“Something Else Is Going On”

 ‘Deaths of Despair and the Future of Capitalism’

Anne Case & Angus Deaton

Princeton University Press, 2021 ISBN 978-069119-0785

 reviewed by Howard Slater


I originally came across the existence of this book in an essay by American revolutionary activist, Idris Robinson. His essay, entitled, ‘On Pain’, seemed a departure from the usual ultra-leftist economistic emphasis in that it actively identified and took cause to propel to the fore the existence of widespread ‘social pain’ (both physical and emotional) taking the guise of what the authors in question here term ‘deaths of despair’. These ‘deaths of despair’ cover suicides and deaths from drug overdoses and alcohol abuse. Whilst the economic system called capitalism, under whose dictatorship we are all coerced to live, is earmarked as a cause in the rise of these ‘deaths of despair’ (in particular the ‘rent seeking’ of the American health industry and lack of welfare provision), it is disheartening to eventually come to read how these two academics seek, in the interstices of much quite catastrophic data, to proffer a solution to these deaths of despair in yet one more ‘reform’ of a capitalism that, in their eyes, is becoming too monopolistic. It’s as if, in face of what they call an epidemic of ‘deaths of despair’, they wish to return to the fundaments of capitalism by extolling the free market and re-promoting the Victorian values of family cohesion, religion and a community belonging based on finding the meaning of life in the servitude of wage labour.  So much for Leftists being accused of nostalgia and a return to the promised land!  

Before returning to this aspect of the issue (the authors are both fully tenured professors in economics) it is worth recalling that over the past decade or so there has been a growing recognition that capitalism, at is has come to function since the 70s (coming ‘off’ the gold standard as the measure of value), is literally ruinous of both the physical and mental health of the vast majority of people. Works like Franco Berardi’s Soul at Work and Precarious Rhapsody have highlighted a contemporary situation – informed by an intensification of the globalisation that Marx could hardly not foresee – of increased job insecurity, self-exploitation, indebtedness and emotional precarity. In his words: “The intense and prolonged investment of mental and libidinal energies in the labour process has created conditions of psychic collapse.” However, if this is bad enough for those ‘lucky’ enough to be employed, what the book under review here does raise to the foreground is that there are some sectors of the population for whom ‘psychic collapse’ would have been something to look forward to. They are talking of the ‘uneducated white working class’ whereas I would prefer to join others in speaking of a ‘surplus population’ whose parameters far outstrip the restricted scope of this book’s focus on a “specific American story of pain.” 

Such a specifity, revealed here in terms of how the ‘deaths of despair’ data is reduced to comparison solely with that of ‘other wealthy countries’ and not placed in a more  international context, nonetheless reveals something quite shocking which may have caused this book to become one of the New York Times ‘most notable books of 2020’. Across many pages the data that renders this book as an empirical tome, is that ‘deaths of despair’ have risen at a far greater rate for the white American working class with the added qualification of their not being educated to degree level. Whilst this smacks, at the extreme, of the existence of a kind of meritocratic eugenics at work in modern capitalism (what’s new?), it also seems problematic to me that ‘whites’ are singled out when the data, taken over a longer time span, as well being inclusive of less spectacular criteria than ‘deaths’ (e.g. ‘social pain’ and the hardly unpacked ‘despair’ of the book’s title), would maybe enable more general conclusions to be drawn about the toll that an increasingly impotent capitalism (modelled on the mafia and gangsterism) is taking on all our life prospects as well as the psychical impact upon us of what it is to be seen not as a person but, in Stalin’s happy phrase, as human capital.  

The authors, then, may, in order have their book fit the ‘current affairs’ bracket, be attempting to explain the rise of populism amongst the American white working class that appears to form the rump of Trump’s support. Alternatively, there must be a widespread panic amidst the entrepreneurial class as to a “depleting” work force which nonetheless – with the now archaic decimation of manufacturing and robotised supply-chain timetabling – seems mainly to employ an ‘uneducated’ working class in services and, increasingly, in the private social care industry which, in line with the themes of this book, is charged with befriending and supporting the growing swathes of the sick, disabled and mentally ill.  This latter ‘industry’ (a growing sector in the UK) brings to the fore a kind of low paid ‘affective labour’ coupled to a form of ‘rent seeking’ through which the public purse is “redistributed upwards.”  

Idris Robinson is acute in what he chooses to détourne from this book. I will join him in citing, as he does, the following paragraph: The lives of many millions of Americans are comprised by pain; some cannot work, some cannot spend time with friends or loved ones in the way that they would like, some cannot sleep, and some cannot do the activities that make daily life possible and fulfilling. Pain can undermine appetite, induce fatigue, and inhibit healing; in extreme cases, it erodes the will to live. (p.88) Idris, similarly based in the American situation, is pulling this book in another direction and I would like to tread this path along with him and add to what he has written. 

If we take Case and Deaton’s criteria of ‘social pain’ (i.e. despair) as an indicator and decrease the emphasis on their more spectacular ‘deaths of despair’ on which there is far more data, what can be seen as catastrophic becomes almost apocalyptic. The authors dream of the existence of an ‘afflictometer’. So do we! For such an afflictometer would reveal in neat graphs not so much an epidemic of ‘deaths of despair’ (bad enough) but a pandemic of social pain (spreading rapidly). What’s more, after the austerity induced by the 2008 bank bailout and, last week, the much-anticipated rise in the price of energy, we only need go to the pub to collect ‘data’ and it doesn’t come in graph form.  As the Czech surrealists suggested: we are living in concrete irrational times when a monthly energy bill can outstrip a monthly salary…, when klepto-capitalism can make money out of pain and death … from ‘natural’ and, yes, planned disasters as Amedeo Bordiga long ago suggested.  This makes it hard to swallow such oxymoronic contentions as these: “The genius of free markets is that people can prosper while helping others.” (115) 

So, with thoughts such as these in mind, we can take a different view about the flailing future of capitalism. Whether it be ‘deaths of despair’ or increasing ‘social pain’ (which latter provides the ante-chamber to ‘deaths of despair’) it is impossible to reform, to make ‘human’, an economic system that thrives on workplace exploitation (surplus value extracted from the workforce in increasingly diverse forms such as ‘affective labour.’) Indeed, the authors themselves offer their readers that “the word labour is often synonymous with pain.” (85) This is in no small part due to the war of each against all; the mutually competitive bedrock of any free market economy. Yet, that these authors extol a faith in the free market (albeit ‘radically’ removing health care from its grasp) not only functions to paint a picture of monopoly capitalism as somehow an ‘excessive’ form of capitalism it fails to take on board the Marxian truism that “monopoly produces competition, competition produces monopoly” and thus that capitalism has an in-bred tendency to increase profits by creating monopolies (assuring growing market-share, buying up competitors, etc).  

So, when they pose the question ‘Why Is Capitalism Failing So Many?’ as the title of Part IV of their book, we cannot be too shocked to see how this more direct and universalising question is tempered by not simply, as they explain,  magically summoning forth a ‘future’ of capitalism as the overall title to their book, but by restricting the scope of the problem to the USA; making monopoly capital the polar opposite of the free market; and scapegoating sectors, such as Big Pharma, as the anti-heroes of an otherwise liberal and benign scenario. This maybe assists them in limiting their ‘solutions’ in the final (and shortest) chapter of the book to the empty verbiage, the incestual code, of governmental policy as journalese: ‘Corporate Governance’, ‘Safety Net’, ‘Anti-trust legislation’, ‘Healthcare Reform’ etc.  

So, perhaps if you can cast a spell by using such a nonsensical phrase as “normal rate of profit” (230), if you can still envision the by now straw-man of “some fantastical socialist utopia in which the state takes over industry ”, if you can seriously believe that you can earn more and live a better life by going to university, if you can reduce this whole sorry structurally embedded affair of inequality to a matter of “unfairness”, then, you can likewise, as a collective of two, believe that capitalism can be reformed and that an ever incremental social pain will no longer give rise to deaths of despair. But it probably also needs the optimism of ivory-tower naivety, a ten-times removed reading of Marx, and the employment of a non-contaminating distance between yourself and those people “that kill themselves when life no longer seems worth living.” (94)