Analyze

“Under a 1986 federal law titled the Emergency Medical Treatment and Labor Act (EMTALA), hospitals are required to treat people who come to the ED presenting with an emergency medical condition, defined as a condition that, without treatment, will likely lead to serious impairment or death. … EMTALA is one of the largest federal mandates to provide services to have gone unfunded (Friedman 2011); costs instead fall on states and local health care systems.” 481

“In bringing ethnographic attention to hot spotting as a technique of governance, we find that it provides lifesaving humanitarian interventions while operating within the racialized structures of violence that produce continual life crises. The institutional rationality of hotspotting and the encounters of care that it produces illustrate the often-contradictory role of medicine in the lives of poor people: both caring and coercive, it intertwines care and violence.” 475; “we conclude by suggesting that economic investment and return are becoming a reigning logic in the governance of poverty, generating hot spots as sites of interest for both policing and health care and decentering normative assessments of deviance, illness, and social problems” 476; “Neoliberal social assistance, as it is practiced in the health care safety net, is conceptualized as an “investment “in the population, as a strategic and targeted deployment of basic resources, one that promises to generate a return on investment for the state or health system in the form of cost savings.“ 485

 The authors examine the practice of “hot spotting,” a form of surveillance and intervention through which health care systems in the US intensively direct health and social services towards high-cost patients.  Health care hot spotting is seen as a way to improve population health while also reducing financial expenditures on healthcare for impoverished people. The authors argue that argue that ultimately hot spotting targets zones of racialized urban poverty—the same neighborhoods and individuals that have long been targeted by the police. These practices produce “a convergence of caring and punitive strategies of governance” (474). The boundaries between the spaces of healthcare and policing have shifted as a “financialized logic of governance has come to dominate both health and criminal justice” (474).

Narrowed critique just to be of sincerity of CSR claims, not ideology of CSR. Consensus enforcing (above) silences any kind of dissent.

Enforcing consensus: Credibility and viability to compete for funding of your NGO is gone if you protest or dissent → performed consensus by silencing “stone throwing” NGOs or irrational opposition because you’re “actually trying to do something”, so the new unethical is the NGO who is just being stubborn or petty; 

Creating ads to educate consumers or communities on how to live responsibly [responsibilization]: flow of ethical expertise, from business/govt thru media to community/consumer 

Awards for CSR accomplishment is like moral capital; it also is ritualized like gift giving, reciprocal gratitude; circuit of exclusive events generates and legitimates this discourse, celebrity speakers, positive vibes

Confession of past sins plus highly visible partnerships with well-known NGOs, a very branded activity

To the extent that corporations genuinely believe that market access is going to end poverty... They seem to genuinely believe that the “third world” governments are corrupt and incompetent, in the way like in Orientalism colonialists seemed to genuinely believe that they were saving the nonwhite people from themselves. And they genuinely believe their resources are better and greater and their distribution networks etc. are better. 

NGOs have their back against the wall - they have to silently accept the language of the corporations and do it their way because they depend on the corporations for funding. So they may not see it as helpful but have to participate anyway

Redefined: New unethical is the NGO who doesn’t support CSR - they are bitter, unprogressive. Legitimate action - ethical - “partnership with business for the common cause”; Illegitimate action - unethical - “misguided, anti corporate campaigning” p17

Proof of the ethical is in rigorously calculated indices of corporate responsibility and awards presented by orgs that supposedly represent civil society

Money funneled thru well-known NGOs who have to do what they say

blame/displacement of scrutiny onto “Southern” i.e. previously colonized governments; pretty blatant language of colonialism (needing to save people from their own corrupt and incompetent governments) cast as “good governance” that corporations can do to lift people out of poverty with market access/inclusion

“Market comes to stand for social system as a whole” -p12

Business-led development becomes development orthodoxy

Reconfigured to appear as a double market competition - corporations competing for awards/ moral capital with their CSR actions, and NGOs as enterprises competing for corporate money to execute social good programs (but of course here the power is with corps to drive what is a social good program)

Public-private partnerships, defining development as market access, making it about scrutiny of “3rd world” government incompetence instead of corporate irresponsibility

This article goes in depth with how the children are being exposed to lead in their water and how that actually leads to them doing worse on exams or standardized tests. This was supported through tests and research.