December 1 is World AIDS Day. Every year, people around the world remember the epidemic as a medical and moral tragedy, a time of heroic patients and long-awaited medical breakthroughs. But the economic story — the one about abandonment, profit, and the marketization of survival — is largely absent. That missing story matters, especially because its logic is resurfacing now.
In the early years of the AIDS crisis, when thousands of people were losing their jobs, housing, and health insurance, the American government didn’t step in to support them. Instead, a new, little-understood financial instrument emerged: people with AIDS began selling their life-insurance policies to investors for quick cash, often just to afford rent, medication, or a measure of comfort in their final months. An investor would pay a patient a portion of their life-insurance “death benefit” — maybe 80 percent, maybe 30, depending on how soon the patient was expected to die. After the patient’s death, the investor would collect the full insurance payout.
These transactions, called viatical settlements, were often portrayed as a macabre curiosity of the epidemic — a clash between “bankrupt” sellers and “morally bankrupt” buyers. Gawking anchors on corporate news shows found a new favorite word: ghoulish. But the viatical market wasn’t an aberration. It was a predictable outcome of austerity and abandonment, a textbook example of what happens when the social safety net is deliberately dismantled and private capital rushes in.
I recently directed a documentary about this industry, Cashing Out, which also explores my own unexpected connection to it: my father was one of the early investors who bought life-insurance policies from people with AIDS. He profited when they died; unbeknownst to me, those profits helped fund my adolescent years — when, incidentally, I was figuring out I was gay.
People tend to fixate on the personal drama of this story, but that reaction…
Auteur: Matt Nadel
