Capitalist Development, Labor Law, and the New Working Class.

• Author: Rogers, Brishen

The Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America

BY GABRIEL WINANT

HARVARD UNIVERSITY PRESS, 2021

REVIEW CONTENTS INTRODUCTION 1845 1. CAPITALISM, DEMOCRACY, AND LPE 1851 A. Neoliberalism and Critical Legal Theory 1851 B. Capitalist Development and the Law 1857 II. THE POSTWAR ORDER AND POSTWAR LABOR LAW 1861 A. Democracy and Domination in Postwar Labor Law 1862 B. The Postwar Era's Excluded Workers 1866 III. NEOLIBERALISM, CARE, AND LABOR LAW 1868 A. From Crisis to Care 1869 B. Labor Law and the New Working Class 1872 CONCLUSION: DEMOCRACY AFTER NEOLIBERALISM? 1876 INTRODUCTION

Of the many facts about steelmaking in Gabriel Winant's The Next Shift--a. history of Pittsburgh's political economy since the 1950s--perhaps the most astonishing is that many steel manufacturers used "hot metal bridges" to carry molten iron across the Monongahela River. (1) By the late 1800s, steelmakers had already built up both shores, often smelting iron in blast furnaces on the north shore, letting it cool into "pig iron" ingots, transporting the ingots across the river, then melting them back down on the south shore to remove excess carbon and make steel. Andrew Carnegie's engineers realized they could save costs if they never had to cool the molten iron, so they developed bridges to carry torpedo-shaped cars full of lava across the river. Each bridge was overbuilt and heavily shielded, in part to protect the workers who transported the cars, but also because if the metal spilled the resulting steam explosion would have destroyed the bridge itself. (2) At least two of the bridges still stand, reminders of the city's storied but danger-ridden industrial past.

Today, a much newer and more mundane pedestrian bridge links two campuses of the University of Pittsburgh Medical Center (UPMC), which has replaced U.S. Steel as the city's largest employer, and whose name now adorns the former U.S. Steel Tower downtown. That bridge crosses Centre Avenue, connecting UPMC Shadyside with UPMC Hillman, one of the world's top cancer institutes, allowing patients and workers to move between the two complexes. Unlike the now-vanished steelworkers who dominate the city's cultural imagination, health care workers are rarely acknowledged, (3) and many are chronically underpaid. (4) In the mid-2010s, one health care worker told a local commission that he had not "gotten more than a 15 cent raise in the 9 years" he had worked at UPMC. (5) Another UPMC employee--who has diabetes, high blood pressure, and a thyroid disorder--told that commission "there are days when I have to choose between buying food and paying for my medications." (6) The health care behemoth has also persistently fought worker organizing, even arguing in litigation that it does not employ any of the tens of thousands of workers at its various hospitals and clinics, and therefore owes them no duties under labor and employment laws. (7) Yet during the COVID-19 pandemic, UPMC adorned the bridge with large white capital letters reading "Heroes Work Here." (8)

The two bridges reflect tectonic shifts that reshaped Pittsburgh's labor market and political economy between the postwar period and the 2008 financial crisis. During that time, relatively well-paid and unionized employment in steel and metalworking plummeted, while low-wage, precarious, and nonunion employment in care sectors surged. (9) The composition of the working class also shifted: while industrial workers were disproportionately white and male, today's health care workers are disproportionately nonwhite and female. (10) This was also a period of growing economic inequality, (11) as the somewhat more egalitarian postwar order gave way to the political-economic order now broadly known as "neoliberalism," and economic risks were shifted from the state and corporations to individuals and families. (12) Parallel economic transformations occurred across wealthy economies during the same time--and within the United States, parallel changes played out in most other northern industrial cities. (13) But inequality has grown far more in the United States than in many other peer nations, (14) and Pittsburgh's devastation and transformation were especially pronounced because metal production dominated its economy for so long. (15)

By focusing on one city's evolution, Winant's book illuminates two aspects of this history, and of neoliberalism's origins and dynamics more generally, that might otherwise remain obscure. (16) First, the book situates both the postwar order and neoliberalism in the long arc of capitalist development, or as Winant put it in an article that preceded the book, in "the historical time of capitalism, from primitive accumulation to industrial maturity to overcapacity." (17) In other words, the decline of industry and the rise of health care were driven in large part by structural dynamics of capitalism itself--most importantly, how investors' relentless demands for profits and accumulation generate constant changes to technology and social relations, while also generating political countermovements against excessive commodification. (18) As Winant shows, deindustrialization was an important inflection point in that process. Second, the book argues that neoliberalism did not just come after the postwar political-economic order, but also evolved out of that order, carrying forward many of its tensions, exclusions, and policy choices. (19) Those include racial subordination inside and outside the workplace, acute class conflicts, and limited decommodification of health care and other social goods. (20) As this Book Review argues, Winant's analysis of the interplay among structural forces, social relations, and institutions also helps explain the evolution of labor law over the same period. I'll come back to this after summarizing Winant's argument.

Winant argues that "both the booming market for care and the huge workforce to supply care grew out of the social and political context of the steel mill." (21) Our postwar order encouraged unions to construct private zones of economic securityfor industrial workers and their families through collective bargaining--yet that order failed to extend full social citizenship to most women and workers of color. (22) Moreover, class conflicts remained intense in steel throughout the postwar period, rendering the work profoundly dangerous and often economically precarious. (23) As industrial capital fled the region in the 1970s and 1980s, steelworkers were left unemployed and adrift, and "the social reproduction of the working class became an increasingly vexed question." (24) Yet steelworkers retained some political power through their unions, some capacity to make legitimate moral claims against the state and capital due to their race and gender, and some purchasing power through their private health care funds. (25) Those health care funds then seeded the new care economy, while parallel political pressures from displaced workers and retirees led the state to increase health care funding. (26) Health care spending therefore "offered an economic fix to the social crisis brought about by deindustrialization." (27)

The modern health care sector is nevertheless "an anomalous one in the history of capitalism, in which self-sustaining productivity growth has historically been a defining feature." (28) Like many other services, care work is difficult to keep profitable because the good provided is inseparable from a person's manual or affective labor--feeding, bathing, changing bedsheets, asking what hurts--and therefore resistant to technological innovation. (29) Many other countries responded to this challenge by socializing a great deal of care provision, but in the United States that option was foreclosed by interest-group pressure from retirees and health care companies, (30) and by white citizens' racialized suspicion of welfare programs. (31) Accordingly, the limited and privatized welfare state of the postwar era evolved into our contemporary health care system, with its peculiar mix of public funding and private provision. (32)

Winant further argues this policy response to the crisis of deindustrialization led to wage stagnation and the degradation of work in health care. Over time, he shows, health care companies generated profits despite lagging productivity in part by legally severing technologically advanced sectors, like advanced imaging, from labor-intensive sectors, like nursing homes. (33) To staff the latter set of jobs, businesses recruited workers who had been excluded from the postwar compact and were susceptible to hyperexploitation due to their races and/or genders, until--as Winant put it in an article that preceded the book--the "relationship between the [postwar] economy's inside and outside became inverted." (34) The industrial proletariat at the core of the postwar order shrank dramatically and a new working class formed among once-peripheral workers, whose labor was understood more as care than as work. (33) Companies continued to suppress wages among that group, which also eroded the quality of care, until today this system delivers only "a strange, degraded kind of security" to most consumers and patients. (36)

The Next Shift has various implications for legal scholars, especially the growing set within law and political economy (LPE) who are focused on the role of law in neoliberalism (37) and on the interrelations among class, race, and gender. (38) As noted above, this Book Review focuses on The Next Shift's implications for labor-law scholarship and theory. In particular, this Review argues that labor law--or the whole complex of laws constituting and governing work (39)--evolved over this period in response to the same structural forces and patterns of groupbased subordination that Winant elaborates. Indeed, Winant's metaphor of the labor market being turned "inside out" also describes labor law's...