Death Panel Presents: Medicare for All Week 2021

M4AW2:05 – Dean Spade on Mobilization and the Limits of the Law

Dean Spade joins us to discuss building the movement for single payer, how the fragmentation of our social welfare systems is used to demobilize us, and how Medicare for All would help build solidarity to fight future struggles.

This interview is part of Medicare for All Week 2021, our second annual limited series on building the movement for health justice. Every day from February 8-13 we'll be airing a new interview on single payer and the need for a national health system in America.

To support Death Panel and make series like Medicare for All Week possible, become a patron at patreon.com/deathpanelpod

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TRANSCRIPT: Dean Spade on Mobilization and the Limits of the Law

(Medicare for All Week 2021) Air date: 12 February, 2021 — Transcript is slightly edited for clarity. [PDF — DOWNLOAD]

Beatrice Adler-Bolton  00:00

Welcome to Medicare for All Week. Today Artie, Phil and I are here with our guest, Dean Spade. Dean, welcome. And thank you so much for joining us!

Dean Spade  00:08

Thanks for having me!

Beatrice Adler-Bolton  00:10

Dean Spade is a Professor of Law at Seattle University and author of the recent book Mutual Aid: Building Solidarity During This Crisis (and the next), as well as the book Normal Life: Administrative Violence, Critical Trans Politics and the Limits of the Law. Dean, you have a fantastic body of work, but we've invited you here today so that we could have a conversation about the limits of judicial reform, but also how to build power — forward looking power behind movements for health justice, not just power that's sort of locked to, let's say, for example, an election cycle, I think that there are some pretty strong mythologies about what we can do in terms of fighting for civil rights in the courts, what these legal challenges to secure civil rights actually mean. But in reality, for example, every legal battle to save the ACA has had very little impact on the material conditions of people's lives. So I think it's important as part of Medicare for All Week to ask why that is, and also to talk about what this framing does in terms of dispersing power, and actually demobilizing people and undermining solidarity. So I thought a good place for us to start was maybe, you've done a lot of work on this in the past. Do you think you could tell us a little bit about this framing that I think you often see in American political discourse, where there's a law that's passed, or this huge legal challenge is mounted. And there's this big push, and you've won, right? And then poof — everyone disperse! Game Over, job done? Good job! We're good to go! What in effect is that actually doing? 

Dean Spade  01:48

Yeah, that's a great question. I mean, I think this really cuts across so many areas of our lives, there's a kind of mythology about law that I think is really central. If something's written in the law, then that's how things will be — that's one of them that really ignores implementation in general. And I think as you just said, for those of us living in the United States, that was an explicit apartheid state, and then passed a set of laws that said "racism was illegal," around the same time as passing laws that said, "sexism and ableism" was illegal in various ways. And then we lived for another half century and actually saw the life conditions of people of color, women and people with disabilities worsen during that period, and wealth, further concentrate, and this huge criminal apparatus grow and explode in this huge border militarism, apparatus grow and explode, we start to have to ask ourselves, what is it law is doing in these settings where we're told that that's where justice will come from, or that is the kind of final step of a social movement is that it passes its law, and then we can all go home, as you said, and I think instead, we see that the legal system is designed. One way that Critical Race Theorists talk about it is that it's preservation through transformation. So if there's a big uprising by social movements, the law will change, just enough to primarily preserve the status quo, I find that to be a useful phrase for understanding what happens. So another example I often look at is in the 1920s and 30s, when there's a lot of amazing labor organizing in the United States. And there's this huge depression. And people are really questioning capitalism and its extractive methods, you see things like the National Labor Relations Act passed and other legislation that is designed to basically pacify, to bring what people what people want — industrial peace, to make it so that workers will go back to the to the same extractive, or even worsening extractive, relations. And with some sort of minimal protection that doesn't actually land in people's lives very much. Or if it does land on anyone's lives, it'll be the least stigmatized of that group of people. So it might work out best for a certain kind of white male worker, but it's really not going to work out for domestic workers or agricultural workers, etc. So we could turn around and do endless examples of this in US law. But one other thing I want to say about this — is that the story, this mythology, about US law is centrally an anti-Black story, because the main thing that hangs on in the political imagination, is that slavery and racism used to be legal, and now they're illegal. And now we're post racism, in a million different ways, that story is central to US nationalism, and that it plays out in all kinds of other areas as well. But it's an anti-Black story about redemption, from anti-Black racism and saying, all is clean and well and for those of us who are aware that the US legal system is a colonial legal system founded in genocide and slavery, constitutively anti black, constitutively anti indigenous, that story is just it's so damaging. Both because it mobilizes people, as you mentioned, like, "Oh, this is going to be taken care of by this law." And also because it prevents mobilization, because it's like, "This has already been taken care of and so it must be that everything is equal, and that we have a race blind and gender blind, etc," you know, those phrases that are used so frequently about our purportedly neutral systems, when, of course, they're actually quite targeted.

Philip Rocco  05:21

This is interesting, because I mean, you know, we're talking, this is like Medicare for All Week, a week ostensibly it's like, a week named after a proposed law. And I think you're rightly identifying these real limits of reformism and of the law to make a profound dent in these in this sort of hierarchy, that sort of existed sort of coterminous with the origins of the American state. And I guess, I wonder, you've been involved also, you know, you're a lawyer, and you've been involved with movements that have some entree into the law, like, what is the law's? I'm very curious, because I think many, many people who mean well and want to do good things, it is like, there is a — an allure of law, that it is the thing that will, you know, be the fulcrum by which we change things. What? Why is that? Why is it so alluring? And can you describe the trap?

Dean Spade  06:33

Yeah, I mean, I think the trap I — because I teach law students, and so I see them; they come to school, they want to free their community, [laughs] the ones who don't just want to like, you know, work in corporate law and get rich, people with really good intentions. You know, this set of people who are like, this has happened in my community or these experiences with immigration system or with and I will end, and I think it's because that's the way we've been told the story. It's like, the big moment is when your charismatic leader signs the bill with the president or stands behind the president while they signed the bill, or the big judicial case, the Roe v. Wade, the Brown v. Board of Education, that's the story. And I think that part of what I also heard in your question is, what is a more strategic way to approach law and it's not about turning our backs, we don't, even though I'm a prison abolitionists, I'm not like, "I'm never gonna deal with the prison system," like no people, my people are in there. So I'm yes, absolutely going to engage with it. So the question is how to engage tactically with law. So what changes about our strategies when we stop thinking, the answer is coming there? And we start thinking very pragmatically, and realistically about the limits of what can be delivered there. And then we say, but will that change the conditions, the terrain of struggle in ways that are useful? And how would that be the case? So for example, I don't think — I think that if what I believe really makes change is mass numbers of people organizing and staying mobilized, then what I want to do is organize for law change in ways that you get there through that, not a backroom deal between an elite nonprofit, and, uh, you know, your state legislator. Our work on legal change, should be mobilizing because there's more people mobilized to say, you know, what, this isn't being implemented, or you know, what, this didn't cover some of us. We were written out of this, or we're gonna we have an ongoing contention with the government and with this legal system, because it is what it is, it's colonial, it's racist, it's sexist. It's ableist. And so the real question is, how do we learn how to put on a lot of pressure, and if we just do lawsuits and policy arguments, and the lobby day visits, that's kind of putting all of our eggs in this basket. It's also not going to get us very far, because the people who those politicians really listened to and who those judges are really guided by, of course, are the people who are the extractors, so we can't beat them at that game. Those people own all those leaders, right? The only time we get any gains is when we're heavily organized. And we're a threat, right. And so it's a really different theory of change that doesn't center law, but might include law as a tactic. Also, banner drops might be a tactic, also blocking coal trains with our bodies might be a tactic. You know, it's not— that is not a preferable tactic. And it's got all these dangers in it, like writing certain people out of the legislation or are having it not be implemented...

Beatrice Adler-Bolton  09:14

Yeah. And I mean, I think this is something that we've really wanted to emphasize as part of this series, which is that Medicare for All specifically, is a means to an end. It's not an end in and of itself. This is — Medicare for All is not the point. It is just an extremely strong loadstone on which to build a bunch of other things. And I think that this is where you start to see some of the strongest opposition to Medicare for All is that, as a piece of policy, obviously, you know, it is — there are limitations, but there are aspects of this policy, which actually do undermine the functions of the institutions of power. And that's kind of an important component of Medicare for All that you've seen people try to appropriate the brand of Medicare for All and then water it down. Or you've seen people trying to remove this aspect of Medicare for All, which would undermine the institutions like taking out Long Term Care or allowing room for private insurance to still be included. We don't have to make policies and laws which inherently uphold institutions, there's still ways to undermine them.

Dean Spade  10:22

Yeah. And also, I think I mean, you guys, I know you've done episodes on trans healthcare in the UK, or looking at places that have broader and more inclusive health care systems, we see that, and even just looking at who gets Medicare now, which there's still people left out, there's still ways in which it doesn't do what it's supposed to do. People are cheated out of care or denied care that are supposed to be covered, like, absolutely, the fight doesn't end, but we'd be on a better terrain of struggle, if we had Medicare for All. And if we had the version that has Long Term Care in it. I mean, it's the level of death and suffering and agony in our communities caused by lack of access to health care, and the stresses around that is it that also impedes our organizing, because people are not surviving, who are wise leaders that we need, and so I think that's the other piece of this.  I think that sometimes when you have a prison abolitionist politics or health care, housing for all politics, these strong beliefs that I have, people are like, "Oh, well, you can't since you can't get that all at once, then it's impractical." But it's like, Oh, absolutely not. None of us are under any illusion that we can get all of our demands in one instance, or certainly not through one piece of legislation. But instead we do an evaluation, we ask, with this particular next tactic, we're thinking of using, perhaps a particular law or legal reform, we're saying, does it leave out the most stigmatized people? Does it harm them? Does it bring material relief? Does it build a system we're trying to dismantle? Is the way that we're winning it going to mobilize lots of people for the next parts of the fight? And those questions, let us assess: is this actually in our interest? Or are we going to be duped by this or demobilized or undermined by this? There's a lot of a lot to debate inside those questions. It's not like there's an obvious answer to each of those questions. But I think even having that level of discernment already suggests a critical view of law. It's not just like get the system to say the nice things about us like they would pass a law that said, we already give everybody health care, and they would love to pass that law. Like they, you know, they pass laws all the time that say they're already doing things that they're not doing that are unenforceable, like just anti discrimination laws in general, or all kinds of laws, right? So what we want to say is like, what is this going to do for us? And are we going to regret anything about this later? And of course, that's speculative. But we have a lot of experience of what we do regret about legal reform who've done that can guide us.

Beatrice Adler-Bolton  12:41

Yeah, exactly. And I think it's really important to be especially analyzing things that are being proposed for whether or not they're going to build on institutions that actively contribute to misery and death and sickness. And also just to be looking basically, is this policy actually designed to sort of carve people out and be demobilizing? And is this a counter-insurgent piece of policy? There's something that you talk about often, which is, I think you called it the "warfare framing" of policy, which is that basically, there are these counter- insurgent moves that are made through policy decisions, which actually cleave movements, and remove some of the urgency and agency and ability to organize it's actually like pushing for these things.

Dean Spade  13:33

Yeah, I mean, I think that I'm very heavily instructed by especially Black liberation struggle, Indigenous struggle, that has named, "the US is at war with our people," that has been especially named by those two movements, I think we can see that for a lot of different groups, there's a genocidal move that has a lot of effect, and it does end people's lives early. And that also we have very rich, abundant resistance to, but when you when you reframe, instead of the US legal system, I should have said this would be anything, there's a background assumption, a nationalist assumption that a lot of people are carrying around — that the US legal system, if you just input the right things will just spit out pure liberation, if we just did it, right. We just had the right court, whatever. And, you know, a lot of us instead are like, Oh, no, this system is a warfare strategy against the people who are targeted as threats or drains, that is how we're framed. And we, once you have that understanding, then you see the the sort of PR moves the system does to absorb our critiques, and so that it's like, "We're gonna have gay cops now, or we're gonna hire women and people of color as cops or we're going to...." I mean, I live in Seattle, and the examples here abound because it's like everyone here [says], I'm going to be a social justice prosecutor and every single person in our government while they build the jails and prisons, and send people into ICE custody, they are all proclaiming themselves like, essentially, abolitionists. I mean, just as soon as the word exits our mouths as activists, they just are already reframing and absorbing them and also passing legislation saying they're committed to them. So that kind of move that counter-insurgency move, which often does happen in the policy context is, is... I just think we have to be so much more sophisticated than we used to have to be in an earlier period of, even of this neoliberal stuff, just the ways they put people who look like us in office, and they, they have, you know, just watching Biden's appointments and his appointments of all these intensely pro-war, pro-oil and gas, people of color. And it's really hard. It's just, we need to do a lot of political ed in our communities, so that people get to have more shared discernment around some of these PR moves that these systems are using to maintain themselves in the face of existential crisis.

Philip Rocco  15:52

But it also seems one of the implications of your analysis is that PR is obviously very important. But so too, is the way that the law is used and designed strategically, as a way of, I don't know, sort of eviscerating the forces that may have mobilized for its creation. So like, the thing that I always think about is like laws create their own social categories and their own sense of what the success of the law would look like, right? They create their own metrics. And, you know, those things then come to stand in for the thing that people were like, we begin to like, measure justice in some way. And then that that standard comes to stand in for the thing that people were pushing for to begin with. That's just one example. But I'm curious, you know, for thinking about like, what are some things that a law could do, that you would want that you wouldn't be looking for, as a sort of counter insurgent or demobilization thing? Because often I find that the thing is that, like, the things that you're talking about are often buried so deep in the damn text, that like, it takes almost like a literary critic to like, pull it out. So like, what should we be looking for? I guess? Yeah.

Dean Spade  17:08

I mean, I think that's a great question. There's not a lot of pieces to it, one piece of it that we have to name, especially with Medicare for All, but also with all legislative strategies is just that stuff gets added or pulled out at the end of the process, or somewhere in the process, when it feels way beyond the reach of the people who might have really tried to work to get it in there. And now, it's the job of these technocrats in Congress or your state legislature. And that feels to me, if we don't have the intense political pressure behind it from mass mobilization of people, then they can just get away with that, the only thing that stops that is when we make it politically impossible. So I think that's just a piece of it. In terms of evaluation, it's just the same things that I think we're all always looking for, is it leaving out the most stigmatized people, you know, or people who don't have or haven't had this type of job, or these kinds of work histories or, whatever the story is, people whose whose care has been determined to be too expensive, because we'd rather they just die. And all of those typical things that happen in our healthcare system and is it doing that? I think a lot about this moment, at the end of Obama's presidency, where there had been so much pressure from the "not one more deportation" movement for so long, and from the dreamers, all these people to take some kind of executive action on immigration, which he could have done very robustly. And instead, he did DACA, and DAPA. And he stood up and gave a speech, and he says, "We want our immigration system to go after felons, not families." And he also, you know, added a bunch of more border enforcement money when he passed those. And, as those always go together, right, and he was doing such important PR work for the concept of immigration enforcement, even while he gave really limited relief to a relatively small group of people. And a lot of micro justice orgs, rightfully named that as a day of mourning, even though they had won for some people. And that was a strategically, a smart way to respond to this. Because, you know, Obama wants to right off is like, I'm the hero of immigration, because I finally gave you guys these crumbs. And the movement was like, No, no, you could have done so much more. And what you've done is divisive and problematic, and is going to have racist results and classist results. And we're not going to declare it this victory. And so I think that's another piece of it. What I notice in my own political context is that a lot of times the larger nonprofits, they want to declare that victory, or they want to make those compromises because they make their money off of being like, we're the ones who passed the big law or whatever. It's the unpaid grassroots organizing groups where nobody's got this as their professional job. They're the ones who are usually saying the truer thing they're usually saying, they're holding the abolitionist line, or they're holding the "absolutely everybody needs to be included" line. And so the question is, how do those groups, they're also the only ones who are actually doing grassroots mobilization whereas they're nonprofits are just kind of doing policy work and not mobilizing people. So how do we, and this is a great moment, I think for grassroots mobilization, right now people are more open to that idea and have just seen it, you know, then and other times in my life, so I'm just like, how do we all tune in to those groups and what they're saying, if we're trying to share space evaluating, and especially when it's highly technical, I mean, one other thing about this, which I'm sure you've seen is that we have all been told under neoliberalism that  law and economics is just too complicated for us, and scientists will do it. And, we should just only know the most basic talking points. And so I saw it this summer, all of these different city and county councils, declared that they were going to defund the police, and then went on to not do that. But a lot of people thought it had happened because their council members stood up and said that, but then most people don't actually have the interest or skills to go into the budgets, almost nobody's paying attention to the actual budget process in their city or county. And in, you know, the people who are [able to read the budget] like, you know, are the people who Amazon hires or whatever, here in Seattle, are making, they have plenty of people hired to make what they want. And so one of the questions is, how do we increase our capacity, to follow the details and to communicate out to our movements because if we are those people who are able to follow those details that can be communicated out in ways that people can understand to , how do we keep mobilization going, when it gets really boring and dry? And sometimes there's really stuff that is hard to read, even if you're a total expert, that stuff is really hard to read, there's a million pieces to it. And so, I mean, you guys, your podcast does a great job of telling us all what's really in those bills. But I think that that's actually a real obstacle to our organizing right now is that people can be more easily bought off with a couple talking points, or just the name of some legislation, and then what's inside is not delivering them what they hoped for, or what they thought they were winning, and that the gap between the fine print, and that talking point is too yawning.

Beatrice Adler-Bolton  22:01

That's why I think we try and be really realistic about Medicare for All because we're always very upfront. And we say, especially me, speaking as a disabled person on current Medicare, Medicare for All will not be this beautiful panacea of like everyone has all the care they need immediately, instantly, however, what it does do, which I think is kind of unusual for policies that we've seen recently that have been proposed, is that it actually does make moves towards creating this large constituency, as you were saying, like with the UK, you have a little bit of an advantage by having all people together under this one, health finance system. And I think the most important reason why this is actually a good thing is that it removes any binary requirement that has to be in there or it removes the sort of constraints that are holdovers from eugenics and the racialization of, just all of our systems of governance in the United States, which is this determination of the deserving and the undeserving recipient of whatever goods and services or resource allocation to survive. And so I think one of the things that's really important when analyzing these things, is exactly what you're saying, looking at who is left out? Who is included? And what are the eligibility determinations, because just looking at how eligibility is framed, really gives you an idea of what the intent behind the policy is, and where the where the targeting is, and who's going to be harmed by it. Because ultimately, one thing that I think is really important to keep in mind is that, oftentimes, when certain groups are, are given their policy concessions that comes at a cost to other people, as well. And I don't really feel like we can claim victory until we're claiming victory through policies that don't harm other people in the process.

Dean Spade  24:01

Yeah, and I think the thing you just said, too, I just want to break it down a little bit more, because I think a lot of people in the US don't know this, is that our tiered public benefits systems are really unusual globally. The idea of putting everyone in one pot and having one public health care system, like in the UK, or many other rich countries, is... why do we have Medicare and Medicaid and then all this other stuff in the middle? 

Beatrice Adler-Bolton  24:23

Right? 

Dean Spade  24:24

Why do we have Social Security benefits for old people who've worked a certain amount and that's different from Social Security benefits for people who haven't worked a certain amount and that's different for TANF benefits for people, and if you just look in our own imaginations, if you think who do I picture when I think Social Security? You're like, "Old white person." Who do I picture when I picture TANF? "Oh that's welfare, I picture a Black mom or a Latinx mom." These tiers have all this political meaning and it relates to how they get funded and how incredibly ungenerous the benefits are and all of these pieces, and it's a super racialized system that comes, I think, from the fact that the US is a settler colony. And so it always, from its founding, had a really strong story about cultivating white lives. And not offering the same, not the same "national us," for Black people, Indigenous people and other people who are newer migrants, the people who are considered the undesirable, the "not us of the nation." And so all of our systems are so broken up that way with these super strong racial and gender messages about who's in each tier and to do Medicare for All is really to undo that potentially. I mean, as you said, we'll still have a lot of problems with the program as they do in countries that have — there still ways the system will cut out certain people's care — but it does it change who fights for that program, and who's in the "us," and that is super threatening to the way the US has organized all of its "let's care for the people" types of assistance as very inadequate and small as they are.

Philip Rocco  26:00

It also seems like there's a double problem here, though, which is that we have this incredibly segmented and segregated series of social programs, and they, they suck in a lot of ways and they really entrap people, prevent them from, for advocating for even their own rights within the program, because of the way that they stigmatize people like that. And this is all something, this is now, I think, increasingly common knowledge. But the tricky thing is that they also actually do provide these material benefits. And so it's very easy to get drawn into fighting these rearguard battles. I mean, this is what nonprofits do. This is like, sort of legal advocacy organizations end up doing — they end up just sort of getting into these fights of like, they're protecting the program, either as it exists, or the things that have been gained in recent years. And that is the way, because those wins are somewhat easier, they are sort of drawn away from actually thinking about what a different program would be. I mean, like, how as somebody who's in these worlds? What do you think about navigating that aspect of it? And the other thing is, we often get criticized for saying, like, "Oh, wow, you know, don't you realize, these these other programs actually provide people like, things that they need, you don't want, like, we could solve this thing, we can deal with all of these problems tomorrow, you heartless, you know, heartless person," right? Can you talk about navigating that as somebody who has all of the tools and works in this world, but also very much thinks about it a very different way.

Dean Spade  27:43

Yeah, I mean, one thing is, I don't think I'd have to say is not only do these programs only inadequately and unevenly provide something for some people, but also people are explicitly criminalized through these programs.

Beatrice Adler-Bolton  27:54

Mmm hm. 

Philip Rocco  27:54

Yeah. 

Dean Spade  27:54

It's easy to get a bill for Medicaid. They're like, "Oh, you weren't eligible for that surgery, you got in April. And you didn't know." And now they're like, "You better sign this thing to pay it all back. And if you don't pay it all back, they'll be criminal consequences." And people are signing that thing. I have friends who do that job of helping people through those systems and [helping] people who've been criminalized for welfare fraud, because they used their food stamps for something they didn't know you couldn't use food stamps for, or I mean, just the amount of not only, not providing things to people, but also, it's one of the ways people enter the criminal system. But I think, yeah, so all the dilemmas you're talking about are really big, and also, really big for me as an anarchist. So I don't think the US government is ever going to provide well being and support for the lives of the people here in a way that's not racist, and sexist, and ablest because that is what I believe is the nature of our colonial government and our legal system. And I think we should fight inside that system for things we can get for people, whether that's me individually representing somebody for their welfare benefits, or whether it's us trying to get a Medicare for All bill that we think is as good as it can be. And I think what that's about is just what you're saying, if you try to bring any critiques, often of any bill, people will be like, "Well, how can you critique this one? We have nothing, and we're just going to get this thing and we have to protect this thing at all costs!" And there's kind of this lack of imagination, and a lot of that is just about how my lifetime has been like, one of the most anti-revolutionary times. Neoliberalism is huge. We have been under attack. So people are like, we are so — it's not this moment, in the same way, it's been the rest of my life, thank goddess — but it has been a time in which we were so delegitimize. Anyone who said people should have housing, people should have health care, some people shouldn't have everything, while other people have nothing. Like, this makes no sense. That has been so stigmatized and unspeakable. And then the nonprofit system, was this system that emerged in the wake of the very revolutionary period in the 60s and 70s. It was a system that emerged to contain and limit the demands and tactics of our movements. So literally, it was like that, we're gonna pay people to do this work as long as they stay [in the lines], we're just going to pay the ones who the rich people and the government say are doing the work correctly, which means their work has to not imagine, outside of these bounds, they have to make what were considered pragmatic arguments within like a reaganomics-or-worse politics. And that, that has really, really, really worked on changing people's horizons and demands. And I think that some of that is changing now. But I think that's the context for that conversation with that person who's like, "How dare you question this thing, if it helps one person, that's the most important thing," as opposed to like, "Hey, I think that might hurt 50,000 people," or whatever. I think what also all prison abolition work requires, all the work that's trying to get people to imagine what we actually want, instead of just, slightly tinker with something that's really horrifying. What that requires is just long term relationship building. And so fulfilling those relationships with the people and the nonprofits in my town and saying, like, "No, please don't do it this way, please don't do it this way, and this is why we think that, and I'm not going to throw you away if you do, but I'm also not going to shut up about how this isn't the right thing, and we're going to do organizing with the lots and lots of people who don't think that's right." And so much of my my life has been spent pressuring, like when they were building this new jail in Seattle, that we fought for years, pressuring the nonprofit's in town to care about this, pressuring them to stand up against the jail, because they had more access to the city council and county council, and mayoral relationships. So we were all these wingnuts, pressuring them, for like eight, seven something six years to get all of them to finally be like, "Oh, yeah, building a jail for kids is bad." And then they joined us in pressuring. So it was like, we never stopped pressuring, but we also continued to work on them because they were part of the ecosystem. But it was because we did this outside, we organized no matter what — you may not join us, but we're gonna keep organizing against this until everyone in town knows what this is. And I think that complex, play inside an ecosystem where you're believing in coalition, and you're also not willing to appease the coalition and just be like, "Oh, sure, yeah, we'll do it your way. Whoever's got the most staff and the most money" and you know... [firmly] No way.

Beatrice Adler-Bolton  32:03

Yeah, I mean, I think it's absolutely important to be building power that's bigger than just an election cycle. Because obviously, I think one of the things that we always see is people saying, "Well, it's gonna take so long, why are you even bothering this fight, because it's gonna take a decade or two decades, or it'll never happen, like you should do something more attainable," and I think that this plays into this short term idea of how power works, which is actually very different from how power actually works. And part of the struggle, I think, is to educate people as to the actual complexity of power, because it's a lot more complicated than then we often talk about it as just being sort of like, person oppresses people, and that's bad. But that's not actually the case, as we've been talking about, there are things built into the very fabric of our lives, that are the systems of power that reinforce all sorts of instances of basically just labeling and marking a person as being disposable. And I think what I like to do, when I push back on these people is, when they're like, "Well, what's your end goal? What if you never win Medicare for All?" What matters to me is building towards a time or a place where no one's disposable, where no one has no-value, where we don't throw people away, where we don't engage in war against people that we think are not valuable. And that's, that's really important. And that's very difficult, but someone also has to be pushing that. And that does not happen overnight. Yes. But it also does not need to be constrained to these arbitrary time limits of the election cycle, and who's in power and this sort of like, jockeying game of constantly defending the ACA, and I feel there's all these all these tactics, which like, kind of bleed off energy too.

Dean Spade  34:10

Yeah, and I think also, I mean, part of — capitalism loves short term thinking. 

Philip Rocco  34:13

Oh yeah.

Dean Spade  34:14

And I think that we have been, it's actually, the denial of real social movement histories that causes what you're describing. It's like people don't haven't gotten to know about the struggles that are that have led to the moments we're in now. And, and so there's this kind of like, "All this is, is whether this guy thinks this about us" or this, you know, like, it's very, produced individuals. There's kind of, especially in national politics, it's a weird celebrity sideshow. I think that really distracts us. And I think what's missing from that is actually how you create the terrain of struggle you want. So to me when I look at like this moment that exploded this summer around police violence and racism, you look at the decades and decades of the prison abolition movement in the United States and all the work people have done to talk about how we really could live without policing. What it would mean to get rid of the police and understand police budgets and all the campaigns all over the country. To stop this, or that jail, or detention center from being built, or prison from being built, and you think about, all of that work, and all of the analysis, and builds, and all of the toolkits that are built and all, and that made it so that when this moment happened, we got — "defund the police" a common term, which I never thought would happen my lifetime. So you don't know when those moments will happen. But when you create the context in the day to day, and that means I think paying a lot of attention to very local politics and trying stuff out and doing it at a scale where it's possible. And then, also we don't know, which things we're working on will work or backfire. So you just make your most educated guess about what you believe in the most and could sit through the effort of, and deal with, and do the boring parts of, for the most, and then hope that it... I mean, here in Seattle, I mentioned that we lost that fight, they built that jail, and they opened it up and put kids in it. And and then during the uprising this summer, suddenly the county exec — the mayor of the county, essentially, who had been the head of that project, he now says, "We're going to close it," and it had been open for less than a year when he was like, "Now we're going to close it." I mean, will they close it? I don't know but our eight years of work to stop it changed the politics of the city, it changed what was possible in the defund campaign in the city council. That work to stop that jail did not win the battle, we thought we were fighting, but it changed what was possible in the conversation when this other moment blew up. And so I think that there's just that also that piece of understanding movements as very long and understanding what seeds you're sowing as way more than like just trying to convince a single politician of something or trying to pass one piece of legislation, which is also why a lot of times you see people sell each other out for legislation, like you were saying before, it's like, we're gonna like give good PR to this horrible anti-choice legislator, because he said something good about gay people in this bill. Those kind of short term decisions are so poisonous to our movements' success overall. But they make sense when we're thinking in that non-social movement history way.

Beatrice Adler-Bolton  37:07

Yeah, I mean, I think it's— this is a really weird moment right now. Joe Biden is firmly within the first 100 days of his term in office. And he was one of the most vocal opponents of Medicare for All during the primary, he had the most conservative health agenda, not to mention, his record on mass incarceration. But I think as a result, a lot of people, even very prominent Medicare for All activists and organizers that we know are really depressed. And I think for a lot of people, it's really difficult to see a path forward for something like Medicare for All. And I get that, but — and we all know, though, that it was always gonna be a long, hard road. And I think part of what's really gotten people down is that things appeared to be looking up a little bit last year. And I think that there's this perception that the health justice movement has been knocked down a couple of pegs. And I think we need to be doing something to be — we need to be encouraging people to own Medicare for All as their own thing, then we need to be building power outside of for years, we need to be addressing the complexity of systems. Do you have any? I mean, you've been doing this for what, 20 years now, Dean?

Dean Spade  38:25

Yeah, I mean, I guess, I don't think I have a full analysis by any means of where Medicare for All stands right now. But our marching orders don't really change when the administrations change, the environment for doing the work can get harder. Sometimes it can get harder when you have an Obama or Biden elected. And then people are like, "Everything's cool." And then you're like, "Oh, god, now we have to really remobilize because a lot of people are going to be like, I'm just so moved by the fact that this cop, who's a Black woman is our Vice President, that all is well in the western United States," those people probably were not likely to be already very mobilized. But there is some of that, we saw some people get mobilized under Trump who weren't before because they're like, "This is scary." And so how do we sustain mobilization? And part of me is just like, I mean, the economic crisis that we are living under COVID, I think, gives the possibility of a lot of people being mobilized around Medicare for All. It gives me a lot of hope around that, because it's just so obvious how our healthcare system is utterly failing us and the devastating consequences of it. But I think ultimately, even when we go through periods where our issue is being ignored or something else to get the headlines, or it's not popular, or we've got elected officials who are just unmovable on something, it's really not the end of the world or end of the road, because ultimately it's just a question, I think it's just a question of mobilization, just like, what is the next level of mobilization and how much pressure? Can we add more pressure? And more pressure, and more pressure, and people are true in talking about Biden in saying he is not gonna do right things unless we constantly pressure him. And that is the right way, I think, to think about this presidency. And so I mean, there's this deep sense, we never know what's going to happen next, but we can just keep putting our effort towards building that pressure. And that and that will have, we hope, some effects, but we don't know exactly when or what other factors will play into it. Mmm hm. 

Philip Rocco  40:24

Well, I think it's a really good point to say that it doesn't change, the administration changes, but the strategy doesn't really change, because I feel like the last, you know, really since since the election, you've seen these sort of, and, of course, it takes place, on Twitter, where, you know, is a sort of just like a little Punch and Judy like element of this, but it's like, "Oh, no, if the democrats don't like put this up to a vote now, then, you know, then the following" or, like, if you don't end sort of, on the other side of the, I guess, sort of scale or spectrum, I don't even if you want to call it that... It's like, "Well, if you don't just now preemptively say that you'll accept, I don't know, not even half a loaf, but like some tiny little increment, then like, then you're — you are now the murderer, you're another killer, you are botching your, your chance." And I think that the, it's worth thinking about the history of, when I go back and look at the legislative history, the ACA is like, yeah, they were not, you know, it wasn't as if there was any sort of sense that this is something that we should go to bat for, like, it's just like people, the the groups that were sort of, like the most mobilized, were willing to accept, literally, whatever, and then literally, whatever is what happened.  And then and then the demobilization occurred as it did. But I think your point is really a valuable one, which is that it's very easy to get distracted by these calls to do this, or do that these sort of like, basically Fantasy Football League kind of shit. But what you're talking about is the real — is actually the real politics. And it's long term.

Dean Spade  42:18

It's also like we, what we're trying to influence, if we're there in the ecosystem, people who've had some stake in the game with Medicare for All, we're trying to move all of them to demand long term healthcare be in there. We're trying to demand everyone, you know, we're trying to push everything to the left, essentially, all the time. And there's a there's the obstacles in that inside your coalition that wants this that are willing to take that deal sooner, and there's the obstacles of like, your targets, the legislators or the president, there's so many pieces to that, but I think just keeping clear about what would be a principled approach and all the millions of ways to push that and you just don't know what's gonna stick, right? So you just try stuff and then reevaluate. I think one of the things that happens a lot for people is that people, especially behind legislation, people just get like, they're certain this legislation will help, or they almost have an identity around it. 

Artie Vierkant  43:10

Right. 

Dean Spade  43:10

And I see this with my students a lot, they'll be like, "I studied drug courts," and, "I wrote a, you know, Law Review article about it, and so now I'm just like, drug courts are great," and I'm like, "oh, we're gonna talk about drug courts harm people." And it's so hard to let it go, or "I study this thing about, you know, training cops this way." And we're gonna talk about how that didn't work. And we all are like that, but especially people who have careers in something, it’s just identity, you know, like...

Beatrice Adler-Bolton  43:11

Mmm hm.

Dean Spade  43:21

It's... it's fashion, it's like policy fashion. It's like...  Yeah.

Philip Rocco  43:37

I don't want to give up the fact that this is no longer a good look.

Beatrice Adler-Bolton  43:42

It's all about branding at the end of the day, I guess really. It is this kind of giant, like people do appropriate these ideas which affect people's lives as part of their identity.

Dean Spade  43:51

Yeah, and I want to feel good about myself. I want to be a good person. So how can we look back at some legislation I helped pass or something and not just be like, "Are you saying I'm a bad person? I worked so hard. You understand? I overworked... I had," you know, people like that just have resentment and difficulty with feedback. These are just like classic human [flaws], you know, especially in our culture. So I think how can we all try not to be like that? How can we all just be relentlessly curious about what works and doesn't work and who it works for, and who got left out and what we didn't notice the first time we didn't perceive — that, to me is the like, and it's also much more interesting to be relentlessly curious about the thing you're working on instead of to just, dig our heels in and be certain it must be the right way.

Beatrice Adler-Bolton  44:27

I mean, there are also so many things beyond just the immediate focus of the policy that needs to be considered as well. Like, for example, there are things that Medicare for All can do beyond just the healthcare space. One thing that we've talked a lot about in this series is how part of the problem with healthcare in the United States is not necessarily the price, but it's the geographical distribution of of healthcare, or it's the distribution of physicians and nurses across the country, where the labor actually is where, where people can afford it. And I think there are all these other things that actually would be massively changed by Medicare for All between just changing the way financing works, or being able to allocate money directly to regions to their hospitals, so hospitals could serve their community instead of being these sort of, for profit surgery centers that are focused on collecting, you know, their, their fee-for-service rates from private insurance companies. And I think it's really important to also consider, what the, what the bigger effects of policies are, because I think we just get caught up constantly and saving these sort of like banner things like "protect pre-existing conditions," we have been in this constant cycle of litigating the ACA, and I think policies like Medicare for All, where you have a larger constituency, obviously, they're they're much more difficult to pick apart. And we do know that, if something like this passes, it will face judicial challenges, probably when it's passed, but, you know, I think there is like real value there too, to thinking about what's bigger than the immediate thing that the policy is actually offering. 

Dean Spade  46:20

Yeah, yeah. And I think that's where movements come in. The technocrats who are working closely on policies often get in the weeds, which is okay, some of that is like, you know, a "harm reduction strategy," or is an "immediate stop gap," or whatever. But we need just healthcare for all understanding and like to be the backup. And we also all need to be like, well, what would a Medicare for All that we're unwilling to pass look like? I feel like a lot of times, we don't spend enough time being like, what are compromises we don't think are acceptable, like in the, you know, in some legislation, where it's not acceptable to leave out undocument people or it's not acceptable to leave up people who have felony records, or, how do we decide that — because I think that that's one of the ways in which I've seen the debate about healthcare often, you know, just cuts out people with particular experiences, or as you're saying, within particular kinds of conditions or regions. How do we have that be a normal kind of assessment that we think and then it's not just like backroom deal for just the lawyers and lobbyists drafting, but instead, it's the movement, really having a conversation about how we will not go forward if these people are left behind, or if these elements are left behind.

Beatrice Adler-Bolton  47:27

I was wondering if for a second, we could talk about that. Because a lot of times people say that the way to accomplish policies that serve everyone is by making sure that you have the right people at the table. And here at the Death Panel, we are not fans of a representation first strategy for public policy, and you've done a lot of work on something that you — that's termed "pink washing," which is where these companies sort of appropriate liberal or progressive agendas in order to bolster their brand image. 

Dean Spade  48:02

Yeah, I mean, we're in that so deeply, the phase of neoliberalism that we are heavily in, this is the moment we're living in. And I think the Obama presidency was one of the really big flash points of it, it was just like, well, how can the first Black president possibly be doing things that are really bad for Black people and lots of other targeted people. And that's what he was doing. I think that comes up all over the place. One of the ways it comes up with the kind of the seat at the table story is it'll be like, I mean, this has been so big in in Seattle during the defund the police campaign that we've been on, where the mayor who's like, horrible, she's just like, "I need to find some Black people who I can get to agree with me and stand beside me and pictures and say that they're meeting with me." And so that it's her way of cutting out, you know, the broader Black movement, right, is to find those representatives, who will love having that moment in the spotlight by being beside her, or feeling really important, because they got to have that, you know, that meeting, but they're actually undermining the other people who are like, we will absolutely not meet with you. Because this is why... you know what I mean? I think that  one of the problems of that kind of space at the table is that they will always find somebody from our communities, whatever that community is, to sit at that table, who will say what they want, we have to if our work isn't based in larger mobilization, and if we're not accountable to a larger set of people, and if we don't have a clear way, that we're part of membership organizations, and there's less people getting to have a say in what we're about and why we're about it and what our messages, then it can really be easy for just that one person who, you know, often is kind of conservative and or maybe went to law school, or maybe really, you know, is a small business owner, whatever, those kinds of stories that that's going to be the representation of this group of people and it's just happening just constantly. And there's a really great chapter in Keeanga-Yamahtta Taylor's book From Black Liberation to Black Lives Matter. Her book from a few years ago, she's got a chapter about this moment in the 70s and 80s I think, where there'd been a huge Black uprising in the United States had so much impact, there's an amazing Black liberation movement. And then there was a turn to elect Black mayors. And she talks about this one race, I think in Ohio, I can't remember which city, where it was kind of like, "Everybody get out of the streets and just vote for this guy!" And so the tag phrase was "Keep it Cool for Carl," like, stay cool, just vote for Carl and Carl, like a lot of the other Black mayors who were voted for, just went on to enact the same kinds of policies that white mayors had enacted before, just like we see consistently with whoever is the token representative of our communities. They got there because they're willing to do the thing that the people in power want. And so I love teaching that chapter and talking to people about that, because we've been learning this lesson for a really long time but our opponents are trying this harder than they've tried it in the past. And how do we help each other stay clear about what we think are the actual outcomes that we want in our communities, instead of what kinds of faces we want, you know, telling us the bad news.

Philip Rocco  51:08

But it also sort of occurs to me that the way that strategy works, it's incredibly clever, which is that trust in government trust in public officials is very low, right. So they can't speak for themselves. So trust is this rare, valuable commodity. So then they, you know, mine that, right, they find "the face," they find the person that they can use as their sort of pass through, and they leverage that. But that only works, if the other person is sort of, if there's really just no — that person is just, a whatever, a stand in that, that ends up having some sort of better credibility, and that credibility isn't challenged. That sounds like what you're sort of talking about is not actually saying who does have credibility on these issues in our community? 

Dean Spade  52:05

Yeah. 

Philip Rocco  52:05

Like, who do we trust, actually, to tell us whether or not this is a good policy? And do we trust the people who are being used as the sort of foil or the, you know, smokescreen for these things?

Dean Spade  52:21

Yeah, I mean and I trust groups that are mostly volunteer unpaid, and where a lot of people are in governance, that's just like, there's no individual, it's, for me, it's a lot more about our people in a process, where they would really be hearing together and coming up with their shared wisdom about; "Who's going to get what? Who's going to be left out, if we do that,  like that?" And so to me, when I look around, whatever issue I'm working on, and I look at who are the groups in this state, or in this region, or whatever, who are holding that line, who are being clear and actually have an organizing base, and people are actually making decisions together. It's not just one charismatic leader, or one boss or whatever. And that's, I think most people don't have, it's hard to see that. Because first of all, every single group, no matter what it's like, and even, it's just one person has a whole website and Instagram and Twitter that makes it look like it's the movement. That's like a huge problem right now, it's actually hard to see in, you'd have to have relationships in order to find out, who's really behind that name, or that org? And also, I think most people aren't encouraged to ask this question, because most people have not actually gotten to find out how social change really happens, because people think it is just when the law gets signed, or when the charismatic person gives a speech. And so even asking, like, "Wait, where did their agenda come from? Did they get a grant from the county to switch their agenda to say, we're going to put this program inside the jail instead of let's not have one?" You know, like, all of that stuff? And I think that's really, it. I mean, this is a really complex problem, because it's both about representation and it's also about the gap between how social change happens and how we've been told that happens.

Beatrice Adler-Bolton  53:53

Yeah, I think one of the things that I feel like I see happening all the time is this feeling that if you aren't some large elite organization, you can't actually have impact unless you are Joe Rogan, or whatever. There's some sort of folly in making a podcast right, and I think this is like part of a larger, mindset of austerity that we talk about all the time on this show, but what in my mind is the best way to fight against that is actually to just fully push, as hard as they did for welfare reform, that we all start taking a little more responsibility for each other because ultimately, a lot of these moves that have happened that have resulted in further immiseration, and just the absolutely hellish health landscape that we have right now it's tied into this process, as you were saying in the beginning of just sort of stabilizing the status quo, of maintaining the process of extraction from the population, of making sure that we're labeling people at a continuous pace in order to sort everyone into their proper bins so that they can, you know, be treated as they've been labeled to be treated. And this is a system that I don't think is sustainable. I think that this is a system that is that in and of itself sort of a trend. And what's important is to react against this idea that the only way to make change is through elites.

Dean Spade  55:24

Yeah, and I think that's really to the scale question. People ask me all the time, I work on mutual aid, like, "Well, yeah, all these, you know, 1000s, or millions or whatever, people are doing all the mutual aid projects, delivering each other groceries and medicine, all this stuff, but like, how do you bring that to scale?" What they're saying, what they're thinking of as scale would mean becoming an ACLU or Planned Parenthood, being one centralized thing and having chapters everywhere and being like, you know, that's how you become elite. And that is how you become elite in an authoritarian society. But that's not the only way to be of scale. I think that real powerful scale is coordinated and networked, autonomous projects, and interventions that are all over that are able to use the wisdom of the place they are — that are able to think about things in different ways and influence each other. And that's also harder to take down, they can't just like, you know, take you down the way they can take you down if you're all centralized, right? And this has been one of the huge lessons of social movements over the last 40 years in my opinion after the formats that were mostly used in the 60s and 70s, that were a bit more centralized. But that idea that what we need is centralized and elite. That is, because that's how the government looks like that. It's like it's literally people modeling their own idea of power on state power, which we know what that — it's really good for extracting. It's really good for imprisoning, it's really good for enforcing borders, for having militaries, it's terrible for actually getting everybody what they need, and adapting to all the complexities of people's lives. And so I think that that's another like mythology about social change. That is, you know, just heartbreaking.

Beatrice Adler-Bolton  56:45

It really is. It's so true. And I think this is all, it might sound silly to say, that these framings that you have to mimic elite structures in order to affect change are part of this sort of warfare tactic. And as a disabled person, like in America, it's pretty, I can't think of a day in the past 10 years that I haven't really felt like the state is at war against me. And we have put all of these burdens in place. And we create all these different programs with different qualifications. And what that ultimately does is it also makes it really difficult for us to help each other. Because if you're trying to get qualified for Medicaid in one state, you can't help — if you're successful, you can't help someone in the next state get qualified for Medicaid, because there's a different system. And I think that's why policies like Medicare for All, you see such strong opposition, because it's not equality, in the sense of like civil rights legislation, where it, as you were talking about, you're just say, making an accessibility illegal, or whatever that means, you know, or making racism illegal. It's not actually equality, it's giving people the tools to work together in order to secure survival for each other, which currently, as it stands, our healthcare system does not do that.

Dean Spade  58:00

I mean, I have to give you an... I have to tell you an example. It's been on my mind so much lately. So you know, a lot of mutual aid projects all around the country have taken in money this year, like to buy people's groceries to pay people's rent or whatever, help people with bail. And if we all took it in through like, you know, your Venmo, or PayPal, or mine, you know, rounded out now I'm gonna be getting a statement from Venmo or PayPal, basically telling me I tax liability from that — for that, right. And so we've been trying to, I've been working with some people, trying to offer some support and create a webinar about this and stuff. But what I was thinking about in depth, like exactly this system that does this, I was like, literally, it's— it's impossible. It's trying to make mutual aid impossible — trying to make just sharing impossible because basically, either we have to have a 501c3, which allows the government to completely surveil and monitor our behavior and put all these limits around it. And it's really hard to get for people who aren't used to filling out forms or who don't even know what that is, or whatever, or we do this thing, and then we give away all the money, and then we end up having a $10,000 or $20,000, or $40,000, depending how much we took in, tax bill. And like it literally is just like — you can't just share, that's so smart of capitalism to be like, if you want to share, you need to do it through this elite way, this complex thing, and then you can get money from rich people, and they'll tell you who you can give to and who can't give to, who they feel comfortable with. Like, it is so deep the ways and I mean, I've had all these conversations with people about like, how disaster relief literally gets in the way of people being able to do disaster relief for their neighbors, right, especially if they've got like the National Guard in the street shooting people, just the ways in which we are not supposed to support each other. And in the end, that is either something's either mystified like the Medicaid application example or like, literally like there is potential criminal penalty if you shared money and gathered it and gave it away and then don't pay this tax bill — that is so intense that we are in such a deeply anti sharing culture. 

Beatrice Adler-Bolton  59:44

Well, I mean, [sarcastically] as probably Ronald Reagan would say — that is the dignity of risk though, which we are all entitled to as humans in this country.

Artie Vierkant  59:54

I mean, you mentioned earlier, when you're talking about what happened over the summer, and how a lot of what was able to happen over the summer happened because of a lot of organizing, much of it at the local level, that had been happening for many, many years. And it kind of strikes me that, you know, I mean, I guess maybe just to sort of like to add to that point — on top of things, we can talk about, for instance, organizing the local level against, the entire cultural carceral system, the entire prison industrial complex, right? Many of which have these, and not just many, which has these very localized tendrils, you know, all over the country. But then it's interesting, because there are many healthcare companies, you know, individual companies and things throughout the United States, there are individual insurance plans within states that people can appeal to or rally against and things like that, but so much of even when you think about organizing at the local level, at the local level, within, you know, let's say a county or something, really, in terms of being able to fund things like more equitably distributing health care, or making healthcare, let's say, free at the point of service to everyone in the community, automatically at the local level, you kind of have to appeal to the state, and then the state is in a bind where they can't deficit spend in the first place. There, for instance, a common thing you hear amongst single payer advocates is, maybe we'll try it in California or in New York first, and that could work, right, with progressive taxation. But at the end of the day, this leaves out, you know, it's like, I feel it strikes me as another way to segment things essentially.

Beatrice Adler-Bolton  1:01:33

Right, yeah. Because it's, yeah, it's like each of these little tiny, I don't know, like "steps" in health, right is a different, separate extractive process. And you have all these sort of little tiny factions. And then it becomes this question of like, well, do we support the survival of human beings? Or do we support the survival of these extractive institutions, which we have codified into being because we've made a law that says that, "the PBM is required to transport the specialty drugs, because they're dangerous. So we can't get rid of the PBM? Because the law exists," and it creates this sort of, endless cycle of reasons why not? Right, which actually don't necessarily, the reason why not is not that it'll harm people, but that, well, we have this system in place. 

Dean Spade  1:02:24

So it's already there.  I think that's why we have to do the local — the local organizing is central, because the local is where people first get engaged, and where if any pressure is going to build, it's going to come from the many, many, many locals. But I've seen this, there's cities that have consent decrees — their police are under consent decrees, because they were found to be doing horrible things to people. And they went through a whole process through the department of justice or a court. And now they're under a consent decree or under some kind of receivership. And those receivers, or whoever's in charge of them now says, "You can't reduce your staff at all." That is happening in some jurisdictions where people have organized to reduce the number of cops and to fit a hiring freeze or ever. So we see these things, I can think of so many examples, but where we find, then we're doing this local organizing around a local thing, but then we hit a federal block, but I think the only way we're gonna get through that federal block ever is if we have had so much powerful local organizing. And so I think it's this like, I mean, organizing is just is just, you know, on some level, it's a local job, even though we do it across regions, and we do it networked, and my group is connected to your group in another state, or, you know, it's still like, that's where people often have a critical mass and consistent relationships, and are taking care of each other in various ways. And people are in it for the long haul together, because that's also the person who babysits your kids or brings you soup, or whatever. And so I think that that it's, and I think in the US, our politics is very pointed at the federal, people think that's where politics is, and the presidency and Congress, and they don't know anything about their city council or county council members are there, even their state legislators, and that whole process is totally opaque to them. And that's where they could have more influence. And occasionally would hit these federal, you know, roadblocks, especially with programs like Medicaid or different, you know, other programs that are funded through federal block grants. But I think it's a hard thing to get people to look towards the local and then have a strategy that still includes connecting the locals. 

Beatrice Adler-Bolton  1:02:25

This, yeah.

Artie Vierkant  1:04:17

Yeah.

Beatrice Adler-Bolton  1:04:18

Yeah. I mean, I think it definitely doesn't help that for decades, now, we've sucked the funding out of every municipality and out of every community in order to sort of consolidate it at this like larger level, because there is this perception of like, "Well, why even go and try to impact the local government? Because it's just too small, like, what change are you actually going to do?" And that in and of itself is like, not only austerity brain, but it's literally a persuasive argument to convince you did not to organize? 

Dean Spade  1:04:48

Yeah, I mean, the one thing that was useful at the Trump administration was that people, people were like, I have to go to the state and local level because federal is a non go...

Philip Rocco  1:04:55

Right.

Dean Spade  1:04:55

....and I think that actually was was good for strategy,

Beatrice Adler-Bolton  1:04:57

Maybe as a final topic for this. I quoted you recently in an essay I wrote about a fashion designer named Pierre Cardin. And I was wondering if you could explain just for the listeners, why you like to use the word "subjection" instead of "oppression," when you talk about issues of power...

Dean Spade  1:05:16

Yeah. That, you know, one of my aims in life is to be is to say things in ways that are understandable to as many people as I can. And that can be challenging. Obviously, nobody can make a universally accessible language of any kind, or ideas, of course, but I try to say things clearly. And when I wrote my book, normal life, I really struggled about whether to use the word oppression, even though I didn't feel like was totally accurate, or to use subjection and ask people to go with me on it. And I end up using subjection. And that's because the word "oppression" implies that a real like, power over and top down and I think that power is more complicated than that, I think that the way we arrive on a game board we arrive on and how we play it is more complicated than that. And when people think of power as only, like, you know, "the power over," they tend — it's very disempowering, and it makes it seem like, the thing we should do is look to the top and try to change the top. So a lot of ideas of like, we should just change the laws, or we should just change who's in the presidency or who's in Congress. Like, it's that kind of like, if we just got the right people there. And if we just got the right things said from the top. And actually, I think most of life doesn't really happen. Like, as we talked about, laws aren't even enforced, like, right, like cops do things all the time, people that are illegal, like, we just, you know, the people in the Medicaid office are denying you even though they shouldn't, and that's part of their system, you know, so we know that. We know that resistance is everywhere, and that social norms determine so much of what we experience whether or not the law says this or that. And so, the word subjection helps me think more about how I get called into being a subject in the system, what kinds of ways that experience of being a subject is shaped, what ideas shape it, what material conditions shape it. And it just suggests a more complex way of thinking about power to me. So that was the main reason was just like, even though oppression is used way more by organizers and people in community, there's nothing wrong with that, when I was like writing down my ideas, I was like, that word kind of clashes with what I'm saying about how we can and should make change as I'm asking people to move their attention away from just changing laws and changing who's on top and instead see that politics is everywhere in our lives, and that we can enact resistance everywhere, and that the most, like, the most powerful thing we can do is a real bottom up strategy. And a real, like, a strategy of deep collaboration. And that is not the same as just being like, well, if we could just get our guy up top, you know, so that's, I'd say, my shorthand on subjection?

Philip Rocco  1:07:55

Well, that's a very, that's a very useful thing to remember. Because it's, again, I think, reforms have a way of telling stories about themselves erasing things about the world in which they work. And it's, yeah, it's very obvious what happens when you don't have a mobilized population, or when you don't have people actually out there willing to fight to make things, in fact, work that that's actually it's easy to, for that to just reside in the shadows, but it matters.

Beatrice Adler-Bolton  1:08:26

Yeah, and I do feel like that, that sort of, like total understanding of where that pressure comes from is much more realistic to people's experiences than than the idea of top down oppression. Because that sort of top down oppression plays into this whole idea of celebrity and monarchy, and there being a silver bullet fix to every problem. And ultimately, at the end of the day, unfortunately, it's a little bit longer, and a little bit harder and a little bit more complex than that. 

Dean Spade  1:08:55

Yeah, I think also, there's this really intense thing where like, I was talking about this, because this week, I was teaching about marooned communities and slavery systems. And most of my students were like, wow, I never heard about any of this. I thought the Civil War was just, you know, "Lincoln's amazing — he ended slavery," I never heard about slave resistance. I never heard about the ways that the resistance of enslaved people and other Black people is actually what caused the Civil War to go away. And, and just, you know, or the way that we talk about FDR and the New Deal, but we don't ever talk about the relentless, intense labor organizing, just to tell the story in a way that's just about the one charismatic figure who's on top and that is such a loss and that is that's to demobilize us. I mean, that really is to make us not, if you don't have an accurate history of why anything ever changed, then how can you do an assessment about like, how you how you want to seek change? And it's right now it's just like, hope for Biden to do this or give me the ACLU and they'll sue about this and it's like, that is — that's not gonna work

Artie Vierkant  1:09:53

Well, and it carries over exactly to what we were talking about much earlier. Very, very early on in the conversation of just people look at it and they're like, okay, we're, you know, we're gonna work for a little bit — well not everyone obviously but you know, there is a sentiment among some people — where they're like, we'll work on this we'll get maybe a, you know, modest incremental gain and then we'll go home.

Dean Spade  1:10:20

Yeah, also today like, we're gonna come back and get the people we left off, which never ever happens, if you can't get the stigmatized people the first time or the thing everybody doesn't want to cover, you're definitely not gonna get it when it's a standalone bill to fix the bill, you know like, and so that feels so frustrating like that idea, like, "Oh, we can't we can include undocumented people this time," or "We can't include people in prison this time. But we'll maybe we'll come back in a future," it's like that is — you've actually just made them so much more stigmatized now, you know?

Beatrice Adler-Bolton  1:10:46

Yeah exactly. And I think all of these programs at the end of the day, like when they're caught up and when we give these stigmatized positions to welfare recipients, to disabled people. And when we set up this sort of continuum of health for like the — we make an example of the people who are at the bottom of this continuum — all it does, at the end of the day, is serve to continue this constant process of certifying the body for work, making sure that capitalism can continue. And that comes at the expense of the survival of our communities of individuals. And it doesn't have to happen that way. And I think, right now is a good time, especially as we were talking about considering COVID to really — trying to to work all angles at once. Medicare for All is the spear and it is part of the fight for housing justice, it is part of the fight for for economic justice, for environmental justice for racial justice, this is a tool — it's not a goal in and of itself. It's not — Medicare for All is not the is not the actual endpoint, we need to be looking bigger and past it — more forward looking

Dean Spade  1:11:58

Yeah we'd be so much better off in all the fights if we had it.

Philip Rocco  1:12:01

Exactly. 

Beatrice Adler-Bolton  1:12:02

And I think you know, this is probably a good place to leave it for today. Dean, where can people find you or find your work? 

Dean Spade  1:12:09

Yeah, I have. A lot of my work is on DeanSpade.net — I don't know why I chose "dot net." But I did. And I also just started having an Instagram account. 

Beatrice Adler-Bolton  1:12:18

Oh, my God. 

Dean Spade  1:12:19

Thank you...I know it was.... I've mixed feelings 

Philip Rocco  1:12:21

[laughs]

Dean Spade  1:12:21

...and I'm on twitter as @dspade)

Beatrice Adler-Bolton  1:12:25

Well, Dean, thank you so much for joining us! 

Philip Rocco  1:12:28

Yeah this was good. 

Beatrice Adler-Bolton  1:12:28

We really appreciate you taking the time. 

Artie Vierkant  1:12:29

Yeah. 

Beatrice Adler-Bolton  1:12:29

It's always a pleasure to talk to you!

Dean Spade  1:12:30

For me too. Great podcast. I love it. 

Beatrice Adler-Bolton  1:12:33

Aww man. I appreciate that.

Artie Vierkant  1:12:35

Always a pleasure, Dean.

Beatrice Adler-Bolton  1:12:36

...and thank you for listening to Medicare for All Week. As always, Medicare for All now. Solidarity forever. Stay alive another week.