Early makes a solid case for democratic unions, ending the book with a call for rank-and-file controlled unions as the superior choice over corporate-style, top-down unions.

The vast majority of workers would agree with Early’s prescription, and in a democratic society, it would be a done deal. However, as with most matters under capitalism, the majority get no choice.

The major weakness of Civil Wars is that it doesn’t explain why a generation of activists failed to democratize the unions and what the next generation of activists must do differently to avoid repeating that failure.

Early does a fine job of explaining who did what to whom in meticulous detail, but he fails to locate these details in an accurate historical context.

Early describes how, after the decline of the social movements in the 1970s,

“…thousands of veterans of anti-war activity, the civil rights movement, feminism, and community organizing migrated to workplaces and union halls with the professed goal of challenging the labor establishment… the largest radical presence in the unions since the 1930s, when members of the Communist Party and other left-wing groups played a key role in the formation of the Congress of Industrial Organizations (CIO).” (p.1-2)

Unfortunately, the 1970s was not the 1930s, and the New Left was not the Communist Party.

The 1930s followed the crash of 1929. The Great Depression created mass deprivation and the economic boom in the Soviet Union gave credibility to communists in the labor movement. The link between the labor movement and the socialist movement was key to the rise of industrial unions in America.

In contrast, the 1970s followed decades of economic expansion that enabled a sizable union bureaucracy to develop. And while the 1960s generation was radicalized by the fight for Civil Rights and the US war in Vietnam, the twin legacies of McCarthy in America and Stalin in the Soviet Union had driven socialists out of the unions and discredited the revolutionary left.

While mass movements won real gains for the working class in the 1960s, the capitalist class regrouped during the 1970s and launched a broad-based class war to regain lost ground. Cut off from the socialist tradition, the New Left was unable to counter the assaults of the capitalist class and the conservatism of the union bureaucracy.

As Early points out, the employers’ offensive was fierce and unrelenting. Companies laid off workers, attacked unions and demanded concessions. Governments of both parties supported this assault by eroding labor standards, deregulating industries, privatizing social services and supporting job migration.

The union bureaucracy was used to a more friendly terrain on which it could negotiate wages and benefits. It recoiled from the prospect of fighting an all-out class war that challenged the right of the capitalists to profit at workers’ expense.

Despite the escalating attacks, union leaders continued to uphold their end of a social contract that no longer existed. They accepted employers’ demands for concessions, no matter how deep, in the hope that once profitability was restored, they would regain lost ground. However, the employers continued to demand concessions, even as the economy boomed and profits soared.

Workers who fought back were fired, and combative unions were decertified. With a few notable exceptions, strikes were defeated, union drives failed and workers became demoralized. The proportion of workers in unions sank into the single digits.

In the face of such defeats, why have union bureaucrats consistently refused to fight? Early provides the usual liberal explanation – that union leaders are simply wedded to the wrong strategy.

A class analysis reveals something different.

The union bureaucracy cannot lead the fight against the employers, not because of wrong-headed ideas, but because the bureaucracy occupies a managerial or middle-class position between capital and labor. Its continued existence depends on the continued exploitation of union members and its role in negotiating the terms of that exploitation. The union bureaucracy cannot challenge capitalism without threatening its own existence, so it must promote conciliation.

The capitalist class understands the true nature of union officialdom. Over the past four decades, employers have relied on the compliance of union leaders to drive down the living standards of the entire working class.

Despite their passivity, union bureaucrats could not allow their membership base to disappear because they need members’ dues to sustain their elevated social position and lavish lifestyles. They couldn’t rally union members to fight the employers without compromising their own middle-class position, so the only other option was to advance themselves at their members’ expense.

To their everlasting discredit, top union officials adopted the capitalist model of turf wars, takeovers and amalgamations. Embracing this ‘compete or die’ strategy, each set of union bureaucrats fought to increase its market share, that is, to grow its own union at the expense of other unions and the labor movement as a whole.

Civil Wars describes in great detail the corruption, back-stabbing, power-grabbing, opportunistic alliances that have marked these turf wars among American unions.

Early explains how the corporate model of organizing was presented as a means to advance workers’ interests (“justice for all”) when it was actually fought at their expense. Millions of dollars in members’ dues and countless union-hours were squandered on lawyers, consultants, politicians, smear campaigns, court battles, settlements, and security forces – not to fight for workers’ rights but to battle other unions and to dominate the rank and file.

The struggle for better contracts, for Medicare-for-all and for passage of the Employee Free Choice Act were all sacrificed to expand the control of high-paid union bureaucrats.

Civil Wars documents how difficult it was to transform unions into power bases for a self-serving bureaucracy. Standing in the way were militant union locals and rank-and-file activists who rely on their unions to defend them at work.

Applying the most disgusting tactics, bureaucrats used members’ dues to finance an attack on any local and any militant who fought for democratic control of their union.

The many were sacrificed to benefit the few. This is the social dynamic of capitalism – a word that does not appear in Early’s book, but is key to any real understanding.

During the Cold War, capitalism severed the link between the cause of labor and the fight for socialism. This link has never been rebuilt, and this explains the sorry state of the US labor movement today.

The tradition of socialism as democratic working-class control was rediscovered too late in the 1960s. When capital launched its war against the working class, the revolutionary left was too small and inexperienced to counter it. With the unions in retreat and the working-class demoralized, the left split.

One segment of the left, to which Early belongs, “went into unions to change the balance of power between labor and capital by first changing power relationships within unions themselves.” (p.16)

The other segment worked to build a base on college campuses in the hope of being able to inject revolutionary politics back into the labor movement when it rose again.

How successful were these strategies?

From the abundance of evidence in Early’s book, we can conclude that the dedication, hard work and personal sacrifice of union activists is an insufficient social force, on its own, to counter the combined power of the capitalist class and the union bureaucracy. Labor militants need the political support of a revolutionary socialist movement.

Sadly, but inevitably, socialist organizations that built a base on campuses became dominated by middle-class academics and professionals who offer abstract, not real, leadership. And they continue to wait for the labor movement to revive.

We can be certain that capital will continue to assault labor, and workers will continue to defend their rights. Whether workers prevail will depend on the extent to which they develop socialist consciousness and socialist organization. When the working class is on the ascendance, this can happen spontaneously. When the class is on the defensive, workers need the intervention of socialists to show them what they are capable of achieving.

Our most urgent task is to reconnect the labor movement with the socialist tradition. For this to happen, labor activists need socialist politics and socialist organizations must reconstitute themselves to place those who lead in the workplace in the leadership of the organization.

Instead of using his knowledge and experience to rebuild the vital link between the cause of labor and the struggle for socialism, Early attacks it. In the final chapter, he promotes the most vulgar anti-Marxism, equating the victory of the workers’ state in Russia under Lenin with its crushing defeat under Stalin.

Like other books that address the state of US labor (Solidarity Divided, Labor in Trouble and Transition), Civil Wars rejects a political solution to the class war in favor of reforming ‘the house of labor.’ As Early documents so well, this strategy has failed in the past. And it will continue to fail because political problems cannot be solved by economic means.

Unions are organizations of economic defense. No matter how well they work together (and their jurisdictional divisions prevent this) unions cannot lead the class because they must represent every worker in the bargaining unit, regardless of those workers’ political views. And capitalism is highly effective in convincing workers to adopt political views that conflict with their class interests.

The two key lessons that flow from Early’s book are ones that he ignores.

The working class must organize separately from other classes, especially from the middle-class union bureaucrats and the middle-class professionals who dominate the social movements. Only by organizing separately can the working class become strong enough to make tactical alliances with other classes.

The working class needs its own independent political party, a revolutionary socialist organization that is dedicated to winning the class war against capital by bringing the working class to power.

In the Realm of Hungry Ghosts: Close Encounters with Addiction
By Gabor Maté, MD (2008)

As in his two previous books, Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder (1999) and When the Body Says No: The Cost of Hidden Stress (2003), Maté situates human suffering in a social context, inviting a political discussion of how social relations affect human health.

Scattered Minds locates symptoms of ADD in the social neglect of children’s needs and concludes, “What begins as a problem of society and human development has become almost exclusively defined as a medical ailment.”

When the Body Says No indicts “industrialized society along the capitalist model” as a source of toxic stress that “escalates as the sense of control diminishes” and causes physical and mental breakdown.

In the Realm of Hungry Ghosts condemns society for depriving human beings of what they need to thrive and then persecuting and punishing them for using drugs to relieve their pain.

All three books are well-written, engaging and brilliantly expose the fake science that pushes a pill for every ill.
Personal solutions?

While Maté situates human distress in the social realm, he seeks solutions in the personal realm.

In When the Body Says No the author concludes,

“In numerous studies of cancer, the most consistent identified risk factor is the inability to express emotion, particularly the feelings associated with anger.” (p.99)

Maté ignores industrial pollution as a cause of cancer and promotes the myth of “the cancer personality” – people who are more likely to get cancer because they repress their emotions, ignore their needs and put others first.

Even if there was evidence to back this myth (which there is not), these characteristics are not individual failings, but behaviors that society demands of all women and that employers demand of all workers.

In Hungry Ghosts, Maté questions why the war on drugs and drug addicts continues despite its total ineffectiveness and considerable harm. He avoids the logical conclusion that this war is not about drugs; it is the means by which the ruling class very effectively justifies its repressive military-prison system.

In all of his books, Maté questions why policy makers consistently ignore the research linking child deprivation and social stress with medical and social problems. He can’t answer this question until he acknowledges the impact of class conflict; the ruling class can accumulate capital only by sacrificing the needs of the working class.

Maté’s books are commercially successful because they tap into popular awareness of social problems while avoiding the uncomfortable conclusion that social revolution is required to solve them.

The result is a liberal version of blaming the victim – society cannot be changed, so the individual must change. This regressive message is more insidious because it is hidden behind a progressive cover.

I recommend these books for the wealth of facts within them. But draw your own conclusions about the solutions we need.

Madness is best understood in relation to its social, political and economic contexts rather than the medical model of ‘mental illness.’ (p.1)

With this opening salvo, author Stephen Harper expertly challenges common assumptions about mental distress and how it is portrayed in the media.

Madness, Power and the Media situates mental distress in a historical context,

“Designating mental illness as a punishable abdication of God-given reason, the Christian Bible can be seen as the earliest ‘media text’ to stigmatize mental illness.” (p.2)

As Foucault observed, while ‘mad behavior’ has been documented for centuries, the ‘mad person’ was created by the 19th century practice of incarcerating those displaying such behavior. Harper concludes, “psychiatry constituted a powerful means of ideological and physical containment” (p.5).

As early as the 14th Century, psychiatric labels were used to discredit social revolt.

“The Peasants’ Revolt of 1381, for example, was described within official discourse as an outbreak of diabolical madness which threatened to overturn the supposedly natural and divinely ordained feudal hierarchy.” (p.2)

Psychiatric diagnoses continue to be used to persecute and incarcerate social and political rebels (i.e., the 1930s eugenics purges in the US, the UK and Nazi Germany and the designation of homosexuality as a mental disorder in the 1970s).

Alongside the religious condemnation of madness, there also developed a secular image of the hero, driven mad by suffering, who rebels against an oppressive social order. As a result, the media not only equates madness with violence, but also with genius and understandable responses to oppression or persecution (Pi).

The media can both villainize and romanticize mental illness.

…by embracing a sense of victimhood and vulnerability, Western culture has succumbed to an infantilising celebration of mental fragility, a development which undermines the capacity of human subjects to take control of their lives or to engage in political activity. (p.7)

Harper cites television series (Profit) and movies (American Psycho) to show how the media sometimes uses individual madness to illustrate the insanity of the capitalist system. These media

“… feature conscience-free anti-heroes who epitomize the values of corporate capitalism and who are nonetheless – or perhaps therefore – merciless killers.” (p.6)

While the State raises the spectre of the ‘mad rebel,’ the pharmaceutical industry prefers to portray mental illness sympathetically, and the mentally ill as victims, in order to expand the market for its remedies.

Madness, Power and the Media is unique among the many books that address these issues, because it

…attempts not simply to applaud or condemn media and film images of madness as ‘positive’ or ‘ negative’ from the inevitably narrow perspective of medical discourse, but to also understand how these images can underline or reinforce the unequal relations of class, race and gender which characterize contemporary capitalist societies. (p.7)

Harper emphasizes that the media portray mental distress differently depending on the race, gender and social class of the sufferer, and these portrayals reinforce class, race and gender oppressions.

Madness in men and upper-class individuals tends to be portrayed as more heroic and creative (Shine) than madness in women, which is shown as more tragic and irrational (The Hours) and madness in working-class individuals, who are typically portrayed as social rejects and deranged killers.

With the odd exception (The Soloist), non-white characters rarely appear as protagonists on television and in films that feature mental distress, even though visible minorities are disproportionately represented in psychiatric institutions.

I especially appreciated the way that Harper challenges both the media portrayal of the mentally ill as more violent (which has no social context) and those who protest that they are not violent (which also ignores social context).

There is… a clear link between violence and poverty…[P]eople suffering with mental distress often belong to a lower social class than those who do not; their higher rates of violent behaviour might therefore be explained in terms of their frustration or anger at their lack of social power… Understanding violence as a response to social coercion is strategically useful, dislodging the stigmatizing notion of violence as an individual act of evil. (p.46)

Harper contrasts the violence of the mentally ill individual with the systemic violence perpetrated by politicians (war, imprisonment, unemployment, strike-breaking, poverty, etc.). While these ‘pillars of society’ are considered sane, they are far more dangerous to society. He concludes that violence can be both oppressive and liberatory, depending on which social class is wielding it and for what purpose.

On reading this book, one is struck by the extent to which mental distress is featured in film, television and print media and the different ways that it is portrayed – as comedic, tragic, heroic, criminal, vulnerable, violent, admirable, despicable, endearing and threatening.

When it comes to treating mental distress, the media universally promote individual solutions and the personal cultivation of happiness while excluding any discussion of social change.

Harper provides a detailed and informative discussion of how men’s and women’s magazines handle mental distress differently, while both obscure the social sources of distress.

As a Marxist, Harper views mental distress as a reasonable response to social inequality, insecurity and alienation, and he questions how psychological equilibrium can be achieved in a context of unequal social relations. He identifies capitalism, rather than neoliberalism, as the problem and argues,

“…for the suppression rather than the reform of capitalism; alienation and poverty are structural features of capitalism itself rather than the side-effects of any particular phase of its development.” (p.198)

Madness, Power and the Media is rich in detailed, thought-provoking analysis. Harper has done an excellent job of organizing a huge amount of material into a comprehensive social context that is both sensitive and astute.

The biggest problem with this book is its academic language and price ($68) which limit its readership. This is unfortunate, because the ideas contained in Madness, Power and the Media should be broadly discussed among working-class readers who can solve the problems it identifies.

The corporate class stole its trillions from us, by exploiting workers at home and abroad – paying us less than our labor is worth – and by laying off workers and squeezing the rest to work a lot harder for much less.

They also steal from our children.

Exploitation and deprivation cause parents to be distressed, depressed, angry, anxious and overwhelmed. An estimated 15 million American children (one in five) live with an adult who suffered a major depression in the previous year. Children respond to parental distress with symptoms and behaviors. The greater the parent’s distress, the greater the child’s distress.

Instead of using some of the corporate treasury to invest in families, distressed children are being labeled with mental disorders and drugged into submission. These children are being robbed of their health and the hope of any real improvement in their lives.

For several decades, researchers like Peter and Ginger Breggin have documented the shocking extent to which American children are being drugged with stimulants and anti-depressants.

Now, thanks to the power of drug-company marketing, distressed children are being drugged with powerful anti-psychotics. In adults, these toxic compounds increase the risk of stroke, cardiovascular disease, obesity, diabetes, suicide, seizures, infection, kidney failure, nervous-system damage and sudden death. The effects on children are unknown.

Last September, an FDA report found that the number of anti-psychotic prescriptions dispensed to children (0-17 years) had risen 22 percent over the previous five years.

The FDA examined six anti-psychotic drugs: Seroquel® (quetiapine); Zyprexa® (olanzapine); Risperdal® (risperidone); Abilify® (aripiprazole); Geodon® (ziprasidone); and Invega® (paliperidone).

In 2008, of the 32 million prescriptions dispensed for these drugs, 4.8 million were dispensed to children (15 percent of the total).

That same year, one million individual children were prescribed these anti-psychotics (19 percent of the total of 5.5 million individuals). Here are the numbers, by age group:

1,770 children aged 0-2
64,664 children aged 3-6
414,451 children aged 7-12
540,760 children aged 13-17

Diagnoses applied to the infants and toddlers (aged 0-2) included: Attention Deficit Disorder; Mental/Behavior Problems, Behavioral
Problems; Other Emotional Disturbances, and Residual Schizophrenia, a diagnosis that can be made on the basis of “odd beliefs and unusual perceptual experiences.”

A more accurate diagnosis for these children’s symptoms and behaviors would be “Parental Distress due to Heartless Social Policies.”   A recent report from the Urban Institute found that 7 percent of all 9-month-old infants live with severely depressed mothers, and 41 percent of 9-month-old infants live with mothers who suffer some form of depression. These rates are higher among mothers living in poverty, who are also more likely to suffer domestic violence.

Only a sick social system would enrich the few by stealing the present lives and future hopes of the many.

The average Ontario welfare recipient gets $500 per month. The special dietary allowance program provided extra benefits of up to $250 per month to enable those with medical conditions to purchase more healthful food. An estimated 20 percent of people on social assistance rely on these extra benefits.

Wong, who specializes in occupation and community medicine, admits to completing about 15,000 special dietary allowance forms in one year. He not only signed forms for his own patients, he also signed them for people attending mass clinics arranged by anti-poverty activists.

Between 2001/02 and 2009/10, the cost of funding the special dietary allowance program rose from $6 million to $220 million. Claiming that the program was being “abused,” the province scrapped it and directed the police to investigate 2,300 recipients of this benefit.

Conservative city councilor Robert Ford, who is running for mayor of Toronto in October, filed a complaint against Wong with the College of Physicians and Surgeons of Ontario. The College must now investigate whether Wong engaged in conduct that “would reasonably be regarded by members as disgraceful, dishonorable or unprofessional.”

Ford insists, “A doctor is there to be a doctor, not to advocate for the poor…You can’t have people in the medical field doing that.”

Wong views the complaint against him as politically-motivated harassment and refuses to be intimidated. At an April 6 public meeting and a July rally he protested government policies that promote homelessness, starvation, sickness and premature death in the richest province in Canada.

“Income level is the best predictor of health,” he said. “We have to invest in human resources – they are not to be wasted.”

Wong points out that cuts to social assistance in the mid-1990s saved the province $2 billion dollars, while the special dietary allowance restores only 10 percent of what was lost.

With regard to the charges against him, he stated, “I don’t know what will happen. But whatever happens to me, I will be happy because I’ve done something useful.”

Roland Wong embodies the spirit in which all physicians should practice medicine.

Watch the 15 minute video of Wong’s April 6 presentation.

This problem is attributed to a fragmented, profit-oriented medical system that denies millions of people access to care.¹ While a national medical plan that covers everyone is desperately needed, improving the general health of the population requires more fundamental change.

Studies show that social inequality affects the health of populations more than any other factor – more than diet, smoking, exercise, and even more than access to medical care.²

Americans suffer the worst health statistics in the industrialized world because they live in the most unequal society in the industrialized world.

Poor health and lack of access to medical care are both symptoms of social inequality. In 1970 the wealthiest 0.1 percent of Americans took in 100 times the average annual income. By 2001, they were taking 560 times the average annual income. In 1980, U.S. life expectancy ranked 14th in the world. By 2007, it ranked 29th.

Inequality is built into and generated by the capitalist system. Capital is created when employers pay workers less than the value of the goods and services they produce. The resulting profit, or capital, is used to extract more capital. As this process repeats over time, capital accumulates at the top of society and misery accumulates at the bottom.

The strategy of divide-and-rule generates even more inequality: between men and women; White and Black; national and foreign-born; straight and gay; etc.

As social inequality grows, the health of the entire population suffers, not just those on the bottom.³

Inequality Kills

A study of 282 metropolitan areas in the U.S. found that the greater the difference in income, the more the death rate rose for all income levels, not just for the poor.

Researchers calculated that if income inequality could be reduced to the lowest level found in the United States, it would save as many lives as would be saved by eradicating heart disease or by preventing all deaths from lung cancer, diabetes, motor vehicle crashes, HIV infection, suicide and homicide combined!⁴ We would see even greater benefits if we eliminated social inequality entirely.

Consider the lives that would be saved just by ending racial inequality.

Without racism, death rates for Black and White Americans would be the same. Yet, every year, Black Americans suffer 300 more deaths per 100,000 people than White Americans. Compare these 300 additional deaths with the 2005 U.S. homicide rate of fewer than 6 per 100,000. Do the math. Racism kills 50 times more people than die at the hands of individual murderers.

Inequality kills kids. Forty-two nations have lower infant death rates than the U.S. The infant death rate in the capital of the U.S. is more than double the infant death rate in the capital of China. In 25 nations, people live longer, on average, than they do in America.

Inequality is so destructive that it can even counter the benefit of higher incomes. Studies show that poorer people living in more equal nations tend to be healthier and live longer than more-affluent people living in more unequal nations. For example, middle-income people in Britain enjoy better health than wealthier Americans.⁵

Men living in Bangladesh, one of the world’s poorest countries, are more likely to reach age 65 than Black American men living in Harlem. Harlem men have higher incomes than Bangladeshi men but live in a more unequal society. Black Americans tend to die prematurely from cardiovascular and other diseases that are linked with class and race inequality.⁶

How does inequality do so much damage?

Power = Health

A study of the highly-stratified British civil service found that health deteriorated as social status fell. This decline in health could not be explained by smoking, exercise or body weight.⁷ Income is not the factor, because professionals who earn less than non-professionals still enjoy better health.⁸

The answer lay in the surprising finding that those near the top of the power structure had worse health than those at the top, even though their life-styles were essentially the same.⁷ The only difference that could account for this is social power.

People with more control over their lives enjoy better health. Bosses live the longest, healthiest lives because they have the most power. As power diminishes, stress rises and health deteriorates. This relationship between social status and health has been found in every nation studied, including the United States.⁹

A 2008 study found widening differences in health between income levels in America. (Income level is often used to measure social status.) The nation’s poorest adults were nearly five times more likely to be in “poor or fair” health than the richest, and at every income level the wealthier group was healthier than the next lower one. This trend was seen in all racial groups.¹⁰ Michael Marmot, who studies the link between social status and health, explains,

Your position in the hierarchy very much relates to how much control you have over your life…Sustained, chronic and long-term stress is linked to low control over life circumstances.¹¹

Under capitalism, only a few people get to make the important decisions. The rest of us get no say over how work will be organized and how social resources will be used. We don’t get to decide if we will build more schools or more prisons, wage war or make peace.

Exclusion from decision-making is strongly linked with cardiovascular disease,¹² and the more powerless a person feels, the faster the disease progresses.¹³ Oppressed sections of the working-class suffer the highest rates of cardiovascular disease,¹⁴ because they have the least social control.

People with little control over demanding jobs are more likely to be overweight and have high cholesterol regardless of age, amount of exercise and smoking habits. By itself, hard work is not bad for your health unless there is also a lack of control. The most health-damaging jobs saddle workers with great responsibility (e.g. caring for patients) while denying them the resources required to meet those responsibilities (enough time to do what is needed).¹⁵

In Unhealthy Societies: The Afflictions of Inequality, Richard Wilkinson links inequality with health-damaging stress. Children show rising levels of stress hormones as their social position falls.¹⁶ Nurses who work under “unfair and unreasonable” bosses have higher blood pressure.¹⁷ Simply speaking with someone with higher social status will raise your blood pressure.¹⁸ The greatest damage is done to those who are put down and ordered around their entire lives.

Stress triggers a higher heart rate, a release of adrenaline, glucose and other neurological responses to help the body respond to a short-term threat. But when extended over long periods of time, they can harm the cardiovascular and immune systems, making individuals more vulnerable to a wide range of conditions including infections, diabetes, high blood pressure, heart attack, stroke, asthma and aggression.¹¹

Solidarity is the Best Medicine

Human survival has always depended on the cooperation that flows from strong social bonds. People who pull together enjoy better health and longer lives.¹⁹ Strong social ties may explain why Hispanic Americans have lower rates of chronic illness than White Americans, despite having lower incomes.²⁰

Human beings cannot be healthy in class-divided societies. From birth to death, capitalism ranks people on a vertical scale, with those higher up being treated as more worthy than those lower down. The unequal relationship between bosses and workers is maintained by divide-and-rule policies that generate more inequality based on sex, skin color, religion, nationality, etc. These divisions rupture social bonds and generate sickness throughout the population.

Universal access to medical care would reduce some of this inequality. However, even the best medical system cannot eliminate the health-damaging effects of poverty, social discrimination, unsafe work, bad housing, poor schools and being denied the right to make decisions that affect our lives. To end these miseries, we must eliminate class divisions and all the other inequalities that follow.

Human sickness is a product of sick social relationships, and human health is a product of healthy social relationships. Replacing class divisions with a cooperative, socialist society would reduce the burden of disease and raise the level of health more than any other measure.

1. Hadley, J. (2002). Sicker and poorer: The consequences of being uninsured. Kaiser Family Foundation.
2. Wilkinson, R.G. (1992). National mortality rates: the impact of inequality? Am J Public Health, Vol 82:8, p. 1082-1084. See also, PBS (2008). Unnatural Causes: Is Inequality Making Us Sick?
3. Rosenthal, S. (2006). POWER and powerlessness, Chapter 11, “Divide and Rule.”
4. Lynch, J.W. et. al. (1998). Income inequality and mortality in metropolitan areas of the United States. Am J Public Health Vol. 88, p. 1074-1080.
5. Quoted in Bowe, C. (2008). U.S. society helping to make people sicker. The Financial Times Limited, February 29.
6. McCord C, Freeman H.P. (1990). Excess mortality in Harlem. New England Journal of Medicine Vol. 322, p. 173-7.
7. DHSS (1980). Inequalities in health: Report of a research working group. Middlesex: U.K. Author.
8. Cited in Schmidt. J. (2000). Disciplined minds: A critical look at salaried professionals and the soul-battering system that shapes their lives. Rowman & Littlefield, p. 103-104.
9. A discussion of American studies linking class and heath can be found in Schmidt. J. (2000). Disciplined minds: A critical look at salaried professionals and the soul-battering system that shapes their lives. Rowman & Littlefield, p. 103-104.
10. Robert Wood Johnson Foundation. (2008). Overcoming Obstacles to Health.
11. Cohen, P. (2004). Forget lonely. Life is healthy at the top. New York Times, May 15.
12. Raphael, D. (2001), Inequality is bad for our hearts: Why low income and social exclusion are major causes of heart disease in Canada, North York Heart Health Network, Toronto, Canada.
13. Everson S, et. al. (1997). Hopelessness and 4-year progression of carotid atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 17:8, p.1490-5.
14. Raphael, D. (2002). Poor choice or no choice?: Even more evidence links low income with disease so why keep blaming lifestyle choices like fries? Toronto Star, October 11, p. F6.
15. Kivimääki, M., et. al. (2002). Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ October 19. Vol. 325, p. 857.
16. Lupien S.J. et al. (2000). Child’s stress hormone levels correlate with mother’s socioeco­nomic status and depressive state. Biol Psychiatry Nov 15. Vol. 48, p. 976-80.
17. CBC. (2003). Bad bosses bring blood pressure to boil: Study. June 24.
18. Long, J.M, et. al. (1982). The effect of status on blood pressure during verbal communication. Journal of Behavioral Medicine Vol.5, p. 165-71
19. Cacioppo, J.T. et al. (2002). Loneliness and health: Potential mechanisms. Psychosom Med May/June, Vol. 64, p. 407-17. Also, House, J.S. et. al. (1988). Social relationships and health. Science, Vol. 24, p. 540-545.
20. Cited in Cohen, P. (2004). Forget lonely. Life is healthy at the top. New York Times, May 15.

This outrage did not occur in the United States, but in Canada.¹ Under capitalism, all nations limit access to medical care, and Canada is no exception.

Why Ration Medical Care?

Most people believe that medical care is a human right, and everyone should have access to the care they need.

However, when profits matter more than human rights, medical care is rationed. People get only what they can pay for, or what employers, insurance companies and governments decide to give them.

The only way to provide medical care as a human right is to provide universal access.

Universal access should not be confused with improved access. Universal access means no rationing, so that the CEO, the factory worker and the homeless addict would all receive the best medical care that society can provide.

Politicians who talk about universal access to medical care don’t mean equal access, they mean that everyone should have some access or more access.

One cannot eliminate class divisions in medicine without also eliminating them in society, so capitalism keeps universal access off the agenda. We are not allowed to question whether medical care (or any essential service) should be rationed by class. We can dispute only the form and extent of this rationing.

Opposition to universal medical care is not only political, it is also financial. While productivity and profits are linked to the health of the workforce, employers don’t want to pay taxes to provide for medical services. And some capitalists reap huge profits from privatized medicine.

The ruling class shows no interest in what is medically preferable — universal access with an emphasis on illness prevention and social health. Its priority is to cut costs, maintain profit-making opportunities and keep the working class under control.

These concerns are addressed by a class-based, treatment-oriented medical system, where the rich have access to the best services, the middle class and skilled workers have limited access through pooled insurance programs, and the poor are provided with a bare-bones basket of government-funded services. This is the standard formula for medical systems under capitalism, with different nations displaying variations on this basic model.

While the debate to reform American medicine emphasizes the differences between the Canadian and American medical systems, both nations are deeply divided by class, and their medical systems reflect those divisions.

In the US, medical rationing is based on ability to pay. The resulting inequality is up-front and obvious. Canada rations medical care by under-funding the public health care system, bringing inequality through the back door.

US Rationing

All Americans can access medical services — if they can pay for them. Most can’t.

Sixty percent of the US workforce make less than $15 an hour. In 2005, the average annual insurance premium for a family of four ($10,880) cost more than the annual income of a full-time minimum-wage worker ($10,712), before deductibles, co-payments and the cost of non-insured treatments.²

Currently, 47 million Americans have no medical insurance. Those who have insurance can’t count on getting the care they need because insurance companies refuse to cover many conditions and set limits on how much they will pay. Whenever possible, they deny payment, forcing people to go without or pay out of pocket, making medical bills a prime source of bankruptcy.

In America’s free-market system, access to medical care is based on the ability to pay, and the working class is free to go without.

Canadian Rationing

Canada has established medical care as a legal right. In reality, the medical system is too poorly funded to provide comprehensive services to all, so some people are excluded altogether, and access is limited for everyone else.

To reduce the cost of medical programs, each province sets conditions on who qualifies for coverage. To obtain Ontario health insurance (OHIP), one must:

* be a Canadian citizen or a documented immigrant

* be a permanent resident of Ontario

* be physically present in the province for 153 days in any 12-month period

Visitors, transients, undocumented immigrants, and refugees without status are not covered.

As a final obstacle, a three-month waiting period is imposed before coverage begins. The Ontario government web site “strongly encourages new and returning residents to purchase private health insurance in case you become ill during the OHIP waiting period.”

In Canada, as in the US, the capitalist class exerts constant pressure to reduce government-funded social services. Bureaucrats are employed to measure “cost-efficiency” and achieve “cost-containment” by reducing the number of services provided, forcing health workers to do more for less and outsourcing to the private sector.

To keep costs down, medical school enrollment has been restricted to the point that Canada needs 26,000 more doctors just to meet the OECD average number of physicians-per-population.

Under-funding forces patients to wait for assessment and treatment, and half of Canadians report waiting longer than they consider reasonable.³ The seriousness of this problem is hotly debated on both sides of the border.

Advocates of privatized health care emphasize how long Canadians wait in order to discredit all government-funded systems, even though millions of Americans with no insurance essentially wait forever. In contrast, defenders of medicare minimize the problem of wait times, making it harder to fight for more funding for the system.

When people have to wait for essential services, those with money and connections find a way to get to the front of the line or to bypass it altogether. The longer the line, the more inequality grows, and the more pressure there is to develop private-sector alternatives.

Comparing the US and Canada

In Canada, 13 provinces and territories administer medical care, resulting in 13 different payers with limited transferability between them. There is also a market of competing private companies that provide workplace, group and individual insurance to cover medical services not funded by the provincial plans.

In the United States, government is the largest single provider of medical funding. About 100 million Americans (one in three) receive medical care through government-funded programs like Medicaid, Medicare, the military and government employee health benefits.

The basic difference between the Canadian and US medical systems is the proportion of government funding to private funding. In Canada, government pays 70 percent of medical costs, while individuals and private insurance companies pay the rest. In the United States, this proportion is reversed.

Government-funded medical systems offer two important advantages: the cost of medical care is socially shared, so that individuals aren’t crippled by medical expenses; and medical benefits are removed from the employers’ control, so that workers can change jobs without fear of losing access to care.

These advantages diminish when governments under-fund the medical system, forcing people to pay for their own care or rely on workplace medical benefits.

Because most Americans want a government-funded universal medical system, they could benefit from learning how Canadian medicare was won, and how it is now being lost.

The Fight for Canadian Medicare

Until the 1960’s both the American and Canadian medical systems were dominated by the private sector. Charitable organizations provided minimal care for the poor. Regular medical care was reserved for those who could pay and for those whose employers would pay for them.

Like their American counterparts, Canadian physicians and insurance companies vigorously opposed any reforms that smacked of “state medicine” or “socialism.” Neither business nor government supported access to medical care as a human right.

During the 1960s, popular pressure grew for universal health care. To contain demand, the federal government launched a Royal Commission to “study” the problem. The Canadian Labour Congress (CLC) made its preference clear:

We favor a system of public health care that will be universal in application and comprehensive in coverage. We favor a system that will present no economic barrier between the service and those who need it. We are opposed to any provision which will require some people to submit themselves to a means test in order to obtain service. We look to a system of health care that will be regarded as a public service and not as an insurance mechanism.⁴

Despite the grass-roots demand for socialized medicine, where the State is both payer and provider, the Medical Care Insurance Act of 1966 established socialized insurance, a publicly-financed, private enterprise system “free of government control or domination.” It took five more years to implement the Act in all provinces.

In the province of Quebec, union demands peaked in the 1972 general strike. In response, Quebec incorporated medical services into a broad social benefits system, paid for and provided by the provincial government.

The Quebec working class is rarely credited for winning the most comprehensive socialized medical system in North America.

Rolling Back the Gains

The initial funding agreement for medicare was 50-50, with federal and provincial governments sharing the cost. In 1977, the federal government created a more complex system for transferring payments to the provinces and dropped its share of medical funding to 20 percent.

As federal funds diminished, the provinces were forced to pay more. The result was round after round of cuts to hospital budgets and other medical services. Because the provinces varied widely in their ability to pay for medical programs, the principle of equal access was eroded.

Medical care was still free, but there was less of it available. Private insurers rushed into the breach created by under-funding. The more services were cut from the medicare basket, the more individuals had to purchase insurance, pay out of pocket or go without.

In 1984, the federal government passed the Canada Health Act to reassure nervous Canadians that medicare was safe. Universal access to medical services was guaranteed on paper, but no funds were provided to implement the principle. Behind the scenes, politicians were preparing the ground for privatized health care.

In 1994, the Ontario government stated,

To have the effective launching pad it needs, the health industries sector must expand its share of its own home market. Steps must be taken to ensure that, as in other countries, the domestic market supports the development of globally competitive companies.⁵

One of these steps was to scrap regulations that ensured a minimum level of daily care for patients in nursing homes.

In 1997, the federal government declared,

Promoting Canadian companies as global health-keepers is the main objective driving the strategies and plans of the government for the medical devices, pharmaceutical and health-services sector.⁶

Behind the mask of health-care “reform” and “restructuring,” the Canadian medical system is being handed, piece-by-piece, to private industry in a manner similar to the dismantling of Britain’s National Health Service.⁷

Publicly-provided medical care is under-funded to the point of crisis, then condemned for its inadequacies. The private sector is proclaimed the only possible savior, and opponents are ridiculed as old-fashioned and sentimental. When the market fails to deliver, the public is told to adapt to “the new reality.”

Canadian medicare is currently so under-funded that, in 2004, Canada’s Supreme Court declared, “The Canada Health Act [does] not promise that any Canadian will receive funding for all medically required treatment.”

The CUPE Hospital Strike

The strongest opposition to the attack on medicare has come from unionized health workers. As operating costs rose and budgets fell, Canadian hospitals became a battleground. In every province, hospital workers fought cuts to staff and programs and out-sourcing of services to for-profit, non-union corporations.

In 1981, the Canadian Union of Public Employees (CUPE) struck the Ontario Hospital Association. At one hospital, workers locked out management and continued working under their own elected committee. For seven days, 13,000 strikers defied provincial back-to-work legislation, the jailing of top union officials and the firing of key strike leaders.

When management refused to budge, the next logical step would have been to mobilize the other sections of CUPE for an all-out public-sector strike. Unwilling to take that step, union officials caved.

The defeat was substantial. Most small, local hospitals were closed. The remaining hospitals were merged into giant conglomerates managed by business consultants.

Privatization has decimated Canadian medicare. Tens of thousands of hospital nursing jobs have disappeared at the same time that hospital stays have been cut, so that fewer nurses care for much sicker patients. Deadly, infectious diseases sweep through hospitals that no longer have enough cleaning staff.⁸

Most rehabilitation and chronic-care facilities have closed or gone private, transferring the burden of caring for the sick, injured and frail to their families.

Hospital out-patient clinics have closed, and discharged hospital patients are now directed to family doctors for follow-up. But there are not enough doctors to meet the demand.

By 2006, fewer than 10 percent of Ontario family doctors were accepting new patients. Currently, five million Canadians (one in six) have no family doctor. Patients can wait weeks to see a doctor, months to see a specialist and many more months for treatment.

Funding cuts have severely damaged Quebec’s model medical system. In 2005, Canada’s Supreme Court ruled that lack of timely access to treatment in Quebec was so serious that the province could no longer prohibit private funding for medically necessary services. Similar legal challenges are expected in the other provinces.

The Canadian experience proves that government-funded medical systems don’t guarantee timely access to needed medical services. Ironically, while many Americans long for a Canadian-style medical system, that system is disintegrating under the pressure of market forces.

We Need a Fighting Labor Movement

Hundreds of American labor organizations have endorsed HR 676 — The United States National Health Insurance Act to establish a national insurance system. However, endorsements alone will not be enough to defeat a powerful medical insurance industry, overcome resistance to increased State funding and counter the right-wing campaign against “entitlements.”

The people at the top of society believe that medical services should be rationed on the basis of class, and they raise the highest stink when anyone suggests that they share access with everyone else. They don’t want any restrictions placed on their access to “Rolls Royce” medicine, and they will fight tooth and claw to keep their class privileges. If you have any doubt of that, read What Happened in Chile: An Analysis of the Health Sector Before, During, and After Allende’s Administration.

If allowed to vote on the matter, most Americans would choose a universal health care system.⁹ Because we will never get to vote on it, we must build a mass movement that is large enough and determined enough to win it.

The extent of medical rationing that exists at any point in time in any nation is determined by the balance of class forces. Too little rationing generates a sense of mass entitlement (or equality) that can be difficult to contain. Too much rationing generates class anger that can also be difficult to contain.

It took a revolution in France to scare Germany into establishing Europe’s first national medical plan in 1883. In Britain, the National Insurance Act of 1911 was rushed through Parliament during a strike wave. And Canadian medicare was consolidated in 1972, the year of the Quebec General Strike.

The US is the only industrialized country without a national medical plan, because the American labor movement has been too weak to win it.

During the crisis of the 1930s, President Roosevelt conceded the New Deal, but excluded national medicare. To quell the protests of the 1960s, President Johnson conceded Medicare and Medicaid, but held the line on universal coverage.

American workers continue to be divided by race and dominated by union bureaucrats who collaborate with management. As a result, working and living conditions for most Americans continue to deteriorate, along with their health and their access to medical care.

We need to build a new labor movement that will fight for comprehensive, universal medicare. The trillions of dollars being spent to impose US control over the Middle East would more than cover the cost of a top-notch national medical system.

We need a fighting labor movement that pays more than lip-service to the principle of “an injury to one is an injury to all” and actively supports health workers who are fighting for higher staff-to-patient ratios, lower work loads and the right to blow the whistle on deficient and dangerous patient-care conditions.

Every day, the world becomes a sicker place. And every day, the gap grows between what people need and what capitalism is willing to provide.

Our challenge is to build a labor-based, mass movement that will reject medical rationing, fight for universal medical care and keep on fighting to end all class inequality.

1. Cited in Lepage-Monette, A., “Programs that work: Ensuring health care for the uninsured,” Medical Post, Toronto, March 4, 2008, p.6.
2. Colliver, V., “Health plans dwindle in U.S.: Number of firms offering insurance drops as costs rise,” San Francisco Chronicle, September 15, 2005, p.C-1.
3. The mortality risk for those who waited longer for hip surgery was 22 percent higher than for those treated within two days of admission to hospital. The Canadian Institute for Health Information. Health Indicators, 2007.
4. Cited in Fuller, C. (1998). Caring for profit: How corporations are taking over Canada’s health care system. Ottawa: Canadian Centre for Policy Alternatives.
5. “Healthy and Wealthy, A Growth Prescription for Ontario’s Health Industries.” Report of the Health Industries Advisory Committee to the Ontario Ministry of Health, March 1994.
6. National Sector Team: Health Industries, “Canadian International Business Strategies – ‘97-’98,” Report for Industry Canada, March 20, 1997.
7. Pollock, A.M. (2004) NHS plc: The privatization of our health care. New York, NY: Verso.
8. Valiquette, L. et. al. (2004). Clostridium difficile infection in hospitals: a brewing storm. CMAJ, July 6, Vol.171, No.1.
9. On November 3, 1998, Illinois residents voted on the “Bernardin Amendment for Universal Health Care” which states, “Health care is an essential safeguard of human life and dignity, and there is an obligation for the State of Illinois to ensure that every citizen is able to realize this fundamental right. On or before May 31, 2002, the General Assembly by law shall enact a plan for universal health care coverage that permits everyone in Illinois to obtain decent health care on a regular basis.” Eighty-three percent of voters in Cook County and 71 percent in the downstate/suburban areas endorsed it. The vote was not binding.

In Solidarity Divided: The Crisis in Organized Labor and a New Path Toward Social Justice,¹ Bill Fletcher, Jr. and Fernando Gapasin insist that we need new answers to these questions if we hope to reverse “the crisis facing organized labor – indeed the crisis facing the entire US working class.” This crisis is marked by declining unionization, inter-union conflict, falling living standards, rising unemployment, growing poverty and deepening oppression.

Solidarity Divided is essential reading. For a summary of the contents, I recommend Immanuel Ness’ thoughtful review.² I will address the strategic questions that Fletcher and Gapasin raise because they are so important to our organizing efforts.

What is the purpose of a union?

Since Samuel Gompers took the Presidency of the American Federation of Labor (AFL) in 1886, the official answer to the question of what is the purpose of a union has been to promote the economic interests of those fortunate enough to be union members.(15) Fletcher and Gapasin argue that this narrow focus on economic self-interest (economic unionism) has been a colossal failure for unions and for the working class as a whole.

Unions are the most organized section of the working class. They could win mass support if they championed the unity, rights and standard-of-living of the entire class, that is, if they addressed social and political issues.

When unions don’t support the class, they cannot count on the class to support them. And without mass support, unions cannot prevail against an employers’ offensive that pits groups of workers against one another. Here’s a good example.

I recently heard a public radio report on a months’ long civic workers’ strike. The head of the union was interviewed first, followed by the city’s mayor (the employer).

The union leader focused on the fairness of the union’s economic demands compared with what other unionized workers in the city have won. The mayor talked about how the strike was an attack against seniors and children. He said that everyone was suffering from the recession, and city workers had no right to put their own welfare above that of others. He added that he could not meet the union’s demands without cutting public services.

The mayor presented himself as the guardian of the greater good, when the reverse is true.

The union had rejected a concession contract. It is fighting to maintain a standard of living that serves as a benchmark for other workers in the area — defending senior’s pensions and good jobs for tomorrow’s workers. However, the union did not say that it was fighting for the rights of all workers. The union did not say that it was fighting against the unreasonable demand that workers should pay for economic problems they did not create. The union did not call on everyone who is suffering from the recession to join its fight and demand that business profits be taxed to provide more good jobs through expanded public services. It said none of these things. Unlike the mayor, it steered clear of “politics.”

So, after hearing both sides, the average person would be inclined to support the mayor against the “greedy unions” who either caused the recession or are demanding more than their share.

How can union supporters convince others that unions fight for everyone, when unions themselves refuse to make this argument?

Polls show that most workers want union jobs, so there is potential for majority support for unions. However, a narrow union focus on economic self-interest does not invite mass support. On the contrary, it can generate resentment among non-union workers. By refusing to fight the political class war, unions are losing the economic battle.

To reverse this situation, Fletcher and Gapasin argue that the union movement must undergo a political transformation to become a labor movement that champions the economic and social interests of the entire working class: union and non-union, employed and unemployed, all races, genders, sexual orientations, native-born and immigrant.

How should unions respond to oppression?

Employers use racism, nationalism, sexism and homophobia to divide workers and weaken their collective power, so unions would benefit from fighting these oppressions. However, most unions go along with workplace and social divisions, and their structure reflects this – most union officials are straight White males.

When unions do address matters of oppression, these are not considered central to the union’s function. Instead, they are usually delegated to separate union departments or caucuses, so that Black members are left to fight racism, women to fight sexism, gays to fight homophobia, etc. The implication is that straight White male workers have nothing to gain from fighting oppression. The question of whether they do or not divides society, the workplace, the unions and the left.

Employers accumulate capital by paying workers less than the value of what they produce. As a result, the gap in wealth between the capitalist class and the working class keeps widening. Capitalism denies that employers exploit workers. Instead, it promotes the view that employers and workers are economic “partners.”

On the other hand, capitalism encourages the belief that sections of the population who are better off have achieved this position at the expense of those who are worse off, i.e., that men benefit from the oppression of women, Whites benefit from the oppression of Blacks, straights benefit from the oppression of gays, workers in richer nations benefit from the exploitation of workers in poorer nations, etc. This idea is widespread, but untrue.³

The belief that some workers benefit from the oppression of others causes the presumed beneficiaries of oppression to feel guilty around their oppressed co-workers who, in turn, feel resentful toward their more “privileged” brothers and sisters. This is divide-and-rule at its finest, and it benefits only the employers.⁴

I could find no reviews of this book that questioned its assertion that some workers benefit from the oppression of others. This issue must be resolved if we hope to build an effective fight against oppression. As the authors state, “[Either] oppressions such as racism and sexism become battlegrounds to unite workers in the larger challenge for power, or they become battlegrounds in the intra-class struggle over resources.” (181)

Building beyond the workplace

Solidarity Divided argues that the struggle against oppression must transcend the boundaries of workplace, union and nation.

The authors describe how the AFL-CIO and CTW union federations limited their response to Hurricane Katrina to economic support for the evacuees and for reconstruction. These unions avoided the political questions of: why the infrastructure of the area had been allowed to deteriorate due to cuts to public services; why poor Black residents were hardest hit; why federal rescue operations were so inadequate; why developers were allowed to bulldoze poor Black neighborhoods to build upscale alternatives; and so on.

Katrina provided an opportunity to challenge racism, poverty and neoliberal government policies and to help Gulf Coast residents organize themselves so they could have a say in the future of the area. But instead of providing political support, the unions offered only charity.

Similarly, unions have not fought against unemployment, for women’s reproductive rights, for affirmative action, for immigrant rights, for gay marriage, etc. At best, resolutions are passed, and money is donated.

Instead of paying lip service to social issues, the authors argue that unions should promote internal political discussion with the aim of mobilizing members to fight for the rights of the oppressed of all classes and for the working class as a whole. (168-9) This will be not be possible without challenging the widespread conviction that straight White male workers actually benefit from racism, sexism and homophobia.

How should unions relate to employers?

Fletcher and Gapasin describe how American unions embraced a social contract with employers after World War II.

The postwar social accord with capital was symbolized by the so-called Treaty of Detroit in 1950, in which Corporate America bought back managerial initiative and control of the shop floor in exchange for cost-of-living raises, employer-sponsored health care, and pension plans. The price was abandonment of class struggle against Corporate America and further bureaucratization of the union movement. Grievance and arbitration procedures replaced the right to strike. “Professional” labor-relations representatives replaced rank-and-file shop stewards as the primary representatives of the unions. (28-9)

In the early 1970s, the economy sank into recession, and Corporate America tore up its half of the social contract. By the late 1970’s, employers were on the offensive, demanding concession contracts to roll back wages and benefits. Both Republican and Democratic administrations backed the capitalist class.

In the wake of President Carter’s firing of postal workers after the 1978 wildcat strike and then the dramatic firing of the PATCO workers by President Reagan, organized labor had no sense of how to build a massive social movement that was anything more than a lobbying effort. Organized labor made excuses for its inaction rather than reflectively and self-critically acknowledging that labor’s “Pearl Harbor” had taken place and that a new form of class warfare was unfolding on the national level. (46-7)

Unions refused to accept the new reality. They continued to operate in a kind of time warp, insisting on upholding their end of a social contract that no longer existed. They accepted employers’ demands for concessions, no matter how deep, in the hope that once profitability was restored, they could regain lost ground. However, even as the economy boomed during the 1980s and 1990s, employers continued to demand concessions.

The unions cannot acknowledge this one-sided class war, because years of compromise and bureaucratization have left them totally unequipped to fight on a class basis. The authors warn, “As long as unions operate solidly within capitalism, accepting its basic rules and premises as permanent, they may be marching to their doom.” (214)

Fletcher and Gapasin disagree with the prevailing wisdom that all union problems can be solved by acquiring more members and building bigger unions. They argue that this strategy cannot succeed unless the push for growth is matched with a political strategy that acknowledges the fundamental conflict between labor and capital, challenges the supremacy of capital, and fights for working-class power.

How should unions relate to the State?

Samuel Gompers believed that the interests of American workers were linked with the interests of American corporations and the American Empire. So the AFL allied itself with US capital and the US State in their program of world domination, even though this partnership put the AFL in direct conflict with the interests of workers in America and around the world.

With the notable exception of US Labor Against the War (USLAW), most US unions continue to back US foreign policy, supporting imperial wars and military aid to foreign governments that attack workers’ rights (ie. Columbia, Indonesia, Israel). As the authors state, “The AFL-CIO and CTW leaderships appear to equate patriotism with support for US foreign policy and are clearly reluctant to entertain broad-based discussion of US foreign policy within the ranks of the union movement.” (120)

Fletcher and Gapasin believe that unions must take a stand against US imperialism, because class solidarity means nothing if American workers back their State to dominate and destroy the lives of workers in other lands.

Similarly, unions must oppose domestic anti-worker policies, including racist immigration measures, a privatized medical system and neoliberal economics that force workers to pay the cost of bailing out failing corporations.

Solidarity Divided challenges the myth that government represents “we the people” (as in, we the people now own shares of GM and Chrysler), when it actually represents the collective interests of the capitalist class (as in, we the capitalist class are using public money to float GM and Chrysler until it can be returned to profitability). As they point out, the State serves the employers by consistently suppressing independent working-class activity.

What’s the solution?

Solidarity Divided advocates building geographically-based unions and workers’ councils that include union and non-union members. Such formations have traditionally provided a base for working-class power. However, the authors do not advocate building an independent political party of the working class.

The authors support independent political action, but not political independence from the Democratic and Republican parties. Instead, they call for a neo-Rainbow approach – building an organization that can work both inside and outside of the Democratic Party.⁵

Unfortunately, the American electoral system is designed to prevent independent mass organizations from developing. Bi-yearly electoral races exert an irresistible pull on all social movements to back particular candidates and to tone down their demands in order to get those candidates elected.

The Democratic Party has been phenomenally successful in absorbing and derailing social movements, the campaign to elect President Obama being the most recent example. Fletcher signed the founding statement of “Progressives for Obama” which states,

We intend to join and engage with our brothers and sisters in the vast rainbow of social movements to come together in support of Obama’s unprecedented campaign and candidacy. Even though it is candidate-centered, there is no doubt that the campaign is a social movement, one greater than the candidate himself ever imagined.⁶

This is how social movements are seduced into supporting a capitalist party that serves the capitalist class. Only a political organization that is dedicated to working-class rule could resist this pull and avoid the demobilization that follows inevitable betrayal.⁷

Despite warning us that the State is not a class-neutral machine, it appears that Fletcher and Gapasin fall into Gompers’ trap of viewing the State as “an empty vessel that could be filled by any sort of politics or political or economic influence… [so that] the working class need not challenge the capitalists for state power.” (15)

This may be the greatest weakness of the book – it calls for building a movement to challenge capitalist oppression, not to end that oppression by bringing the working class to power.

The problem may be the mistaken belief that some workers benefit from the oppression of others. If this were true, then a society run by workers would not end oppression, so that it would be necessary to seek cross-class alliances. However, this is a dangerous road because cross-class alliances typically subordinate working-class demands.

Can unions be reformed?

Fletcher and Gapasin argue that the existing unions cannot be reformed, because they are structured to prevent democratic control from the base. (165-6)

The authors provide numerous examples of how conservative and even right-wing union leaders have used socialists to build the unions while denying them any power unless they agree to be co-opted into the bureaucratic structure.

The book describes how the union machine has applied anti-democratic methods to prevent the class-based expansion of union struggles (Decatur, Illinois) and to crush internal rank-and-file rebellions (Ron Carey and Teamsters for a Democratic Union). A more recent example is the SEIU takeover of United Healthcare Workers -West, when it insisted that front-line health care workers had the right to vote on who should represent them and to participate in bargaining contracts with their employers.

For those attempting to build independent unions, Fletcher and Gapasin warn that capitalism creates the conditions under which undemocratic business unions are reproduced and by which even the most well-intentioned leaders are co-opted. Preventing such corruption requires stringent counter-measures that make sure members keep collective and democratic control of the union. As the authors put it, “members must be active participants in the change process rather than recipients of someone else’s work, even if that work is conducted on their behalf.” (66)

This is a huge challenge in a society that dominates workers to keep them passive.

It should be noted that the book’s many examples of rank-and-file defeats are drawn from years of relatively low class struggle. Democratic rebellions would be more likely to succeed in a context of rising class struggle.

If unions are too weak to challenge the employers, how can they lead a more general class uprising? The answer is that they can’t, but other sections of the class can and, in the process, revitalize the unions. The 2006 million-strong general strikes in defense of immigrants’ rights were fed by the rising unionization of immigrant workers. They also fed into that unionization.

While Fletcher and Gapasin promote a mutually beneficial relationship between unions and social movements, they are unclear on how this can be achieved, given the narrow economic focus of the union bureaucracy and the domination of most social movements by professionals. Class politics can provide an answer.

The authors rightly argue that race/color is the key division in the American working class (and in American society) and so the fight against racism must be central to the labor movement. However, I would argue that, within the unions themselves, the central division is one of class, not race.⁸

Fletcher and Gapasin describe how the ascension of rank-and-file workers to union officialdom “marks the beginning of a transition from one class to another.”(58) They also describe the revolving door between union officials and local politicians. (102,159) But instead of attributing the conservative politics of the trade union bureaucracy to its position as a professional middle class, the authors attribute these politics to outmoded and unproductive “old-style thinking.” (108)

If the problem of union strategy is simply one of ideology, then the unions could be reformed. If the problem is a class divide within the unions, then a revolution-from-below would be needed to turf out the union professionals and put the worker-members in power. The same would hold true for social movements dominated by professionals. Unions and social movements that joined forces to advance class concerns would be a might force indeed. However, there is huge resistance to acknowledging the existence of any class-divide within the unions.⁹

Conclusion

Solidarity Divided calls for a return to the class-struggle politics that originally built the unions. This call could not be more timely, as today’s unions lack the political clarity required to advance their own limited demands, let alone to champion the rights of workers and the oppressed.

The questions raised by the authors deserve serious consideration, widespread discussion and further development. After reading this book, I eagerly read every review I could find in the hope of learning more, but what I found was disappointing.

Most criticism of this book was self-serving, in that the authors were condemned for setting themselves up as authorities and equally condemned for not being authoritative enough to address every possible concern. And it was distressing to see so much academic competition over who is “getting it right” when we must pull together to achieve the political clarity and the organization we so desperately need. This low level of politics is the result of 30 years of setbacks and defeats for our class, and the reason why Solidarity Divided was written and is so important.

As Fletcher and Gapasin remind us, “Class struggle is built into the fabric of all societies that have classes.” To develop these struggles, we must answer the strategic questions that Solidarity Divided has placed on the table.

1. Solidarity Divided: The Crisis in Organized Labor and a New Path Toward Social Justice, by Bill Fletcher, Jr. and Fernando Gapasin (2008). University of California Press. The numbers in parentheses indicate page numbers from the book.
2. Book Review: Solidarity Divided: The Crisis in Organized Labor and a New Path Toward Social Justice, by Immanuel Ness. First published in Socialism and Democracy, No. 49, March 2009.
3. “The politics of identity,” by Sharon Smith. International Socialism Review, Issue 57, January–February 2008.
4. “Emphasizing divisions,” pp.197-202 of POWER and Powerlessness, by Susan Rosenthal (2006). Trafford.
5. “Visualizing a Neo-Rainbow” by Danny Glover and Bill Fletcher Jr., The Nation, Feb 14, 2005.
6. “Barack Is Our Best Option – And You’re Needed Now!” by Tom Hayden, Bill Fletcher, Jr., Barbara Ehrenreich, and Danny Glover. Progressives for Obama, March 24th, 2008
7. The Democrats: A Critical History, by Lance Selfa (2008). Haymarket Books. Chicago.
8. “Class-Divided Unions,” by Susan Rosenthal, March 23, 2007.
9. Professional Poison: How Professionals Sabotage Social Movements, and Why Workers Should Lead Our Fight, by Susan Rosenthal (2009).

The Summit was called in response to planned health-service cuts that will affect every hospital in the province. If the cuts go through, Emergency Departments will be closed, local birthing services will be eliminated, hospital departments and beds will be lost, paramedical and support services will be privatized and fees for hospital patients and visitors will be increased.

The goal of the meeting was to organize a province-wide campaign to prevent the loss of these essential services. The first order of business was to counter the lies that justify the cuts.

The Cuts are Not a Response to the Economic Recession

Back in 1994, the Ontario government presented its plan to transform the medical system into a cash-cow for the private sector.

“To have the effective launching pad it needs, the health industries sector must expand its share of its own home market. Steps must be taken to ensure that, as in other countries, the domestic market supports the development of globally competitive companies.”¹

One of these steps was to scrap regulations that ensured a minimum level of daily care for nursing home patients. Major cuts to funding and services followed.

The cuts were so unpopular that the Conservative Party was voted out of office in favor of the Liberal Party, which has betrayed its election mandate by planning this round of even deeper cuts.

In 2006, before the recession began, the Liberals passed the Local Health System Integration Act to dismantle the public hospital system under the guise of “integration.” The province was divided into 14 geographic areas, each of which was assigned a Local Health Integration Network (LHIN) with the power to cut and reorganize regional medical services.

Economists warn that health-service cuts will deepen the effects of the recession, because every lost hospital job will cause another job loss in the community. Moreover, increased wait-times for medical services will cost the province billions more dollars in lost work time and productivity.

The Cuts are Not About Improving Hospital Efficiency

Our hospitals are not being cut to make them more efficient, but to boost the profitability of the private sector.

Ontario hospitals are the most “efficient” in the country. Between 1981 and 2008, the hospital share of the Ontario health budget fell from 52 percent to 37 percent. Ontario has fewer funds for health and social services because the government has chosen to support corporate profits instead.

Because of low corporate tax rates, only 15 percent of Ontario’s GDP goes to government funding, compared with 17 percent for the rest of Canada. As a result, Ontario has the lowest per-capita government expenditures: $6,905 in 2007 compared with $8,692 for the rest of Canada.

Hospital cuts facilitate the movement of medical services (and funds) from the public sector to the private sector. This is accomplished in a two-step process. First, government funds hospitals below the level required to match the rate of inflation and population growth. (Currently, half of Ontario hospitals are in deficit, and 70 percent are expected to be in deficit by next year.) Second, hospitals are forced to cut services to balance their budgets.

By Canadian law, medical services provided in hospitals must be publicly funded and provided free of charge. Once these services leave hospital, they can be taken over by the private sector and sold to those who can pay for them.

The Cuts are Undemocratic

Instead of matching health dollars to the needs of the population, the population is expected to sacrifice its needs to budget mandates. There is no way to achieve this democratically.

According to the Ontario Ministry of Health,

“The [LHIN] legislation places significant decision-making power at the community level and focuses the local health system on the community’s needs.”

In fact, the LHINs are staffed by government appointees who are not elected and not accountable to anyone but the Ministry.

Small, local hospitals are built and maintained by dedicated community fund-raising. They are vital to the economies of their areas, providing jobs and helping to attract new industry. These hospitals are scheduled to be closed, despite the protests of the people who built, maintain, work in and rely on them.

The Ministry of Health has required all hospitals to sign “Hospital Accountability Agreements,” that compel hospitals to cut services to meet restricted budgets. Those that don’t “agree” have the cuts imposed.

Hospital CEOs who protest the cuts have been fired and replaced by government-appointed supervisors. Community-elected hospital boards that reject the cuts have been dissolved and replaced by government-appointed managers. Communities that protest this lack of democracy have been told that hospitals are too large and complex to be run democratically!

These Cuts Will Kill

Most small and rural hospitals are scheduled to be closed. These hospitals are critical for providing timely care in outlying areas. Additional travel time to larger hospitals can mean the difference between life and death.

Patients need social support to recover, and local hospitals provide easy access to family and friends. If these hospitals close, families will be forced to travel to larger centers to see their loved ones. No provision has been made to assist in this travel, so low-income families will be unable to visit at all.

Emergency Rooms will become even more congested. The cuts of the mid-1990s (dubbed “the Harris cuts,” after the Premier at the time) eliminated many hospital and chronic-care beds, making it more difficult to transfer patients out of Emergency.

Before the Harris cuts, Ontario’s ERs were moderately congested 9 percent of the time and severely congested 0.5 percent of the time. After the cuts, they were moderately congested 23 percent of the time and severely congested 6 percent of the time.

The backlog in Emergency Departments is not caused by too many people using ERs irresponsibly, but by sick, injured and elderly people needing beds that aren’t available. Patients can spend hours, even days, in the ER waiting for a hospital or chronic-care bed while lying on uncomfortable stretchers in the hallways of a noisy, trauma-filled environment.

ER staff suffer high rates of burnout, and turnover is high. Regular conflicts erupt between ambulance paramedics bringing new patients and ER staff who cannot cope with the demand.

Combine overcrowded Emergency Rooms, hospitals filled to capacity, and cuts to cleaning staff and you have a perfect breeding ground for deadly hospital infections like SARS, MRSA and C. Difficile.

The medical system has no surplus capacity to handle an epidemic or mass trauma event. And this is before the coming round of cuts that have been described as “Harris on steroids.”

The Problem is Not a Lack of Money

While the government squeezes hospital budgets, it is going hundreds of millions of dollars over budget to establish private “P3″ (public-private-partnership) hospitals.

The 2008 Provincial Auditor’s report found that the total cost of one P3 hospital was $300 million more than it would have cost to build and operate the hospital publicly.

Despite public disapproval of P3s and their higher costs, the province plans to build more of them, because P3s are a convenient conduit for transferring public funds to the private sector.

As OHC organizer Natalie Mehra points out,

“[T]he only advisors that the government listens to are those who come from the P3 industry – the financiers, law firms, service privatizers and giant construction firms who directly benefit from the exorbitant costs of this privatization policy.”

What Will it Take?

The dismantling of Ontario’s public hospital system has provoked major protests across the province. Public rallies and marches, petitions and thousands of letters to the editor have condemned the cuts. There have been a few small victories – some hospitals kept open, some services saved – but not nearly enough. It was clear to everyone at the meeting that much more will be needed.

There were many suggestions of how to fight back. One was to try to convince the government and the LHINs that their “restructuring” plans are medically unsafe, economically unsound and inappropriate for a recession. The OHC has collected a mountain of evidence that this is so.

Unfortunately for us, the government doesn’t care about these things. It serves a business class that is locked in a fierce competition for profits, and ensuring those profits is all that matters.

Another strategy was to mobilize people in numbers large enough to “inflict political pain” on the ruling Liberal party. Suggestions included town hall meetings, mass leafleting and postering, door-to-door campaigning, media events, letters to the editor, rallies, marches, demonstrations and civil disobedience coordinated across the province. This is definitely doable. Since the OHC was launched in 2003, it has organized a province-wide network of activists.

A few voices proposed hospital strikes and sit-ins. These suggestions were not taken up, despite the many union representatives at the meeting. Decades of defeats and compromise have produced widespread demoralization among workers. Nevertheless, the power of organized hospital workers, backed by patients, families and community groups, is our best hope for winning this fight.

The future of our public medical system is at stake. In order to mobilize the forces necessary to stop the cuts, we must convince them that it is possible to put people before profit.

1. Cited in Fuller, C. (1998). Caring for profit: How corporations are taking over Canada’s health care system. Ottawa: Canadian Centre for Policy Alternatives.

The Commission confirmed previous reports of health inequities between nations as well as “health gradients” within them. It confirmed that the poor are worse off than those less deprived, the less deprived are worse off than those with average incomes, and so on, up the social hierarchy. It confirmed that this health gradient exists in all nations, including the richest. It also confirmed that health equality cannot be achieved by medical systems alone.

Water-borne diseases are not caused by a lack of antibiotics but by dirty water, and by the political, social, and economic forces that fail to make clean water available to all; heart disease is caused not by a lack of coronary care units but by the lives people lead, which are shaped by the environments in which they live; obesity is not caused by moral failure on the part of individuals but by the excess availability of high-fat and high-sugar foods.

None of these findings is new. Studies of health inequity date back to the Industrial Revolution of the 19th century and spurred the development of the public health movement.

The founder of Social Medicine is generally considered to be Rudolf Virchow (1821-1902), a liberal physician and public health activist. However, I think that title properly belongs to Frederick Engels (1820-1895), Karl Marx’s comrade and collaborator. Engels was the first to connect a broad number of medical and social problems to the way capitalism is organized.

Between September 1844 and March 1845, Engels documented the human impact of the industrial revolution in England. He published his findings in The Condition of The Working Class in England: From Personal Observation and Authentic Sources.

Over the past 163 years, much has changed. The United States has replaced England as the center of the industrial world. Higher living standards have lengthened life-spans and lowered child death rates in many nations. Yet much remains the same, and some things are worse.

As the WHO report documents, health inequities continue to follow income inequities, and both are increasing. In 1980, the richest countries had a gross national income 60 times that of the poorest countries. By 2005, this difference had more than doubled. The global population now suffers many of the same health and social problems that Engels documented in England: extreme poverty, environmental pollution, lack of sanitation, contaminated food, preventable diseases and premature deaths.

As I read the WHO report, I wondered what Engels would think of it. So I constructed a fictional interview for the purpose of comparing his findings with current conditions. His words (taken from his book) are in italics. I am responsible for the rest of this imaginary conversation.

Class and Health

SR: Your book documents a strong link between class and health in, what was in your time, the wealthiest nation in the world.

Engels: Yes. In Liverpool, in 1840, the average longevity of the upper classes, gentry, professional men, etc., was 35 years; that of the business men and better-placed handicraftsmen, 22 years; and that of the operatives, day-laborers, and serviceable class in general, only 15 years.

SR: In the United States, currently the world’s richest nation, death rates are not recorded by class. However, the nation’s poorest adults are nearly five times more likely to be in “poor or fair” health than the richest, and at every income level the wealthier group is healthier than the one below it. This health gradient exists in all racial groupings.

Engels: There is a heavy mortality among young children in the working-class. The tender frame of a child is least able to withstand the unfavorable influences of an inferior lot in life; the neglect to which they are often subjected, when both parents work or one is dead, avenges itself promptly, and no one need wonder that, in Manchester, more than 57 per cent of the children of the working-class perish before the fifth year, while but 20 per cent of the children of the higher classes, and not quite 32 per cent of the children of all classes in the country die under five years of age.

SR: America’s infant deaths are recorded by location and race, which are loosely related to class. In poorer states, like Mississippi, infant death rates are more than double what they are in richer states like Vermont. And the overall death rate for Black babies is two-and-a-half times higher than it is for White babies.

You found a report of differing mortality rates on different streets.

Engels: Yes. Dr. P. H. Holland studied a suburb of Manchester. He divided the houses and streets into three classes each, and found that the mortality in the streets of the second class is 18 per cent greater, and in the streets of the third class 68 per cent greater than in those of the first class; that the mortality in the houses of the second class is 31 per cent greater, and in the third class 78 per cent greater than in those of the first class; that the mortality in those bad streets which were improved, decreased 25 per cent. Holland concluded his report with this unusually frank remark.

When we find the rate of mortality four times as high in some streets as in others, and twice as high in whole classes of streets as in other classes, and further find that it is all but invariably high in those streets which are in bad condition, and almost invariably low in those whose condition is good, we cannot resist the conclusion that multitudes of our fellow-creatures, hundreds of our immediate neighbors, are annually destroyed for want of the most evident precautions.

SR: Such detailed studies are rarely done here, but I suspect the results would be comparable.

Bad Food

SR: You document the poor quality of food consumed by the working class.

Engels: In the great towns of England the best food can be found, but it costs money; and the workman, who must keep house on a couple of pence, cannot afford much expense. The potatoes which the workers buy are usually poor, the vegetables wilted, the cheese old and of poor quality, the bacon rancid, the meat lean, tough, taken from old, often diseased, cattle, or such as have died a natural death, and not fresh even then, often half decayed.

On the 6th of January, 1844 (if I am not greatly mistaken) in Manchester, eleven meat-sellers were fined for having sold tainted meat. Each of them had a whole ox or pig, or several sheep, or from fifty to sixty pounds of meat, which were all confiscated in a tainted condition. In one case, fifty-four stuffed Christmas geese were seized which had proved unsaleable in Liverpool, and had been forwarded to Manchester, where they were brought to market foul and rotten. But these are by no means all the cases; they do not even form a fair average.

SR: We continue to suffer from contaminated meat and vegetable produce. In Britain in 1986, a deadly brain disease (BSE) was caused by feeding diseased animal parts to cows that were later consumed by human beings. Over a hundred people died and many more were infected. The victims were mostly workers who ate cheap ground beef, which is mass produced by pooling many carcasses.

Today, food is produced and distributed on a much larger scale than it was in your time, which makes the problem of contamination much more serious. In 2003, the first infected cow surfaced in the U.S., and before the diagnosis could be confirmed, meat from the infected animal had been distributed to more than eight states, and the cow’s infected spinal cord had been incorporated into food for pets, pigs, and poultry.

Engels: And when one reflects upon the many cases that escape detection under the slender supervision of the market inspectors — when one considers how great the temptation must be, in view of the incomprehensibly small fines mentioned in the foregoing cases; when one reflects what condition a piece of meat must have reached to be seized by the inspectors, it is impossible to believe that the workers obtain good and nourishing meat as a usual thing.

SR: We have many more regulations to protect the food supply, but they are poorly enforced. Companies are “trusted” to regulate themselves. When problems arise, the government’s first concern is to protect industry profits. After the first infected cow was found, the Department of Agriculture reassured us that ” the food supply is fully protected and consumers should feel fully confident that the beef supply in this country is very safe to eat.” When more diseased cows were identified, the DA announced that it was reducing testing for BSE. Less testing lowers the risk of identifying sick animals.

Engels: The capitalists have made progress in the art of hiding the distress of the working-class.

SR: You also describe extensive food adulteration.

Engels: Dealers and manufacturers adulterate all kinds of provisions in an atrocious manner, and without the slightest regard to the health of the consumers. But don’t take my word for it. Let us hear from the Liverpool Mercury (I delight in the testimony of my opponents):

Salt butter is molded into the form of pounds of fresh butter, and cased over with fresh. In other instances a pound of fresh is conspicuously placed to be tasted; but that pound is not sold; and in other instances salt butter, washed, is molded and sold as fresh…. Pounded rice and other cheap materials are mixed in sugar, and sold at full monopoly price. A chemical substance – the refuse of the soap factories – is also mixed with other substances and sold as sugar…. Cocoa is extensively adulterated with fine brown earth, wrought up with mutton fat….Nasty things of all sorts are mixed with tobacco in all its manufactured forms.

SR: It’s no different today. The better-off can afford a wholesome, organic diet, while the workers’ food continues to be adulterated. It’s almost impossible to find cheap food that does not contain a long list of additives to enhance color, flavor, texture and shelf-life. Many of these additives are indigestible or harmful, but they make cheap food very profitable. These adulterated foods fill the bellies of the working class, generating digestive disorders, malnutrition, obesity and diabetes.

Child Drugging

SR: You condemn “the custom of giving young children spirits, and even opium” to keep them quiet.

Engels: One of the most injurious patent medicines is a drink prepared with opiates, chiefly laudanum, under the name Godfrey’s Cordial. Women who work at home, and have their own and other people’s children to take care of, give them this drink to keep them quiet, and, as many believe, to strengthen them. They often begin to give this medicine to newly born children, and continue, without knowing the effects of this “heart’s-ease”, until the children die. The less susceptible the child’s system to the action of the opium, the greater the quantities administered. When the cordial ceases to act, laudanum alone is given, often to the extent of fifteen to twenty drops at a dose. The effects upon the children so treated may be readily imagined. They are pale, feeble, wilted, and usually die before completing the second year. The use of this cordial is very extensive in all great towns and industrial districts in the kingdom.

SR: Today, child drugging has reached epidemic proportions, with millions of youngsters being prescribed addictive substances to keep them quiet and compliant.

Despite the many parallels, conditions for workers in the industrial nations are generally better then they were in your time. You acknowledge this in the 1892 preface to your book when you wrote, “the most crying abuses described in this book have either disappeared or have been made less conspicuous.”

Engels: The state of things described in my book belongs, in many respects, to the past, as far as England is concerned. Repeated visitations of cholera, typhus, small-pox, and other epidemics have shown the British bourgeois the urgent necessity of sanitation in his towns and cities, if he wishes to save himself and family from falling victims to such diseases. Moreover, the capitalists were learning, more and more, that they could never obtain full social and political power over the nation except by the help of the working-class. So they accepted reforms that raised the workers’ standard of living.

SR: The worst problems you describe can now be found in the poorer nations. Even so, contaminated air, food and water continue to plague even the richest ones. We have the science and technology required to protect health, but the drive for profit prevents us from using it effectively.

Your book covers much more ground, and there’s so much more we could discuss, but let’s proceed to the matter of solutions.

What Must Be Done?

SR: To reduce health inequality, the WHO report recommends improving living and working conditions; and distributing power, money, and resources more equitably. And in a series of “What Must Be Done” boxes, it makes specific suggestions, including:

Invest in early childhood development and in the education of women.

Remove the barriers to girls and boys enrolling and staying in school

Provide clean water, sanitation systems and electricity for all.

Ensure safe, secure, and fairly-paid work, year-round work opportunities, and healthy work–life balance for all.

Ensure a healthy standard of living below which nobody should fall due to circumstances beyond his or her control

Provide universal access to quality health-care services.

Engels: How will they implement these measures?

SR: The Commission emphasizes “the primary role of the state in the provision of basic services essential to health (such as water/sanitation) and the regulation of goods and services with a major impact on health (such as tobacco, alcohol, and food).”

Engels: Has the capitalist class ever paid any serious attention to social grievances? Have they done more than pay the expenses of half-a-dozen commissions of inquiry, whose voluminous reports are damned to everlasting slumber among heaps of waste paper on government shelves? Have they even done as much as to compile from those rotting blue-books a single readable book from which everybody might easily get some information on the condition of the great majority. No indeed, those are things they do not like to speak of.

SR: As you said, the capitalists need the cooperation of the working class to stay in power, and health inequity has become so serious and so global that it cannot be ignored. We now have a mountain of reports on the condition of the working class, but none indict capitalism for the problems they document. All call for the State to curb the greed of the capitalist class through regulation.

Engels: Regulations are as plentiful as blackberries; but they only contain the distress of the workers, they cannot remove it. Must I remind you that the capitalist class can exist only by depriving the working class of what it creates? That is the basis of the system which tends more and more to split society into a few Rothschilds and Vanderbilts, the owners of all the means of production and subsistence, on the one hand, and an immense number of wage-workers, the owners of nothing but their labor-force, on the other. So that inequality of all kinds is caused, not by this or that secondary grievance, but by the system itself — this fact has been brought out in bold relief by the development of capitalism.

SR: The WHO report disagrees, assuring us that “the private sector has much to offer that could enhance health and well-being,” in particular, by improving working conditions. It also recommends that “private sector activities and services (such as production and patenting of life-saving medicines, provision of health insurance schemes) contribute to and do not undermine health equity.” Yet none of these measures is profitable. On the contrary, they would all cut into profits. This is like asking the fox not to eat the chicken, but to safeguard its health instead.

Engels: When one individual inflicts bodily injury upon another such injury that death results, we call the deed manslaughter; when the assailant knew in advance that the injury would be fatal, we call his deed murder.

Capitalism daily and hourly commits social murder. It has placed the workers under conditions in which they can neither retain health nor live long; it undermines the vital force of these workers gradually, little by little, and so hurries them to the grave before their time. The capitalist class knows how injurious such conditions are to the health and the life of the workers, and yet does nothing to improve these conditions.

SR: Your book calls on the capitalist class “either to continue its rule under the unanswerable charge of murder and in spite of this charge, or to abdicate in favor of the laboring-class. Hitherto it has chosen the former course.” Did you really expect them to abdicate their rule?

Engels: I confess that I was only 24 when I wrote the book and politically immature when I stressed that socialism is a question of humanity and not of the workers alone. This is true enough in the abstract, but absolutely useless, and sometimes worse, in practice. So long as the wealthy classes not only do not feel the want of any emancipation, but strenuously oppose the self-emancipation of the working-class, so long the social revolution will have to be prepared and fought out by the working-class alone.

And today, those who, from the “impartiality” of their superior standpoint, preach to the workers a Socialism soaring high above their class interests and class struggles, and tending to reconcile in a higher humanity the interests of both the contending classes — these people are either naive, with much to learn, or they are the worst enemies of the workers — wolves in sheep’s clothing. I explain this more fully in Socialism, Utopian and Scientific.

SR: I can see why the capitalists don’t want to acknowledge you as the founder Social Medicine. They still recoil at your insistence that the only way to improve health and eliminate health inequity is to abolish class divisions. And yet, the evidence continues to prove you right.

A 1998 study of American cities found that the greater the difference in income, the more the death rate rose for all income levels, not just for the poor. Reducing income inequality to the lowest level found in the United States would save as many lives as would be saved by eradicating heart disease or preventing all deaths from lung cancer, diabetes, motor vehicle crashes, HIV infection, suicide and homicide combined

Moreover, the WHO report calculated that, if racism were abolished so that mortality rates between White and Black Americans were the same, 886,202 deaths would have been avoided between 1991 and 2000. Over the same period, only 176,633 lives were saved by medical advances. And many millions would be saved by raising living standards in the poorer nations.

Engels: Clearly, the need is greater than ever. But until workers fight back as a class, there can be no progress.

SR: That’s so true. The WHO report starts with a bang — INEQUALITIES ARE KILLING PEOPLE ON A GRAND SCALE — and ends with a whimper, with a plea for the “political will” to make change.

Thank you for taking the time to talk with us.

Engels: Don’t thank me. Organize!

While medical diagnoses are based on science, psychiatric “diagnoses” are not at all scientific. They do not reveal what is wrong, what is the preferred treatment, and what is the likely outcome. Nor are they reliable. Different psychiatrists who examine the same patient typically offer different “diagnoses.” Moreover, psychiatric “diagnoses” move in and out of favor, depending on a variety of social factors.

Psychiatric “diagnosis” is actually a labeling process, where the patient’s symptoms are matched with a grouping of symptoms listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Psychiatric Disorders (DSM). As we shall see, this psychiatric “bible” was developed and is maintained by financial and political interests.¹

Sigmund Freud

Who decides what is normal or healthy and what is deviant or sick?

Before the 20th century, life stresses were generally seen as spiritual problems or physical illnesses, and people turned to religious advisors and physicians for help. Medical doctors treated “hysteria” and “nerves” as physical problems. Psychiatry was restricted to the treatment of severely disturbed people in asylums.² The first classification of psychiatric disorders in the United States appeared in 1918 and contained 22 categories. All but one referred to various forms of insanity.

In 1901, Sigmund Freud revolutionized psychiatry by breaking down the barrier between mental illness and normal behavior. In The Psychopathology of Everyday Life,³ Freud argued that commonplace behaviors — slips of the tongue, what people find humorous, what they forget and the mistakes they make — indicate repressed sexual feelings that lurk beneath the surface of normal behavior.

By linking everyday behavior with mental illness, Freud and his followers released psychiatry from the asylum. Between 1917 and 1970, as psychiatrists cultivated clients with a broad range of problems, the number of psychiatrists practicing outside institutions swelled from eight percent to 66 percent.⁴

The social movements of the 1960′s opposed psychiatry’s focus on inner conflict and emphasized the social sources of sickness instead. Dr. Alvin Poussaint recalls the 1969 convention of the American Psychiatric Association (APA).

“After multiple racist killings during the civil rights movement, a group of black psychiatrists sought to have murderous bigotry based on race classified as a mental disorder. The APA’s officials rejected that recommendation, arguing that since so many Americans are racist, racism in this country is normative.”⁵

Growing the industry

In 1980, the APA overhauled the DSM. The Task Force established to create the new manual declared that any disorder could be included,

“If there is general agreement among clinicians, who would be expected to encounter the condition, that there are significant number of patients who have it and that its identification is important in the clinical work it is included in the classification.”⁶

In other words, the new DSM was not based on science, but on the need to maintain existing patients and include new ones who might seek help for any number of problems. A profitable and self-perpetuating industry was born. The more people could be encouraged to seek treatment, the more conditions could be entered into the DSM, and the more people could be encouraged to seek treatment for these new conditions.

By 1994, the DSM listed 400 distinct mental disorders covering a wide variety of behaviors in adults and children. Significantly, racism, homophobia (fear of homosexuality) and misogyny (hatred of women) have never been listed as mental disorders. In 1999, the chairperson of the APA’s Council on Psychiatry and the Law confirmed that racism “is not something that is designated as an illness that can be treated by mental health professionals.”⁷ Homosexuality was listed as a mental disorder until activists campaigned to have it removed.⁸

The women’s liberation movement condemned labeling symptoms of oppression as mental illnesses. In They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal, Paula Caplan explains,

“In a culture that scorns and demeans lesbians and gay men, it is hard to be completely comfortable with one’s homosexuality, and so the DSM-III authors were treating as a mental disorder what was often simply a perfectly comprehensible reaction to being mocked and oppressed.”⁹

Caplan describes efforts to prevent “Masochistic Personality Disorder” from being included in the DSM. This disorder assumes that women stay with abusive spouses because like to suffer, not because they lack the resources to leave. Despite protest, “Masochistic Personality Disorder” was added to the 1987 edition of the DSM, although it was later dropped.

The inclusion of “Pre-Menstrual Dysphoric Disorder” (PMDD) in the DSM also raised a protest. According to Caplan,

“The problem with PMDD is not the women who report premenstrual mood problems but the diagnosis of PMDD itself. Excellent research shows that these women are significantly more likely than other women to be in upsetting life situations, such as being battered or being mistreated at work. To label them mentally disordered — to send the message that their problems are individual, psychological ones — hides the real, external sources of their trouble.”¹⁰

As soon as PMDD was listed in the DSM, Eli Lilly repackaged its best-selling drug, Prozac, in a pink-pill format, renamed it Serafem, and promoted it as a treatment for PMDD. By creating Serafem, Lilly was able to extend its patent on the Prozac formula for another seven years.

A marketing gold mine

The DSM is a marketing gold mine for the drug industry. The FDA will approve a drug to treat a mental disorder only if that disorder is listed in the DSM. Therefore, each new listing is worth millions in potential drug sales. Most of the experts who construct the DSM have financial ties to pharmaceutical companies, and every new edition of the DSM contains more conditions than the previous one.

Once the DSM lists a new mental disorder, drugs for that disorder are heavily marketed for everyone who might fit the symptom checklist. (Doctors are also encouraged to prescribe these drugs for “off-label use,” which means to anyone they think might benefit.) Not surprisingly, the numbers of people “diagnosed” with a mental condition rise rapidly after a drug is approved to treat that condition.

In 2005, a major study announced that “About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life…”¹¹ How is this possible? Has it become normal to be mentally ill, or has the definition of mental illness expanded beyond reason? Both could be true.

Capitalism damages people in many ways. It’s also true that the more people can be labeled as sick, the more profits can be made from selling them treatments. In Creating Mental Illness, Alan Horowitz warns,

“…a large proportion of behaviors that are currently regarded as mental illnesses are normal consequences of stressful social arrangements or forms of social deviance. Contrary to its general definition of mental disorder, the DSM and much research that follows from it considers all symptoms, whether internal or not, expected or not, deviant or not, as signs of disorder.”¹²

Most people know the difference between normal behavior (such as grief over the death of a loved one) and abnormal behavior that could indicate an internal disorder (such as prolonged grief for no apparent reason). However, the DSM does not consider what happens in people’s lives. With one exception (Post-Traumatic Stress Disorder), the DSM lists and categorizes symptoms outside of any social context. As a result, DSM-based surveys artificially increase the numbers of people suffering from mental disorders and, therefore, the market for drug treatments.

DSM-inflated rates of mental illness are typically accompanied by the warning that not enough people are getting treatment.¹³ The question of whether or not they are actually sick is never raised.

Social control

Psychiatry has a long history of medicating the oppressed, including children, for social control.¹⁴

Using DSM criteria, at least six million American children have been diagnosed with serious mental disorders, triple the number in the early 1990′s. The rate of boys aged 7 to 12 diagnosed with Bipolar Disorder more than doubled between 1995 and 2000 and continues to rise.

A 2007 survey of 8- to 15-year-olds discovered that nine percent met the DSM criteria for attention deficit/hyperactivity disorder (ADHD). The survey found that fewer than half of these children had been diagnosed or treated, “suggesting that some children with clinically significant inattention and hyperactivity may not be receiving optimal attention.” Noting that poor children were least likely to receive medication, the authors of the study recommend “further investigation and possible intervention.”¹⁵

Instead of addressing the stressful social conditions that agitate children, psychiatry imposes conformity through medication. To force compliance with this oppressive system, access to insurance benefits, medical care and social services depends on “having a diagnosis.”

The psychiatric-pharmaceutical industry treats illness as strictly individual and internal — the result of faulty genes or chemical imbalances. In reality, human problems exist in a social context.

Most of the symptoms listed in the DSM describe human responses to deprivation and oppression (anxiety, agitation, aggression, depression) and the many ways that people try to manage unbearable pain (obsessions, compulsions, rage, addictions). Depression is strongly linked with poverty,¹⁶ and alleviating poverty can lift depression.¹⁷

Under capitalism, addressing the social causes of misery is politically risky and unprofitable. So psychiatry extracts the individual from society, splits the brain from the body, severs the mind from the brain and drugs the brain.¹⁸

A sick society

Capitalism is a system that requires the majority to have no control over their lives and to believe that this condition is normal. Therefore, all reactions to inequality and deprivation must be viewed as signs of personal inadequacy, biological defect, mental illness — anything other than reasonable responses to unreasonable conditions.

During slavery days, experts argued that Black people were psychologically suited for a life of slavery, so there must be something wrong with those who rebelled.¹⁹ In 1851, the diagnosis of “drapetomania”(runaway fever) was developed to explain why slaves try to escape.²⁰ Not much has changed. Today, exploitation and oppression are considered normal, and those who rebel in any way are considered to be sick or deviant and in need of medication or incarceration.

What’s the diagnosis for a sick society? We know what’s wrong. Most people are kept in sick social conditions so that a few can maintain their wealth and power. What is the treatment? Putting human needs first would eliminate most human misery. Who will deliver the medicine? The majority must organize to take collective control of society.

I don’t expect this diagnosis to appear in the DSM anytime soon.

1. Kirk, S.S. & Kutchins, H. (1992). The selling of DSM: The rhetoric of science in psychiatry. New York: Aldine De Gruyter.
2. Horowitz, A.V. (2002). Creating mental illness. Chicago: University of Chicago Press.
3. Freud, S. (1901/1991). The psychopathology of everyday life. New York: Penguin
4. Shorter, E. (1997). A history of psychiatry: From the era of the asylum to the age of Prozac. New York: John Wiley & Sons.
5. Poussaint, A.F. & Alexander, A. (2000). Lay my burden down: Suicide and the mental health crisis among African-Americans. Boston: Beacon Press, p.125.
6. Spitzer, R.L., Sheeney, M. & Endicott, J. (1977). DSM III: Guiding principles. In Psychiatric diagnosis, (Eds). Rakoff, V., Stancer, H. & Kedward, H. New York: Brunner Mazel.
7. Egan, T. (1999). Racist shootings test limits of health system and laws. New York Times, August 14, p.1.
8. “DSM and homosexuality: A cautionary tale.” in Kirk, S.A., Kutchins, H. (1992). The selling of DSM: The rhetoric of science in psychiatry. New York: Aldine De Gruyter p 81-90
9. Caplan, P. (1995). They say you’re crazy: How the world’s most powerful psychiatrists decide who’s normal. New York: Addison-Wesley, pp.180-181.
10. Caplan, P.J. (2002). Expert decries diagnosis for pathologizing women. Journal of Addiction and Mental Health. September/October 2001, p.16.
11. Kessler, R.C., Berglund, P., Demler, O., Jin, R. & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. Vol.62, No.6, pp.593-602.
12. Horowitz, A.V. (2002). Creating Mental Illness. Chicago: University of Chicago Press. p.37.
13. Talen, J. (2005). Survey says nearly half of all Americans will be affected by a mental illness, some before adulthood. Newsday, June 7.
14. Breggin, P.R. & Breggin, G. R. (1994). The war against children: How the drugs, programs, and theories of the psychiatric establishment are threatening America’s children with a medical ‘cure’ for violence. New York: St. Martin’s Press.
15. Froehlich TE, et.al. (2007). Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med. Vol.161, pp.857-864.
16. Duenwald, M. (2003). “More Americans Seeking Help for Depression.” New York Times, June 18.
17. Costello EJ, Compton SN, Keeler G, Angold A.(2003). Relationships between poverty and psychopathology: a natural experiment. JAMA. Oct 15, Vol.290, No. 15, pp.2023-9.
18. Ross, C.A., & Pam, A., (1995). Pseudoscience in biological psychiatry: Blaming the body. New York: Wiley.
19. Poussaint, A.F. & Alexander, A. (2000). Lay my burden down: Suicide and the mental health crisis among African Americans. Boston: Beacon Press.
20. Cartwright, S. (1851). Report on the diseases and physical peculiarities of the Negro race. New Orleans Medical and Surgical Journal. May, p. 707.

Across the globe, malnutrition and lack of medical care cause more than three million babies to die at birth every year. Every year, more than half a million women die in pregnancy or childbirth, and millions more are crippled.

Poverty and inequality cause most maternal deaths. In 2000, the number of maternal deaths per 100,000 women was 2 in Sweden, 17 in the United States, 330 in Asia, and 920 in Sub-Saharan Africa. If any nation can lower the maternal death rate to 2 per 100,000 women, then that should be the expected standard everywhere.

In the United States, mothers get little or no support. The arrival of a child turns life upside down. Frequent night feedings exhaust parents who are expected to work the next day. Despite talk about “family values,” Americans are not entitled to paid parental leave.

Financial uncertainty adds to physical and emotional stress. Family expenses rise at the same time that the mother’s pay check is reduced or discontinued. How long can a new mom afford to stay off work? Will she lose her job? Will she find another one? Will there be affordable childcare? Americans are not entitled to childcare support.

Lack of social support causes more women to be hospitalized for psychiatric problems around the time of childbirth than at any other time in their lives.

About 85 percent of new mothers experience “baby blues,” the fatigue, sadness and irritability that commonly follow childbirth or adoption. From 10 to 17 percent of new moms suffer clinical depression due to changing hormones, sleep deprivation, social isolation, financial stress, a difficult or traumatic birth, difficulties breast feeding, low social support, financial problems, inadequate housing and relationship problems.

Approximately one in 800 new mothers develops full-blown psychosis. In Texas, Andrea Yates suffered from hallucinations that compelled her to murder her five children. In Toronto, a family doctor jumped in front of a train, killing herself and her infant son.

Society demands that mothers manage without support. When they cannot cope, they are presumed to be inadequate. Postpartum depression and psychosis are under-recognized and under-treated because most women feel too ashamed to seek help.

Every child is a gift to humanity. Yet, lack of social support makes the child-raising years the most stressful for men and women. Parents of both sexes suffer more depression than non-parents.

This is the heartless reality behind celebrations of Mother’s Day. Talk is cheap. Parents and children have a right to real social support. Cards and flowers are not enough.

The bad news is that two major health workers’ unions, SEIU and CNA, are at war — a term used by both sides. SEIU accuses the CNA of undermining their efforts to organize, and the CNA accuses the SEIU of making cozy deals with management that hurt workers.

This is a real war. The home page of the CNA posts a sign, “Had it with SEIU? Work for a REAL union.” On April 12, hundreds of SEIU members physically attacked the Labor Notes conference to protest the CNA.

There are several roots to this conflict, including the question of whether to organize medical facilities wall-to-wall (SEIU includes all health workers) or by trade (nurses in one union and support staff in another). Wall-to-wall unions are undoubtedly more effective. In practice, workers organize as best they can in the particular circumstances they face. Another pressing concern is the extent to which management should be included in the process of union certification.

Unfortunately, these issues have been submerged by an increasingly vicious turf war that is dividing and weakening the ability of health workers to fight the real enemy — management.

The conflict is complicated by a sizeable rank-and-file rebellion inside SEIU. United Health Workers-West (UHW) opposes top-down control of SEIU and demands one-member-one-vote democracy. CNA is using this split within SEIU to press its case that SEIU is a business union that doesn’t represent workers’ interests. However, UHW condemns CNA for sabotaging a number of its union drives (see www.seiuvoice.org).

As a newer union, CNA boasts that it is more progressive than the longer-established SEIU. And there is some truth to this. On the other hand, CNA’s war with SEIU shows that it also takes a bureaucratic approach to unionizing, going over the heads of rank-and-file SEIU workers to dictate what it believes is the best way forward.

What’s the solution? During the Labor Notes conference, heated accusations flew between CNA and SEIU members. At one point, Patricia Campbell of the Independent Workers Union of Ireland stated: “You must stop fighting among each other and unite. You need to kick out the bureaucrats in both your unions. That’s the only way you can advance your struggle for patients’ and workers’ rights.”

I agree. The union IS the workers. Union leaders, who act against the rank and file of ANY union, should be replaced.

For a class analysis of unions, see my blog of March 23, 2007, “Class-Divided Unions.”

The only constant in life is change. I grew up during the 1960s, a time of great social change. Blacks, women and gays were marching for their rights. Workers were winning higher wages and benefits. America was being defeated in Vietnam. Yugoslavia was intact. Germany was divided. And computers were found only in science labs.

Just a few decades later, the world has changed dramatically, and so have people’s expectations. My parents expected me to have a better life than they had. I do not expect my children to do as well as I have done. I entered adulthood with great hope for the future. My grandchildren wonder if the world will last long enough for them to have children.

Given so much change over such a short period, I am amazed when people insist that change is not possible, that the past does predict the future, for individuals and for society.

Consider these common statements: You can’t change human nature. Once a criminal, always a criminal. We tried socialism/communism, and it didn’t work. You’ll never get people to cooperate, demonstrate, rebel, etc.

Such pessimism serves as a self-fulfilling prophecy that blocks change. When we expect nothing to change, then we do nothing to create change.

Only the ruling elite benefit from this massive failure of the imagination. They can stay in power as long as they convince the rest of us that capitalism is the only possible social system, so that it is futile, even reckless, to want anything else.

Like all ruling classes that came before it, the capitalist class wants to rule forever. The only change they want is more capitalism. They organize society as if there were no past, no future and no consequences. Only today matters — today’s sale, today’s profit. We all know the consequences: environmental devastation, epidemics of preventable disease, endless wars of acquisition, and a juggernaut of greed that tramples human lives across the globe. Their dream is our nightmare.

Dare to Imagine

Fortunately, the past does not predict the future. Civilizations come and go. Empires rise and fall. Capitalism will also give way to new social formations. Another world is possible.

Not all choices are available. We can’t turn back the clock. We can only go forward. And we didn’t choose the conditions into which we were born and in which we must struggle. Nevertheless, we can make choices today that will change the future.

We can choose to believe that we can move beyond capitalism and class divisions. We can choose to believe that the majority have a common interest in pulling together. We can choose to imagine a future that is good, even wonderful!

Knowing our past is essential to changing our future. To discover who we could become, we must know how capitalism has shaped us to be who we are. By appreciating the problems that our ancestors solved in the past, we can gain the confidence to solve our problems today.

Because the future is unknown, we cannot predict if our efforts will succeed. We can be sure that, if we don’t try, we will surely fail. We can choose to act anyway, in hope, instead of surrendering to pessimism, passivity and despair.

The past does not predict the future. The future is ours to shape, by making choices today that will bear fruit tomorrow. Let us dare to dream of a better world — a caring, sharing, truly democratic world. Let us take those actions today that will bring that world one step closer.

Science tells us that the mind cannot be reduced to an activity of the brain. The mind is created and sustained in a complex dance between human beings. Cut off from social relationships, the mind loses its ability to function. Evidence for this comes from socially-deprived infants and from adults kept in isolation or subjected to sensory deprivation.

For more than 95 percent of human history, people lived in small, cooperative societies. Over the past few thousand years, our species underwent an amazing cultural evolution. Our brains did not change biologically, but how we used them did. As people pooled their experiences and accumulated knowledge from one generation to the next, their minds developed. And as their minds developed, they created new social arrangements to meet their changing needs.

Capitalism blocks this creative process. While knowledge continues to accumulate, it is not shared. And while some people are moved forward, many more are hurtled backward. The central problem for capitalism is how to create profit, not how to develop human potential. To maximize profit, capitalism must disrupt human relationships and stifle human potential.

The more we are divided and deprived, the more wealth can be generated for the people at the top. Any form of collectivism is a threat to the system, from union organizing to demands for government-funded services.

Instead of using our minds to solve our common problems, we get to decide only which section of the elite will dominate us. Instead of working together to raise our living standards, we labor to enrich the elite. Instead of protecting ourselves and each other, we fight their barbaric but profitable wars.

The human mind crumbles under such conditions. Epidemics of anger, anxiety, inter-personal conflict and deep discouragement create an ocean of human misery. Adding insult to injury, these signs of social sickness are mislabeled as “personal problems” and “mental illness.”

To preserve itself, capitalism must block the infinite potential of the human mind. And I do mean infinite. There is no limit to the number of ways that we could organize our lives and society.

The average human brain contains approximately 100 billion nerve cells or neurons. Each neuron has about 10,000 connections with its neighbors. When you consider that each of these connections can be turned on or off, the number of possible firing patterns is greater than the number of known particles in the universe. When you add the different ways that each human mind could connect with the other six billion minds on the planet…well, I think you get the picture.

Capitalism has stuck humanity in a giant historical rut and bamboozled us into thinking that this is the best we can do, that we have reached the end of our history. Not So! We have barely begun to explore our potential. However, if capitalism has its way, we never will.

We can’t let this happen. We have created capitalism, and we can change our minds and replace it with something much better.

Correction: The original version of this review incorrectly identified Naomi Klein as a co-flounder of the American Freedom Campaign. This was a mistake. Naomi Wolf is the co-founder. The text has been revised accordingly. My apologies to Ms. Klein and to my readers.

It’s often been said that we are the majority, and they can’t put us all in jail. Naomi Klein proves otherwise. It’s true, they can’t put us all in jail, but they don’t need to. Klein is the anti-globalization author of No Logo: Taking Aim at the Brand Bullies. In her bold new book, The Shock Doctrine: The Rise of Disaster Capitalism, she explains how “radical capitalists” use shock treatment to impose anti-human policies on unwilling populations.

Under normal conditions, most people reject plans to raise profits by waging wars, depressing living standards, deepening inequality and decimating civil rights. Nor do they choose to abolish government regulations, minimize corporate taxes, privatize government functions and eliminate social services. Yet that is what the “free market” demands. In essence, free people don’t choose wars and free markets, they choose peace and government services, like universal health care.

Because democracy is the enemy of the free market, free-market fundamentalists must use force to get their way. “Countries are shocked — by wars, terror attacks, coups d’état and natural disasters.” Then, “they are shocked again — by corporations and politicians who exploit the fear and disorientation of this first shock to push through economic shock therapy.” A third shock is delivered “by police, soldiers and prison interrogators” against those who resist. A succession of “aftershocks” provide more opportunities for profit.

While populations are reeling and disoriented, their economies are pillaged in a capitalist feeding frenzy. Public wealth is handed to the private sector, and private debt is transferred to the public sector. A few become fabulously wealthy, and the majority are impoverished. Whether this happens quickly, as it did in Chile 30 years ago, or more gradually, as in America today, Klein describes the outcome as “extraordinarily violent armed robbery.” By the time the population recovers its bearings, the economy has been looted and the theft sanctioned by law.

This may sound way over the top, but it isn’t science fiction. Klein’s research is meticulous, and she provides many examples to make her case: Latin America, South Africa, Poland, Russia, Asia and the Middle East.

In Iraq, the U.S. invasion (Shock and Awe) was followed by economic shock. American bureaucrats rewrote Iraq’s laws to permit 100 percent foreign ownership of Iraqi businesses and to let foreign companies take all their profits out of the country, tax free. All 200 of Iraq’s state companies were offered for sale, and the central bank was prohibited from financing state-owned businesses. A continuing military occupation, mass incarceration and torture force compliance with these policies.

In the United States, the shock of September 11 was used to privatize sections of the state that were previously off-limits, including disaster response, national security and the military. As Klein puts it, “For decades, the market had been feeding off the appendages of the state; now it would devour the core.” She describes the result as a “hollow government” that subcontracts state functions to the private sector and, in the process, transfers public funds into private coffers. “In 2003, the Bush administration spent $327 billion on contracts to private companies — nearly 40 cents of every discretionary dollar.” This process has been accompanied by mass detentions, secret prisons, extensive spying, elimination of due process, and torture.

Klein insists that the use of torture is not an aberration but a necessary display of the state’s determination to crush all opposition. Neither individual pain nor mass misery can be allowed to block the road to power and profit. Torture is “a foolproof indication” that “a regime is engaged in a deeply anti-democratic project, even if that regime happens to have come to power through elections.”

The impact of The Shock Doctrine cannot be captured in a short review. You must read it to appreciate the full significance of what Klein has uncovered. As an added bonus, it reads like a fast-moving detective story, unmasking the individuals and forces that are pushing our world into barbarism. Until the last few chapters, I couldn’t put it down.

The chicken and the egg

Despite her keen observations, Klein confuses the chicken of power with the egg of profit. She states, “I believe that the goal of the Iraq war was to bomb into being a new free trade zone.” This is mistaken.

Washington invaded Iraq to obtain a military base in a strategically important region of the Middle East. From this position, America can secure its global dominance by controlling a large portion of the world oil supply. Of course, enormous profits are being made in the process. But power comes first.

American companies could never claim Iraqi oil without the U.S. military. As Thomas Friedman observed,

The hidden hand of the market will never work without a hidden fist. McDonald’s cannot flourish without McDonnell Douglas, the designer of the F-15, and the hidden fist that keeps the world safe for Silicon valley’s technology is called the U.S. Army, Air Force, Navy and Marine Corps.

Confusion concerning the relation between power and profit leads Klein to view the rise of disaster capitalism as something new. In fact, it is the logical outcome of a system that has always sought profit at any price.

The British Empire was built on savage colonialism. America grew wealthy off the labor of African slaves. The displacement of poor people after disasters like Katrina and the Asian tsunami is an extension of the displacement of aboriginals and everyone else who has ever stood in the way of profit. What’s new is the astonishing efficiency with which human lives and the environment are being destroyed.

However, Klein doesn’t hate capitalism. Her target is the ruthless free-market doctrine preached by Milton Friedman and the Chicago School of Economics. Klein advocates a mixed capitalist economy, with “a free market in consumer products” and generous social services provided by a class-neutral state that serves everyone’s needs. How reasonable! Yet Klein provides more than 500 pages of evidence that the capitalist system is fundamentally unreasonable.

Klein compares capitalism to a drug addict, where the drug is profit. By definition, addiction is not a reasonable behavior. As Bob Dylan sang in “Highway 61 Revisited,” a capitalist will sell tickets to World War III if he could profit by doing so.

Moreover, Klein’s “third way,” which she describes as a mix of capitalism and socialism, is an historical oddity that developed as a temporary response to social crisis. Examples include the American New Deal in response to the Great Depression and the post-war European welfare states. Once the threat of revolution is removed, the drive for profit resumes. The New Deal has been dismantled, and European states are privatizing their economies. Vulture capitalists are devouring Britain’s welfare state, and Canada continues to privatize social services, despite annual government budget surpluses.

Klein takes the classic liberal position of compromise, the belief that capitalism can be made to suit everyone’s needs. As she puts it, “I am not saying that all forms of market capitalism are inherently violent. It is imminently possible to have a market-based economy that requires no such brutality.” The experience of ordinary people says otherwise.

Workers’ lives are brutalized every day by systemic disrespect, lack of control, overwork and unemployment, financial stress and fear for the future. Capitalism needs profit, profit requires worker exploitation, and exploitation is inherently violent. As Klein herself puts it,

An economic system that requires constant growth, while bucking almost all serious attempts at environmental regulation, generates a steady stream of disasters all on its own, whether military, ecological or financial. The appetite for easy, short-term profits offered by purely speculative investment has turned the stock, currency and real estate markets into crisis-creation machines, as the Asian financial crisis, the Mexican peso crisis and the dotcom collapse all demonstrate.

Klein shows us that capitalism is the enemy of democracy, so that any form of collectivism is seen as a threat to the system. That’s why President Bush rejected government-funded health care for low-income children. For business to triumph, everything that defines us as human must be swept away.

Three forces that CAN win

Klein tries to end this book on an optimistic note. She describes how people bravely reconstruct their lives after the shocks wear off. However, the resilience of people who rebuild, while immensely admirable, cannot counter the power of capitalism to keep on destroying. Klein also mentions the Bolivarian revolutions in Latin America and the worker cooperatives that she and her husband document in their must-see film, The Take. Oddly, Klein does not call for activists to rebuild the vibrant anti-globalization movement that was knocked off its feet after 9/11.

In the opening chapters, Klein names the forces that can defeat capitalism. In every nation they have targeted, free-market capitalists have identified three threats to their privatization agenda: organized workers (who could take the economy away from them); marxists (who encourage workers to do just that); and the principle of solidarity (which is incompatible with free-market individualism).

While Klein is passionate about solidarity, she is not a marxist. She doesn’t want to replace capitalism, she wants only to tame it. So she sidesteps the potential of the working class to liberate us from the disaster that is capitalism.

Naomi Wolf (no relation to Naomi Klein) co-founded the American Freedom Campaign, whose goal is “to reverse the abuse of executive power and restore our system of checks and balances.” The Campaign has gathered millions of signatures on a petition to defend the Constitution.

Wolf should read Klein’s book. Her description of Chile’s military coup proves that a Constitution presents no barrier to determined profit-seekers. Only the working class could have stopped that horror. But while workers begged for arms to defend their elected government, Chile’s president placed his faith in the Constitution. It was a disastrous and fatal mistake.

Real democracy and real freedom mean the power to control the economy. Capitalism will never choose to give that up, no matter how many people sign a petition.

Despite these weaknesses, The Shock Doctrine is essential reading for a new generation of activists. Few books help us to understand the world. Even fewer do it in an accessible form. Klein connects the dots to reveal the deepening conflict between what most people want and where capitalism is taking us. She tells us that the world is descending into barbarism, not because of human nature, not because people don’t care, not because we lost any argument, but because we have not yet organized in sufficient numbers to prevent it.

The good news is that human beings not only suffer, we also rebel, and we can learn to rebel more effectively. As Klein reveals, there are three forces that can defeat capitalism: the organized working class, the politics of marxism and the principles of solidarity. Her final message is absolutely right. It’s time to organize.

Naomi Klein poses the same question. Her new book, The Shock Doctrine, documents how the people in power engineer catastrophes and exploit naturally-existing crises to profit a few. How awful! Who are we, that we tolerate such injustice?

Capitalists and their supporters reply, “Human nature is brutal and cannot change.” They want to keep the door shut on any discussion of who we are and the kind of society we could have. As far as they are concerned, we are their creatures and should remain so. We labor to enrich them. We suffer and die to build their empires. That’s who they want us to be.

Who decides who we are? Moore and Klein and a growing number of activists are saying, “We decide who we are.” And so the revolution begins.

Who do we want to be?

People value kindness more than any other characteristic. Compassion in thought, word and deed is universally appreciated regardless of nationality, culture or religion. By acknowledging kindness as the highest human value, we define who we are and the type of world that we want.

We want to live in a compassionate and sharing world, a giving-and-forgiving world, a help-each-other-out world, an all-for-one-and-one-for-all world, a socialist world, democratically managed by all of us, for all of us.

A truly democratic society can remake itself in any way it chooses. As Klein points out, the idea that people should not have the power to decide how the economy functions “is and remains the single most anti-democratic idea of our time.”

The capitalists don’t want a kind world or a democratic world. There would be no profit in it. They want more and bigger weapons, more surveillance, more prisons and more repression to keep their profits flowing and protect their power to shape society for their exclusive benefit.

However, when millions begin to ask, “Who are we?” the days of the oppressors are numbered.

We are the majority, and we can build a fair and just world. We lack confidence in ourselves and each other, but that can change. Together, we can release ourselves and our oppressors from this heartless hell of chasing profit. There can be no act of compassion greater than that.

Feminists would describe this behavior as workplace machismo, or male toughness. Marxists would describe it as false consciousness, where workers fail to recognize their class interests, in this case, to protect their health on the job.

I suspected something else, so I replied, “I think I understand. If you value your hearing, then you are valuing yourself, and that would create conflict in a job where you are not valued.” His eyes widened in recognition. Then he looked at the floor and nodded. His wife asked me what I was talking about. And so I explained.

The more employers devalue their employees, the less they have to pay them, and the more profit they will make. In contrast, employees seek greater recognition of their contribution in the form of higher wages. Workers command more respect when they pull together.

In 1937, General Motors was the biggest corporation in the world. Genora (Johnson) Dollinger describes the confidence of workers who forced GM to recognize their union:

“Every time something came up that couldn’t be settled or the workers got a tough foreman who told them, “Go to hell,” they’d shut down the line. The men were so cocky, they’d say to the foremen, “You don’t like it?” They’d push the button and shut down the line.”

In response, the capitalist class set out to strip the unions of their power. In Subterranean Fire: A History of Working-Class Radicalism in the United States, Sharon Smith explains how conservative union officials joined with government to drive socialists and other militants out of the unions. By the 1950s, American unions had been transformed from fighting organizations controlled by workers to bureaucratic organizations run by middle-class professionals. But the bosses wanted more. They wanted complete control of the shop floor.

Degrading Workers

In Labor and Monopoly Capital: The Degradation of Work in the Twentieth Century, Harry Braverman describes how employers robbed workers of their power by applying an industrial system called “scientific management” or Taylorism.

Frederick Winslow Taylor developed three methods for transferring control over the labor process from workers to managers: separating mental and manual work; de-skilling the labor process; and micro-managing every step of the work. In combination, these methods reduce the skilled worker to a cog in a machine, interchangeable with any other cog. As a writer of the time observed,

“It is not, truly speaking the labor that is divided; but the men: divided into mere segments of men — broken into small fragments and crumbs of life; so that all the little piece of intelligence that is left in a man is not enough to make a pin, or a nail, but exhausts itself in making the point of a pin or the head of a nail.”

Today, Taylor’s methods are the norm. Fast-food restaurants are structured like assembly lines. Hospitals function like factories where separate departments tend to different parts of the body, in assembly-line fashion. Classroom courses are scripted to the point of describing which hand gestures to make while teaching.

Devalued workers are treated as expendable. An estimated 55,000 Americans die every year from occupational injury and illness, far more than died on 9/11. Despite this shocking level of industrial slaughter, politicians do not denounce employers as “terrorists,” and they do not order Homeland Security to patrol the workplace.

Ninety percent of all work sites in America, covering 40 percent of the nation’s workforce, are not inspected regularly for health and safety violations. When violations are found, the penalties are too small to force any real change.

The State virtually gives employers a license to kill workers. In 1970, Congress declared that causing the death of a worker by deliberately violating safety laws is a misdemeanor (not a felony) with a maximum sentence of six months in jail. This is half the maximum for harassing a wild donkey on federal land.

Workers stripped of skill, dignity and social worth suffer low morale, sickness and frequent absenteeism, all of which lower productivity. To boost productivity, experts in medicine, psychology and human relations serve as the maintenance crew for the human machinery. These professionals are not employed to remedy the assault on the worker. Their job is to manage the worker’s reactions to that assault. The worker becomes the problem, not the way work is organized. And that’s how a middle-aged worker with hearing loss ends up at the doctor’s office feeling embarrassed about not using hearing protection.

False Consciousness?

Is this worker suffering from “false consciousness”? I would say no. He knows he has a conflict. He understands the danger of excessive noise and wants to protect himself. However, he also recognizes (even when he can’t put it into words) that if he and his co-workers valued themselves, it would be more difficult to tolerate a job where they are not valued.

Given the employer’s disregard for their hearing, these workers have two choices. They can unite and demand less noise and more effective health and safety provisions. Or they can “go along” by dissociating from their need to protect themselves. The first option would create conflict with the boss. The second option creates conflict with themselves and each other. The workplace is structured to promote the path of least resistance, which is to “go along to get along.”

When challenging the social order seems impossible, machismo serves as a form of collective self-defense. Machismo helps male workers bear their degradation by making it seem that they choose to risk their health on the job, as a confirmation of their manly toughness.

To view the problem only as masculine strutting is to fail to recognize the worker’s real oppression. To view the problem only as false consciousness is to disregard the creative forms of self-defense that workers use when they see no class-based alternative.

Similarly, racist workers have a legitimate need to defend their jobs. However, workers who blame other workers for their problems trade apparent short-term gain for real long-term pain. The need for self-defense is real, but the method is self-defeating, because employers use racism to lower living standards for all workers.

Socialists strive to provide workers with the knowledge and experience that will help them to see the social source of their misery and their collective power to end it. The term “false consciousness” is used to explain why workers persist in supporting a system that oppresses them. (Feminists also use the term “false consciousness” to explain why women support a system that oppresses them.)

Marx never used the term “false consciousness,” and Engels refers to it only once, in a letter. However, the concept bears an uncanny resemblance to Freud’s concept of psychological resistance. When Freud’s patients refused to accept his interpretation of their problems, he called this “resistance,” a psychological defense against discussing, recalling or thinking about painful realities.

Freud’s concept of resistance assumes that the therapist is always right and the patient is always wrong. In reality, therapists frequently fail to appreciate the larger social context that compels people to behave in ways that seem self-defeating, but are actually self-preserving in the absence of other choices.

Consider the unconfident woman who stays with an abusive mate despite her therapist’s recommendation that she leave. Freud would view the deadlock between therapist and patient as resistance, where the patient is resisting the therapist. There is another possibility. The therapist may not appreciate the woman’s financial inability to support herself and her kids and the real possibility that her mate may kill her if she leaves.

Just as the concept of resistance creates conflict between therapist and patient, the concept of false consciousness creates conflict between socialists and non-socialist workers. Who decides whose consciousness is “true” and whose consciousness is “false”? Socialists may not appreciate the extent to which capitalism is structured to keep most people feeling powerless most of the time, regardless of what they know, and that understanding these forces is the first step to overcoming them.

The Body Tells the Truth

The self-defense methods that workers use to “get through” are not entirely successful. They preserve a semblance of dignity, but fail to protect against the ravages of exploitation. What the mind refuses to acknowledge, the body protests by generating pain and other disabling symptoms (like hearing loss). As Michael Schneider writes in Neurosis and Civilization:

“As long as the working class does not rebel against these new and intensified forms of exploitation, heart, stomach and circulatory diseases of individual workers will rebel for them. Even though the worker may still ‘go along,’ his circulation, in any event, will not. Even if he says, ‘actually I feel alright,’ his stomach ulcer will prove the contrary.”

As the rich get richer, the rest of us get sicker. Capitalism produces obscene wealth at one end of society and epidemics of dis-ease everywhere else. The medical system hides the relationship between class and illness by treating sickness as an individual malfunction, instead of the inevitable price of a profit-driven system. Even universal health care cannot stop the sickness produced by capitalism. Only the working-class majority can transform an illness-generating society into a health-generating one.

Machismo, racism, dissociation, sickness and other forms of self-defense both mask and reveal the reality of worker oppression. By viewing worker compliance with capitalism as false consciousness, socialists pit themselves against workers.

Workers do not want to suffer. They want to be judged even less. Socialists can align with workers by appreciating the complexities of their lives and their need to defend themselves. This alliance is essential for workers to learn to fight as a class.

As Braverman concludes, until workers fight back as a class they will “remain servants of capital instead of freely associated producers who control their own labor and their own destinies,” and they will “work every day to build for themselves more ‘modern,’ more ‘scientific,’ and more dehumanized prisons of labor.”

This conflict between the rulers and the ruled reflects a deeper, structural rift. In a series of three articles (Z Magazine, February, April, May, 2007), Jack Rasmus reveals how,

“From the early 1980s on, income inequality widened, deepened, and accelerated until today well over $1 trillion in income is being transferred every year from the roughly 90 million working class families in the U.S. to corporations and the wealthiest non-working class households.”

Thirty-five years of pro-business policies have hurtled class inequality back to the level of the 1920s. One percent of Americans now owns half the nation’s wealth. By 2005, U.S. millionaires owned $30 trillion in assets, more than the annual wealth produced in China, Japan, Brazil, Russia and the European Union combined!

The extent of inequality is angering the working class and alarming sections of the establishment. In “the land of opportunity,” inequality is typically blamed on the have-nots for lacking the skills and determination to succeed. Now that the majority has been left behind, this excuse has lost credibility. Consider the following editorial from the New York Times (August 29, 2007),

“The median household income last year was still about $1,000 less than in 2000, before the onset of the last recession… When household incomes rose, it was because more members of the household went to work, not because anybody got a bigger paycheck…The earnings of men and women working full time actually fell more than 1 percent last year…The spoils of the nation’s economic growth have flowed almost exclusively to the wealthy and the extremely wealthy, leaving little for everybody else.”

Americans are seething with discontent over falling living standards, the environmental crisis, the war and the abysmal state of the medical system. In the spring of 2006, this anger exploded in the largest demonstrations in the nation’s history. Protesting anti-immigrant policies and chanting “We are America,” the working class rose up and punched the capitalist class in the face. That fall, the Republican majority was swept from office by voters who were sick of government lies, incompetence and corruption.

Reform or revolution

A section of the ruling class is concerned that popular discontent could coalesce into a generalized rebellion against the system. This happened after World War I, in the 1930s and again in the 1960s.

There are only two solutions to such crises: reform from above to restore confidence in the system or revolution from below to replace it. Let’s examine the first option.

Both the Democratic and Republican Parties are committed to the American Empire and to the conquest of Iraq. To counter widespread anti-war sentiment, Washington has repackaged the war as military support for the Iraqi government, with Iraqi incompetence being blamed for “delaying” troop withdrawal. Regular announcements of “signs of progress” imply that the war is winding down when it is actually escalating. This stalling tactic seems to be working, for now.

Reducing class inequality presents a greater challenge. The New York Times concludes, “What are needed are policies to help spread benefits broadly — be it more progressive taxation, or policies to strengthen public education and increase access to affordable health care.”

The elite immediately cry “socialism!” at the suggestion that any portion of the social pie should be returned to the working class. Capitalists want a State that enacts policies just for them and rescues only them. And that’s what they get. In countless ways, capitalism functions as a kind of socialism for the rich.

America’s tax laws free the largest corporations from paying any tax whatsoever. Federal judges have allowed ailing industries to abandon billions of dollars in “burdensome” pension obligations. The multi-billion-dollar federal bailout of mortgage lenders has not been matched by any money for working-class home owners facing foreclosure. And while the Bush administration allows Medicare-funded insurance companies to keep millions of dollars that should have been returned to beneficiaries, it vigorously pursues beneficiaries to recover money that it says is owed to insurance companies.

While the New York Times complains about such injustices, it doesn’t want socialism. It wants a lesser-evil capitalism directed by the Democratic Party.

Liberals and liberal institutions condemn the worst aspects of capitalism in order to preserve the system as a whole. Most Americans want more investment in the nation’s infrastructure. They want universal healthcare and more funding for schools. They want New Orleans rebuilt and their bridges secure. Liberals fear that if the system fails to deliver, the majority will reject the system.

Wiser capitalists remember the French Revolution. Those who take too much can lose their heads. Billionaires like Bill Gates and Warren Buffett prefer to return a small piece of the pie than forfeit the entire bakery.

Gates criticizes the “inequality gap” and devotes a tiny portion of his fortune to charity. Buffett says it’s unfair that he pays less than 18 per cent of his income in taxes, when his secretary pays 30 per cent of hers. Gates and Buffett aren’t socialists. Like the robber-baron philanthropists of the previous century, they understand that their class must appear generous to preserve its system of organized thievery.

President Roosevelt faced a similar choice when he fought for the New Deal despite opposition from business interests. In A People’s History of the United States, Howard Zinn explains,

“The Roosevelt reforms…had to meet two pressing needs: to reorganize capitalism in such a way as to overcome the crisis and stabilize the system; also to head off the alarming growth of spontaneous rebellion…— organization of tenants and the unemployed, movements of self-help and general strikes in several cities.”

Reining in a 35-year wealth-grabbing binge won’t be easy. Despite liberal demands that Democrats in Congress develop a spine, the Democratic Party serves the business class. Returning any wealth to the working class would undermine Corporate America’s ability to dominate the global economy.

Unless it is forced to use the carrot to quell discontent, the ruling class prefers to use the stick. The war on terror, with its attack on civil liberties, is the capitalists’ response to inequality and injustice. They seize the wealth; they do not share it. They crush their victims; they do not rescue them. And they don’t feel threatened by a labor movement that is currently too weak to mount a sustained rebellion. At the same time, their confidence has been shaken by their failures to win the war, create a workable immigration policy and resolve the health-care crisis.

Channeling discontent

Liberals argue that an ounce of prevention is worth a pound of cure. The capitalist class is a tiny minority that needs majority consent to rule. That consent could be lost if social problems are allowed to deepen. Liberals prefer to align with social discontent in order to contain it within established channels.

When the President defended insurance industry profits over the needs of sick children, the New York Times shared the nation’s outrage. In “An Immoral Philosophy” (August 1, 2007), Paul Krugman writes,

“What kind of philosophy says that it’s O.K. to subsidize insurance companies, but not to provide health care to children?…9 in 10 Americans – including 83 percent of self-identified Republicans – support an expansion of the children’s health insurance program…There is, it seems, more basic decency in the hearts of Americans than is dreamt of in Mr. Bush’s philosophy.”

The liberal media are running to get ahead of a growing number of dissidents, like Naomi Klein and Michael Moore, who are fueling discontent. Klein’s best-selling book, The Shock Doctrine: The Rise of Disaster Capitalism, has joined Moore’s documentary film, SiCKO, to punch holes in the lies that prop up the system. When Oprah and Moore agree on national television that America needs some form of socialized medicine, the wind is definitely shifting.

Suddenly, “socialism” is not such a dirty word. In “A Socialist Plot” (August 27, 2007), Krugman writes, “The truth is that there’s no difference in principle between saying that every American child is entitled to an education and saying that every American child is entitled to adequate health care.”

Liberals must convince the capitalist class that a lesser-evil-capitalism, even when it calls itself socialism, is preferable to the threat of real socialism. However, conservatives argue that granting reforms will be the start of a slippery slope. If Americans think they have a right to health care, what else will they think they deserve?

Conservatives remember the 1960s, when Americans gained the confidence to demand racial equality, women’s liberation, aboriginal rights, gay liberation, more social support, higher wages, safer working conditions, more affordable housing, better schools and more access to medical care. There was organized opposition to the arms race, nuclear power, the death penalty, American foreign policy and the Vietnam War. It took a concerted effort and many years to beat back that rebellion.

Is America ready for socialism?

The social crisis and the conflict at the top have opened a space to discuss genuine socialism, a worker-run democracy where ordinary people take collective control of the economy and direct it to meet human needs. The material conditions already exist for such a society.

Because socialism is based on sharing, there must be more than enough to go around. That is no longer a problem. If the yearly production of American workers was transformed into dollars and equally shared among the population, it would provide $45,000 for every man, woman and child in the nation, or $180,000 for every family of four. This sum would be many times larger if everyone who wanted to work was employed and if the wealth produced in previous years was included.

The same is true on a world scale. Between 1800 and 2000, the amount of wealth produced grew eight times faster than the global population. Only a few have benefited. By 2001, 497 billionaires enjoyed assets of $1.54 trillion, more than the combined incomes of half of humanity.

The second criterion for socialism is a matter of choice. Human beings create the societies in which they live and they can choose to change them.

Most Americans do not choose socialism because they are bamboozled into thinking that it would not be in their interest. Our rulers insist that there is no alternative to capitalism, as they intensify their barbaric tactics of blame-the-victim and divide-and-rule. By dazzling us with their power, they hope that we will not discover our own, much greater power.

Capitalism isn’t threatened by talk of cooperation and sharing. However, it cannot tolerate demands for a society based on these principles. That’s why the elite have made “socialism” a dirty word. If people knew they could meet their needs and solve their problems without a ruling class, they would have no need for capitalism.

Socialist organizations bring ordinary people together to discover and use their collective power. Where capitalism divides and fragments, socialists link individuals, struggles, past events and future dreams into a unified struggle for human survival.

The battle for ideas is critical. To isolate workers and re-enforce their feelings of powerlessness, the capitalist class infects them with fear and pessimism. In contrast, socialists connect workers’ experience of individual suffering with their collective power to eliminate that suffering. It’s easy to believe in those who believe in themselves. Socialists believe in the working class even when it does not believe in itself.

The anti-globalization movement of the late 1990s raised the hope of change. So did the massive anti-war demonstrations that preceded America’s invasion of the Middle East. When the U.S. began bombing Baghdad, many became discouraged and retreated from activism.

Today, rising discontent is not matched by a corresponding rise in struggle. While millions of Americans are enraged by the deterioration of their lives and society, decades of defeat have deepened the belief that real change is not possible. But beliefs change.

The working class is obedient, not stupid. It has rejected the war despite a steady stream of pro-war propaganda. Workers are also exceedingly patient, but there is a limit to how much unfairness they will tolerate.

With the economy sliding into recession, the New York Times warns, “It seems that ordinary working families are going to have to wait — at the very minimum — until the next cycle to make up the losses they suffered in this one. There’s no guarantee they will.”

No one can know when the next struggle will erupt or what its outcome will be. Only one thing is certain. The needs of the capitalist class will continue to clash with the needs of humanity. If we can organize ourselves in sufficient numbers to end the war and win universal health care, we need not stop there. We could proceed to build a very different world based on peace and security for all.

In 2000, Julian Sher produced an explosive television documentary exposing a conspiracy to convict Truscott: important witnesses were never called to testify; more likely suspects, including a known pedophile, were never questioned; and important leads were kept from the defense, the judge and the jury. Were prosecutors defending the conviction to cover up that conspiracy?

On August 28, 2007, the Ontario Court of Appeal finally acquitted Truscott of murder, but refused to proclaim him innocent. Doing so would have strengthened the argument that Truscott had been maliciously prosecuted.

Richard Moran studied 124 exonerations of US death row inmates between 1973 and 2007. He found that two-thirds of these convictions resulted from “intentional, willful, malicious prosecutions.” He writes in the New York Times,

Mistakes are good-faith errors — like taking the wrong exit off the highway, or dialing the wrong telephone number. There is no malice behind them. However, when officers of the court conspire to convict a defendant of first-degree murder and send him to death row, they are doing much more than making an innocent mistake or error. They are breaking the law.

Kenneth Foster Jr. is a victim of malicious prosecution, condemned to die for the 1996 murder of Michael LaHood. The prosecution acknowledges that Foster did not shoot LaHood or actively participate in the slaying. Foster only drove the car in which LaHood’s killer was riding on the night of the murder. Nevertheless, the 1974 “Texas Law of Parties” allows the death penalty to be imposed on anyone involved in a crime where a murder occurs, even if the accused is not involved in the murder or even aware that a murder is intended.

A public campaign to save Foster’s life pressured Texas Governor Rick Perry to commute his death sentence hours before the execution was scheduled to take place. This turnaround is an exception, as Richard Moran explains,

Even when a manifestly innocent man is about to be executed, a prosecutor can be dead set against reopening an old case. Since so many wrongful convictions result from official malicious behavior, prosecutors, policemen, witnesses or even jurors and judges could themselves face jail time for breaking the law in obtaining an unlawful conviction.

The Canadian penal system cannot compare with the extreme barbarism of the American system, yet their goals are the same — to incarcerate as many people as necessary to control the “unruly masses.”

In Blaming the Victim (1976), William Ryan notes, “The prisoner is the visible symbol of crime contained — the criminal caged and restrained — to give the unwitting citizen the feeling that the cops and jails are preserving his safety.”

Defense attorney Clarence Darrow explains that the misnamed “justice” system has nothing to do with justice. It exists to legalize the crimes of the capitalist class. In Crime and Criminals (1902) he writes,

Those men who own the earth make the laws to protect what they have. They fix up a sort of fence or pen around what they have, and they fix the law so the fellow on the outside cannot get in. The laws are really organized for the men who rule the world. They were never organized or enforced to do justice. We have no system for justice, not the slightest in the world.

Darrow defined a criminal as someone with predatory instincts who has insufficient capital to form a corporation. Corporations can and do ignore the law. General Electric has been convicted of more than 280 counts of contract fraud, yet not a single GE executive sits in jail. Meanwhile, California’s three-strikes law sends petty thieves to jail for life. Gary Ewing got 25 years for stealing three golf clubs, and Leandro Andrade was sentenced to 50 years for stealing nine children’s videotapes.

The French novelist Balzac observed, “Behind every great fortune there is a crime.” Yet, capitalism defines crime only in ways that target the working class. If you take pencils home from work, that is considered stealing. If the power company raises its rates every month, that is considered business. In 2006, Las Vegas declared it a crime to feed homeless people in public parks. Failing to provide housing for the homeless, jobs for the jobless, medicine for the sick, and food for the hungry are not considered crimes. Businesses can lawfully withhold life’s essentials from those who cannot pay. Where is the justice in this?

In The Rich Get Richer and the Poor Get Prison (2000), Jeffrey Reiman calculates that corporate crimes cost ordinary people more money and cause more deaths than common street crimes. Executives market dangerous products, manufacturers dump toxic chemicals into the environment, and managers plot to destroy jobs and steal pensions.

Unlike many murderers sitting in prison for life, these gentleman bandits, these intelligent, educated men and women who slowly and methodically plan the crimes that wreck the future of untold numbers of people, know exactly what they are doing and who will be hurt. Their crimes of cold, selfish greed reflect, in their own way, even more indifference to life than murder.

The Crime of Poverty

Those who talk about cracking down on crime never talk about cracking down on the root cause of crime, the capitalist system itself.

The poorest neighborhoods have similar (high) murder rates, whether they are predominately Black, White or Hispanic. Drug addiction, prostitution, theft, assault and murder are the result of no jobs, no money, no future and no hope.

A 2004 national survey of American cities revealed a direct relationship between unemployment, less education, lower income and serious crime, including robbery, rape and murder. That year, Newton, Massachusetts was rated the safest American city. Camden, Pennsylvania was rated the most dangerous. Why the difference?

Newton’s employment rate was more than five times higher than Camden’s. More than two-thirds of Newton residents had university degrees, compared with only five percent of Camden residents. And the median household income in Newton was more than three times that of Camden’s. The root of crime in Camden is class deprivation. If Camden residents had the same living standards as Newton residents, they would enjoy the same low crime rates.

As the capitalist system sinks deeper into crisis, the greedy people who run society demand more convictions, more prisons, more and faster executions to keep their victims under control. There can never be enough blood to quench their fear of us. Their fear is justified.

We, the majority, have the power to end this criminal social system and create a truly just world. Campaigns to defend the victims of injustice provide a glimpse of that possibility.