Health Care Slavery and Overwork

teleSur English, August 24, 2015

A recent volume by a leading left U.S. historian is titled “The Age of Acquiescence.”  Its author argues that U.S. workers and citizens have in the last four plus decades lost the will to resist organized wealth and power – a sad departure, he thinks, from their previous long history of mass mobilization against political, social, and economic privilege.

The book is brilliant, erudite, and deeply knowledgeable, particularly when it comes to the political economy and ideology of neoliberal capitalism and the shifting composition and nature of the U.S. power elite. Still, it is flawed by its exaggeration of contemporary popular surrender and – curiously enough and more to the point of this article – by its underestimation of forces that tend to generate fear and a sense of powerlessness amongst the populace.

One such force that receives no attention is the critical role the nation’s employment-based health insurance system plays in deepening the power of bosses over workers and closing off democratic space. It’s no small matter. It’s bad enough that working people have to calculate the risks of going without paychecks before daring to challenge their workplace masters to any significant degree. In the U.S., uniquely among so-called modern capitalist democracies, employees also have to factor in the chances of losing health coverage for themselves and their families along with their jobs. The common 19th century American understanding of the employer-employee relationship as a form of slavery (“wage slavery“) takes on new meaning in light of workers’ dependence on employers for affordable health care.

Employment-based health insurance is a widely ignored underpinning of business-class rule in the U.S. So is endemic overwork in the U.S., home to the longest working hours in the industrialized world. As the pioneers of the American labor movement knew quite well, meaningful popular democracy depends on time – on the possession by the populace of leisure time to study, understand, and communicate and organize on the issues of the day. Time is, among other things, a key democracy issue. Overworked citizens lack the leisure required to participate in politics in an adequately informed, organized, and effective manner. The much-bemoaned American “time squeeze” – a critical part of the nation’s stark “democracy deficit” – also does not receive attention in “The Age of Acquiescence.”

It happens to be intimately related back to the nation’s employment-based health insurance system.  Health care costs amount to a very sizeable portion of total employee “compensation” in the U.S. Of critical significance, these costs are paid per full-time worker employed, not per hour worked.  And this, as the left economist Juliet Schor pointed out 23 years ago in her brilliant study The Overworked American: The Unexpected Decline of Leisure in America, is a major underlying “structural incentive” pushing capitalist employers to get as much work from as few salaried workers as possible.

A different form of democracy-disabling overwork related to the United States’ private health insurance system is experienced by millions of low-wage, no-benefit U.S. workers who take second and third jobs to make ends meet. A major expense pushing them into overwork is the ever-escalating cost of private health insurance in a society that has failed to join with other industrialized “democracies” in de-commodifying health care- in providing universal coverage as a basic human right.

On the back of “The Age of Acquiescence,” another leading left historian (employed by the same elite history department as the book’s author) praises the volume for “helping the 99 percent understand the terms of their defeat and, more important, how they can once again go on the offensive.”  It’s a strange accolade.  Few among “the 99%” are going to read the book’s learned reflections on capitalist hegemony in the age of “disaccumulation” At the same time, consistent with its title, the volume says little if anything about how “we the people” might spark new mass movements against the nation’s unelected and interrelated dictatorships of money, class, empire, race, gender, and eco-cide.

Certainly, however, there is no mystery about what policies we need to overcome the two great authoritarian forces discussed here. The first and most obvious policy change would be to disconnect health insurance from employment by introducing universal government-provided health coverage under a single-payer system would democratize and de-commodify access to medical goods and services. Single-payer (“Improved Medicare for All”) would also significantly reduce the costs of health care, increase labor demand (and hence workers’ bargaining power), and create more of the leisure time working people require to be meaningfully engaged in their nation’s supposedly democratic political system.  It would help working people develop more courage and capacity to resist elite domination – courage and capacity that sorely needs enhancement in a time when the nation’s top 1% owns more wealth than the bottom 90% and a vastly oversized share of the nation’s “democratically elected” officials. Along with a significant upgrade in the U.S. minimum wage, the re-legalization of union organizing to bring back the labor movement (“the people that brought you the weekend,” to quote a clever bumper sticker), the enforcement of rules on overtime pay, giant federal jobs programs to build new environmentally sustainable infrastructure and create decent employment opportunities, and the expansion of other parts of the social safety net, single payer would contribute richly to the creation of a context in which ordinary Americans might “once again go on the offensive” against the privileged few.

It’s not for nothing that you can’t receive Food Stamps while engaged in a labor strike in the U.S. The business class used its influence to prohibit state assistance to striking workers long ago.  They know that working peoples’ marketplace and workplace bargaining power is enhanced by the existence of a strong welfare state, which reduces the hazards involved in challenging capitalist authority by providing working class people alternative sources of income and protection to those provisionally extended by capitalists. The business lobby has pushed through the dismantlement and de-legitimization of social welfare programs for decades in the U.S. because capitalists-as-employers want, in Frances Fox Piven’s words, “to make long hours of low-wage work the only available option for many.”

Many of the policies required for a revival and expansion of popular resistance in the U.S., including single-payer, are advocated by presidential candidate Bernie Sanders. No doubt that is  part of why his large rallies around the country have been treated by the nation’s reigning corporate media as a strange and passing curiosity undeserving of serious, sustained, and respectful attention. A critical 1% asset, the dominant news media naturally treats the Sanders phenomenon as a minor story compared to the spectacle of diversion and reaction provided by the blustering billionaire and uber-narcissist Donald Trump, a onetime fan of single-payer who boasts that his fortune lets him get whatever wants from the nation’s politicians an officeholders.

Politicians and electoral extravaganzas aside, people are in fact organizing and resisting concentrated wealth and power around these and other issues beneath and beyond quadrennial candidate-centered election spectacles. Given the remarkable obstacles to such activism – including the dismissive verdicts of elite (if sometimes leftish) academicians as well as the more relevant barriers of overwork and health care slavery – I am most impressed by the remarkable depth and degree of the resistance that does occur in the U.S. today.

Facebook Comments
By | 2015-08-25T17:04:35+00:00 August 25th, 2015|Articles|