Society still perceives disability as a medical matter. That is, society
associates disability with physiological, anatomical, or mental ìdefectsî
and hold these conditions responsible for the disabled personís lack of full
participation in the economic life of our society, rather than viewing their
exclusion for what it is -- a matter of hard constructed socio-economic
relations that impose isolation (and poverty) upon disabled people. This
medicalization of disability places the focus on curing the so-called
abnormality - the blindness, mobility impairment, deafness, mental or
developmental condition - rather than constructing work environments where
one can function with such impairments.
 

In my view, the economic system can be held primarily responsible for
disabling physically and mentally impaired people. Disablement is a product
of the political economy or the interaction between individuals (labor) and
the means of production. In this view, disabled peopleís oppression can be
traced to the restraints imposed by the capitalist system. Those who control
the means of production in our economy impose ìdisabilityî upon those with
bodies which have impairments perceived to cause functional differentials
and as such, do not conform to the standard (more exploitable) workerís
body.
 

Since passage of the Americans with Disabilities Act in 1990, for example,
business has fought, tooth and nail, integrating disability in the workplace
by providing a reasonable accommodation as required by the ADA. In the first
decade of the law, the disabled employment rate has not budged from its
pre-civil rights figure of 70 percent unemployed. Capitalist business
accounting practices can be held accountable.
 

Disabled persons are isolated and excluded from full participation in work
life because business practices foster it. As I have written previously:
 

ìThe goal of business is to make profits. The basis of capitalist
accumulation is the business use of surplus labor from the work force of
skilled labor in a way which generates profits. Typical business accounting
practices weigh the costs of employment against profits to be made.
Productive labor, or exploitation of labor, means simply that labor is used
to generate a surplus value based on what business can gain from the worker
productivity against what it pays in wages, health care, and benefits (the
standard costs of having an employee). The surplus-value created in
production is then appropriated by the capitalist. The worker receives
wages, which in theory, covers socially necessary labor, or what it takes to
reproduce labor-power every working day.
 

The employer will resist any extra-ordinary or nonstandard operation cost.
From a business perspective, the hiring or retaining of a disabled employee
represents nonstandard additional costs when calculated against a companyís
bottom line. [Economist, Richard] Epstein endorses this point of view,
stating that employment provisions of the ADA are a ìdisguised subsidyî and
that ìsuccessful enforcement under the guise of ëreasonable accommodationí
necessarily impedes the operation and efficiency of firms.î
 

Whether real or perceived in any given instance, employers continue to
express concerns about increased costs in the form of providing reasonable
accommodations, anticipate extra administration costs when hiring
nonstandard workers, and speculate that a disabled employee may increase
workerís compensation costs in the future. Employers, if they provide health
care insurance at all, anticipate elevated premium costs for disabled
workers. Insurance companies and managed care health networks often exempt
ìpre-existingî conditions from coverage or make other coverage exclusions
based on chronic conditions, charging extremely high premiums for the person
with a history of such health care needs. Employers, in turn, tend to look
for ways to avoid providing coverage to cut costs. In addition, employers
characteristically assume that they will encounter increased liability and
lowered productivity from a disabled worker.
 

Prejudice-based disability discrimination, resting on employer assumptions
that the disabled person cannot do the job or on employer-resistance to
hiring a blind, deaf, mobility or otherwise impaired person just as they
might not want to hire blacks or women, undoubtedly contributes
significantly to the high unemployment rate of disabled people. Disabled
workers also face inherent economic discrimination within the capitalist
system, stemming from employersí expectations of encountering additional
nonstandard production costs when hiring a disabled worker as opposed to
hiring a worker with no need for special accommodation, environmental
modifications, liability insurance, maximum health care coverage or even
health care coverage at all.
 

Using this analysis, the prevailing rate of exploitation determines who is
"disabled" and who is not. Disability thus represents a social construct
which defines who is offered a job and who is not. An employee who is too
costly (significantly disabled) will not likely become (or remain) an
employee at all. Census data tends to support his view. For working-age
persons with no disability the likelihood of having a job is 82.1 percent.
For people with a non-severe disability, the rate is 76.9 percent; the rate
drops to 26.1 percent for those with a significant disability.î [ìBacklash,
the Political Economy, and Structural Exclusion,î 21 BERKELEY JOURNAL OF
EMPLOYMENT AND LABOR LAW (Feb. 2000) pp 348-349.]
 

The ADA has not ìleveled the playing fieldî - the goal of most civil rights
legislation - by eliminating economic discrimination.
 

In liberal capitalist economies, redistributionist laws which, if enforced,
will cost business are necessarily in tension with business interests, which
resist such cost-shifting burdens. This is evidenced by employers hard
resistance to providing reasonable accommodations, the business-biased
conservative courts which are consistently ruling on behalf of employers,
not workers with impairments and the persistent high disabled unemployment
rate.
 

Capitalists benefit by not having to employ or retain a worker with an
impairment. Therefore many disabled workers are, and will continue to be,
eliminated from mainstream economic activity. So the question becomes is it
possible to reform business practices so that disabled persons are not
excluded from the workforce?
 

Government could offer subsidies to offset business costs to level the
playing field. Indeed it has recently passed one such reform, the Work
Incentives Act, a subsidy that will allow disabled workers to retain their
public health care by permitting them to buy into Medicare and Medicaid. But
typical of most reforms, this measure falls way short. For example, the
buy-in is only for an eight year stretch. What then?
 

Other dubious subsidies already exist. Section 504 of the Rehabilitation Act
of 1973 provides that federally-financed institutions are required to pay a
"fair" or ìcommensurateî wage to disabled workers, but they are not required
to meet even minimum wage standards. The traditional sheltered workshop is
the prototype for justifying below-minimum wages for disabled people, based
on the theory that such workers are not able to keep up with the average
widget sorter. Any nonprofit employer is allowed to pay subminimum wage to
disabled employees under federal law, if the employer can show that the
disabled worker has "reduced productive capacity."
 

6,300 such U.S. workshops employ more than 391,000 disabled workers, some
paying 20 to 30 percent of the minimum wage; as little as $3.26 an hour and
$11 per week. In reality, workers with disabilities in these workshops know
that they are sometimes paid less, not because they lack productive capacity
but because of the nature of segregated employment.
 

Government could pay for disabled workersí reasonable accommodations.
Perhaps that would remove the issue of that added cost from the employerís
bottom line and stop some employers from fighting disabled employeesí much
needed accommodations in court.
 

Such reform, however, is not likely to make a difference in any substantive
sense. For one, productivity is the center of capitalist accumulation. Labor
is always, a priori, the retarding factor of productivity because labor can
never produce fast enough or equivalently, at a low enough valued rate, to
suit the expectation of an accelerating profit curve. It is likely that
impaired persons (due to the reasons explained above) will always be seen as
less than what is desirable to maximize profit. In addition, the
put-into-practice theory of a natural unemployment rate assures that the
Federal Reserve will see to it that large numbers of people are kept
unemployed to preserve the ìhealthî of the economy. Disabled persons are
traditionally a part of this ìreserve army of labor.î
 

But it must also be recognized that workers with impairments in socialist
countries also face isolation from the mainstream economic activities of
their societies. Sheltered workshops for the blind existed under communism
in Poland and they still do today under the new market regime there.
Impairments are medicalized under socialism as in the U.S. under capitalism.
All of the welfare states whether capitalist, communist or socialist, have
wrongly deemed disabled people as medical defects ìunable to workî and
shifted them onto (in the U.S. below-poverty level) government subsistence
programs or put them in paternalistic sheltered workshop environments. Being
confined to living on abject poverty benefits is then called a ìprivilege.î
None have created modes of production where disabled persons can fully
participate in the economic lives of their nations and provide for their
families.
 

In the search for envisioning a just new economy, we must ask what is an
economy for: to support market driven profits and outmoded models of
production or to sustain social bonds and encourage full participation for
all -- including those members of our society who have an impairment?
 

An economy is only working if it works for people, if it delivers health
care, a living wage and a secure livelihood and income for every person. A
government guarantee of full employment would require reorganizing the
economy to allow everyone free choice among opportunities for useful,
productive and fulfilling paid employment or self-employment. In order to
bring more excluded persons into the workforce, it will be necessary to
expand the work environment beyond the capitalist profit motive and ensure
that federal and state governments act as the employers of last resort. Base
compensation must be set at a living real wage below which no renumeration
for disabled or nondisabled workers is allowed to fall.
 

Because illness (as separate from impairment) can make it impossible for
some to work for pay with a reasonable accommodation or to sustain a job,
those individuals must have a government entitlement to an adequate standard
of living which rises with increases in the wealth and productivity of
society.