Speculative Fiction and the Political Economy of Healthcare: Chang-Rae Lee’s On Such a Full Sea

Abstract

Chang-Rae Lee's 2014 novel On Such a Full Sea uses the genre of speculative fiction to reflect on longstanding healthcare debates in the United States that have recently crystalized around the Affordable Care Act. The novel imagines the political economy of healthcare in a future America devastated by environmental illness. What kind of care is available and to whom? Who provides it? Who pays for it? What about distribution and access? The different healthcare systems governing each of three geo-social zones in Lee's future society represent exaggerated versions of the scenarios participants in the ACA debate claim their opponents' health policies would produce. The essay argues that Lee's novel ultimately favors a version of universal government-funded care over a system based on supposed free-market principles, even as the novel also tries to make room for conservative Americans' fears about the specter of so-called "socialized medicine." More broadly, the essay contends that the health humanities should devote more attention to literary and artistic engagements with healthcare as a system: a complex set of financial models, public and private institutions, government policies, and actors whose roles range well beyond patient and care provider.

Biocolonial pregnancies: Louise Erdrich’sFuture Home of the Living God(2017)

“…Following the approach of Phillip Barrish, who argues that health humanities ought to address what he has termed ‘health policy fiction’, I have outlined the effects and implications of these policies on reproductive health because healthcare is ‘a complex set of financial models, public and private institutions, government policies, and actors whose roles range well beyond patient and care provider’ ( Barrish 2019, 297 ). Epidemics are ‘catalyst[s] for social change’ ( Reagan 2010, 5 ), and as illustrated within Future Home, though they often give rise to newly adapted health policies, they are also catalysts for new forms of stigma and new opportunities to demarcate or marginalise difference.…”

“…Working within a speculative genre which allows for a temporal reframing of colonial oppression, Erdrich presents a dystopian society that seems to be a fictionalised future but is in fact a biocolonial rendering of the historical and ongoing injustices experienced by Native American women. Like Erdrich’s characters, our methods of reading ‘health policy fiction’ ( Barrish 2019 ), of theorising representations of biocolonialism and of relating to Indigenous scholarship within the health humanities must likewise demonstrate this capacity to adapt. This article has offered a reading of biocolonialism as it relates to reproductive healthcare in one work of Native American fiction.…”