Introduction

The first part of this series focused on a critique of the phrase “good jobs and decent work” expressed in the Ontario Federation of Labour’s campaign titled “Building the Fight for a Workers-First Agenda” (https://ofl.ca/event/activist-assembly-2022/). This post will focus on a critique of the phrases “high quality affordable housing” and “health care.” I draw on earlier posts for such critiques.

The so-called radical left here in Toronto rarely engages in any detailed criticism of unions or groups of unions. Quite to the contrary. They either make vague assertions about “the trade-union elite” or the “trade-union bureaucracy” (union bureaucrats or business unions), or they remain silent when faced with the persistent rhetoric that unions use. It is hardly in the interests of the working-class to read merely vague criticisms of unions or to not read anything concerning the limitations of unions or groups of unions.

The Ontario Federation of Labour (OFL)

What is the Ontario Federation of Labour (OFL)? On its website, we read the following:

WHO WE ARE

Just as workers unite in a union to protect their rights, unions also unite in federations of labour to fight for better working and living conditions. The Ontario Federation of Labour (OFL) serves as an umbrella group for working people and their unions.

From our inception in 1957, the OFL has grown to represent over one million Ontario workers belonging to more than 1,500 locals from 54 affiliated unions, making us Canada’s largest labour federation. Our strong membership and constant vigilance make us a formidable political voice.

WHAT WE DO

We push for legislative change in every area that affects people’s daily lives. Areas like health, education, workplace safety, minimum wage and other employment standards, human rights, women’s rights, workers’ compensation, and pensions.

We also make regular presentations and submissions to the Ontario government and mount internal and public awareness campaigns to mobilize the kind of political pressure that secures positive change for all workers – whether you belong to a union or not.

To accomplish these goals, we work with affiliated local unions and labour councils across the province. We also partner with other community and social justice organizations to build a fairer and more inclusive society that meets everyone’s needs.

The Ontario Federation of Labour’s Worker’s-First Agenda Campaign

On the above web page, we read:

That means good jobs and decent work for all workers; a $20 minimum wage; high quality affordable housing; accessible and well funded health care, long term care, education, and other public services; justice for Indigenous people and racialized communities; climate justice and a livable planet; and so much more!

These are winnable demands, but only if we fight for them. That’s why we need you to help build the fight for a workers first agenda in our province.

I certainly agree that workers need to fight to create a workers-first agenda. However, I seriously question that what the Ontario Federation of Labour calls a workers’ agenda expresses a full and complete workers’ agenda.

As is usual, I hardly oppose the fight for reforms that benefit workers. However, is what is proposed anything other than the fight for a more humanized form of capitalism? Let us see.

High Quality Affordable Housing

What would be required to actually provide high-quality affordable housing? We are not provided with any guidance over the issue. Admittedly, such high-quality affordable housing would be, in part, a function of the specific town or city for their provision. Generally, either such high quality affordable housing would be provided through private construction by capitalist firms, by the capitalist government, or a combination of the two.

High quality affordable housing also refers to different kinds of housing: rentals or outright buying (through mortgages).

If housing were provided mainly by private firms, then house and condos prices may well rise (as they have in Toronto, Vancouver and other Canadian cities).

But the document probably refers to such high-quality affordable housing being provided by–the capitalist state and rented by tenants (although government-subsidized purchases of houses and condos is also possible).

There is no indication otherwise how such high-quality affordable housing would be provided. The housing would become social housing, managed by the government, with its current oppressive structures. Social housing, even if relatively affordable (rent determined by level of income) hardly need be quality. Indeed, as I pointed out in another post (Exposing the Intolerance and Censorship of Social Democracy, Part One: The Working Class, Housing and the Police):

Immediate Incident as an Occasion for Grassroots Activism

On Good Friday, April 2, 2021, 23 police cruisers showed up at 33 Gabian Way, which is a 19-story building owned by Vila Gaspar Corte Real Inc., or Villa Gaspar Corte Real Non-Profit Housing Inc. (there is some inconsistency in spelling the company).

The building is a combination of rental and social housing, built in 1993. There are 248 residential units. Apparently, the building is linked to Project Esperance, which is a non-profit registered charity. It services 111 units of from one- to three-bedroom units. Rents are geared to income.

…

as the incident at 33 Gabian Way demonstrates, public housing can be quite oppressive. Evictions can occur in just as brutal fashion as in private housing. The left should not idealize the public sector—which they often do.

The issue of the oppression of tenants in “affordable housing” is not addressed in any way by the OFL. To be a tenant is to automatically be subject to precarious living since there is “an inherent imbalance of power” between tenants and landlords.

The OFL also does not address how the split in the working class between those who own houses and see them as vehicles for rising asset values and those who only rent (from other workers who own houses or condos) is to be addressed. As I wrote in the same post:

Housing, Police and the Working Class

The use of houses as equity among the working class has led to a split within the class in terms of immediate material interests. From Michael Berry, “Housing Provision and Class Relations under Capitalism: Some Implications of Recent Marxist Class Analysis,” in pages 109-121, Housing Studies, Volume 1, Issue 2, pages 115-116:

Income differences are, as has been argued, also internalised within classes. In the case of the working class, for example, higher paid workers in primary jobs are doubly advantaged; they enjoy both higher and more secure wages and a higher probability of: (a) gaining access to owner-occupation; and (b) securing high capital gains from domestic property ownership. Conversely, workers in the secondary job market and those relegated to the reserve army of unemployed are more likely to be denied access to home ownership, or, if allowed access, concentrated in housing submarkets where property values remain relatively stable. Tenancy therefore evolves as a residual tenure category in a dual sense; not only can land supporting rental housing often be converted to more profitable non-residential uses, it evolves as ‘housing of last resort’ for less privileged sections of the working and nonworking population whose low incomes place strict limits on the rental returns to landlords, both factors leading to a degree of underprovision and homelessness.

In summary, working class disunity, associated with unequal access to and benefits from home ownership, and its political expression through various forms of struggle, is part of a wider system of inequality and exploitation. Both forms of advantage to higher paid workers privileged position in the workplace, over and against the immediate interests of other workers. depend on their being able to maintain their privileged position in the workplace, over and against the immediate interests of other workers.

Accessible and Well-funded Health Care

I have already posted on the issue of health in the context of the class power of employers in a series of posts (see for example Working for an Employer May Be Dangerous to Your Health, Part One). I also have addressed the issue in other posts (such as  Health Care: Socialist versus Capitalist Nationalization). I will draw on already posted posts to question whether a well-funded health care system is really possible under an economic, political and social system characterized by the dominance of a class of employers. I will dispense with quotes when it comes to my own comments in previous posts.

The Issue of Public or Nationalized Health Care

Health care even in a nationalized context can easily be an expression of oppression and exploitation. The idealization of nationalization often goes hand in hand with an argument  that we need to extend public services in health and education (as Sam Gindin, former research director for the Canadian Auto Union (CAW, now Unifor, the largest Canadian private-sector union)  has argued). However, nationalized health care can easily become an oppressive experience for workers (as well as patients). From Barbara Briggs (1984), “Abolishing a Medical Hierarchy: The Struggle for Socialist Primary Health Care,” pages 83-88, in the journal Critical Social Policy, volume 4, issue #12, page 87:

GPs AND SOCIALISM

Socialists have traditionally argued for state control of key areas of the economy and of the provision of welfare services such as health and education. Socialist health workers have argued for general practitioners to become salaried employees of the Area Health Authorities, along with the ’ancillary workers’, instead of continuing to enjoy the independent self-employed status that they insisted on to protect their status when the NHS [National Health Service of the United Kingdom] was set up.

But the NHS, the largest employer in the country, has shared with nationalised industries the failure to demonstrate any evidence of ’belonging to the people’: because of the backing of the state it has proved a ruthless and powerful employer, keeping the wages of unskilled and many skilled workers also at uniquely low levels; time and again, union members seeking improvements in pay and amelioration of very poor working conditions have been defeated. Nor has the NHS shown any kind of effective accountability to its users. Public spending constraints have hit the NHS not only by causing a decline in working conditions and in the services provided, but also by imposing even more centralised planning priorities based on the need to save money whatever the cost.

This situation likely characterizes the Canadian public health-care system as well.

Health Care Versus Health Services

In the context of the class power of employers, health care is impossible. Rather, what is provided is health services. From Bob Brecher (1997), (pages 217-225), “What Would a Socialist Health Service Look Like?,” in the journal Health Care Analysis,  volume 5, issue #3, page 221:

Service’ implies server and served; consultant and client; provider and consumer. But none of these describes the sort of relationship between carer and person carefd for that the two principles outlined suggest. To take the example of the NHS again: despite the intentions of its founders, it was the connotations of service–by turn beneficently providing for patients and ‘servicing’ them as though they were objects–which helped provide amply justified dissatisfactions with the resultant shortcomings of the NHS treatment: and these have been used to undermine its founding principles. The combination of professional paternalism, especially in respect of senior doctors; an inability or unwillingness to treat people rather than their symptoms; and an attitude of ‘servicing’ and being ‘serviced’ all helped alienate people from what was supposed to be ‘our’ NHS, enabling successive conservative governments to turn what was at its inception at least a ‘social’ health service into an expliictly anti-socialist one. … these are not accidents of the British context: such terms and the attitudes and mores they describe are inimical to a socialist structure, based as that must be on considerations of equity and respect.

It is important to emphasize, as Brecher points out, that the assumption that nationalization is somehow socialist without further ado itself contributes to the Conservative backlash and the emergence of neoliberalism. By indulging the social-democratic or social-reformist left, with their talk of “decent work,” “fair contracts,” “fair share of taxes,” “$15 Minimum Wage and Fairness,” and the like, the so-called radicals have in reality contributed to the neoliberal backlash. What is needed is not indulgence of such talk, but continuous critique of such talk. What is needed is a critical attitude towards the so-called “left” and its associated idealized institutions.

Does the OFL provide such a critical attitude? Not at all. It assumes that health care (rather than health service) is possible in the context of the domination of a class of employers. On the other hand, its standard is really health service rather than health care; its standards in this area, like in so many other areas, is quite low. But that applies in general to social democracy or social reformism.

Health Services Provided Fail to Meet Health-Care Needs

The OFL fails to address the issue of the relation between health care and prevention of sickness, injury and disease. In a socialist society, health care would still be important. From  Calum Paton (1997),  (pages 205-216), “Necessary Condtions For A Socialist Health Service,” in Health Care Anal., volume 5, page 209:

A socialist health service in a non-socialist society may be forced to stress care and rescue rather than prevention, health maintenance or the promotion of better health and more equal health status. Nevertheless this may be an important role. Even in a utopian society of perfect health promotion and prevention, people are more likely to die of more complex comorbidities at a later stage in the life cycle. The concept of substitute mortality and morbidity is useful here. 5 As a result simplistic trade-offs which suggest that ‘the more primary care there is, the less secondary care will be necessary’, are unlikely to be true either in the here and now or in the perfect society.

To be cared for with dignity, and to suffer with dignity and to die with dignity–these would all be important aspects of socialist health care.

The OFL also excludes a major issue dealing with health: its prevention. It ignores entirely the need to consider the prevention of disease, injury and sickness in the first place. What are the social conditions that increase the likelihood that a person would become a patient in the first place? Undoubtedly, as we become old, we will likely become patients at some stage in our lives–there is no getting around this fact. However, there are social determinants of health as well, and consequently becoming a patient is also often a function of social conditions.

In a socialist society, prevention would be a major focus of social policy and would deal with addressing the social determinants of health problems, ranging from health problems linked to the workplace to health problems linked to other environmental conditions, including food processing.

Today, though, many social determinants are largely ignored in favour of focusing on servicing those already sick. Consider breast cancer. It arises in many instances from environmental conditions, and yet most money is allocated to servicing those already inflicted with the disease rather than with preventing it from arising in the first place. From Faye Wachs (2007), (pages 929-931), “Review. Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy. By Samantha King,” in Gender & Society, volume 21, number 6 (December), pages 930-931:

Recent studies reveal that simply removing known carcinogens from products and our environment could prevent thousands of cases annually (Brody et al. 2007). However, funding for such research is limited, while the monies for identifying and curing existing cases is the focus of most efforts. Indeed, many of the companies that fund survivorship continue to use known carcinogens in their products. King points to the fact that despite increased awareness, rates of breast cancer have increased from 1 in 22 in the 1940s to 1 in 7 in 2004. Even if one considers women’s increasing longevity, this still indicates an increase in the prevalence of breast cancer. Moreover, structural factors that affect risk and survivorship, such as socioeconomic status, remain woefully understudied.

Personally, the issue of cancer research funding versus caring for cancer patients hits home. In March 2009, I was diagnosed with invasive bladder cancer, and in June 2010 I was informed that I had a 60 percent chance of dying in the next five years (it never happened, of course). The extent of “inquiry” into why I had cancer was a sheet of paper when I was admitted into the hospital for surgery. Two questions related to the causes of the cancer were: Did I smoke? And did I or had I worked in areas that might contribute to cancer. Nothing more. Of course, scientific research is much more extensive and hardly limited to inquiry into specific personal cases. I did find, however, that no qualitative inquiry into possible causes of cancer indicated a lack of a certain kind of cancer research in the area.

Even worse, in December 2015, I was diagnosed with rectal cancer. In 2016, I asked the doctor why I had cancer again. His answer was: “Bad luck.”

Like the doctor, I suspect that the OFL neglects the wider picture of a society dominated by a class of employers.

The Division of Labour and the Silence of the OFL Social-Reformist or Social-Democratic Left

Related to the issue of a lack of perception of the wider picture is the OFL’s lack of reference to the hiearchical division of labour within the health field. Such a division itself has health implications:

One highly useful example from the empirical literature that illustrates the effects of process alienation is that of Whitehall I and Whitehall II studies of Whitehall civil servants (Marmot et al., 1997, 1999). Forbes and Wainwright (2001, p. 810) have commented, but do not develop further, that the evidence and results from the studies appear ‘to be directly related to the Marxian concepts of alienation and exploitation’. The research has identified that among civil servants of differing ranks there are decidedly different experiences of health that appear to relate to how much control a worker has in their workplace. Looking more squarely at the studies a picture of how process alienation is at play can be established. In both studies, there is a clear social gradient in mortality (Marmot et al., 1984) and morbidity (Marmot et al., 1991). In these studies we see how a worker’s health is affected by the extent of their control (examples being, choosing what to do at work, in planning, or in deciding work speed) within their working environment (Bosma et al., 1997), and how on a variety of measures the health, whether physical (for men and women) or mental (mainly for men), is influenced by the position or rank that they hold within the organization (Martikainen et al., 1999). This chimes very much with the alienation that arises out of the labour process where ‘[i]nstead of developing the potential inherent in man’s powers, capitalist labour consumes these powers without replenishing them, burns them up as if they were a fuel, and leaves the individual worker that much poorer’ (Ollman, 1976, p. 137).

It is unlikely that the OFL has ever inquired into reasons why a hierarchy of skilled and less skilled workers arises in the first place; such a hierarchy has advantages from the point of view of the class of employers. Charles Babbage (a pioneer in developing some principles of computer construction in the nineteenth century), published a book in 1832 titled On the Economy of Machinery and Manufactures, where he pointed out a major advantage for such a hierarchy. From Harry Braverman, Labor and Monopoly Capital: The Degradation of Work in the Twentieth Century, pages 79-80:

In “On the Division of Labour,” Chapter XIX of his On the Economy of Machinery and Manufactures, the first edition of which was published in 1832, Babbage noted that “the most important and influential cause [of savings from the division of labor] has been altogether unnoticed.” He recapitulates the classic arguments of William Petty, Adam Smith, and the other political economists, quotes from Smith the passage reproduced above about the “three different circumstances” of the division of labor which add to the productivity of labor, and continues:

Now, although all these are important causes, and each has its influence on the result; yet it appears to me, that any explanation of the cheapness of manufactured articles, as consequent upon the division of labour, would be incomplete if the following principle were omitted to be stated.

That the master manufacturer, by dividing the work to be executed into different processes, each requiring different degrees ef skill or ef farce, can purchase exactly that precise quantity ef both which is necessary for each process; whereas, if the whole work were executed by one workman, that person must possess sufficient skill to perform the most difficult, and sufficient strength to execute the most laborious, ef the operations into which the art is divided. 13

Of course, there may be other explanations of a hierarchical division of labour than the allocation of diverse skills to different individuals for the purpose of cheapening the total wage bill, but this process undoubtedly forms part of the reason why there exists a hierarchical division of labour.

Some workers in that hierarchical division of labour may, on the other hand, be more autonomous than others. Doctors may, for example, be formally employees at hospitals, but their monopoly of certain skills may give them much more autonomy than other employees. Some or even many may form part of the middle class, but other employees in the hierarchy at work have less autonomy–such as nurses, nurses’ aids, food workers and custodians. Greater autonomy at one pole often entails less autonomy (greater oppression) at the other pole. The OFL says nothing about this situation.

Social democrats in various spheres of society (such as the economy, education, health and unions) generally assume the legitimacy of the hierarchical division of labour in society; the OFL likely does so as well. They seek reforms within such hierarchy–rather than challenging such a hierarchy in the first place.

Conclusion

The OFL, like many social-democratic or social-reformist organizations, likely engages in rhetoric when it uses such phrases as “high quality affordable housing” or “accessible and well-funded health care.” Its reference to housing likely refers to public housing in one form or another–which can be just as oppressive as housing funded through mortgages or the paying of rent. Its reference to health care likely refers to health services rather than health care, and it neglects the need to shift some health-care priorities to prevention rather than care. Furthermore, it is silent over the hierarchical (dictatorial) division of labour, which itself has health implications.

Is there any surprise that the right has gained support from some sections of the working class when the social-democratic or social-reformist left fail to address the oppressive nature of public services, or when it fails to criticize the inadequate nature of the current form of public services?

What do you think?