How Health Care Became the Big Industry in Steel City

Bad times for American labor are also boom times for a certain strain of American apathy. According to a well-worn narrative, the post-war era was a model of heavy industry and stable union jobs; A family with 2.5 children can reunite with just one breadwinner – a radical working-class man who topped a sooty industrial plant before he arrived at home, which was maintained by his doting wife.

The decision following the collapse of its steel industry, Pittsburgh, exemplified how the trace memory of an old identity can remain in a football team (Steelers), a nickname (Steel City) and a local beer (Iron City), while the industry In fact it thrives there – health care – does not receive such reverence or recognition. The fastest growth in the field is not for anesthetists or X-ray technicians, but for poorly paid care; Most of these care workers are women, and many of them are Black.

During the pandemic, these workers have been called “necessary” – but as historian Gabriel Vinant points out in “The Next Shift”, remuneration and job security have not been retained. Wint writes, “Care workers are together everywhere and anywhere.” “They are responsible for everyone, but no one is responsible for them.”

There has been much discussion of pink-collar work changing blue-collar work, but what emerges from this book is Wintant’s argument that two different phenomena are in fact inextricably linked: “This one It was not coincidental that care labor was industrial. Employment declined. “In the 1970s, dendropitization pushed the sick and growing population into unemployment, toward the welfare state – forever, in the American case – for their survival.” Unlike other social institutions that cut political pressure and austerity, the US health care system flourished, which already grew in response to the rise of health insurance collectively in the later years of the flush.

Wint discovers the surprising story of how this happened with Pittsburgh in his mind. The city and its surrounding counties are one of the greatest examples of the local economy, which is not only shaped, but is connected to the steel industry, whose reach extends through the entire social fabric, the level of family relationships Is just below. Vinant, who teaches at the University of Chicago, consulted the archives, examined the data and conducted his own interviews on how a steel city became a health care aide.

Credit …Jeanette Astrath

“The Next Shift” is an original work of serious scholarship, but it is also vivid and readable; Winant has an eye to tell, and sometimes to bitch, in detail. An aspiring steelworker recalled that he always brought his lunch in a brown paper bag that constantly failed to protect his sandwich from starving rats; He opposed getting a proper lunch like the others because it would mean that he resigned himself to live. One woman remembered that she had grown up amidst the silent silence of a house, which had to be kept silent and dark, so that the father whom she could barely see, who worked in the night shift, would get some sleep during the day. Could. Families had to organize themselves for the needs of the industry. Each family became “a small factory”.

Despite the sentiment that is associated with the steel mill, the work he produced was not only dangerous, but also unpredictable and not isolated. Winant describes how a coke shovel working night shift lost “control over the rhythms of his body – to eat, sleep, work hard”, which in turn made it harder to maintain a display of manhood that made his identity difficult. Was very central to. It is not mentioned that the job security borne by the union’s collective bargaining was not evenly distributed. In the 1950s, as steel demand diminished with the end of the Korean War, layoffs first struck black workers – they were marginalized within the union, and the mill was in the worst condition.

For a time, steelwork unions received higher wages, outpacing inflation; Then, responding to government pressure to keep wages down, he negotiated for better health insurance, which created his own inflation in the health care system. Winant explicitly presents the peculiarity of the system by developing the peculiarities of the system as a “public-private welfare state” – a side effect of rising health care costs and entangled and entangled interests. Who does not seem able to replace anyone.

It was a public-private welfare state awaiting workers working by a crumbling industry. Vincent stated that two social institutions have been rich in prisons and health care delivery since the 1980s: “Like the expansion of the prison system in the last decades of the 20th century, the rise of the health care industry led to economic recovery. The social crisis brought about by deind industrialization. “

Hospital work was labor intensive, and it opened up a job market for black Americans, including domestic workers, who were displaced by automation and industrial decline for the first time. Their exploits, Winant says, “constitute the basis of bonuses for everyone.” This task force was largely left out of the medieval prosperity and security it helped to create, and the ensuing cycle was vicious: “The caretaker may be offered insured portions of the working class in large quantities because Its cost was passed in such a significant proportion. Through low pay to hospital staff. “

This system, depicted in Winant’s eye-opening book, is not only inhumane, but also inconsistent. At the end of “The Next Shift”, he introduces us to Nila Payton, a medical secretary, who takes a phone all day from patients with mesothelioma and black lungs in the pathology office where she works. The place is part of Pittsburgh’s vast hospital complex, but his office is so understood that it is sometimes difficult to find someone to cover the phone when he needs to use the bathroom. She says it has damaged her bladder, and she never received more than 15 percent growth in nine years of working there.

“Like many patients,” Wintent writes, “Peyton is now in medical debt – though in his case it’s for his own employer.”

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