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“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).
Training in programming skills takes a new prominence as an area of tech-for-good: previously, there was a great deal of focus on k-12 and university education to teach programming skills in order to increase social mobility and access to high-paying jobs, or just because STEM education is a good in some stories, or to increse diversity in tech fields as an end unto itself.
Now re-skilling, in this case through a private corporation's CSR and advertisement campagin for new paying membership, is taking on new significance as massive layoffs and furloughing has left people at home, responsibilized to find a new job. Meanwhile, the tech industry is in quite a few cases hiring as reliance on digital connectivity for things that were once done in-person has increased with quarantining.
By matching purchases of Pro Membership of their programming training with five donation subscriptions, this private business is casting itself as socially responsible. They are re-skiling people who have been furloughed or laid off during the pandemic and this allows them to be competitive for jobs that are still in demand as programmers. Programming and tech industries are the most resilient in a situation of social distancing, as everyone more or less fully relies on digital connectivity for interaction, and this company is capitalizing on that situation to increase its paying membership while boosting its image of social responsibility.
As a purchaser of Pro Membership, I'm doing a good because I'm "unlocking" the donations to 5 people who get the opportunity to receive training in a new skill through a premium version of a free platform, and this might get them employment.