“Everyone Deserves Care”

A historian friend once taught me the German word Zeitgenossen, explaining that it referred to one’s contemporaries, or members of one’s generation, but also more particularly connoted something like a “time-comrade.” Gabe Winant has become a great time-comrade to me, a thinker whose insights into questions of history and generationality, kinship and aging, have deeply enriched my own thinking on these subjects. His first book, The Next Shift: The Fall of Industry and the Rise of Health Care in Rust Belt America, traces the transformation of Pittsburgh, the archetypal industrial steel town, into a city powered by the labor of hospital workers. It offers both a finely drawn portrait of working-class life in industrial and postindustrial Pittsburgh and a vision for how care work—which has long divided workers along lines of race, gender, and generation—could become the basis for a new kind of solidarity. In doing so, it also offers a profound look at how not just the workday but the life course has been ordered and reordered by the economic shifts of the past 75 years. I took the opportunity to chat with Gabe about the book, and about the past, present, and future of American labor. This conversation has been condensed and edited. It originally appeared in yesterday’s email newsletter, to which you can subscribe here.

Ari M. Brostoff: Your book cuts through a whole debate playing out on the left right now over the legacy of the New Deal and whether it’s a good model for our politics today. Can you explain what you think people are arguing about and how you see the book intervening?

Gabriel Winant: I think the legacy of the New Deal has become a proxy for questions about what class is, where the sources of collective solidarity and power might lie. On the one hand, it presents a usable past of a recent history of working-class power changing the country. On the other, the working-class subject at its center—the mass industrial worker—can’t be taken as a stand-in for the working class as a whole, not anymore.

So the concern is that when we show excessive fealty to the New Deal, we risk ossifying our concept of class around the particular social and political configuration that gained recognition in the 1930s and 1940s, which in fact was uneven and internally contradictory. Ultimately, the point is not to determine whether the New Deal was good or bad, but to position ourselves historically in its aftermath. There wasn’t an enormous social rupture, there wasn’t a revolution or a civil war that marked its end. Instead, something institutionally emerged out of it; there’s a good deal of continuity into our present. So rather than construct a tight historical parenthesis around the New Deal, to say our social order was good then and now it’s bad, what I argue for is apprehending the material consequences of it that we still live with.

What my book is trying to say is that there was this real moment of working-class power in the New Deal that we can see clearly in a place like Pittsburgh. In 1950 half of all employment was what we would call blue collar—in the steel industry most of all, but there were still coal miners in the outskirts, and there were trucking and rail and warehousing and other kinds of machine production. This was all unionized work. In places like Pittsburgh or New York or Philadelphia or Detroit, a kind of quasi-social democracy emerged, in which workers had real power. I tell the story of the 1959 steel strike, which remains to this day the largest strike in US history—maybe half a million workers over four months. President Eisenhower had sworn to stay out of it, but was forced by the union to settle things basically on their side.

That working-class power is also a component of what we call social citizenship. The American welfare state that emerged from the New Deal was distinctive in that it centered private sector employment and constructed a hierarchical relationship between the breadwinner and his dependents, particularly his wife and children. It constructed a stratified relationship between those with access to that social citizenship and those who stood outside of it and were thereby forced to survive in other ways, by servicing the people who did have access. That’s basically the relationship between the steel worker and the healthcare worker. 

AMB: I was really interested in the idea that the healthcare markets created by union negotiations at the peak of American labor power—the insurance coverage that unionized industrial workers won that meant nonunionized hospital workers would care for them—wound up transforming industrial workers into consumers of their own health.

GW: Yeah—though it’s important to note that within the institutional frame of the postwar welfare state, this particular kind of consumption was a collective experience, a potent expression of what it meant to be socially included. I found this amazing collection of interviews done in the 1970s by a group of feminist sociologists. They interviewed hundreds of white working-class women—mainly Slovaks, Poles, Italians, and so on—and asked them how they feel about scientific medicine. You can tell that what they want to hear is women saying, “Oh, no, I use remedies from the old country.” And instead, they’re told again and again, “Are you kidding? The hospital is incredible—you stay as long as you want, they bring you food, they check in on you. You don’t pay a dime.” This was a key moment for me, because I could connect it to these very high rates of what health economists call utilization of the healthcare system. Pittsburgh generated 1.6 inpatient days per capita in 1979. Our national average today is about a third of that. 

At the same time, Black Pittsburghers were scared of the hospital, and rightly so—medical racism was common, and moreover their own relationship to employment-based health insurance was less secure because their jobs were less safe. And by the late 1960s, hospital work was also one of the main employment opportunities for African Americans, but often near the minimum wage, outside the protection of labor law—and often grueling and dangerous work.

So on one side you have a collective experience of health care consumption as a manifestation of the social needs and rights of one fraction of the working class; on the other hand you have the exclusion from those same rights, and indeed excluded people being mobilized to realize those rights for those who do have them. So at a very intimate level, the welfare state organizes one’s sense of the integrity of one’s own body and what that means in relation to the larger social order.

AMB: You argue that there is also an opportunity for another historical transformation here, through new kinds of solidarity around care work. 

GW: The book argues that we have had a dynamic for a long time in which health care routed through markets pits care workers against those for whom they care, or more broadly, between people who need care and people who get it. That can play out in the form of a generational conflict, and it often takes racialized and gendered forms, given who provides care. But there is also a basis to imagine a different kind of solidarity—between care workers fighting for different working conditions and those they take care of—given how unhappy consumers are at this point about the state of American health care. I think that is our best bet for working-class unity, on the model of the teacher strikes of the last decade, in which teachers’ working conditions and students’ learning conditions have been successfully equated in a political struggle. Hopefully it’s possible to imagine that cycle of working-class formation and activity around the principle that everyone deserves care. 

AMB: Among other things, The Next Shift is an entry in an ongoing conversation about the politics of the life course. You draw, for instance, on theories of biopolitics—as political theorists call the modern regime in which the state seeks to regulate and control life itself—and on the feminist tradition that takes the life course as the terrain of struggle for reproductive freedom and bodily autonomy. How does your book add to those conversations?

GW: We have an idea right now that there are phases of your life when you give care and phases when you receive it, or a group of people for whom care is the assigned task, and another group for whom care is an entitlement. The reality that everyone needs care is parceled out into an uneven social division of labor, around which lives are then structured unequally.

This system produces generational conflict as people move through structured phases of the life course, creating conflicting temporalities. Different institutions laid down across various working-class pasts grind against each other: Victory for the CIO in the 1930s and 1940s and mass employment in the war industries in the 1940s and 1950s meant mass retirement in the 1970s and 1980s, following a life structured by nested cycles of working-class temporality: shift schedule and overtime, pay period, contract cycle, seniority, and so on. The basis of those enormous health care markets serving the organized working-class was actuarial logic; they depended on having a group of subscribers to a health plan moving forward in time together. On the other hand, the reproduction of this working class, particularly as it entered retirement, mobilized a whole different group of people moving through a different life course characterized by different temporal cycles: meal production, housecleaning, marriage, pregnancy, childbirth. The rhythms of care don’t lend themselves to the abstract temporality of industrial production so well, yet the needs of the first group caused the second group to have to speed up its care production, both within the home and eventually in the waged workforce, within hospitals and nursing homes.

Caregiving is both time-bound—and thus can be exploited—and simultaneously it wants to be unbound, to be freely given and received, and this is its utopian element even in its exploitative shell. The book tells a story in which caring for the old becomes a burden, and a mechanism of exploitation within the working class. Yet there’s also the possibility for a dialectical reversal here: Our transformation into a society where our institutions and our labor are geared more and more toward caregiving makes it possible to imagine a world where everyone gives and receives care, rather than conscripting poor women to do it for everyone else. 

This where the imperative arises to look on the working-class past, the CIO, the New Deal, in a new way: We don’t want to fetishize it as the one good thing that ever happened, then was tragically lost; we don’t want to write it off as inconsequential or worthless. Instead the point is to position ourselves in relation to that history. The rituals that attach us to the past—the workshifts that reproduce our elders, that signify ongoing oppression and exploitation for the largest fraction of the working class today, and which embody the worst inheritances of the New Deal state—also may, under the right alignment, open onto a radically different future. 

AMB: This feels related to a certain liberal Jewish narrative about the 20th century, in which there was a time in the lives of the Jews when we worked, and now a separate time when we are cared for.

GW: When someone says to me, “Why are you a labor historian?” I sometimes say, “Well, my great-grandfather Morris was a socialist and a cutter in the garment industry who lived on the Lower East Side.” But that was a long time ago. I can draw on that history, it means something to me, it maybe got me pointed in the right direction in the first place. But there are huge differences not only between me and Morris, but between me and the historians a generation or two ago who would’ve put Morris at the center of the stories they told. And those differences have to do with the changing social history of Jews over the course of the 20th century. Labor historians in the 1960s or 1970s mainly would’ve been educated and taught at public universities, in the great expansion and democratization of that system by the postwar liberal state; I on the other hand did my PhD at Yale and now teach at UChicago. I spent grad school fighting tooth and nail for a union because of the downward trajectory of the academic economy, and that experience—beyond any kind of callow loyalty to an unknown great-grandfather—was what really made me a labor historian. All to say, the historian does not occupy a fixed point in time from which the past can be apprehended, but is blown along by historical change. American Jews once thought FDR was God, and even the historians among us entertained the idea. Now we’re in a different moment.

AMB: I was joking to my coworkers that I was going to get the “secret Jewish history” of your book, even though we’re against secret Jewish histories. Some of my own preoccupation with questions about the politics of time and the life course is very Jewish, I suspect, though I’ve often thought of it in terms closer to the ones you use in the book. I’m trying to think about what I actually mean by that, and think it may something to do with secularism. Religious Judaism is so constituted around the regulation of time, both through everyday rituals and over the course of a lifespan. I wonder if, in the cultural specifics of secular, diasporic Jewish life, there’s a way that increments of time—the day, or the life—get continually foregrounded as this site where regulation and ritual could be, but aren’t. It’s as if we’re moving through the life course without instructions for how to do so, but with an awareness that this means we have to consciously and constantly ask questions, including political questions, about what that looks like. 

Thinking about your book in these terms, it seems like you’re actually looking at the organization of time that your great-grandfather’s generation helped create, and resisting the tendency, a couple generations out, to attempt to return to that organization in an orthodox way, even when it’s no longer grounded in material reality. When in fact, the dialectics of secular, diasporic Jewishness would ask that we not only create new kinds of time, but also refuse to get trapped inside them.

GW: Yes, well said. I think time plays out in multiple layers—organizational, generational, and so on. It’s not that hard to see how a particular organization of time can become ossified. We can recognize ourselves as inheritors of the history and victories of the American workers’ movement, while at the same time emancipating ourselves from the impulse to simply go back or defend what we had. 

In terms of the book, that would mean imagining a new order of time both at the level of the life course and down to the level of the day, which is totally possible. But it’s not possible within a narrow framework of immediate reform. Certainly, there are important immediate reforms: We should have paid family leave; if you have kids or you have a sick or elderly or disabled relative who needs care, that should be much more formally structured into our working lives. Homecare workers should be better paid and have fewer clients and be able to work more slowly. These are the kinds of steps that it’s very possible to imagine winning, and to the extent the book represents an immediate political intervention, that’s what it is. 

But we can also expand on that logic: What if I was responsible for the kids and the elderly on my block? In return, if I were to have kids, what if the neighbors were responsible for my kids too? What if we made each other meals? It’s not hard to begin to imagine a democratic and cooperative world in one’s own social environment. In principle, it’s not such a wild leap to make.

AMB: It seems to me that visions for collectivizing childcare are familiar, at least in general terms, to many people on the left, but that this might be less true of eldercare. I wondered if you had a vision for what a utopian eldercare would look like.

GW: It’s something I think about a lot without having a full answer to it. Ai-Jen Poo’s book The Age of Dignity ends with a utopian vision that I think is very compelling, in which long-term care is integrated into residential communities that have access to trained caregivers but in which the elderly aren’t ghettoized. But I think the principle we want to strive for is one in which the principle of medicalization is erased. In this country, we treat old age as a medical problem. That’s how people get access to care—through Medicare and Medicaid—whether or not it’s strictly medical care. It often is not, right, it’s someone straightening up their house and buying groceries and wiping their body in various ways. And I think that utopian vision of it will integrate genuine medical needs that exist into a logic of communal and collective care. It’s easy to imagine a world in which parents leave kids above a certain age with old folks to watch, similar to a model you might have of a kind of premodern family, though there’s no reason for it necessarily to be kinship-based. Or where young adults bring food to elders in a regular way and exchange knowledge and skills.

AMB: That spatial similarity between childcare and eldercare makes me think of an interview with the architect Daniel Libeskind in the Housing issue of Jewish Currents, about how he’s trying to design collective eldercare facilities that draw on his own experience growing up in cooperative housing in New York. While we’re on the question of space, one more question: Is Pittsburgh actually the best Rust Belt city, or is it just the one I happen to have hung out in, as well as the one you happen to be obsessed with? I’m also curious about how you would situate Squirrel Hill, a really special Jewish community that remained urban in the late 20th century as Jews in so many enclaves throughout the country moved to the suburbs. Do the world of Squirrel Hill and the world you sketch in your book have anything to do with each other?

GW: Pittsburgh has stood in as the symbol of the Second Industrial Revolution; it’s a place where I can put on social realist glasses and see the world like a labor historian of the 1970s, where the CIO seems like the telos of history. And by the same token, it’s a place where I can figure out how to take them off. I also grew up in Philadelphia, and I’d never been to Pittsburgh; in my mind, it was this other part of the world on the other side of the Alleghenies, where they bend metal, where it’s still the industrial age. So the city was a means for me to work through these issues. 

In terms of its internal differentiation, Pittsburgh is very hilly. Different parts of it are very different from each other, because they’re hard to get between. Squirrel Hill was not a place where steel workers lived, nor is it where a lot of low-wage health care workers live today. It speaks to the ethnic segmentation that existed even among the industrial working class: There was a sense that Jews were too weak to work in steel mills, as opposed to the Eastern Europeans, who management saw as mules. 

I interviewed a steel worker who worked at Homestead Works, an icon of American labor history, which was immediately across the Monongahela River from Squirrel Hill. He regaled me with these stories of the shit these young white guys doing these jobs in the ’70s would get up to. For example, they would take these pressurized air canisters they had lying around, line them up on the riverbank, and then take sledgehammers and knock the tops off, so they would rocket across the river and crash into the trees in Squirrel Hill. I’m not sure what that says about the segmentation of middle-class Jews and blue-collar workers, but maybe it’s something.