Karl Marx on the shop floor

Recently, I was invited to participate in a discussion on "Capitalism, Justice, and Healthcare" at the Radical Philosophy Association (RPA) conference. Other speakers on the panel spoke about concepts of the "public good" and "fair trade." I talked about the protracted battle in the health care workplace against what Karl Marx called alienated labor.

In my daily activity on the shop floor, I see Marx's philosophy constantly come to life in a way that is different from the usual analyses of Marx's texts. I was looking forward to discussing Marx's writings with others. I left this particular panel feeling disappointed.

I thought, "Where was Marx"? There was little direct and explicit discussion of Marx's philosophy from others on this panel. This steered the general discussion toward reform and regulation.

In response, I said that I am not against regulation, but again, where was Marx? I brought the discussion back to the shop floor. I believe Marx would not have been against regulation, but, to him, that is only a small beginning, not an end in itself. Marx's life-long pursuit was going beyond politics to achieve concrete self-determination in the workplace, realizing "human power which is its own end."

Health care regulation emerged to referee battles in the health care workplace. Career legislators have codified a mountain of regulation. We are subjected to an army of regulators, overseers, watchdog agencies, governmental and non-governmental.

On my way to the conference I heard a radio interview with Studs Terkel, rebroadcast as an in memoriam upon his passing. I told the RPA audience that he reminded me how events unfolded on my shop floor for the last several years. Terkel said he encountered many particulars in the thousands of interviews he did with everyday working folks. He listened carefully when his subjects spoke in order to "see the universal" in these stories. I said to myself: "That's it!" The important thing was to see the universal in the particular.

Terkel reminded me that we workers kept recounting to each other our daily struggles with HMOs over the last decade. We compiled countless horror stories from patients who related their individual sufferings at the hands of the HMO industry. The universal these stories collectively developed into was that health science and technology are nothing without the recognition that health care is fundamentally a human-to-human interaction.

During our vibrant discussions on the shop floor, many new ideas developed. This energized a movement for quality care led by workers. One of our key victories was a landmark provision for quality care in our contract. Many other gains were won over the following years. We won legislation to mandate minimum nurse-to-patient ratios. We won mandatory use of safe needles. We won protection for whistle-blowers. We won more rigorous enforcements of patients' Bill of Rights, and many, many more.

DISCUSSIONS LED TO GAINS

Healthcare today, as we know it, would not be where it is without all those key reforms, written into contractual language, as well as into legislation. Easily forgotten, especially by our labor leaders now obsessed with winning legislation, is the source, the shop floor, where workers continue discussions as their conflict keeps emerging in new ways.

In the years following our legislative gains, the HMO industry has continued to restructure itself, finding many loopholes around legislation. The work is more alienating than ever. Shop floor conditions have gotten to the point where capitalist discipline has transformed us into unwilling accomplices in HMO abuse. The labor leaders don't know what we workers know concretely on the shop floor--legislative reforms mean nothing without a continuing workers' movement. They are merely dead letters. It is living labor which animates any shop-floor union rules or governmental regulations.

When Studs Terkel reminisced about the thousands of individual stories he elicited, I relived in my mind how collectively a myriad of individual worker stories, each armed with their own force of reason, eventually becomes universally recognized as a movement. It takes a rigorous philosophy, not just any theory, to recognize the reason of that movement.

Raya Dunayevskaya proved time and again that Marx never developed his theories without one ear very close to the ground, where average workers sweated and struggled. She called it the "movement from practice that is a form of theory." I call it the "shop floor."

While the RPA conference had many who spoke on Marx, what I was looking for was a discussion of how Marx's philosophy comes to life in our daily struggles. Dunayevskaya said it is the theoretician's obligation to meet that movement from practice with a movement from theory. Failure to do so would mean intellectuals have abdicated their share of responsibility towards revolution.

Without an ongoing engagement with working-class activity on the shop floor, we are merely spinning our wheels at one reform effort after another. What is capitalism if not a never-ending alternation between crisis and reform? The point is to work out an alternative to get out of this cycle.

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