94 Neither the state nor the market

Part of the reason for the recent resurgence of interest in the commons has been people’s perception that neoliberalism has subordinated; ‘every form of life and knowledge to the logic of the market’ ^[1], and that this has ‘heightened our awareness of the danger of living in a world in which we no longer have access to seas, trees, animals, and our fellow beings except through the cash-nexus’ (ibid). But, at the same time, we have also become disillusioned with the idea of ‘The State’ as a viable alternative (see Chapter 7). Antonio Negri argued in support of the commons because it would mean that;

‘we no longer cede to the state, or capital, or any other external power (the churches, the mosques, the synagogues — in short, to the force and madness of command, which works by way of charity) the role of managing what is ours’ ^[2].

Proudhon argued that any system that constrained our choices (through a scope of practice, for instance), forced us to act in a particular way (regulatory authority), or constrained our ability to learn to make our own decisions (professional training), was immoral, and that mutual co-dependence should replace all forms of compulsion. Only through sociability, association, and mutualism based on our shared rights and duties, do we achieve the greatest justice, freedom, and equality ^[3]. The commons, then, are fiercely opposed to both ideas like Communism and any form of state control, and rampant individualism. Some echoes of this sentiment in physiotherapy can be seen in the recent work of Eline Thornquist and Hilder Kalman;

Slipping anchor

What might physiotherapy look like if it was not underpinned by biomedicine, state patronage or private enterprise?

What is it about physiotherapy that relies on these social technologies for its survival? Would it even exist without them?

‘And increasing interest for private enterprise is evident among Norwegian physiotherapists, a development fuelled by the contemporary concern with the body and health, producing a market for exercise and training. These changes are putting the tensions between the market versus the state, between interest in profit-making versus social mandate, on the professional-political agenda anew’ ^[4].

The existential and physical crisis we all face as intermingled and co-dependent entities has forced Michael Hardt and Antonio Negri to argue that we now have to completely rethink the concepts underpinning collective social life on the planet. The old capitalistic language of public and private, of individual rights and inclusion, now needs to be replaced by mutual association, or an ‘open network’ built around common rights, belonging, and abundance ^[5].