The heroin epidemic in America has a death-toll comparable to the AIDS epidemic at its peak, but this time, there's no movement coalescing to argue for the lives of the economically sidelined, financially ruined dying thousands — while the AIDS epidemic affected a real community of mutual support, the heroin epidemic specifically strikes down people whose communities are already gone.
The Occupy movement rallied around the idea of the "precariat," the downwardly mobile former members of the middle class who were one layoff or shift-reduction away from economic ruination. Below the precariat is the unnecessariat, people who are a liability to the modern economic consensus, whom no corporation has any use for, except as a source of revenue from predatory loans, government subsidized "training" programs, and private prisons.
The precariat benefits from Obamacare, able to pay for coverage despite pre-existing conditions; the unnecessariat suffers under Obamacare, forced to pay into the system before going through the same medical bankruptcies they'd have endured in order to get the coverage they need to survive another day.
You're likely to be in the unnecessariat if you live in a county that has high levels of addiction and suicide — the same counties that poll highest for Trump.
Corporations have realized humanity's long nightmare of a race of immortal, transhuman superbeings who view us as their inconvenient gut-flora. The unnecessariat are an expanding class, and if you're not in it yet, there's no reason to think you won't land there tomorrow.
If there's no economic plan for the Unnecessariat, there's certainly an abundance for plans to extract value from them. No-one has the option to just make their own way and be left alone at it. It used to be that people were uninsured and if they got seriously sick they'd declare bankruptcy and lose the farm, but now they have a (mandatory) $1k/month plan with a $5k deductible: they'll still declare bankruptcy and lose the farm if they get sick, but in the meantime they pay a shit-ton to the shareholders of United Healthcare, or Aetna, or whoever. This, like shifting the chronically jobless from "unemployed" to "disabled" is seen as a major improvement in status, at least on television.
Every four years some political ingenue decides that the solution to "poverty" is "retraining": for the information economy, except that tech companies only hire Stanford grads, or for health care, except that an abundance of sick people doesn't translate into good jobs for nurses' aides, or nowadays for "the trades" as if the world suffered a shortage of plumbers. The retraining programs come and go, often mandated for recipients of EBT, but the accumulated tuition debt remains behind, payable to the banks that wouldn't even look twice at a graduate's resume. There is now a booming market in debtor's prisons for unpaid bills, and as we saw in Ferguson the threat of jail is a great way to extract cash from the otherwise broke (thought it can backfire too). Eventually all those homes in Oklahoma, in Ohio, in Wyoming, will be lost in bankruptcy and made available for vacation homes, doomsteads, or hobby farms for the "real" Americans, the ones for whom the ads and special sections in the New York Times are relevant, and their current occupants know this. They are denizens, to use Standing's term, in their own hometowns.
UNNECESSARIAT [Anne Amnesia/More Crows]