The nursing homes of New York state became COVID-19 super spreaders last spring under the misrule of Gov. Andrew Cuomo — some 6,600 residents have died in them, in part because he sent many infected residents back to their homes.
Yet there is a small bright spot. A recent Health Affairs study found that New York nursing homes where the staff was unionized had a 30 percent lower rate of death than those that were not. A likely reason was that unionized staff were better able to obtain PPE for themselves, "one mechanism that may link unions to lower COVID-19 mortality rates," note the authors.
This is just part of a general pattern. As Jacob Leibenluft demonstrates in Foreign Affairs, the pandemic has tended to hit hardest those countries that do not value their workers. Places with low minimum wages, no guaranteed sick leave, no national health insurance, patchy unemployment benefits, and so on — that is, places like the United States — ended up effectively forcing precarious workers out into the teeth of the pandemic, where they caught and transmitted the disease by the millions. And as I have argued, viewing essential workers as disposable is something that emerges naturally out of the cramped, impossible American vision of liberty as being solely the freedom from government rules.
Freedom from the Market, an excellent new book by Roosevelt Institute Director Mike Konczal, adds some important historical perspective to this conversation. There is another American tradition of liberty, one dating back to the very start of the American nation, and one in line with the struggle of nursing home workers to protect themselves and those they care for from gruesome death today. As he writes, "true freedom requires keeping us free from the market."
Konczal's book is organized around several stories of how Americans in the 19th and early 20th century sought to protect themselves from the ravages of capitalism. This is important, because this period is often portrayed as a sort of laissez-faire dystopia, which is largely accurate in broad terms. But even then, there was massive resistance to the social misery, poverty, and dislocation caused by market institutions.
In the early 19th century, when the industrial revolution was still in its early stages, the ownership of land got a great deal of attention from all political corners. The rich were snapping up much of the land into great estates, which many argued foreclosed the possibility of a republic of free yeoman citizenry as envisioned by Thomas Jefferson. This led reformers like Thomas Skidmore to argue for the mass redistribution of land, and the end of land inheritance. His specific ideas never came to pass, but the general sentiment motivated reforms like the Homestead Act, which distributed some "246 million acres of land, or around 16 percent of the public domain," to 1.5 million ordinary citizens, for free. (Most of this land was straight-up stolen from Native Americans and Mexico, of course, but it was still a very large piece of wealth redistribution — and premised on the idea that freedom cannot be based on the simple market exchange of property.)
Another story was the long fight for the eight-hour day. Konczal tells the story of early 20th century bakers in New York City — a time when due to lack of cooking facilities in crowded tenements, daily bread was part of the life support system for huge chunks of the city. The work was grueling, dangerous, and unhealthy; worst of all the hours were relentless: "A strike by New York bakers in 1881 demanded a reduction in hours to just a 12-hour workday." Imagine a 12-hour shift being an improvement.
Moreover, the idea that these working hours were part of some kind of free contract between workers and employers was completely preposterous. Obviously the employers dictated terms to workers who were forced to accept any job on offer, even if it killed them, as it often did. Alas, when New York state attempted to regulate the working hours of bakers in 1895, the Supreme Court struck down the law based on an invented freedom of contract they read into the Fourteenth Amendment (while at the same time the court was studiously ignoring all its provision on civil rights, by the way). It would take Franklin Roosevelt's attack on conservative legal tyranny to break down the obstacle to regulations on the working day — which, again, was the state protecting workers from the brutal unfreedom of market institutions.
A more depressing story is that of social insurance and universal health care. By the late 19th century it was clear that yeoman farming was simply not compatible with a modern economy, and most people would have to work for their daily income. Yet that meant anyone who could not work for whatever reason — if they were sick, injured, disabled, elderly, had a new baby, or there were simply not enough jobs to go around — would fall into destitution. The problem of injury and disability got particular attention at the turn of the century, because many jobs in those days were hellishly dangerous. In 1890, common jobs like "railroad workers, trainmen, brakemen, and coal miners … faced death rates roughly two to eight times higher than that of the most dangerous job that exists now." If income was distributed through the market, then anyone who could not bend himself or herself into whatever shape it needed would starve.
All that created a movement for "voluntarist" associations that would provide some kind of mutual insurance for their members — in line with prevalent thinking, then and now, that social objectives are always best solved through private institutions. But another reformer, Isaac Max Rubinow, correctly argued in 1913 that only the government could truly insure everyone against the risks of daily life. "Those who needed the insurance the most were least capable of paying and likely to face discrimination from private insurers … only compulsory, universal public insurance could make sure there was no way for people to be lost," writes Konczal. Rubinow's thinking eventually prevailed partly in the form of Social Security, Medicare, Medicaid, unemployment insurance, and other government programs that protect those who the market would leave to drown.
It's depressing to read this history because it's been over a century since Rubinow wrote his book, and Americans are still dealing with many of the exact same problems he outlined. We have a half-decent pension for retired people, inadequate benefits for unemployment and disability, and upper-middle class people have a variety of mediocre benefits administered through the tax code, but not much else. We have no national paid sick or family leave, no public day care (as we briefly did during the Second World War, as Konczal points out), no universal health-care program, no child allowance, and as a direct consequence, the highest poverty rate among rich nations.
Nevertheless, this is all vital history. Conservatives have loudly laid claim to American heritage — to patriotism, civic symbols, U.S. history, and above all the idea that this is a land of liberty. Yet as we have seen, their notion of freedom means preventing the government from saving Americans' lives from COVID, throwing innocent refugees into concentration camps, and most recently, literal violent sedition.
American history contains many dark chapters, but they are not the only ones. From 1776 to this day, many Americans have fought to reform this country so that it lives up to the creeds in its founding documents, and espouses a freedom that isn't a sick joke. The 435,000 and counting pandemic casualties piled up show us that "life, liberty, and the pursuit of happiness" always requires competent and firm government.