Sickly, Idle and Risky Minorities: Race and Diabetes under Singapore’s Emergent “Insurantial Imaginary”

This article highlights the role of the “insurantial imaginary”, defined as a social context in which profitable, useful and necessary uses can be found for insurance technology, as a condition that shaped the articulation of the sickly, idle and risky racial minorities within Singapore’s public health discourse on diabetes. Focusing on parliamentary speeches relating to diabetes between 1965 to 2020 as well as healthcare financing policy documents, I argue that the narrative of sickly, idle and risky minorities bodies tied to broader notions of racialized responsibility and accountability emerged sharply under a universal national health insurance system. Where parliamentary discussions on diabetes as a public health issue before the institution of universal health insurance circa 2014 utilized racial categories in the classificatory or administrative sense, these very categories became endowed with new meanings and moral imperatives, where Malays and Indians were urged to lead healthier lifestyles to reduce the national insurantial burden. This study builds on the literature on race in medicine by underlining the role of healthcare financing as a technology of racial biopolitics.