicago Press, 2018); Iwan Morgan and Philip Davies, From Sit-ins to SNCC: The Student Civil Rights Movement in the 1960s (Gainesville: University Press of Florida, 2013); Benjamin Houston, The Nashville Way: Racial Etiquette and the Struggle for Social Justice in a Southern City (Athens: University of Georgia Press, 2013).
54 Rebekah Kowal, “Staging the Greensboro Sit-Ins,” TDR 48 (2004): 141.
55 Mitchell and Snyder, Biopolitics of Disability, 210.
56 Interview, Randy Alexander, July 21, 2018.
57 Interview, Karl Meyer, August 26, 2018.
58 Interview, Keith Caldwell, September 10, 2018.
59 Interview, Meyer.
60 Interview, Catherine Lemaire Lozier, September 20, 2018.
61 Interview, Jane Hussain, July 2, 2018.
62 Interview, Cathryn Chamberlain, September 22, 2018.
63 Wheat, MCIL blog, July 10, 2005.
64 Anita Wadhwani, “As TennCare Protest Stretches on, Governor Shares Big Macs,” Tennessean, June 28, 2005.
65 Wheat, MCIL blog, August 1, 2005.
66 Chaput and Hanan, “Economic Rhetoric as Taxis,” 44.
67 Interview, Don DeVaul, September 10, 2018
68 Jack Halberstam, “Proliferating Cripistemologies: A Virtual Roundtable,” eds. Robert McRuer and Merri Lisa Johnson, Journal of Literary and Cultural Disability Studies 8 (2014): 152.
69 Interview, Chamberlain.
70 Interview, John Zirker, September 11, 2018.
71 Interview, Lozier.
72 Rose, The Politics of Life Itself, 149.
73 Interview, Lozier.
74 Bob Herbert, “Curing Health Costs”; Trudy Lieberman, “Mismanaged Care,” The Nation, November 22, 2005; Jacqueline Fellows, “Poor in Peril as Tennessee Debates Health Care Cuts,” National Public Radio, July 28, 2005.
75 See Gordon Bonnyman, “The TennCare Cuts: Plunging into the Unknown,” Tennessee's Business 15 (2006): 2–5.
76 Four years after the cuts, hospitals continued to be negatively affected. Vanderbilt University, for example, had its uncompensated care grow from $108 million in 2006 to about $276 million in 2009.
77 Interview, Tim Wheat, June 15, 2018.
78 Tim Chavez, “TennCare Protest is a Finer Form of Patriotism,” Tennessean, July 3, 2005: A19.
79 Trudy Lieberman, “Mismanaged Care,” The Nation, December 12, 2005.
80 Interview, Chamberlain.
81 Interview, DeVaul.
82 Interview, Meyer.
83 Wheat, MCIL blog post, June 21, 2005.
84 Wheat, MCIL blog post, July 2, 2005.
85 Puar, Right to Maim, 17.
86 Mitchell and Snyder, Biopolitics of Disability, 14.
87 The word “incarcerate” was used repeatedly on the MCIL blog.
88 Dolmage, Disability Rhetoric, 162.
89 MCIL blog, August 2, 2005. One respondent to this manuscript worried that the protesters were mocking a person with mental illness. There is no evidence that Fromme had a mental illness.
90 Interview, Chamberlain.
91 Lennard Davis, Enforcing Normality: Disability, Deafness, and the Body (New York: Verso, 1995), 130.
92 Interview, Hussain.
93 Interview, Alexander.
94 Interview, Hussain.
95 Interview, Wheat.
96 Interview, Alexander.
97 Governor Phil Bredesen, “State of the State Address,” C-SPAN, January 28, 2008.
98 Interview, Wheat.
99 Cathernie Chaput, “Rhetorical Circulation in Late Capitalism: Neoliberalism and the Overdetermination of Affective Energy,” Philosophy and Rhetoric 43 (2010), 14.
100 Martha Cooper, “Rhetorical Criticism and Foucault's Philosophy of Discursive Events,” Communication Studies 39 (1988): 1–17.
101 Dolmage, Disability Rhetoric, 94.
102 Interview, Alexander.