by Alessandro De Giorgi*

In a much-quoted segment from the Prison Notebooks, Italian communist intellectual Antonio Gramsci outlined his famous definition of a crisis of hegemony:

If the ruling class has lost its consensus, i.e., is no longer “leading” but only “dominant,” exercising coercive force alone, this means precisely that the great masses have become detached from their traditional ideologies, and no longer believe what they used to believe previously. The crisis consists precisely in the fact that the old is dying and the new cannot be born; in this interregnum a great variety of morbid symptoms appear. (Gramsci 1971, 276).

Although Gramsci’s theorization was a critique of the specific historical conjuncture that supported the rise of European fascisms in the 1930s, the materialist lens he forged provides an invaluable tool to understand the cyclical crises of hegemony that have affected Western capitalist societies through the twentieth century. In the notes that follow, I would like to argue that the “great variety of morbid symptoms” characterizing the present historical moment—specifically, the rise of right-wing populisms across the Western world—signals a crisis of hegemony of the neoliberal regime of capital accumulation sustained by liberal/centrist political parties and a rearticulation of class power along authoritarian lines.

The recent emergence of right-wing populist formations in Europe—the National Front in France, Golden Dawn in Greece, the Party for Freedom (PVV) in the Netherlands, Jobbik in Hungary, Alernativ für Deutschland in Germany, the UK Independence Party in England, and of course Trump Republicans in the US—is the latest development in this process of reconfiguration of race and class politics. Yet, despite the appeal that such a label may hold in the face of increasingly autocratic and chauvinistic tendencies in the Western world, we should be wary of calling these developments simply as a form of neo-fascism, or fascism 2.0. Indeed, there are several risks implicit in adopting such a rhetoric: (a) it is a rather ahistorical simplification that prevents a structural analysis of current tendencies; (b) it equalizes all opposition (reformist vs. radical, institutional vs. grassroots) under the generic umbrella of liberal-democratic resistance; and (c) it constricts opposition within a purely reactive mode (i.e., it obstructs the effort to envision not just a less fascist neoliberal society, but a radically different one). A more useful frame of analysis might be what radical political economist Ian Bruff has recently called “authoritarian neoliberalism.” In opposition to the “liberal neoliberalism” endorsed by the centrist parties that have been hegemonic in Europe and the US in the last few years, “authoritarian neoliberalism” is characterized by the fact that

dominant social groups are less interested in neutralizing resistance and dissent via concessions and forms of compromise … favoring instead the explicit exclusion and marginalization of subordinate social groups through the constitutionally and legally engineered self-disempowerment of nominally democratic institutions, governments, and parliaments. (Bruff 2014, 116)

In this sense, whereas liberal neoliberalism à la Obama preempted substantive democracy under a thin veil of democratic rhetoric—let us not forget that cases of police brutality spiked under the friendly Obama administration, and of course immigrant deportations reached the unprecedented number of 2.5 millions—authoritarian neoliberalism à la Trump obliterates formal democracy, too, behind a thick cloud of populist rhetoric. The political vocabulary through which authoritarian neoliberalism articulates its hegemony is that of authoritarian populism famously described by Stuart Hall (1985): a political discourse based on an abstract notion of “the people” that establishes a rhetorical convergence between the objectives of those in power and the demands of the citizenry by channeling both against various undeserving “others” (e.g., criminals, immigrants, terrorists, welfare queens, etc.). This narrative combines different strategies to neutralize the formation of interracial/class-based solidarities:

(a) First, it artificially elevates certain social groups rhetorically constructed as deserving (on the basis of race, ethnicity, nationality, religion, sexuality) above other social groups with whom they share a common subordinated class position in society. The concept of comparative racialization proposed by Lisa Marie Cacho is particularly useful here:

Ascribing readily recognizable social value always requires the devaluation of an/other … In the United States, human value is made legible in relation to the deviant, the non-American, the non-normative, the pathologized, and the recalcitrant. (Cacho 2012, 18–19)

(b) Second, authoritarian populism denounces the undue advantages (e.g., wasteful welfare, reverse discrimination, permissive rights, lax borders, tolerant law enforcement) supposedly enjoyed by the more underprivileged groups at the hands of a self-serving liberal power elite.

(c) Third, it equates—in a sort of zero-sum game—the improvement of social conditions for the deserving social groups with the cultural/political/institutional marginalization of the undeserving social groups (e.g., through criminalization, discipline, surveillance, deportation).

In this context, cyclical moral panics—triggered by political elites and amplified by corporate media—pave the ground for authoritarian law-and-order by equating street crime with a threat to the personal safety of law-abiding citizens by the racialized poor; illegal immigration with a threat to the social mobility of working Americans by criminal aliens; terrorism with a threat to American values by enemy civilizations; welfare with a threat to taxpaying Americans by an irresponsible underclass; and LGBTQ rights with a threat to the stability of the American family by pathological subcultures.

What kind of opposition can we envision in the current conjuncture? Inspired in particular by some of the insights put forward by Keeanga Yamahtta-Taylor (2016), I briefly outline below what I see as the minimum necessary building blocks of insurgent politics in the present moment:

(a) First, social movements should work towards overcoming the single-issue orientation of most current politics and, most importantly, the “non-profit industrial complex” that sustains this paradigm of political action (including forms of “professional activism”).

(b) Second, we should overcome any simplified and depoliticized notion of privilege as an individual feature that subjects can somehow un-learn—for example, by adopting proper “technologies of the self” (Foucault 1988). This also means overcoming the self-congratulatory rhetoric about individual trajectories of healing, awakening, self-care, etc. These models are not only compatible with the dominant neoliberal ethos of personal responsibility and individual achievement, but they are building blocks of its renewed hegemonic hold.

(c) Third, we should be wary of the creation of institutionally coopted (if not state-sponsored) “safe spaces” that end up reinforcing dominant notions of safety as personal security from individual aggressions; particularly when promoted or coopted by institutions eager to prevent insurgent mobilizations (e.g., university campuses), such spaces may become tolerated reservations for injured identities that work effectively to soften any opposition to structural inequalities. Liberated spaces are not assigned by powerful institutions; they are taken from them.

(d) Finally, against the proliferation of court-actionable claims to “injured statuses” as the main form of resistance to white supremacy, we need to build intersectional communities of struggle: we need to engage in political action that acknowledges and organizes the plural nature of our movements, while at the same time consolidating stable political formations tasked with carrying forward the unique cause of the construction of the common. In this project, oppressed identities (the ones imposed by racial capitalism) must become visible against the color-blind nature of contemporary racism, the gender-blind nature of contemporary sexism, and the class-blind nature of contemporary capitalism. However, the ultimate aim of our insurgent politics should be the abolition of any “identity as property” (to paraphrase Cheryl Harris)—that is, liberation from identity as an organizing principle of any social hierarchy. Michael Hardt and Antonio Negri (2009, 331) frame this idea in terms of a distinction between mere emancipation, which is still anchored to the dominant framing of identity, and liberation, which requires instead a complex articulation of singularities. It is in this sense that Frantz Fanon (1967, 8) notoriously advanced the controversial statement “I propose nothing short of the liberation of the man of color from himself”.

In conclusion, against the abstract and amorphous notion of “the people” invoked by authoritarian populism, at the same time uncritically undifferentiated and profoundly divided, we should mobilize the concrete reality of insurgent singularities fighting at the same time against a multiplicity of intersecting oppressions and toward the common goal of a post-capitalist society.

References
Bruff, I. 2014. “The Rise of Authoritarian Neoliberalism.” Rethinking Marxism, 26(1): 113–29.
Cacho, L. M. 2012. Social Death: Racialized Rightlessness and the Criminalization of the Unprotected. New York: New York University Press.
Fanon, F. 1967. Black Skin, White Masks. New York: Grove Press.
Foucault, M. 1988. “Technologies of the Self.” In Technologies of the Self: A Seminar with Michel Foucault, edited by L.H. Martin, H. Gutman, and P. Hutton, pp. 16–49.  Amherst: University of Massachusetts Press.
Gramsci, A. 1971. Selections from the Prison Notebooks. New York: International Publishers.
Hall, S. 1985. “Authoritarian Populism: A Response to Jessop et al.”. New Left Review, 151: 115–24.
Hardt, M. and A. Negri 2009. Commonwealth. Cambridge, MA: Belknap Press.
Yamahtta-Taylor, K. 2016. From #BlackLivesMatter to Black Liberation. Chicago: Haymarket Books.

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*Alessandro De Giorgi is Associate Professor at the Department of Justice Studies, San Jose State University (e-mail: alessandro.degiorgi@sjsu.edu). His teaching and research interests include critical theories of punishment and social control, urban ethnography, and radical political economy. He is the author of Rethinking the Political Economy of Punishment: Perspectives on Post-Fordism and Penal Politics (Ashgate, 2006). Currently, he is conducting ethnographic research on the socioeconomic dimensions of concentrated incarceration and prisoner reentry in West Oakland, California.

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Image: “Liberate the commons,” © Social Justice.

by Tom Bodenheimer*

Photo by LaDawna Howard, used under CC BY 2.0.

March 24, 2017 marked seven years and one day since the signing of the Affordable Care Act (“Obamacare”) into law on March 23, 2010. On that seventh anniversary, House Speaker Paul Ryan abandoned the Republican plan to repeal and replace Obamacare because of a shortage of Yes votes. Whereas this was a great victory for those of us who believe that health care is a right, the fate of Obamacare is not yet settled. Because of rising costs to patients, Obamacare could collapse under its own weight. In the short run, we need to take action to reduce patients’ health care costs; in the long run, only a single payer system can fix Obamacare.

Speaker Paul Ryan’s Plan

The now-defunct Republican plan to repeal and replace Obamacare targeted both portions of the Obamacare law: 1) the individual mandate, which requires people without insurance to purchase insurance—assisted by a federal subsidy—or pay a penalty; and 2) the expansion of Medicaid. First, the Ryan plan eliminated the requirement that people without insurance sign up for individual health insurance offered through federal or state-based insurance exchanges. This requirement was needed to encourage young, healthy people to purchase health insurance because they subsidize insurance for older people and people in poor health. In place of the requirement to purchase health insurance, the proposed legislation provided tax credits to help people afford health insurance. However, the tax credits were small compared with the subsidies provided under Obamacare, meaning that many people would be unable to afford health insurance. Lower-income middle-aged people would have their insurance premiums increase from $1,700 under Obamacare to $14,600 under Ryan’s plan. Insurers would be able to increase patient out-of-pocket costs (deductibles and copayments) beyond the levels allowed under Obamacare. Savings from reductions in health care costs under the Ryan plan would largely go to tax cuts for the very wealthy.

Second, Ryan’s plan would have eliminated Obamacare’s expansion of Medicaid that insured 10 million new people. With the attack on both the individual mandate and the Medicaid expansion, the Congressional Budget Office estimated that 24 million people would lose their insurance under Ryan’s legislation.

The Problems of Obamacare

Now that Obamacare will continue to be the law of the land, what are its future prospects?

The individual mandate is under the control of insurance companies; they can choose to participate or not, and they can raise their premiums if they are not making profits. Three of the largest insurers are pulling out of Obamacare in a number of states, leaving people fewer choices. The 2017 premiums are up an average of 22%, more in some states and less in others. From 2015 to 2017, the percent of insured Americans having trouble affording their health insurance premiums (even with the Obamacare subsidies) rose from 27% to 37%. The percent finding it difficult to afford copays for doctor visits and prescriptions has risen from 24% to 31%, and 43% of insured persons, up from 34%, have trouble paying the deductible.

If costs to patients continue to rise, more and more people may opt to pay the penalty rather than purchase health insurance. If many young healthy people decide not to continue their Obamacare coverage, it could have disastrous consequences. Here’s why: Older adults pay premiums that do not fully cover their medical expenses, while younger adults pay premiums that more than cover their expenses. For the system to work, young people need to enroll in sufficient numbers to produce a surplus in premium revenues that can be used to cross-subsidize the deficit created by older people. If many younger people do not renew their insurance coverage in late 2017, premiums will again rise rapidly and more people will be unable to afford health care. While the Congressional Budget Office does not think this will happen—it could.

The Medicaid expansion portion of Obamacare is highly successful. In the 32 states that expanded Medicaid, everyone below 133% of the federal poverty line receives insurance—in most states with minimal out-of-pocket costs. However, a number of states, for example Indiana when Mike Pence was governor, started to charge premiums and copayments to people who have very little money. If they do not pay, they are kicked off Medicaid. The Republican Congress is likely to introduce new legislation, specific to the Medicaid portion of Obamacare, that severely limits the amount of Medicaid funds available to states for their Medicaid programs (so-called block grants or fixed sums per Medicaid enrollee). Such legislation would cause states to cut benefits to Medicaid enrollees and/or burden them with out-of-pocket costs that they cannot afford. Whether or not the attack on Medicaid will pass the Senate depends on whether Republican governors, who would lose federal money from the Medicaid block grants, put pressure on their Republican senators to vote No. If all Democrats oppose this legislation, it takes only three Republican senators to join them in voting No to defeat these cutbacks.

Options for Improving Obamacare

Over the past few weeks, thousands of people made their voices heard: Do not repeal Obamacare. But those voices could turn against Obamacare if costs continue to climb. Democrats need to introduce legislation to reduce the premiums, copayments, and deductibles under Obamacare. It won’t be easy given the realities of the insurance market. What are the options?

1) Increase the subsidies to reduce premium costs, making it more affordable for young healthy people to enter the insurance market.
2) Add a public option insurer that offers lower premiums, copayments, and deductibles than private, for-profit insurers.
3) Join Bernie Sanders and push for a single-payer system that eliminates the insurance industry from health care and provides excellent coverage for all Americans, financed by a progressive tax.

None of these options are likely in a Republican-controlled federal government. But states could enact legislation—ideally instituting a single-payer system—to address Obamacare’s shortcomings. Without confronting the growing costs of health insurance and health care, the future of Obamacare is uncertain.

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*Tom Bodenheimer is a primary care physician who practiced in San Francisco’s Mission District for 32 years. He is currently Professor Emeritus of Family and Community Medicine at University of California, San Francisco.